مقایسه اثربخشی روان درمانی وجودی با درمان مبتنی بر پذیرش و تعهد بر ترس از صمیمیت و خودابرازگری جنسی در زنان دارای تعارضات زناشویی
محورهای موضوعی : روانشناسی
زهرا دهمنی
1
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علی اصغر اصغرنژاد فرید
2
*
,
رضا گل پور
3
1 - دانشجوی دکتری روانشناسی عمومی، گروه روانشناسی، واحد تنکابن، دانشگاه آزاداسلامی، تنکابن، ایران.
2 - دانشیار، گروه روانشناسی بالینی، دانشگاه علوم پزشکی ایران، دانشکده علوم رفتاری و بهداشت روان، تهران، ایران.
3 - استادیار گروه روانشناسی، دانشگاه پیام نور، تهران، ایران.
کلید واژه: روان درمانی وجودی, درمان مبتنی بر پذیرش و تعهد, ترس از صمیمیت, خودابرازگری جنسی, تعارضات زناشویی,
چکیده مقاله :
این پژوهش با هدف مقایسه اثربخشی رواندرمانی وجودی با درمان مبتنی بر پذیرش و تعهد بر ترس از صمیمیت و خودابرازگری جنسی در زنان دارای تعارضات زناشویی انجام شد. روش پژوهش نیمهآزمایشی با طرح پیشآزمون و پسآزمون با گروههای آزمایش و کنترل و دوره پیگیری سه ماهه بود. جامعه آماری شامل تمامی زنان دارای تعارضات زناشویی مراجعه کننده به مرکز خدمات مشاوره و روان درمانی پرهام شهر تهران در سال 1402- 1401 بود، که با روش نمونهگیری در دسترس تعداد 45 نفر انتخاب و بهصورت تصادفی در دو گروه آزمایش و یک گروه کنترل (هر گروه 15 نفر) گمارش شدند. گردآوری اطلاعات با استفاده از پرسشنامه ترس از صمیمیت (Descanter & Thelen, 1991) و پرسشنامه خودابرازگری جنسی (Snell et al., 1989) انجام شد. گروههای آزمایش درمان را در 8 جلسه 90 دقیقهای بهصورت یک بار در هفته دریافت کردند و گروه کنترل در انتظار درمان قرار گرفتند. دادهها با استفاده از تحلیل کوواریانس چند متغیره تحلیل شد. نتایج نشان داد هر دو مداخله درمانی بر کاهش ترس از صمیمیت و افزایش خودابرازگری جنسی آزمودنیهای گروه آزمایش اثربخش بودهاند (05/0>P). نتایج آزمون تعقیبی بنفرونی نیز نشان داد میزان اثربخشی دو درمان بر ترس از صمیمیت یکسان بوده است (05/0>P)، اما در متغیر خودابرازگری جنسی، تأثیر درمان پذیرش و تعهد بیشتر از درمان وجودی بود. براساس یافتههای پژوهش میتوان نتیجه گرفت که درمان وجودی و درمان مبتنی بر پذیرش و تعهد بر ترس از صمیمیت و خودابرازگری جنسی موثر است که درمان مبتنی بر پذیرش و تعهد بر بهبود خودابرازگری جنسی موثرتراست.
This research was conducted with the aim of comparing the effectiveness of existential psychotherapy with therapy based on acceptance and commitment on fear of intimacy and sexual self-expression in women with marital conflicts. The research method was semi-experimental with a pre-test and post-test design with experimental and control groups and a three-month follow-up period. The statistical population included all women with marital conflicts who referred to Parham Counseling and Psychotherapy Service Center in Tehran in 2022-2023, 45 people were randomly selected by the available sampling method and divided into two experimental and one experimental groups. The control group (15 people in each group) was appointed. Data collection was done using fear of intimacy questionnaire (Descanter & Thelen, 1991) and sexual self-expression (Snell et al., 1989). The experimental groups received the treatment in 8 sessions of 90 minutes once a week, and the control group was waiting for the treatment. The data were analyzed using ANOVA with repeated measures. The results showed that both therapeutic interventions were effective in reducing the fear of intimacy and increasing the sexual self-expression of the test group subjects (P<0.05). The results of Benferroni's post hoc test also showed that the effectiveness of the two treatments on fear of intimacy was the same (P<0.05), but in the variable of sexual self-expression, the effect of the acceptance and commitment treatment was greater than the existential treatment. Based on the findings of the research, it can be concluded that existential therapy and therapy based on acceptance and commitment are effective on fear of intimacy and sexual self-expression, which is more effective in therapy based on acceptance and commitment on improving sexual self-expression.
