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To examine how relational behavior and maternal representations are manifested before and after parent-infant psychotherapy, mothers’ and infants’ behaviors and maternal narratives were assessed in 45 clinic-referred dyads who participated in psychodynamically informed parent-infant psychotherapy. Pretreatment and posttreatment assessments included observations of mothers’ and infants’ behaviors (CIB; Feldman, 1998) and assessment of maternal representations (PDI; Aber, Slade, Berger, Bresgi, & Kaplan, 1985). Parent-infant psychotherapy consisted of weekly child-mother, child-father, and two parents’ sessions. Following psychotherapy, maternal sensitivity and child engagement showed a significant increase. An increase was also evidenced in the richness of maternal narratives regarding the mother-infant relations. During the pretreatment assessment, maternal intrusiveness was associated with restricted narratives, lack of joyful descriptions, and reduced coherence and child engagement was associated with maternal narratives characterized by incoherence and reduced joy. Maternal reports of high psychological distress were associated with higher maternal intrusiveness and lower maternal sensitivity following psychotherapy. Discussion focuses on the unique opportunities for infants in parent-infant psychotherapy as well as the need for further understanding of the processes underpinning change following this treatment modality.