Amber Nipper, PsyD, is a 2021 graduate of the Clinical Psychology Doctoral Program at Antioch University, Seattle.

Dissertation Committee

Mark Russell, PhD, Committee Chair

Steven Curtis, PhD, NCSP, MSCP, Committee Member

Thomas K. Brasted, PsyD, Committee Member

Document Type


Publication Date



According to the American Academy of Pediatrics (AAP, n.d.), 40% to 50% of individuals seeking mental health services terminate prematurely due to lack of access, lack of transportation, financial constraints, child mental health professional shortages, and stigma related to mental health. These barriers contribute to primary care providers assessing and managing mental health concerns at increasing rates, particularly symptoms consistent with attention deficit/hyperactivity disorder (ADHD). ADHD is a neurobiological disorder beginning in childhood that is defined as “a persistent pattern of inattention and/or hyperactivity-impulsivity that interferes with functioning or development” (American Psychiatric Association [APA], 2013, p. 59). Current literature shows that ADHD and psychological trauma have similar symptom presentation and influence on one another. The present study explored primary care providers’ assessment and management process for ADHD, including how psychological trauma is incorporated and barriers that primary care providers experience. Semistructured interviews were conducted with three board certified general pediatricians based in the United States who have conducted assessments of ADHD with children and adolescents. Interpretative phenomenological analysis (IPA), a qualitative phenomenological approach, was used due to its ability to emphasize and summarize the lived experiences of the participants. This research identified 10 superordinate, or shared, themes throughout the three interviews: professional identity, diagnostic considerations, aspects of assessment, factors impacting assessment, types of treatment, factors impacting treatment, personal abilities and confidence, limitations in school training, need to self-education, and increasing access to care. The purpose of this study was to gain a better understanding of primary care providers’ assessment and treatment processes for ADHD with children and adolescents, with particular interest in how psychological trauma was viewed and incorporated, and to identify perceived barriers primary care providers experience throughout this process. This research is meant to improve children’s mental health by highlighting barriers in conducting evidence-based assessment and treatment of ADHD and other mental health conditions.


Amber Nipper, PsyD, 2021

ORCID Scholar ID# 0000-0002-8175-9259