Evidence suggests that the early course of psychosis might be important in the long term outcome of the disease. Moreover, pharmacological treatment has important limitations in this population which has increased the interest in the combination of psychological and biological treatments. Recently, cognitive therapy has been modified and applied to the field of psychosis. For decades several studies have shown its effectiveness in the treatment of psychotic symptoms which has led to formulate new and more comprehensive cognitive treatments for early psychosis. These new cognitive approaches have been assessed in clinical trials. In the same way, the study of the pre-psychotic phase and prevention of illness is becoming important. Two aspects are especially relevant in this regards: the possibility of prospective detection of patients at risk of developing psychosis and the search for adequate treatments in this phase. Recent studies concerning early and pre-onset psychosis cognitive treatment are reviewed by the authors.