The Use of Synchronous Videoconference in Bipolar Patients

A Novel Study on Therapist Mentalization Capacity, Therapeutic Process, and Efficacy within Videoconferencing Psychotherapy (VCP) Intervention Context

  • Roberto Maluenda-Gatica University of Edinburgh
  • Matthias Schwannauer University of Edinburgh
  • Angus MacBeth University of Edinburgh
Keywords: Severe Mental Illness, Bipolar Disorder, Mentalization, Therapeutic Alliance, Videoconferencing Psychotherapy, Ruptures, MCT


Background: A considerable literature has developed around demonstrating the clinical relevance of mentalizing as a construct. However, much of the emphasis has been on patients’ deficits rather than therapist’s abilities. Although it may be the case that therapist’s mentalization capacity can facilitate better outcomes in psychotherapy, there is a dearth of empirical evidence concerning the impact mentalization has on therapist competencies in psychotherapy and the implications of this in clinical practice dyads.

Methods/Design: A pilot study will use an integrated design. A longitudinal case series alongside a qualitative grounded theory approach will be utilized to develop a context-specific, grounded micro theory model of therapeutic alliance rupture and resolution during online psychotherapy with patients with bipolar disorder. 10 dyads of therapists and patients will be assessed by pre-and post-session outcome ratings, as well as baseline and post-therapy performance ratings during the four-month intervention period. In addition, semi-structured grounded theory interviews will be conducted with participants to gain a deeper understanding of their experiences during the therapeutic process.

Discussion: New research findings on videoconferencing-enabled clinical interventions have been needed since the COVID-19 pandemic began. According to an assessment of the available evidence, little is known about psychotherapy, and significant gaps remain. This paper describes a protocol of a pilot aimed to capture the explicit and implicit knowledge that emerge from therapists and patients during the therapeutic process in order to investigate the complex process of therapeutic interaction beyond “outcome effects”.