This (first) chapter o f the book addresses foundational or conceptual, as well as ethical and historical, underpinnings o f PCC for people with SMI. Such a frame work is helpful in order to try to understand the pertinent driving principles and fundamental challenges, as well as how and from what PCC for people with SMI developed, so that a deep and broad understanding of PCC for people with SMI can emerge. This chapter grounds the latter parts o f the book in such an attempted understanding and prepares the way for a discussion o f different aspects o f PCC for people with SMI in the other chapters o f the book. These chapters are structured according to the structure of the Patient-Centered Clinical Method (PCCM), which is the backbone o f the book series to which this book belongs. The PCCM is briefly described in Section 1.1, Foundations and Ethics of Person-Centered Approaches to Indi viduals with Serious Mental Illness, as are some other person-centered approaches. As in other sections and chapters of this book, the aim is to present a pluralistic yet critically minded discussion o f PCC for people with SMI.