In this CCC, four child and adolescent psychiatrists discuss cases of adolescents presenting with symptoms that appeared psychotic in nature but turned out to be anxiety disorders presenting with psychosis. Of main concern is the possibility patients may be misdiagnosed with a primary psychotic disorder resulting in medication treatment that may not be necessary but no cognitive-behavioral therapy or exposure response prevention therapy is used, both first-line therapies for anxiety disorders. Attendees gain a broader understanding of the diagnosis and treatment of these adolescents, both optimizing psychiatric and psychological treatment and minimizing adverse effects from a potentially inappropriate use of antipsychotic medication.