The delivery of mental health services to infants, toddlers, preschoolers, and their families involves a complex interweaving of skills that straddle disciplines and test boundaries. Provision of such services is a testament to the strength of practitioners who struggle to balance the necessary knowledge base, application strategies, and self-awareness required by the work. It is a fragile dance, with the practitioner often initiating a conversation that a caregiver does not want to have, testing and retesting boundaries as the work unfolds, and maintaining a steady, yet ever adapting, view of individual children and families. The practitioner must provide constancy in an ever changing world while remaining open to new possibilities.