The grave physical and emotional consequences of childhood abuse and neglect are undisputed. Although the risk factors for child maltreatment are well established, implementing effective treatment methods remains a challenge. This paper describes three treatment challenges and solutions for replacing potentially abusive or neglectful parenting with child-appropriate parenting. The treatment challenges include: (a) conflict between participants' cultural and religious beliefs and our treatment goals, (b) cognitive limitations including inaccurate developmental expectations for the child, and, (c) an excess of negative affect and a deficit of tender feelings for the child. Solutions for these challenges evolved from clinical investigation of participant barriers to treatment, and include Socratic dialogue during treatment regarding culture and religion, use of visual metaphor in explaining abstract parenting concepts, perspective-taking exercises, techniques for anger awareness and management, and activities to increase shared positive affect and maternal emotional awareness. Policy implications and caveats concerning the limited empirical support for these techniques are discussed.