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The goal of this exploratory study is to document the changes to the reflective functioning (RF) of high-risk mothers during a dyadic psychotherapeutic process based on the Watch, Wait, and Wonder (3W) approach. Three mother-child dyads were assessed before, during, and after 15 sessions of 3W therapy. This paper presents the changes observed in the mothers’ behavior, as well as the results of various assessments of parental reflective functioning, parental stress, and empathy. Based on these results, the authors suggest some modifications to the 3W intervention in cases of high-risk parent-child dyads in order to improve parental reflective functioning.