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This single-case longitudinal study examined changes in therapist and patient mentalization over five video-feedback sessions with a mother experiencing postpartum depression. Using qualitative and observational coding, the study analyzed the moment-to-moment evolution of mentalization within therapeutic interactions. The intervention assessed both therapist and patient mentalization, identifying three core themes related to the therapeutic process. Video-feedback contributed to increased maternal mentalization, fostering a more accurate perception of the infant’s needs and emotional states. Improvements in maternal mentalization were associated with reduced anxiety and self-doubt, greater sensitivity, and enhanced attachment behaviors. The participant also reported decreased depressive symptoms and greater confidence in interacting with her infant. Findings indicate that video-feedback provides a structured and reflective space for mothers to observe, interpret, and regulate their caregiving behaviors through guided self-observation and therapeutic scaffolding. These results underscore the role of video-feedback in enhancing mentalization within mother-infant psychotherapy, offering a promising intervention for addressing postpartum depression-related caregiving difficulties. While findings highlight its potential to bridge the gap between perceived and actual caregiving behaviors, further research is needed to examine its mechanisms of change, long-term impact, and clinical applicability.