Karin Gepp, Psy.D., is a 2017 graduate of the Psy.D. Program in Clinical Psychology at Antioch University, New England

Dissertation Committee:

  • Susan Hawes, Ph.D., Committee Chair
  • Vincent Pignatiello, Psy.D., Committee Member
  • Cynthia Whitaker, Psy.D., Committee Member


correctional setting, forced termination, working alliance, Interpretative Phenomenological Analysis

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This is a study of the experiences of forced terminations in correctional facilities, particularly their impact on the working alliance between mental health service providers and incarcerated patients. The study includes an introduction to the research problem and its context, followed by a discussion of the literature on the working alliance in psychotherapy, conditions of forced terminations in the treatment of the incarcerated, the problem of forced termination and the working alliance in the correctional settings, and the study’s research methodology. The research methodology is qualitative and includes semi-structured interviews of providers in correctional settings and an analysis of these accounts using Interpretative Phenomenological Analysis (IPA). The results of this study are based on the major themes found in the interviews. In addition to supervision, participants spoke of the importance of the working alliance to help patients become motivated and “invest” in therapy. To establish a solid alliance, providers suggested using empathy, active listening, and validation as well as non-judgmental and respectful behavior, regardless of the patient’s crimes. Given the unpredictable setting and short-term nature of therapy in correctional settings, providers generally moved fast in sessions and focused on their tasks. The interviewed providers also prepared their patients of the possibility of forced termination and regularly reviewed progress and achievements with them. Further, providers discussed areas of improvements with patients, which they may be able to explore with future therapists. Most providers wished they had the opportunity to help their patients find therapists when forced termination occurred and wanted to be able to contact future providers. Some also wanted to continue contact with the patient during the transition period. These ideas were seen as potential strategies to counteract the negative effect of forced termination. Given the small sample of mental health providers who were interviewed for this study, the findings presented cannot be generalized to apply to all forced termination cases in correctional settings. However, they may enable future researchers to conduct quantitative studies on the development of the working alliance, forced termination outcomes, and their interaction in the correctional setting.


Karin Gepp

ORCID Scholar ID# 0000-0001-8934-1757