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In this paper we present a conceptual model focusing on activity performance and social participation of individuals in the period prior to their first acute episodes of psychosis. The model was developed using the constructivist grounded theory method. Data from interviews and documents was collected from 25 primary participants. Interviews were also conducted with 15 members of the participants’ support networks and six experts in the field of early psychosis and rehabilitation. The model illustrates how the core constructs of activity performance and social participation are set against the natural context and influenced by shifts in three determinants: faltering personal capacities, negotiating for success and risk factors. The model suggests rehabilitation and recovery practices in early intervention work.