Psychiatrist Barbara Piovano proposes a model for the parallel treatment of severely disturbed children and their mothers, that preserves her commitment to the classic dyad while creating a forum to expose the interactive aspects of the parent-child relationship for exploration and intervention. Dr Piovano's method mandates adjacent therapy by separate practitioners with a common supervisor who is poised at the intersection of complex transference and relational dynamics. Case material, derived from both private and institutional clinical settings, demonstrates application of the parallel treatment approach and its revelations, which include: the influence on the child of the prevailing relational context, the influence on the parent of the pathology of the child and the extent of the collusion between them.