Objectives: Psychotic clients may be difficult to engage in psychological therapy, and many potential participants decline to participate in controlled trials of cognitive behavioural therapy. The aim of this study was to investigate psychotic patients' perspectives regarding therapy. Design: The design was qualitative and used thematic analysis to investigate emerging themes. Methods: A total of 46 inpatients with psychosis were interviewed about their views on therapy. Interview summaries were submitted to thematic analysis. Results: A total of 41% of participants were rated as interested, 36% were rated as not interested and 23% appeared ambivalent, or their interest in therapy was unable to be assessed. Themes related to interest in therapy included the desire to build skills, to address (usually non-psychotic) symptoms and for a therapeutic relationship. Themes related to not wanting therapy included a denial of psychological problems, distrust in the healthcare system and psychologists and low perceived efficacy in therapy. Conclusions: A large minority of psychotic patients may be interested in therapy, although mostly not to address psychotic symptoms. Future research on pre-treatment approaches to disconfirm negative perceptions and increase interest in therapy is warranted.