CBT for psychosis is becoming a well-established sphere of practice covering not only problems of symptoms persistent to medication and poor medication adherence but also topics of psychosis and relapse prevention and treatment. However, there are only a few studies of specificity of CBTp for children, adolescents and young adults. In this paper, we review literature on CBTp and its efficacy in youth. Based on our clinical experience, we discuss three special topics to consider in work with youth: motivation and meaning of symptoms, developmental issues, family and social issues. First, symptoms are appraised as negative, neutral or positive in the whole context of patients’ expectations, beliefs, hopes and life activities. Second, hospitalization and treatment perceptions depend on family and social communications. Examples of meaning of illness and treatment specific for youth are discussed. Third, treatment formulation should be considered from developmental perspective while decisions and skills that are the best “here and now” may interfere with future challenges, social transitions and situation changes.