Experimenting with uncertainty: A strategy to help with excessive worry and anxiety

Treatment will involve a brief behavioural experiment intervention targeting negative beliefs about uncertainty. This brief intervention will follow a similar protocol outlined in Hebert and Dugas (2019), and extensively described in Robichaud et al. (2019). Those in the immediate treatment condition will recieive two individual weekly (60 minute) sessions delivered via an internet video conferencing platform (Zoom). Uncertainty is a natural trigger for worry in humans. We use worry as a way to plan and prepare in order to make us feel certain. However, if we hold negative beliefs about uncertainty, that is, we expect uncertain events or situations to always turn out negatively and catastrophically this may become the fuel for the engine of excessive worry. Holding negative beliefs about uncertainty may also mean that as well as worrying, we may avoid uncertain situations, engage in excessive planning, rechecking, or reassurance seeking in order to feel more certain. One way to change how we think about uncertainty is to gradually re-introduce uncertain events into our life, and see whether the feared outcome actually happens and how we cope. This is called a behavioural experiment. Behavioural experiments targeting negative beliefs about uncertainty are devised individually with the person, and could include walking a different route, trying a new class, or delegating tasks to others. The first session will include psychoeducation regarding the relationship between negative beliefs about uncertainty and excessive worry, along with exploring the person’s thoughts, feelings and behaviours they have towards situations that are unpredictable, novel or ambiguous (i.e., situational triggers for the feeling of uncertainty). Following this discussion, the clinician will collaborate with the participant to set up three behavioural experiments to test out their negative beliefs about uncertainty over the course of the next week. Participants will be asked to write down in a participant diary their experience of engaging in each of the three behavioural experiments. The second session will involve debriefing with participants regarding how the behavioural experiments went, including how they went, what they learnt, as well as how they coped if the feared event did occur. Following the two-week waitlist period, participants in the waitlist control condition will be offered the same two-session behavioural experiment intervention. Treatment will be delivered by fully registered psychologists under the supervision of an experienced clinical psychologist. All treating psychologists will be thoroughly trained in the administration of the treatment protocol by the project investigators. All sessions will be video recorded and at least 10% of sessions will be randomly selected for treatment fidelity.