The clinician's helpful and hindering uncertainty scale (CHUS). Development, factor structure, and initial validation

The ability to tolerate incomplete knowledge, or uncertainty, is a central clinical competence, yet it is an understudied topic. The few measures of therapist uncertainty tolerance that exist require clinical experience, limiting their usefulness for tracking development through training. We present the development and initial validation of the Clinician Helpful and Hindering Uncertainty Scale (CHUS), designed for use across all stages of clinical training.

Based on comprehensive conceptual clarification, 68 items were constructed to reflect six facets denoting attitudes toward and dealing with uncertainty. Using confirmatory factor analysis (CFA), the measure's conceptual fit and psychometric properties were examined in a combined sample of 376 English-speaking psychotherapists and students. Construct and concurrent validity were assessed through associations with self-efficacy, intolerance of uncertainty, professional self-doubt, and coping. Qualitative interviews with 15 participants explored the potential utility of CHUS in training.

CFA supported a 30-item, six-factor structure. Factors showed good internal consistency (McDonald's ω = .74-.91) and expected correlations with established measures. Qualitative analyses suggested that CHUS stimulated self-reflection and was viewed as helpful for professional development.

The CHUS shows promising initial psychometric properties and may represent a useful multidimensional measure of clinical uncertainty for research and training purposes.