The recent empirical and conceptual development of the concepts of mentalization and reflective functioning (RF) have yet to be fully linked directly to the clinical process in psychodynamically oriented psychotherapy with children and adolescents. In this paper, two categories of mentalization or psychological mindedness are briefly described. In the first example, the child is deemed agnostic toward processes of mentalization, and treatment is geared toward setting a frame to this type of experience of self and other. In the second stance, the child is overtly antagonistic toward such processes, and treatment is aimed at responding to challenges to this framework. In the last category, the child is already showing arenas of psychologically mindedness, and the therapeutic process is aimed at broadening this framework to other affects. Two detailed clinical vignettes are then provided to demonstrate how the child's relative degree of awareness of the affective and cognitive states of themselves and others can be assessed and then enhanced in the therapeutic process.