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Reflective-functioning (RF) is the ability to recognize the existence and nature of mental processes taking place in the self and in others (e.g., intentions and wishes). RF was investigated here as a patient variable during the process in two studies of brief psychotherapy. The first study investigated cognitive–behavioral therapy (CBT) and interpersonal psychotherapy (IPT) in the TDCRP sample. The second study investigated psychodynamic psychotherapy (BPDT). The Psychotherapy Process Q-set (PQS) was implemented to identify process correlates associated with high and low RF in order to distinguish which specific components in the psychotherapeutic process are related to RF. Process correlates defining high RF had good outcome, and process correlates defining low RF had poor outcome. RF remained stable or decreased during treatments and was linked with personality characteristics in the patients.