“This wasn’t in the manual”: a qualitative exploration of tolerance of uncertainty in the practicing psychology context
Objective: The ability to tolerate uncertainty has been identified as a necessary capacity in healthcare workers. This study aims to explore experiences of uncertainty and coping among practicing psychologists. Method: Semi-structured interviews were conducted with 24 participants. A critical realist approach was employed and thematic analysis utilised. Results: Participants identified perceived causes of uncertainty which included, complex and risky clients, lack of therapeutic engagement and ethical dilemmas. Participants experienced primarily negative physiological, emotional and cognitive responses to uncertainty. Coping behaviours included seeking supervision, focusing on oneself, focusing on client-related activities, and avoiding clients associated with uncertainty. Experiences of uncertainty were noted to change over time. Conclusions: This paper supports the need to better understand how psychologists can be supported to manage uncertainty and its effects on professional practice. The role of training and supervision models in promoting strategies to support psychologists’ tolerance of uncertainty is highlighted. KEY POINTS What is already known about this topic: The phenomenon of “uncertainty tolerance” as it relates to healthcare professionals is the focus of an expanding body of research, and has been linked with level of stress and risk of burnout in medical trainees. The importance of uncertainty tolerance has been identified in practicing psychology literature. Psychology practice frequently involves the challenges or probability, ambiguity, and complexity. There is a dearth of empirical studies specific to how practicing psychologist’s experience and respond to uncertainty, and how this may change over time. What this topic adds: The experience of uncertainty was very common within this practicing psychologist group, suggesting it is a significant workplace challenge and/or stressor for practicing psychologists. Participants in this study experienced primarily negative physiological, emotional and cognitive responses to uncertain clinical situations. Participants reporting using supervision to cope with uncertainty and that their experiences of uncertainty changed over time. Recommendations regarding the role of supervision in supporting psychologists in their experiences of uncertainty, and the need for training programs to provide professional socialisation to uncertainty.
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