Clinical practice with severely retarded and psychotic clients requires a change in theory and technique. Based on original research and practice, Prouty describes the changes needed to reach low-functioning clients not generally accessible to psychotherapy. Evolving from Carl Rogers' assertion that Psychological Contact is the first condition of a therapeutic relationship, Pre-Therapy is a technique that can be applied to regressed psychotics and dual-diagnosed mentally-retarded patients, as well as to other poorly integrated populations. Drawing from his own practice with extreme clients, he shows how Pre-Therapy can be used to facilitate these pre-conditions of therapy. He further shows that treatment of hallucinations reveals them to be expressions of deep trauma and profound rendings of the self-structure.