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The authors of the present article propose adjustments to the parent-baby psychotherapy framework in light of recent theoretical, clinical and technical findings in perinatal psychopathology. The points of view put forth here are based on a review of the literature of early therapies and their evolution in order to look more closely at the indications for this type of treatment as well as its epistemological, semiological, material, technical and therapeutic aspects. Because of this, the very clear position of the authors in their role as child-centered caregivers has brought them to think about the encounter with the baby and his parents, to formulate a framework, to organize the time, space and objects for each session and to accompany the therapeutic process as a function of their identification with the baby’s situation. Finally, an account of psychotherapy illustrates the way in which the complexity of this type of clinical work imposes a permanent questioning as to how the therapists operate in terms of containment, third-party position, otherness, differentiation, metaphorisation and transformation of psychic processes.