Two large randomised clinical trials, the OPUS and the LEO trials, investigating specialised assertive intensive treatment in early phases of psychosis have been shown to have positive effects on clinical symptoms, substance abuse, and user satisfaction although only some of these positive effects are sustainable over time. At a five-year follow-up, there were no clinical differences between the specialised assertive intervention group and standard care, but significantly more intervention patients were able to live independently and spent significantly fewer days in hospital. As a consequence of these outcomes, a comparison of five years and two years of specialised assertive treatment is currently being undertaken. Crucial elements in specialised assertive intensive treatment are the assertive approach and family involvement, and there is also some evidence supporting the inclusion of cognitive behavioural therapy, supported employment and weight management.