Razi Journal of Medical Sciences

Background & Aims: Depression is a feeling of extreme sadness and grief that can range from mild frustration to a feeling of great despair (1). Depression affects the quality of married life of individuals and impairs their performance more than anxiety disorders and as much as the most common medical diseases (2). In this regard, the development of intimacy between spouses is the first step towards creating a desirable marriage (5); Therefore, establishing and maintaining intimate relationships in marriage is a skill and an art that, in addition to early mental health and healthy experiences, requires the acquisition of skills and the performance of special tasks (6).
In this regard, research shows that the root of many marital problems is the lack of intimacy and communication problems between spouses (2). Dissatisfaction with intimacy may lead to increased conflicts, decreased marital satisfaction, and emotional and psychological problems (7); In today's society, couples have severe and pervasive problems to establish and maintain an intimate relationship, and often seek treatment to re-establish levels of trust and satisfaction in their relationship, especially issues related to emotional-communication ties with important people in life (9). People who have difficulty developing intimacy often seek counseling for their marital problem, while increasing and improving intimacy is often one of the goals of couple therapy (7). Therefore, various therapeutic interventions have been performed with people with low quality marital relationships, and it has been confirmed that one of the effective therapeutic interventions to improve the quality of marital relationships and promote marital intimacy is to enrich marital life training based on Glaser theory of reality therapy.
Considering the above and the importance of married life on the one hand, the negative impact of depression on life on the other hand and considering the impact of reality therapy on married life, therefore, by reviewing research conducted at home and abroad, research on the impact of reality therapy on Intimacy and marital satisfaction have not been performed in depressed married women. On the other hand, policymakers, researchers and psychotherapists in our country have not paid much attention to preventive methods and these methods need more scientific study, so the present study is necessary.
Methods: For the present quasi-experimental and applied research, which was conducted with the experimental and control group and the pre-test, post-test and two-month follow-up research plan, 30 depressed women referred to two counseling and psychology centers in Mashhad in 1398 (94 people) were 30 people. They were purposefully selected and randomly divided into two groups: reality therapy and control. After completing the consent form, they completed the Walker and Thompson Marriage Intimacy Questionnaire (1983) and the Enrich Marital Satisfaction Questionnaire (1989). Then, the subjects of the experimental group underwent 8 sessions of 90 minutes under the reality therapy program of Duba et al. (2009). Immediately after the intervention and two months later, the questionnaires were completed again by the subjects
Finally, descriptive statistics (mean and standard deviation) and Shapirovilk tests, analysis of variance with repeated measures and Bonferroni post hoc using SPSS software version 23 were used for statistical analysis of data.
Results: The results showed that the mean marital intimacy of the experimental groups in the post-test stage increased compared to the pre-test. It was also found that group reality therapy intervention compared to the control group increased marital intimacy after the test and stability in the follow-up phase of married women. It was also found that the difference between the mean of marital intimacy between pre-test and post-test and follow-up stages was significant (P = 0.001) but the mean difference between post-test and follow-up was not significant, indicating that the results in follow-up did not return and the effect of intervention was stable. .
Another finding showed that the average marital satisfaction of married women in the experimental group increased in the post-test stage compared to the pre-test. It was also found that group reality therapy intervention compared to the control group increased marital satisfaction after the test and stability in the follow-up phase in married women. The results of post hoc test showed that the mean of marital satisfaction between pre-test and post-test and follow-up stages was significant (P = 0.001) but the mean difference between post-test and follow-up was not significant, indicating that the results in follow-up stage did not return and the effect of intervention was stable. have been.
Conclusion: The results showed that the mean of marital intimacy in the experimental group increased in the post-test stage compared to the pre-test. It was also found that training has been able to affect marital intimacy in the post-test and follow-up stages, and this effect has remained stable until two months after the end of training, according to the results of the Bephrone post hoc test.
In the above explanation, it can be said that in reality therapy, it emphasizes on cultivating a sense of responsibility to satisfy the basic needs of oneself and one's spouse and liberation from external control; Therefore, people may not have paid enough attention to their own needs and the needs of the other party, because meeting each other's needs in the marital relationship is one of the important factors in improving marital intimacy; However, attending reality therapy training sessions has been able to draw their attention to these important issues and to consider them in practice (2). Therefore, teaching how to look at these needs and meet them has been able to help couples. (20). As a result of reality therapy training, awareness about the intensity of couples' needs and creating a sense of responsibility has increased, and as a result, satisfying their needs has been able to play an important role in creating and improving sincere relationships.
Another finding showed that the mean of marital satisfaction in the experimental group increased in the post-test stage compared to the pre-test. It was also found that these trainings were able to affect marital satisfaction in the post-test and follow-up stages, and this effect remained stable until two months after the end of the training.
In explaining the results in terms of the effect of reality therapy, it can be said that Glasser's emphasis on accepting responsibility for each person's behavior helps people to examine and examine their own behavior instead of addressing their spouse's behavior and putting him or her under a magnifying glass. Play their part in problems and reduce marital satisfaction And thus improve their relationships; Reality therapy counselors based on Glasser's concepts try to increase couples 'trust, intimacy and marital satisfaction in their clinical interventions by increasing responsibility in couples and teaching communication skills, and strengthen couples' sense of commitment; Another factor that Glasser considers effective in strengthening and stabilizing marital relations is the couple's attention to each other's wants and needs; They learn to satisfy their own and their spouse's needs through loving behaviors (22).