|Year : 2017 | Volume
| Issue : 1 | Page : 11-16
Effectiveness of schema therapy on marital satisfaction and marital relationship quality in married women
Bahar Khatamsaz, Elham Forouzandeh, Davoud Ghaderi
Department of Psychology, Isfahan (Khorasgan) Branch, Islamic Azad University, Isfahan, Iran
|Date of Web Publication||16-Jan-2017|
Dr. Elham Forouzandeh
Department of Psychology, Isfahan (Khorasgan) Branch, Islamic Azad University, Isfahan
Source of Support: None, Conflict of Interest: None
Aim: The aim of this research was to study the effectiveness of schema therapy on two main components of marital life, marital satisfaction and quality of their relationship in order to reach methods and to develop these two components. Methods: Thirty subjects under study were chosen by convenience sampling from counseling and work centers in Shahin Shahr and then randomly divided into test and control groups. Enrich couples' marital satisfaction, Jerabek communication skills, and Young's schema questionnaires were used prior to and after the therapy. Data were analyzed by the multivariate analysis of variance and covariance using SPSS 18.0 (Released 2009. PASW Statistics for Windows, Version 18.0. Chicago: SPSS Inc). Results: Controlling the covariate variable, difference between the two tests and control groups for marital satisfaction, and marital relationship quality after the intervention are significant (P < 0.01). Conclusion: Schema therapy is effective in increasing marital satisfaction and marital relationship quality.
Keywords: Marital relationship quality, marital satisfaction, schema therapy
|How to cite this article:|
Khatamsaz B, Forouzandeh E, Ghaderi D. Effectiveness of schema therapy on marital satisfaction and marital relationship quality in married women. Int J Educ Psychol Res 2017;3:11-6
|How to cite this URL:|
Khatamsaz B, Forouzandeh E, Ghaderi D. Effectiveness of schema therapy on marital satisfaction and marital relationship quality in married women. Int J Educ Psychol Res [serial online] 2017 [cited 2019 May 20];3:11-6. Available from: http://www.ijeprjournal.org/text.asp?2017/3/1/11/186513
| Introduction|| |
Emotional and psychological health of society depends on family's health which in turn depends on continuity and health of the relationship between husband and wife. Results of a decade's research showed that marital satisfaction is effective on the health of family and person, and there is a positive relationship between marital dissatisfaction and high rate of divorce in America and other countries.  In addition, stress pushes families toward increasing depression, a feeling that results in a reduction of self-esteem and self-efficacy.  A common definition for display of joy and stability in a marital relationship is the marital satisfaction.  In fact, marital satisfaction is the conformity of person's expectations from life and what he/she actually experiences. Marital satisfaction is an attitudinal variable and also an individual characteristic of husband and wife. It is, in fact, the couples' positive attitude toward different aspects of their relationship. 
Bradbury et al. have divided the components affecting marital satisfaction in two groups:
A: Interpersonal processes that occur between the couples and include interactive behaviors, communication skills, problem solving techniques, conflict, coping efforts, love between couples, quality of sexual relationship, common goals, agreement on religious and belief issues, couples' attachment style, family traditions, cooperation in child care, devotion, commitment, understanding, emotions, behavior patterns, social support, violence, life stress, incompatible ascriptions, and negative change in spouse's behavior.
B: Environment that couples live in, meaning the situation that probably is significant and important for the couples. The environments in regard to the marital satisfaction include: (1) Children, (2) biography, characteristics of spouse and his/her first family, (3) life pressures and transitions.
