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Clinical Materials

The uncertainty distress model is a trans-diagnostic and trans-situational framework to understand how threat and uncertainty can lead to distress including, but not limited to, anxiety. The model is available:

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). the Cognitive Behaviour Therapist.

Open access available from:


On this page, you can find links to some materials that we have developed to support interventions that target different parts of the model.


The ongoing COVID19 pandemic is causing enormous harm across the world in human lives and unmeasurable suffering. Emotional problems provoked by this situation can be normal considering the situation, but we need to investigate how the uncertainty about the virus and other areas (e.g., economy, healthcare, transport) affected by this pandemic are altering our lives, as well as how can we better cope with uncertainty and threat. You can help us by filling out our survey (It will take you 30 minutes).

Managing and Rebalancing Information

This worksheet addresses the role of information and how it contributes to perceptions of threat and uncertainty. This intervention is predicated on the assumption that many people are receiving a vast amount of information. The information may or may not be helpful, will vary in quality, and may contribute to distress. There are many different ways unhelpful information consumption could be addressed; this worksheet provides one possibility with a worked case example.

A Typology of Information

This resource sheet provides a way of thinking about different types of information, the possible effects on people, and what to do about it. It is designed primarily for therapists to understand the different types of information and their effects, rather than as a worksheet to use for patients.


Task Review and Planner

One of the key features of CBT is the use of “between session interventions” which are commonly known as homework.  An important step in the use of any exercise or task is to complete the loop: review what was attempted, whether there were any difficulties in implementing the plan, reflect on what happened, summarize any key learning, and then plan any changes.  This worksheet provides one way of following up previous homework.  It is designed to be used with any homework task.

Noticing Certainty Seeking Behaviour

One of the first steps to tolerating uncertainty is to notice the behaviours used to help manage the uncomfortable feelings associated with uncertainty.  This worksheet provides the therapist with an introduction to certainty seeking behaviours and how they can be identified.  It also includes a worksheet to use with clients and two completed examples.


​To work with uncertainty in the room, the worksheet helps to investigate the subjective experience as a bodily felt sense. Avoiding the sensations and bodily reactions to unknown situations is part of ‘keeping a lid’ on the experience and hampers the process of tolerating uncertainty-related discomfort. The interoceptive worksheet supports the experience of being with, sitting with and beginning to relate to the feeling states arising in the face of uncertainty.   

  • ​A recording to tap into embodied experiences of safety/unsafety

The recording offers a mindful yet playful way to explore experiences of safety/unsafety as a felt sense. In order to help clients to engage with uncertainty and the related bodily felt discomfort, building the experiences of safety or feeling ‘safe enough’ in a body-integrative manner is paramount.

Intolerance of Uncertainty Scale - 5-item version (IUS-5)

The IUS-5 is the 5-item version of the Intolerance of Uncertainty Scale (IUS; Freeston, Rhéaume, Letarte, Dugas, & Ladouceur, 1994), the gold standard measure for IU. It has two versions, the original 27-item and the 12-item (IUS-12; Carleton, Norton, & Asmundson, 2007). Our research team has developed an even shorter version of the IUS, both psychometrically sound and quicker to administer, which would increase its utility in research studies with an elevated number of measures. 

Intolerance of Uncertainty Behaviour in Everyday Life Questionnaire (IUBEL)

The IUBEL was developed to assess a range of behaviours people may use in response to uncertain situations. Repertoires of behavioural strategies are highly idiosyncratic, both across situations and between people. Behaviours may be deployed according to specific characteristics of the situation, sequentially as a function of the imminence of the situation, or as a function of current mood state. The questionnaires can capture a range of behaviours which can inform formulation. There are two versions, General, and Situational.

  • IUBELQ  1.0 Guide for therapists, development, measure 1.0

  • IUBELQ  1.0 - Situational Measure

  • IUBELQ  1.0 - Generalized Measure

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