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Alyssa J. Mayer, PsyD, is a 2025 graduate of the PsyD program in Clinical Psychology at Antioch University, Seattle.

Dissertation Committee:

William Heusler, PsyD, Committee Chair

Laura Rowley, PhD, Committee Member

Michael Toohey, PhD, ABPP, Committee Member

Keywords

unexpected feedback, neurodevelopmental self-diagnosis, lived experience of psychologists delivering feedback, interpretative phenomenological analysis (IPA)

Document Type

Dissertation

Publication Date

2025

Abstract

The purpose of this study was to describe the experience of licensed psychologists who provided unexpected feedback to assessment clients about not meeting the criteria for neurodevelopmental disorders. Individuals are increasingly seeking formal evaluation for neurodevelopmental disorders based on anecdotal information they come across on the internet. Many people develop strong identity attachments to these diagnostic labels, and it can be incredibly dysregulating to learn that they do not meet the criteria for a diagnosis. Six psychologists participated in semi-structured virtual interviews to share their experiences providing clients with this type of unexpected feedback. Through an interpretive phenomenological analysis framework, the data was consolidated into six broad themes: (a) the client experience, (b) conflicting professional identities, (c) seeking to understand, (d) coping tools, (e) defining successful feedback, and (f) improving training. This study may serve as the foundation for enhancing training programs’ approaches to unexpected feedback, as well as future research documenting aspects of this phenomenon. This dissertation is available in open access at AURA (https://aura.antioch.edu) and OhioLINK ETD Center (https://etd.ohiolink.edu).

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Alyssa J. Mayer, PsyD, 2025

ORCID Scholar No. 0009-0002-2611-2951

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