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What is 'Pre-Therapy'?

Pre-Therapy was developed by Gary Prouty, and is an offering of contact to persons who may have contact impairments such as clients with learning disabilities, brain injury, dementia, psychosis. The therapists role is to offer 'contact reflections' to the client.

The interaction from therapist to client is broken down into five types of reflections, which are as follows:

Situation reflections: the therapist reflects to the client the immediate surroundings. An example being ‘it is raining outside’ or ‘you are wearing blue jeans’.
Body reflections: the therapist reflects what the client is doing with their body, either by doing the same with their body, or by saying it to the client. An example would be ‘you are tapping your foot’, and the therapist also taps their foot.
Face reflections: the therapist reflects to the client what they see on the clients face, which could be a possible named feeling the therapist thinks they see in the client. An example could be ‘you are smiling, you look happy?’. As the clients face changes the therapist follows the clients lead reflecting on any facial changes. A further example could be, ‘you are clenching your teeth, you look anxious?’. As the therapist engages with the client, the client is responding with facial changes.

The therapist is starting to offer empathy by possibly reflecting on the clients inner world.
Word-for-word reflections: the therapist reflects the clients words by repeating them back. The therapist chooses the words that they feel they understand, or hold the most meaning to the client. This may also include any sounds or noises that the client makes. By doing this, the therapist can facilitate contact that holds or develops into further communication by the client.  
Reiterative reflection: the therapist repeats a reflection that seems to have been successful in facilitating development in making contact with the client.


Pre-Therapy can be an opportunity to support a more meaningful engagement with clients who may ordinarily appear to be confined

or restricted to their inner world. [Source: Lisbeth Sommerbeck]

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