With respect to psychological contact and mental distress and person-centred therapy, the work of Garry Prouty is of preeminence (Points 15 and 68). Prouty asked the fundamental question `What happens if the ®rst of the necessary and suf®cient conditions is not met?' This led to the development of a personcentred system of thought and practice embracing clients with (for example) profound learning dif®culties or schizophrenia. This became known as pre-therapy (see Prouty 2002a and b) which (2002b: 55) is described as `a theory of psychological contact . . . rooted in Rogers' conception of psychological contact as the ®rst condition of a therapeutic relationship'. According to Krietemeyer and Prouty (2003: 152) pre-therapy theory `was developed in the context of treating mentally retarded or psychotic populations'. This is because, in Prouty's experience, such people are `contact-impaired' and have dif®culty forming interpersonal connections. Pre-therapy theory led to the development of a set of practices by which psychological contact could be established (see case studies presented by Van Werde 1994: 125± 128 and Krietemeyer and Prouty 2003: 154±160) and for which Prouty (2001: 595±596) summarises the research evidence.