Aghili, S. M., & Kashiri, S. (2022). The Effectiveness of Acceptance and Commitment-Based Therapy on Uncertainty Intolerance, Turmoil Tolerance, and Sexual Function in Betrayed Women. The Neuroscience Journal of Shefaye Khatam, 10(3), 57-67. doi: 10.52547/shefa.10.3.57. (In Persian)
Azarnik, M., Rafiepoor, A., Hatami, M., & Mousavi, M. S. (2021). Evaluation and comparison of the effectiveness of communication and marital skills training on marital conflicts and sexual performance of female students. Journal of Health System Research, 17(3), 159-166. doi: 10.22122/jhsr.v17i3.1421. (In Persian)
Babahasani, K., Amini, N., ShafieAbadi, A., & Deyreh, E. (2020). Effectiveness of Existential Group Therapy on Experience and Perception of Suffering, Emotional Regulation and Happiness in Migraine patients. Scientific Journal Social Psychology, 14(58), 295-309. https://psychology.ahvaz.iau.ir/article_680984.html. (In Persian)
Cao, H., Fine, M. A., & Zhou, N. (2022). The Divorce Process and Child Adaptation Trajectory Typology Model: The Shaping Role of Predivorce and Postdivorce Interparental Conflict. Clinical Child and Family Psychology Review,25(1), 500-528. https://doi.org/10.1007/s10567-022-00379-3
Charny, I. W. (1992). Existential/dialectical marital therapy: Breaking the secret code of marriage: Psychology Press. https://www.routledge.com/ExistentialDialectical-Marital-Therapy-Breaking-The-Secret-Code-Of-Marriage/Charny/p/book/9781138869172
Chisari, C., McCracken, L. M., Cruciani, F., Moss-Morris, R., & Scott, W. (2022). Acceptance and Commitment Therapy for women living with Vulvodynia: A single-case experimental design study of a treatment delivered online. Journal of Contextual Behavioral Science, 23(2), 15-30. https://doi.org/10.1016/j.jcbs.2021.11.003
Choi, K., Kim, Y., & Jeon, H. (2020). Comorbid anxiety and depression: clinical and conceptual consideration and transdiagnostic treatment. Rethinking and understanding recent discoveries, 89(7), 219-235. doi: 10.1007/978-981-32-9705-0_14.
Couture, S., Vaillancourt-Morel, M., Hébert, M., & Fernet, M. (2023). Associations between conflict negotiation strategies, sexual comfort, and sexual satisfaction in adolescent romantic relationships. Sex Research, 60(3), 305-314. https://doi.org/10.1080/00224499.2022.2043230.
Curtis, A., & Miller, R. B. (2023). Existential Psychotherapy in a Community Context: The Inspiring Case of" Keo". Pragmatic Case Studies in Psychotherapy, 19(1), 45-53. doi: https://doi.org/10.55818/pcsp.v19i1.2129
Derrick, J. L., Testa, M., Wang, W., & Leonard, K. E. (2023). Elixir of love or venom of violence: When does a drinking event result in couple intimacy or couple conflict?. Addictive behaviors, 136, 1-24. https://doi.org/10.1016/j.addbeh.2022.107488
Descutner, C. J., & Thelen, M. H. (1991). Development and validation of a Fear-of-Intimacy Scale. Psychological assessment: A journal of consulting and clinical psychology, 3(2), 2018-225. https://doi.org/10.1037/1040-3590.3.2.218
Dukes, A. T., Gutierrez, D., & Goshorn, J. R. (2022). Logotherapy infused family therapy: A systematic review of clinical interventions for family counselors. Humanistic Counseling, 61(1), 18-29. https://doi.org/10.1002/johc.12168
Falahzadeh, H., Farzad, V., & Falahzadeh, M. (2011). A study of the Psychometric Characteristics of Fear of Intimacy Scale (FIS). Journal of Research in Psychological Health, 5 (1),70-79. doi: 20.1001.1.20080166.1390.5.1.7.7. (In Persian)
Falconier, M., Nussbeck, F., Bodenmann, G., Schneider, H., & Bradbury, T. (2015). Stress from daily hassles in couples: Its effects on intradyadic stress, relationship satisfaction, and physical and psychological well‐being. marital and family therapy, 41(2), 221-235. https://doi.org/10.1111/jmft.12073.
