Communication skills training focuses on approaches to the open discussion of tension or distance in the relationship and on ways to enhance the relationship in light of the significant transition through which the client is undergoing. Qualitative research suggests that interpersonal problems are even more central in understanding the clinical presentations of clients with perinatal distress than non-perinatal clients who struggle with depression and anxiety. Cognitive behavioral therapists use the cognitive case conceptualization, particularly the client's history of relationships and interactions with others, as a guide for determining appropriate points of intervention on an individualized basis. Psychoeducation and therapeutic interventions could target constructs such as responding to the infant's cues, recognizing affective states, sustaining infant's attention, and providing opportunities for infants to explore their environments. Each success experience builds confidence in perinatal clients that they can rely on as they approach increasingly sensitive and difficult interactions.