Objective: This case report highlights folie a duex of a caregiver that complicate the management of a case of childhood onset schizophrenia. Methods: We report a case of a young Malay girl with symptoms of schizophrenia and her caregiver who share her delusion. Result: Folie a duex in the caregiver caused difficulty in the initiation and maintenance of treatment of a child with schizophrenia. Conclusion: Treating children with schizophrenia is not easy and could be complicated by the folie a duex in caregiver. Although Child Act 2001 can be applied in order to deliver appropriate treatment to this group of patients, one must be cautious about the implication in therapeutic alliance.