Facing the fog: barriers and facilitators to communicating uncertainty among psychologists.

Abstract

Objective: Uncertainty is an unavoidable aspect of healthcare service provision, particularly for psychologists who often navigate complex ambiguous clinical scenarios, which can evoke negative responses and increase risk of adverse outcomes. This study explores the willingness of Australian psychologists to communicate uncertainty to clients, identifying facilitators and barriers to this process.

Method: We surveyed 70 Australian psychologists providing direct client care. The survey focused on barriers and facilitators to communicating uncertainty through responses to a vignette depicting a common therapeutic scenario featuring uncertainty. Thematic analysis was undertaken using Nvivo.

Results: Key themes describing barriers included psychologist's internalization of uncertainty as personal and professional inadequacy, fear of negative client reactions, and a lack of skills in effectively communicating uncertainty. Conversely, facilitators included comfort with uncertainty, external professional supports, and strong therapeutic relationships.

Conclusions: The findings underscore the need for enhanced training of psychologists in uncertainty communication, focusing on developing adaptive responses and effective communication strategies. Addressing uncertainty is crucial given its inevitability, psychologist's pervasiveness discomfort with uncertainty and barriers to its communication. Future research should explore the nuanced experiences of psychologists in diverse practice settings working within a range of therapeutic modalities, and the impact of uncertainty on the therapeutic relationship.