Grounded theory was employed to elucidate how public health nurses (PHNs) develop therapeutic relationships with vulnerable and potentially stigmatized clients, specifically, single mothers living in low-income situations. We named the emerging theoretical model Targeting Essence: Pragmatic Variation of the Therapeutic Relationship, after discovering that although PHNs strove to achieve relational goals, their attention was primarily focused on the goal of ascertaining concerns foremost on the hearts and minds of mothers, and that PHNs had to accomplish these goals within short practice timeframes. The study's focused context elicited a nuanced explanation of the dynamic relationship-building process derived from subjective relationship experiences of PHNs and single mothers living in low-income situations. We believe Targeting Essence will serve as an effectual relationship-building model, enabling PHNs to know essentially what mothers want and need, and enabling mothers to know essentially that their PHN can be trusted not to render judgment.