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Understanding the Experience of Online and In-person Psychotherapy for Individuals with Bipolar Disorder
Thesis (MA)--Stellenbosch University, 2026.
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| Format: | Thesis |
| Language: | English |
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Stellenbosch : Stellenbosch University
2026
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| _version_ | 1867613740794380288 |
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| access_status_str | Open Access |
| author | Bolnick, Gabriel |
| author2 | Kagee, Ashraf |
| author_browse | Bolnick, Gabriel Kagee, Ashraf |
| author_facet | Kagee, Ashraf Bolnick, Gabriel |
| author_sort | Bolnick, Gabriel |
| collection | Thesis |
| dc_rights_str_mv | Stellenbosch University |
| description | Thesis (MA)--Stellenbosch University, 2026. |
| format | Thesis |
| id | oai:scholar.sun.ac.za:10019.1/135632 |
| institution | Stellenbosch University (South Africa) |
| language | English |
| last_indexed | 2026-06-10T12:40:57.522Z |
| license_str | Other — see source repository |
| provenance_str_mv | Harvested via OAI-PMH from SUNScholar — Stellenbosch University Repository |
| publishDate | 2026 |
| publishDateRange | 2026 |
| publishDateSort | 2026 |
| publisher | Stellenbosch : Stellenbosch University |
| publisherStr | Stellenbosch : Stellenbosch University |
| record_format | dspace |
| source_str | SUNScholar — Stellenbosch University Repository |
| spelling | oai:scholar.sun.ac.za:10019.1/135632 Understanding the Experience of Online and In-person Psychotherapy for Individuals with Bipolar Disorder Bolnick, Gabriel Kagee, Ashraf Stellenbosch University. Faculty of Arts and Social Sciences. Dept. of Psychology. Thesis (MA)--Stellenbosch University, 2026. Bolnick, G. 2026. Understanding the Experience of Online and In-person Psychotherapy for Individuals with Bipolar Disorder. Unpublished masters thesis. Stellenbosch: Stellenbosch University [online]. Available: https://scholar.sun.ac.za/items/08764e0e-adac-4416-9ac5-5787ebd49b80 Introduction: The increased use of technology within everyday life has had a vast range of implications within modern day society. Moreover, the increased use of technology has seen a simultaneous increase in psychotherapy being conducted online. However, there is limited research on the topic of online psychotherapy and even less qualitative research. Thus, I sought to understand how individuals with bipolar disorder (BD) experience online and in-person therapy. Individuals with BD constitute a clinically significant population group. The condition is characterized as severe and chronic, which introduces increased precarity for such a group. Psychotherapy has been shown to reduce episodic and related symptomology for individuals with BD. Therefore, I sought to understand how online and in-person therapy impacts the therapeutic experience and alliance for individuals with BD. Lastly, attachment theory was deployed as a framework, which helped the study understand how participants’ therapeutic relationships were impacted by their modality. Methods: The research design of this study was of a qualitative-exploratory nature. Nine participants were recruited for the study. All the participants within the study had received a formal bipolar diagnosis and had made use of online and in-person psychotherapy with the same therapist. In-person, semi-structured interviews were adopted and guided by Bowlby’s attachment theory. The interviews were recorded, transcribed, and then analysed using a reflexive thematic analysis. I then analysed the interviews, with the help of ATLAS.TI. Findings: I identified four main themes and thirteen sub-themes. The four main themes were: 1) Therapeutic Dynamics, 2) Emotions During Therapy, 3) Containment and Safety in Therapeutic Spaces, and 4) The Online Frame. I found that participants with BD experienced online and in-person therapy differently. Participant accounts indicate that online therapy increased participants' accessibility and flexibility to therapy, which significantly helped participants during manic and depressive episodes. Furthermore, online therapy introduced precarity to participants' therapeutic experiences. In-person therapy provided increased safety and containment for participants. This experience was largely due to the use of non-verbal communication, embodied co-presence, and the consistency of the in-person therapeutic frame. Participants indicated that in-person therapy protected their therapeutic alliance and aided the exploration of their internal world. Therefore, I found that online and in-person therapy is experienced differently for individuals with BD, with the differences increasing both benefits and hinderances to effective psychotherapy. Discussion: The findings of the study revealed that online and in-person therapy elicits different experiences. Through the lens of attachment theory, it was found that online therapy decreased the potential for therapeutic work from a secure base. Moreover, the online modality reduced the ability of the therapist to be a secure attachment figure, which negatively impacted participant's therapy. Online therapy also increased ruptures to the therapeutic alliance. Yet prevailing ruptures during online work offered participants the potential for repair, which further developed their therapeutic alliance. In-person therapy aided work from a secure base, which was due to the dynamic use of embodied co-presence, non-verbal communication, and experiences of safety and containment. Furthermore, whilst viable for use, the experience of differing modalities introduces different benefits and hinderances to therapy for individuals with BD. Masters 2026-04-07T05:51:30Z 2026-04-07T05:51:30Z 2026-03 Thesis https://scholar.sun.ac.za/handle/10019.1/135632 en Stellenbosch University 207 pages application/pdf Stellenbosch : Stellenbosch University |
| spellingShingle | Bolnick, Gabriel Understanding the Experience of Online and In-person Psychotherapy for Individuals with Bipolar Disorder |
| title | Understanding the Experience of Online and In-person Psychotherapy for Individuals with Bipolar Disorder |
| title_full | Understanding the Experience of Online and In-person Psychotherapy for Individuals with Bipolar Disorder |
| title_fullStr | Understanding the Experience of Online and In-person Psychotherapy for Individuals with Bipolar Disorder |
| title_full_unstemmed | Understanding the Experience of Online and In-person Psychotherapy for Individuals with Bipolar Disorder |
| title_short | Understanding the Experience of Online and In-person Psychotherapy for Individuals with Bipolar Disorder |
| title_sort | understanding the experience of online and in person psychotherapy for individuals with bipolar disorder |
| url | https://scholar.sun.ac.za/handle/10019.1/135632 |
| work_keys_str_mv | AT bolnickgabriel understandingtheexperienceofonlineandinpersonpsychotherapyforindividualswithbipolardisorder |