Vol. 2, Issue 1, Part A (2025)

Background: The rapid expansion of digital health has transformed mental health service delivery, creating new opportunities for virtual therapeutic engagement between nurses and patients. Building a strong therapeutic rapport remains central to effective mental health care, yet translating this into virtual settings presents unique challenges. Objective: This study aimed to evaluate the effectiveness of structured, empathy-driven communication strategies in strengthening therapeutic rapport during virtual mental health nursing consultations, and to examine their impact on patient engagement and satisfaction. Methods: A quasi-experimental, mixed-method design was employed involving 200 adult participants receiving telepsychiatry care. Participants were randomized into intervention and control groups. The intervention group received structured communication training emphasizing reflective listening, verbal validation, and camera-based eye contact, while the control group received standard care. Rapport was assessed at baseline, mid-intervention, and post-intervention using the Working Alliance Inventory. Patient satisfaction and adherence were measured using validated scales. Quantitative data were analyzed using paired t-tests and repeated measures ANOVA, while qualitative interviews underwent thematic analysis. Results: The intervention group demonstrated significantly higher improvements in Working Alliance Inventory scores compared to controls, with medium-to-large effect sizes. Patient satisfaction was substantially higher, and dropout rates were lower in the intervention group. Qualitative data revealed that structured communication fostered trust, emotional connection, and a sense of presence despite the digital medium. Conclusion: Structured communication strategies significantly enhance therapeutic rapport in virtual mental health nursing, demonstrating that intentional relational behaviors can effectively bridge the digital gap. Integrating communication training into nursing education, standardizing telehealth protocols, and addressing technological barriers can strengthen patient engagement and therapeutic outcomes in digital mental health care. These findings support the strategic expansion of virtual nursing services as a viable, patient-centered model for the future of mental health care.