Pre-Therapy is an evolution from client-centered theory and practice. The focus of Pre-Therapy is on regressed patients such as the psychotic retarded or chronic schizophrenics. It is also applicable to demented populations. The central construct is psychological contact, described as the necessary condition of psychotherapy and outlined on three levels: (1) the contact reflections—the “work” the therapist does; (2) the contact functions—the psychological process of the patient; (3) the contact behaviors—operationalized behavior for measurement. The Pre-Expressive Self, an intuitive and heuristic concept, interprets the progress from pre-expressive to expressive states of communication that is necessary for psychotherapy.