This is a study of the complex factors that contributed to the development of adolescent psychoses in two stepbrothers, ages 12 and 15. The identified patient, the younger boy, was in what appeared to be a reversible stage of early adolescent psychosis and his 15 year old newly acquired stepbrother in a nonreversible stage. Each boy was a mentally gifted, neurologically handicapped adolescent who was inextricably vulnerable on the basis of his neurodevelopmental sensitivity to specific immobilizing parental fears and conflicts. Their inherent problems set them apart from their intact teenage sisters and affected the nature and quality of their total life experience. Those working with psychotic children and their families must bear these relationships in mind for optimal strategic intervention and change. In the management of psychotic adolescents and their families, the individual and family therapist could work to everyone''s disadvantage if these important neurodevelopmental difficulties are not considered.