Client Uncertainty and the Process of Change in Psychotherapy: The Impact of Individual Differences in Self-concept Clarity and Intolerance of Uncertainty

Abstract

We describe a number of ways in which two major components of client uncertainty, namely, self-concept clarity and intolerance of uncertainty may either facilitate or impede change in psychotherapy. Clients with low self-concept clarity find it much more difficult to clearly identify and understand their problematic thoughts, emotions, and behaviors; thus slowing down their progress through the various stages identified in Prochaska’s model of psychotherapeutic change. To illustrate, they may engage in much more contemplation prior to action, as they struggle to increase their awareness and insight. Clients with high intolerance of uncertainty experience substantial discomfort when faced with uncertainty, causing them to be highly motivated to avoid or minimize any aspects of psychotherapy that focus on change. This may cause them to avoid confronting their problems during the action stage of therapy. We further suggest that it would be beneficial to assess these two components of client uncertainty very early on in the therapeutic process, in order to facilitate a given client’s progress. Finally, we indicate a need for much more research that explores the role of these two individual difference constructs during therapy. This might include, for example, studies that directly examine how self-concept clarity and intolerance of uncertainty may relate to progress through each stage of change, or the selective use of avoidance strategies.