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Making friends with uncertainty: experiences of developing a transdiagnostic group intervention targeting intolerance of uncertainty in IAPT. Feasibility, acceptability and implications

Published online by Cambridge University Press:  27 October 2020

Layla Mofrad Open the ORCID record for Layla Mofrad [Opens in a new window] ,
Ashley Tiplady ,
Danielle Payne Open the ORCID record for Danielle Payne [Opens in a new window]  and
Mark Freeston
Layla Mofrad
Affiliation:
Talking Helps Newcastle (Cumbria, Northumberland Tyne and Wear NHS Foundation Trust, Insight Healthcare and The Newcastle upon Tyne Hospitals NHS Foundation Trust), Newcroft House, Market Street East, Newcastle upon TyneNE1 6ND, UK
Ashley Tiplady
Affiliation:
Newcastle Hospitals Occupational Health Service, Regent Point, Regent Farm Road, GosforthNE3 3HD, UK
Danielle Payne*
Affiliation:
Talking Helps Newcastle (Cumbria, Northumberland Tyne and Wear NHS Foundation Trust, Insight Healthcare and The Newcastle upon Tyne Hospitals NHS Foundation Trust), Newcroft House, Market Street East, Newcastle upon TyneNE1 6ND, UK
Mark Freeston
Affiliation:
School of Psychology, Newcastle University, Newcastle upon TyneNE1 7RU, UK
*
*Corresponding author: danielle.payne3@nhs.net
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Abstract

Co-morbid mental health diagnoses present challenges for services structured to provide disorder-specific models of treatment, such as those structured around Improving Access to Psychological Therapies (IAPT). Intolerance of uncertainty (IU) has been identified as both disorder specific and transdiagnostic, although little research explores transdiagnostic approaches to treatment of IU alone. A cognitive behavioural therapy treatment targeting IU previously established for individual therapy was adapted for a group within an IAPT primary care service: the ‘Making Friends with Uncertainty’ (MFWU) group. Twenty patients presenting with symptoms of a range of disorders including generalised anxiety disorder, obsessive compulsive disorder and depression completed the intervention in three groups. Measures of IU, anxiety and depression administered in the first and final sessions of the group have been analysed as well as examining common themes in participant feedback and facilitators’ own reflections. The results showed that nine participants (45%) showed reliable change in IU following the group and 16 (80%) showed reliable change on a measure of depression or anxiety. A thematic analysis identified universality, tolerance and acceptance and the manifestation of IU in the group process as key. The results suggest that the MFWU group provides an effective and feasible option for individuals presenting to IAPT services, including those reporting co-morbid difficulties. Implications for future practice are discussed as iteration and evaluation of the framework and content will continue.

Key learning aims

  1. (1) To gain an overview of a transdiagnostic model of IU.

  2. (2) To develop understanding of a group intervention for building tolerance to uncertainty.

  3. (3) To describe some group processes observed and learn from the delivery of a transdiagnostic group intervention.

  4. (4) To consider applications of transdiagnostic treatment in a group setting in IAPT.

  5. (5) To understand how to structure a group treatment for IU, and which factors to consider.

Keywords

groupIAPTtransdiagnosticuncertainty
Type
Empirically Grounded Clinical Guidance Paper
Information
the Cognitive Behaviour Therapist , Volume 13 , 2020 , e49
Copyright
© British Association for Behavioural and Cognitive Psychotherapies 2020

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References

Further reading

Bottesi, G., Mawn, L., Nogueira-Arjona, R., Sanchiz, P. R., Simou, M., Simos, G., & Freeston, M. H. (2020). A short-form version of the Intolerance of Uncertainty Scale: initial development of the IUS-5.CrossRefGoogle Scholar
Freeston, M. H., Tiplady, A., Mawn, L., Bottesi, G., & Thwaites, S. (2020). Towards a model of uncertainty distress in the context of Coronavirus (Covid-19).CrossRefGoogle Scholar

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