Razi Journal of Medical Sciences

fa مقایسه اثربخشی و ماندگاری مصاحبه انگیزشی و درمان فراتشخیصی بر صمیمیت زوجین مراجعه‌کننده به مراکز مشاوره Comparison of the Effectiveness and Durability of Motivational Interview and Meta-Diagnostic Treatment on Intimacy of Couples Referring to Counseling Centers روانشناسی بالینی Clinical Psychiatry پژوهشي Research زمینه و هدف: صمیمیت به وجود تعامل بین همسران اشاره می‌کند و نبود یا کمبود آن یک شاخص آشفتگی در رابطه زناشویی است. هدف از انجام تحقیق حاضر مقایسه اثربخشی مصاحبه انگیزشی و درمان فراتشخیصی بر صمیمیت زوجین مراجعه کننده به مراکز مشاوره بود. روش کار: جهت انجام تحقیق کاربردی و نیمه آزمایشی که با طرح پیش آزمون‑ پس آزمون و پیگیری بود، از بین زوجین مراجعه کننده به مراکز مشاوره شهر شهرکرد در سال 1399-1400 (1250 زوج) با روش نمونهگیری هدفمند 60 زوج انتخاب و به صورت تصادفی به دو گروه ازمایش و یک گروه گواه تقسیم شدند. قبل، بلافاصله بعد و پیگیری 45 روزه آزمودنیها پرسشنامه صمیمیت ووندن بروک و برتمن (1995) را تکمیل کردند همچنین گروههای آزمایش هر کدام 8 جلسه 90 دقیقه-ای مداخله مورد نظر را دریافت کردند.در نهایت دادهها با استفاده از آزمون تحلیل واریانس با اندازهگیری مکرر و آزمون تعقیبی بون فرونی تجزیه وتحلیل شدند. یافته‌ها: نتایج نشان داد آموزش مصاحبه انگیزشی و درمان فراتشخیصی بر صمیمیت زوجین تأثیر معناداری دارند. همچنین مشخص شد بین آموزش مصاحبه انگیزشی و درمان فراتشخیصی تفاوت معناداری در بهبود صمیمیت زوجین وجود ندارد. در نهایت اینکه نتایج مبین پایداری اثرات مصاحبه انگیزشی و درمان فراتشخیصی بر صمیمیت زوجین در مرحله پیگیری بود. نتیجهگیری: با توجه به نتایج استفاده از این مداخله‌ها برای بهبود صمیمیت زوجین کاربردی به نظر می‌رسد. Background & Aims: Intimacy is one of the most basic elements in a couple's relationship. Intimacy is a dynamic concept in human relationships, especially in marital relationships, which means openness and non-inhibition in relationships and the closeness of two or more people in various emotional, logical and functional dimensions. Couples who experience a higher degree of intimacy, apart from socioeconomic status, report significantly fewer adjustment problems in their marital relationship (1). Given the importance of intimacy, identifying effective intervention and educational approaches to increase couple intimacy to improve couple relationships will be very useful. One of these approaches is motivational interviewing, which is a combination of principles and techniques derived from a very wide range of models of psychotherapy and behavior change (4). In addition, given that many marital problems have emotional roots, the recent approach to meta-diagnostic treatment to resolve couples' problems has come into focus; Because this treatment emphasizes emotions and maladaptive emotion regulation strategies, emotional experience and response to emotion is the main basis in the meta-diagnostic approach (12). But it is not clear which intervention is more effective. On the other hand, it is not clear whether these interventions affect intimacy or not, and which intervention is more effective is also in a state of ambiguity. Methods: In order to conduct applied and quasi-experimental research with pre-test and post-test design, from couples referring to counseling centers in Shahrekord in 1399-1400 (1250 couples), by purposive sampling method and provided entry conditions For the study (with at least a third grade of middle school, age range 25 to 45 years, no disabling physical or mental illness) 60 couples were selected and randomly divided into three groups of motivational interview, meta-diagnostic treatment and witness. Before, immediately after and 45-day follow-up, the subjects completed the Wonden Brook and Bertman (1995) intimacy questionnaire, and the experimental groups each received 8 sessions of 90-minute intervention. Finally, from descriptive statistics (mean and standard deviation) and Kalmogorov-Smirnov tests, analysis of variance with repeated measures and Bonferroni post hoc using SPSS software version 25 at a significance level of 0.05 for statistical analysis of data used. Results: The results showed that the meta-diagnostic therapy group and motivational interviewing could lead to a change in the mean scores of the couple's intimacy (intimacy, agreement, honesty, love and commitment) in the post-test and follow-up stages. In order to be effective, the meta-diagnostic therapy and motivational interview therapy group was able to increase the mean scores of the couple's intimacy (intimacy, agreement, honesty, interest and love and commitment) in the post-test and follow-up stages. On the other hand, it was found that there were no significant changes between the pre-test scores. The results showed that the mean scores of the couple's intimacy variable, regardless of the effect of grouping, changed significantly during the post-test and follow-up stages, which is a significant difference compared to the pre-test (p = 0.001). On the other hand, it