A randomized controlled trial was conducted to examine the effectiveness of Adherence-Coping-Education (ACE) Therapy. Twenty-four individuals were randomized to receive 14 sessions of either ACE therapy in addition to treatment as usual (TAU), or Supportive Therapy (ST) in addition to TAU. Participants were assessed on measures of medication attitudes, insight, symptoms, and social functioning. ACE therapy was well tolerated, with comparable attrition rates between the two interventions and high therapy attendance. ACE Therapy was associated with significant improvements in medication attitudes as well as psychotic symptoms, insight and functioning. A greater proportion of individuals in the ACE condition had clinically significant change on positive symptom scores than did those in the ST condition. These results lend initial support for the feasibility of ACE Therapy, and suggest that it may facilitate recovery from an initial psychotic episode. Findings are discussed within the context of the study’s limitations.