Substance abuse creates enormous risks for the developing relationship between mother and infant. Thus, the perinatal period is a critical aspect of addiction treatment. This article highlights the importance of relationships and the reflective supervision that is crucial in the delivery of integrated infant mental health service for pregnant women with addiction. The authors provide an example of how a client at the Mother's House Haven, a residential substance abuse treatment facility, worked with her community-based doula, and the doula's work with the case supervisor.