was found that the variable of grouping (post-diagnostic treatment group therapy) regardless of stages (pre-test, post-test and follow-up) had a significant effect on the intimacy variable of couples. This means that meta-diagnostic treatment was a significant effect compared to the control group (p = 0.001). Finally, the results indicate that meta-diagnostic treatment with the interaction of stages also had a significant effect on the test stages (pre-test, post-test and follow-up) of the couple intimacy variable (p = 0.001). The results of post hoc test (Table 3) show that the difference between the mean scores of pre-test and post-test is significant by following the variable of couple intimacy. However, there is no significant difference between the mean of the post-test and the follow-up of this variable. This means that the mean scores of couples intimacy in the follow-up phase did not change significantly compared to the post-test, but due to the lack of follow-up scores compared to the post-test and a significant change in follow-up scores compared to the pre-test shows that the effectiveness of meta-diagnostic treatment on intimacy over time Preserved. On the other hand, it was found that the difference between the mean scores of intimate couples in the experimental group of meta-diagnostic therapy and the experimental group of motivational interviews was not significant and this finding means that the effectiveness of meta-diagnostic treatment and motivational interviews on the intimacy of couples was not significant. However, the difference between the experimental groups (meta-diagnostic therapy and motivational interview) with the control group was significant. In a summary, it can be stated as follows: Transdiagnostic treatment intervention and motivational interview have a significant effect on the level of intimacy of couples; However, the effectiveness of meta-diagnostic treatment and motivational interviewing on the level of intimacy of couples are not significantly different (Table 4). Conclusion: In explaining the effectiveness of motivational interview on couples intimacy, it should be noted that the therapist's goal in motivational interview is to create a safe environment to express problems and then, strengthen the desire to change to improve relationships in the client, which leads to increased intrinsic motivation. . Since intimacy is a feature that is not a fixed feature and changes when the couple is faced with stressful situations. Therefore, motivational interviewing, by increasing the couple's inner motivation to maintain intimacy in difficult life situations, causes the couple to communicate with each other emotionally (increase interest), then plan with interest to improve their relationship (reduce boredom) and from this Satisfy and enjoy your action (increase intimacy) (9). In explaining this finding, it may be pointed out that couples are more likely to not be able to use positive emotions effectively in times of conflict, and on the contrary, they have a lot of negative emotions, which causes other problems such as negative perception. Concerns about their relationship with their spouse and improper marital functioning become a reason for their intimacy to be disrupted. However, emotional awareness training in meta-diagnostic therapy makes them aware of the existence of negative emotions and their negative impact on themselves, or try to recover emotions in different situations to keep the emotion healthy, and thus, the rate of marital problems is reduced and in The result is marital intimacy (14).   مصاحبه انگیزشی, درمان فراتشخیصی, صمیمیت زوجین Motivational interview, Meta-diagnostic Treatment, Intimacy of couples 69 76 http://rjms.iums.ac.ir/browse.php?a_code=A-10-5737-2&slc_lang=fa&sid=1 Anahita Panahi آناهیتا پناهی 3900319475328460072229 3900319475328460072229 No PhD Student in psychology, Department of psychology, Shahrekord Branch, Islamic Azad University, Shahrekord, Iran دانشجوی دکتری روان شناسی، واحد شهرکرد، دانشگاه آزاد اسلامی شهرکرد، ایران Ahmad Ghazanfari احمد غضنفری agazan5@yahoo.com 3900319475328460072230 3900319475328460072230 Yes Associate Professor of Psychology, Department of Psychology, hahrekord branch, Islamic Azad University, Shahrekord, Iran دانشیار، گروه روان شناسی، واحد شهرکرد، دانشگاه آزاد اسلامی، شهرکرد، ایران Tayebe Sharifi مریم چرامی 3900319475328460072231 3900319475328460072231 No Assistant Professor of Psychology, Department of Psychology, Shahrekord Branch, Islamic Azad University,Shahrekord, Iran استادیار، گروه روان شناسی، واحد شهرکرد، دانشگاه آزاد اسلامی، شهرکرد، ایران Reza Ahmadi رضا احمدی 3900319475328460072232 3900319475328460072232 No Associate Professor of Psychology, Department of Psychology, Shahrekord Branch, Islamic AzadUniversity, Shahrekord, Iran دانشیار، گروه روان شناسی، واحد شهرکرد، دانشگاه آزاد اسلامی، شهرکرد، ایران