Outcome studies of mentalization-informed play therapy for children (MIPT-C) with High-Functioning Autism Spectrum Disorder (HFASD) are uncommon, while fewer studies have investigated MIPT-C process. Theory of the false self is used to illuminate the results of psychotherapy process studies of MIPT-C from the treatments of two children from different cultures studied in two research labs (Goodman in the United States and Ramires in Brazil). These studies suggest that 1) children with HFASD tend to develop characteristic interaction structures (i.e. patterns of reciprocal interaction between therapist and child) that resemble each other across treatments but differ from interaction structures observed in the treatment of a child with another psychiatric diagnosis; 2) therapist-child ruptures can force compliant behavior, which masquerades as therapeutic progress; and 3) therapists tend to use more directive approaches earlier in treatment and gradually increase their adherence to mentalizing process. Clinical implications and future directions for research are discussed.