Razi Journal of Medical Sciences

fa مقایسه اثربخشی زوج درمانی مبتنی بر پذیرش و تعهد ACT و طرحواره درمانی ST در بهبود سواد عاطفی، ابرازگری هیجانی و تمایز یافتگی در زوج های با دلزدگی زناشویی Comparing the Effectiveness of Couple Therapy Based on Acceptance and Commitment ACT and Schema Therapy ST in Improving Emotional Literacy, Emotional Expression and Differentiation in Couples with Marital Distress روانشناسی بالینی Clinical Psychiatry پژوهشي Research <div style="text-align: justify;">زمینه و هدف: دلزدگی زناشویی از جمله مؤلفههای مهم در روابط زوجین است که وجود آن موجب بروز اثرات منفی بر زوجین و خانواده می شود. در این میان درمان مبتنی بر پذیرش و تعهد به عنوان یک درمان موج نو و طرحواره درمانی به عنوان درمانی که تلفیقی از درمان های دیگر می باشد، با هدف قرار دادن زمینه های هیجانی، شناختی و رفتاری در مشکلات ارتباطی زوجین، به حل مشکلات انها می پردازند. از این‌رو، پژوهش حاضر با هدف مقایسه اثربخشی درمان مبتنی بر پذیرش و تعهد و طرحواره درمانی بر بهبود ابراز هیجانی، خودمتمایزسازی و سواد عاطفی زوجین با دلزدگی زناشویی بپردازد. روش کار: این پژوهش نیمه آزمایشی از نوع پیش آزمون- پس آزمون با گروه کنترل است. به این منظور تعداد 30 زوج که به مرکز مشاوره آستان مهر مشهد در بهار سال 1401 مراجعه نمودند با روش نمونه گیری هدفمند انتخاب شدند و به صورت تصادفی در سه گروه درمان مبتنی بر پذیرش و تعهد، طرحواره درمانی و کنترل گماشته شدند. مقیاس دلزدگی زناشویی پاینز، پرسشنامه ابرازگری هیجان، پرسشنامه تمایزخود و پرسشنامه سواد عاطفی در دو مقطع پیشآزمون، پسآزمون مورد استفاده قرار گرفتند. افراد گروههای آزمایش در جلسات درمان (هر جلسه90 دقیقه) شرکت کردند و اعضای گروه دیگر (گروه کنترل) هیچ درمانی را دریافت نکردند. برای بررسی داده‌ها از آزمون تحلیل واریانس با اندازه گیری مکرر و یک متغیره استفاده شد. یافته ها: نتایج بدست آمده از تحلیل آماری داده ها نشان داد که بین هر دو گروه درمانی و گروه کنترل از نظر اثربخشی درمان تفاوت معناداری وجود ندارد. اما اندازه اثر مشاهده شده برای هر درمان، تأیید کننده اثربخشی هر دو گروه درمانی در بهبود سطح ابرازگری هیجانی، خودمتمایزسازی و سواد عاطفی بود. همچنین تفاوت معناداری بین مرحله پیگیری با پس آزمون در اعضای نمونه پژوهش مشاهده نشد.  نتیجه‌گیری: این یافته ها بیانگر لزوم تمرکز بر شاخص های شناختی و هیجانی در رویارویی با دلزدگی زناشویی و طراحی برنامه های درمانی می باشد. بنابراین می توان گفت که هر دو درمان اجرا شده می توانند از طریق ایجاد بازسازی های شناختی، رفتاری و هیجانی، به بهبود شرایط زوجین با دلزدگی زناشویی کمک کنند.</div> <div style="text-align: justify;">Background & Aims: Conflicts between individuals are a common and unavoidable issue. One of the most important reasons for couples seeking counseling is their decision to divorce (1). An unhealthy family environment caused by conflicts, hypocrisy, and arguments between spouses can lead to negative consequences for the children's lives, which may manifest as defiance and disobedience to social norms in the future (3). Empathy is a crucial factor in creating or preventing marital intimacy, as it can reduce the emotional distance between spouses. Studies show that awareness of emotions and the impact of this awareness on interpersonal relationships in married life is effective (12). Couples who possess a certain level of self-awareness can maintain their individuality and independence while also having strong, genuine, and non-threatening emotional intimacy (13). Expressing emotions is related to some marital processes, including marital satisfaction; competent individuals in terms of emotions can identify and understand their feelings, recognize the underlying meanings of those feelings, and express their emotional states more effectively to others (17). Marital therapy is an important component of healthcare services, and research has shown that therapy based on acceptance and commitment is a type of effective treatment for reducing marital conflicts (19). The healing cycle is a combined treatment that integrates cognitive-behavioral therapy, object relations theory, psychodrama therapy, and attachment theory into a systematic treatment model (22). Therefore, the present study aimed to investigate whether marital therapy based on acceptance and commitment and the healing cycle can have a significant impact on improving emotional empathy, emotional expression, and self-awareness in couples with marital distress. Methods: In this study, a semi-experimental design was used. The research design was of the applied type and semi-experimental (with a pre-test and post-test with a control group) and was approved by the university's Ethics Committee with the code IR.IAU.BOJNOURD.REC.1401.016 in the ethics system. The statistical population consisted of all couples who sought treatment at the Astane Mehr Center in Mashhad in the spring of 1401. From