Intolerance of Uncertainty Formulation (Dugas)
A formulation based on Dugas' intolerance of uncertainty model — mapping IU, positive beliefs about worry, negative problem orientation, and cognitive avoidance.
Written by Tarun Vermani, Trainee Clinical Psychologist Last reviewed
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Intolerance of Uncertainty Formulation (Dugas)
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Intolerance of Uncertainty
Positive Beliefs About Worry
Negative Problem Orientation
Cognitive Avoidance
Reflection
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The Intolerance of Uncertainty Formulation (Dugas) is an interactive cognitive behavioural therapy (CBT) worksheet, most often used in CBT for generalised anxiety (GAD).
It is designed to be used within therapy rather than as a standalone self-help tool: a therapist introduces it, works through it collaboratively, and helps make sense of what it surfaces. You can preview the full worksheet above, then assign it digitally for clients to complete between sessions on any device — or download it as a print-ready PDF.
How it works
Most people work through it in around 20 minutes. It moves through five short steps:
- Intolerance of Uncertainty
- Positive Beliefs About Worry
- Negative Problem Orientation
- Cognitive Avoidance
- Reflection
Completed on the Formulate platform, your client's answers are saved automatically and shared straight back to you, so you can review them before the next session rather than waiting for a paper copy to come back.
The CBT approach behind it
In common with other CBT methods, the Intolerance of Uncertainty Formulation (Dugas) works by mapping how the parts of a problem connect and keep it going (formulation). The aim is not positive thinking but a clearer, shared understanding of what keeps a difficulty going — and practical, testable ways to change it.
Because it is a CBT tool it stays focused on the here-and-now links between thoughts, feelings, the body and behaviour, and it works best as one part of a wider course of therapy rather than as advice or a diagnosis.
Evidence & sources
This worksheet is grounded in established cognitive behavioural therapy theory and practice. Key sources include:
- Dugas, M.J. & Robichaud, M. (2007). Cognitive-Behavioral Treatment for Generalized Anxiety Disorder. New York: Routledge.
- Wells, A. (2009). Metacognitive Therapy for Anxiety and Depression. New York: Guilford Press.
For use alongside professional support
Formulate provides educational CBT resources for use with a qualified therapist. They are not a substitute for professional assessment, diagnosis, or crisis care.
If you need urgent help now:
- Emergency services: 999 — if you or someone else is in immediate danger
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More Generalised Anxiety (GAD) worksheets
View all Generalised Anxiety (GAD) worksheets →Generalised Anxiety (GAD)
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A formulation based on Wells' metacognitive model of GAD — mapping the role of positive and negative beliefs about worry in maintaining the worry cycle.
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Learn to distinguish between practical worries (that you can act on) and hypothetical worries (that are about "what if") to respond differently to each.
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Work through a structured process to decide whether a worry is practical (take action) or hypothetical (practise letting go).
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Tolerating Uncertainty Practice
Practise noticing and tolerating everyday uncertainty to build your tolerance muscle.
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Worry Diary with Postponement Record
Track worries as they occur, classify them, practise postponing hypothetical worries to a designated worry period, and record outcomes.
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Positive Meta-Beliefs About Worry
Identify and challenge positive beliefs about worrying — the beliefs that keep you worrying because you think it helps.
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