Early intervention services play a crucial role in providing treatment for young people experiencing a first episode psychosis. However, on average, 30 per cent of young people disengage from treatment, which may result in untreated symptoms, difficulty returning to school or work and relationship breakdowns. This qualitative study aimed to understand the help-seeking experiences and initial engagement with an early intervention service. Semi-structured interviews were conducted with nine young people and five caregivers, focussing on engagement in the first eight weeks of treatment. Themes were identified using thematic analysis. Key findings were that participants entered the early intervention service after a time of intense distress and confusion. This was related to symptoms, difficulties working or studying, and initial experiences of help-seeking and treatment. Commonly there was relief on meeting a caring person who would be their support going forward. However, trust was influenced by previous positive and negative experiences. Establishing a therapeutic relationship and building trust are dynamic and relational concepts, and as such, they warrant reflection by all key stakeholders. Awareness and understanding of these concepts may guide changes to individual practice and service development.