this population, 30 couples were selected using convenience sampling. They were randomly assigned to three groups: commitment-based therapy and acceptance (15 couples), healing cycle therapy (15 couples), and the control group (15 couples). The inclusion criteria included being between the ages of 25 and 45, having no signs of primary depression or anxiety disorders, and no mental or sexual disorders, which were identified through a screening interview conducted by the researcher and a trained assistant in clinical psychology. Additionally, participants had to score above the cutoff point of the marital distress scale (the cutoff point for this scale is 84), and couples had to have at least 5 years of cohabitation. Participants had to have a minimum of a diploma and no substance dependence. The exclusion criteria included seeking other treatments or counseling services simultaneously or having more than three consecutive absent sessions and participants not wanting to continue treatment. In this study, the following instruments were used: the Couples Burnout Measurement, Emotional Expression Questionnaire, Self-Awareness Questionnaire, and Emotional Awareness Questionnaire. Results: The findings showed that the mean differences in the research variables (emotional expression, self-awareness, and emotional empathy) in the two measurement stages were statistically significant (P<0.01). The interaction between the repeated measure and the experimental variable (acceptance-based and commitment therapy and healing cycle therapy): The mean differences between the research variables in the experimental and control groups in the three measurement stages were statistically significant (P<0.01). The experimental variable (acceptance-based and commitment therapy and healing cycle therapy): The mean differences of the research variables in the experimental and control groups were statistically significant (P<0.01). The purpose of presenting the above hypothesis was to examine the impact of the experimental variables. Since the calculated F value for acceptance-based and commitment therapy and healing cycle therapy is greater than the critical F value at a degree of freedom of 2 and 57 and a significant level of P<0.05, the null hypothesis is rejected. Based on the rejection of the null hypothesis, it can be concluded that acceptance-based and commitment therapy and healing cycle therapy had a more significant impact on improving the research variables (emotional expression, self-awareness, and emotional empathy) in the married couples of the experimental groups compared to the control group. Conclusion: The results showed that the mean scores of emotional empathy, emotional expression, and self-awareness in the members of the experimental groups were significantly higher than those in the control group in the post-test. Additionally, the effect size indicated that providing acceptance-based and commitment therapy and healing cycle therapy had a significant impact on improving the levels of emotional empathy, emotional expression, and self-awareness in the married couples of the experimental groups. In conclusion, the provided therapies were able to have a meaningful impact on improving the levels of emotional empathy, emotional expression, and self-awareness in the members of the experimental groups, and it was determined that there was no significant difference in the impact of acceptance-based and commitment therapy and healing cycle therapy on the research variables among the members of the experimental groups.</div> فرسودگی زناشویی, بیان هیجانی, خودمتمایزسازی, سواد هیجانی, درمان مبتنی بر پذیرش و تعهد, طرحواره درمانی Marital burnout, emotional expression, Self-differentiation, Emotional literacy, Therapy based on acceptance and commitment, Schema therapy 1 13 http://rjms.iums.ac.ir/browse.php?a_code=A-10-7504-1&slc_lang=fa&sid=1 Morteza Razmara مرتضی رزم آرا 3900319475328460079113 0009-0002-3487-0189 No PhD Student, Department of Counseling, Bojnord University, Islamic Azad University, Bojnord, Iran دانشجوی دکتری مشاوره، واحد بجنورد، دانشگاه آزاد اسلامی، بجنورد، ایران Mahmoud Jajarmi محمود جاجرمی mahmoud.jajarmi@gmail.com 3900319475328460079114 3900319475328460079114 Yes Assistant Professor, Department of Psychology, Bojnord Branch, Islamic Azad University, Bojnord, Iran استادیار، گروه روان شناسی، واحد بجنورد، دانشگاه آزاد اسلامی، بجنورد، ایران Mohsen Doustkam محسن دوست کام 3900319475328460079115 3900319475328460079115 No Assistant Professor, Department of Psychology, Mashhad Branch, Islamic Azad University, Mashhad, Iran استادیار، گروه روانشناسی، واحد مشهد، دانشگاه آزاد اسلامی، مشهد، ایران