Faghani, A., Gholestani Por, M., & Sadati, S. Z. (2023). Comparison of the effect of existentialism therapy and acceptance and commitment-based therapy on resilience and existential anxiety of veterans with Cmt disease. Military Psychology, 14(2), 101-117. 10.52547/JPS.22.125.1001(In Persian)
Gerschwer, S. (2022). Conflicts over intimacy within mature, happy marriages reliance and reliability in intimate relationships: An interpretive phenomenological analysis. Conflict Resolution Quarterly, 39(3), 261-274. https://doi.org/10.1002/crq.21321.
Grant, Z. (2023). Development of Southern Interracial Marriage and Divorce: Why Our Children are Code-Switching. Crossings: Swarthmore Undergraduate Feminist Research, 1(1), 135-149. https://works.swarthmore.edu/crossings/vol1/iss1/11/.
Haghjou, F., & Javanbakht Keshikani, S. (2021). Effectiveness of Logo Therapy to the Marital Satisfaction and Sexual Function in Women with Multiple Sclerosis. Applied Research In Counseling, 4(12), 83-102. https://www.jarci.ir/article_244339_bc1030f9036591627fcdd9164e26e34c.pdf. (In Persian)
Hamidikian, P., Niknam, M., & Jahangir, P. (2021). Prediction of latent marital aggression and fear of intimacy based on self-compassion with the mediating role of guilt in married people. Journal of Applied Family Therapy, 2(1), 65-90. doi: 10.22034/aftj.2021.269755.1055. (In Persian)
Hayes, S. A., Orsillo, S. M., & Roemer, L. (2010). Changes in proposed mechanisms of action during an acceptance-based behavior therapy for generalized anxiety disorder. Behaviour research and therapy, 48(3), 238-245. https://doi.org/10.1016/j.brat.2009.11.006.
Hayes, S. C., Strosahl, K. D., &Wilson, K .G. (2016). Acceptance and commitment therapy: The process and practice of mindful change. Second Edition. New York: Guilford Press. https://www.guilford.com/books/Acceptance-and-Commitment-Therapy/Hayes-Strosahl .
Irannezhad, Z., Hamidi Poor, R., Heidari, H., & Davoudi, H. (2021). The effectiveness of Acceptance and Commitment Therapy (ACT) group training on attachment, intimacy and sexual satisfaction in women with sexual reluctance. medical journal of mashhad university of medical sciences, 64(2), 2865-2875.doi: 10.22038/MJMS.2021.18899. (In Persian)
Jafari Razaji, F., Arvin, S., Nikrouy, F., & Ghaffarian, S. (2021). The role of satisfying basic psychological needs, difficulty in regulating emotion and Feeling lonely in predicting fear of intimacy in female sex workers. Rooyesh-e-Ravanshenasi Journal, 10(7), 151-162. doi: 20.1001.1.2383353.1400.10.7.2.4. (In Persian)
Khodadadi Sangdeh, J., Sepehrtaj, S. A., Mirzaesmaeili, M., & Sadat Sepehrtaj, F. (2020). The effectiveness of cognitive existential group therapy on caregiving burden of mothers of children with thalassemia major. Journal of Preventive Medicine, 7(3), 52-42. Doi: 10.29252/jpm.7.3.52. (In Persian)
Khodayari, M., & Ahadi, H. (2021). The Prediction of marital adjustment based on sexual self- disclosure mediating social exchange in women with early marriage. Journal of Psychological Science. 20(107), 2059-2075. doi: 10.52547/JPS.20.107.2059. (In Persian)
La France, B. (2019). The impact of sexual self-disclosure, sexual compatibility, and sexual conflict on predicted outcome values in sexual relationships. The Canadian Human Sexuality, 28(1), 57-67. doi: 10.3138/cjhs.2018-0005.
