This chapter introduces the person-centred approach to more severe psychopathology and shows that it is relevant to people with mental health needs than is often thought to be the case. It highlights the development of the person-centred approach because it is one area which has the potential to make an impact on much of psychiatric practice, both in residential and community care settings and within certain professional roles such as mental health nursing. This would of course require recognition of its value by policy-makers, managers, commissioners of mental health services and people in a position to influence the culture of mental health services. The chapter focuses on the pioneering work of an American psychologist, Garry Prouty, who has developed what is termed 'pre-therapy'. Pre-therapy evolved through Prouty's search for a way of helping those patient/ client populations who 'cannot fully use relationship or Experiencing processes', drawing upon his experience of working with people with chronic psychosis, schizophrenia and learning disabilities.