The changing global economy has brought changes in immigration patterns. Today female workers are sought in Western countries to serve as caregivers. These women leave behind their own children to provide a better future for them by caring for other people's family members in wealthier countries far from home. Immigration policy in the host countries often makes it impossible for these women to gain the documentation necessary to bring their own children to live with them for many years. This economic phenomenon has created a clinical one: the stress on the relationship between these mothers and the children with whom they are reunited. This article focuses on three distinct categories of separation and reunion experience among families who have migrated from the Caribbean to the United States. It suggests issues to be addressed in each category of relationship to promote successful treatment.