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Despite evidence indicating high rates of distress among parents with infants in neonatal intensive care, few neonatal intensive care units (NICU) have psychologists on staff. Recently, the National Perinatal Association (NPA) has recommended that all NICUs staff psychologists dedicated to supporting families and medical providers. This article presents a three-part model of NICU psychological interventions that is relationship-based and context attentive, including: (1) the maternal/paternal experience, (2) transition to home, and (3) work with staff. The narrative descriptions are grounded in case vignettes, and supported by the literature as well as survey research obtained from a nation-wide sample of psychologists (n = 20) currently working in a NICU setting. Combined, a significant number of behavioral objectives are identified, and explored through the lens of ethical care and treatment in a NICU setting.