Mazarei Sotoodeh, A., Bakhshipour, A., & Jajarmi, M. (2022). The Effectiveness of Existential Group Therapy on Increasing Intimacy and Marital Satisfaction in Depressed Married Women. Razi Journal of Medical Sciences, 29(2), 39-50. Doi: 20.1001.1.22287043.1401.29.2.3.6. (In Persian)
Mikaeili, N., & Ebadi, M. (2022). Developing Structural Equations for Marital Relationship Distress Based on Facial Emotion Recognition: The Mediating Role of Relational Aggression in Infertile Women. The Neuroscience Journal of Shefaye Khatam, 10(2), 22-32. doi: 10.61186/shefa.10.2.22. (In Persian)
Musapur, H., Mehravar, M., Batue, A., Hosseini, S. H., & Changi Ashtiani, J. (2020). Outcomes of procrastination in marital conflicts: A qualitative study. Razi Journal of Medical Sciences, 27, 174-185. http://rjms.iums.ac.ir/article-1-6380-fa.html. (In Persian)
Nabiei, A., Hosseini, S. S., & Kakabaraie, K. (2020). The pattern of structural equations in relation to the tendency to divorce with communication skills and the health of the main family with the mediating role of marital intimacy and marital conflicts. Journal of The Ministry of Health and Medical Education, 4(1), 9-17. http://islamiclifej.com/article-1-386-fa.html. (In Persian)
Nasiri, Z., Honarparvaran, N., Shahshahani, F. J., & Samani, S. (2022). Investigating the precipitating and exhibiting factors of marital infidelity: a qualitative study. Journal of Applied Family Therapy, 3(1), 110-135. doi: 10.22034/aftj.2022.305871.1208. (In Persian)
Rezapour Mirsaleh, Y., Aryanpour, H., Amini, R., & Fallah, T. (2021). Effectiveness of existential therapy on marital forgiveness and family function of women affected by marital infidelity. Research in Clinical Psychology and Counseling, 10(2), 105-122. doi: 10.22067/TPCCP.2021.36339.0. (In Persian)
Safdari, H., Naderi, F., Moradi Manesh, F., & Makvandi, B. (2022). The Effectiveness of Acceptance Based Therapy on Anxiety Sexual satisfaction and depression in infertile women. Medical Journal of Mashhad University of Medical Sciences, 65(5), 1249-1258. doi: 10.22038/MJMS.2022.67174.3982. (In Persian)
Sharifain M, Saffarinia M, Alizadeh Fard S. (2019). Structural Model of Vaginismus Disorder based on Marital Adjustment, Sexual Self-Disclosure, Sexual Anxiety and Social Exchange Styles. Journal of Research in Psychological Health, 12(4), 48.-65. Doi: 10.52547/rph.12.4.48. (In Persian)
Sun, F. K., Hung, C. M., Yao, Y., Fu, C. F., Tsai, P. J., & Chiang, C. Y. (2021). The effects of logotherapy on distress, depression, and demoralization in breast cancer and gynecological cancer patients: A preliminary study. Cancer Nursing, 44(1), 53-61. doi: 10.1097/NCC.0000000000000740
Thompson, E. M., Destree, L., Albertella, L., & Fontenelle, L. F. (2021). Internet-based acceptance and commitment therapy: a transdiagnostic systematic review and meta-analysis for mental health outcomes. Behavior Therapy, 52(2), 492-507. https://doi.org/10.1016/j.beth.2020.07.002
Ünal, Ö., & Akgün, S. (2022). Conflict resolution styles as predictors of marital adjustment and marital satisfaction: An actor–partner interdependence model. Family Studies, 28(3), 898-913. https://doi.org/10.1080/13229400.2020.1766542
Wang, X., & Zhao, K. (2023). Partner phubbing and marital satisfaction: The mediating roles of marital interaction and marital conflict. Social Science Computer Review, 41(4), 1126-1139. https://doi.org/10.1177/08944393211072231
Watter, D. N. (2018). Existential issues in sexual medicine: the relation between death anxiety and hypersexuality. Sexual medicine reviews, 6(1), 3-10. https://doi.org/10.1016/j.sxmr.2017.10.004
Zand, M. E., & Askari, F. (2023). The effectiveness of group consultation base on acceptance and commitment therapy on family performance and marital intimacy women clients in family counselling center of Qom. Rooyesh-e-Ravanshenasi Journal (RRJ), 12(6), 163-172. Doi: 20.1001.1.2383353.1402.12.6.16.0
Zohrehvandi, Z., Babakhani, N., & Taheri, A. (2022). The Effectiveness of Acceptance and Commitment Therapy (ACT) on Perceived stress & Psycho-Somatic Signes & emotional distress in IVF infertile women. Applied Family Therapy Journal, 3(2), 496-516. doi: 10.22034/aftj.2022.310062.1230. (In Persian)