On the other hand, studies show that marital relationship quality is the strongest predictor of marital satisfaction. It is obvious that when two strange people with different tastes come together, continuity and quality of their relationship depends on their knowledge and skills of how to consolidate the relationship.  Quality of marital relationship has a fundamental role in evaluating the overall quality of family relations. A decent marriage enables people to achieve a sense of identity in their lives.  Segrin and Flora  define the quality of relationship as a transition process in which people create meaning, share, and adjust. Communication skills such as active listening and explicit talking can increase the quality of relationship which in turn can be a good predictor of marital satisfaction.  Therapists with different approaches have tried to improve relationships by formulating marital problems and finding roots of conflicts. For example: Cognitive approach relates satisfaction or dissatisfaction of couples to different thinking toward actions and behaviors of their spouse. Cognitive psychologists believe that most marital misunderstandings have roots in prejudiced and illogical thinking of the couples.  Ellis et al.  believes that unreasonable attitudes and imaginations can play a big role in creating an inefficient emotional relationship. From a cognitive point of view, some factors can weaken the effectiveness of a relationship and result in a lack of understanding or correct decoding of the message. Some examples include false beliefs, prejudices, and negative attitudes. Hawton et al.  have found cognitive behavioral methods to reduce communication issues and increase the quality of marital relationship. On the other hand, behavioral approaches have emphasized the relationship between communication skills and marital adjustment.  For example, Rezazadeh's  research showed that there is a significant relationship between couples' communication skills and marital adjustment. Marital adjustment in couples with strong communication skills is higher than those with weak communication skills. Therapists, who follow this approach, use education of communication as their main intervention. Other researches have also shown the role of communication skills training in increasing marital satisfaction  and enhancing family performance in problem solving, communication, roles, emotional accompaniment, affective involvement, behavior control, and general family function.  On the other hand, schema-based approach is built on the fundamental belief that the unique circumstances that person experiences during childhood, plays an important role in creating a set of beliefs about self and others, which is called maladaptive schemas. Early maladaptive schemas are deep and inclusive patterns or themes that form in childhood or during teen years and remain throughout the path of life. These schemas concern the relationship of a person with self and others and are strongly inefficient. In addition to the schemas that they bring to the relationship, each couple creates some schemas in the ongoing relationship too, which is specific to the current one. Incompatible nature of schemas is revealed when patients interact with others, especially their spouse, in such a way that their schemas are approved. Early maladaptive schemas always reveal themselves in the course of a relationship and affect family interaction. Schema therapy, which was created by Yang, is a new and integrated treatment, mainly built on the extension and expansion of methods and concepts of classic cognitive behavior therapy. In this treatment, the therapist aims to identify these schemas and try to correct or change them. Based on the patient's problem, schema therapy can be short, medium, or long-term.  Since maladaptive schemas remain throughout the life of the person, they can cause personal and family problems and these problems can result in the reduction of marital satisfaction and quality of relationship, and consequently, the breakdown of family life. In this research, we tried to study the effectiveness of correction of couples' maladaptive schemas on quality of relationship and marital satisfaction of subjects, therefore in addition to evaluate effectiveness of this therapy, we add to literature of research in this topic.
| Methods|| |
This is a quasi-experimental research and was carried out with pretest-posttest and control group. For test subjects, we chose from Baran "e" Mehr and Nobahar counseling centers and also social work clinic of Shahin Shahr. Subject volume for this project is 30 persons who were chosen from the available people in these centers.
Test group received schema therapy, but control group received no treatment. Seven sessions (twice every week) of 45 min were held personally. Contents of therapy sessions are presented in [Table 1].
Test subjects were randomly put into two groups of 15. The test group received therapeutic intervention based on schema therapy and control group did not receive any treatment. Seven therapy sessions of 45 min were held for each person twice every week.
Criteria for entering this research were: Sex (being female), being married, and age: Minimum of 20 years and maximum of 55, education: Junior high degree in the least and exit criteria included: Severe psychological disorder and drug abuse.
Data obtained from the pretest and posttest of both groups were analyzed on the two levels of descriptive and inferential statistics. Research subjects were 30 persons with an average age of 34.67 and standard deviation of 7.66 and because age has a significant correlation with researched variables; it was not used as a covariate variable. On descriptive statistics level, average and standard deviation and on inferential statistics level, multivariate analysis of variance and covariance were used. Obtained data were analyzed by SPSS 18.0 software (Released 2009. PASW Statistics for Windows, Version 18.0. Chicago: SPSS Inc). Schema therapy protocol was provided using Yang's treatment techniques and schema therapy books (application guide for clinical experts).
Enrich marital satisfaction questionnaire
This questionnaire was first established in 1994 by Olson to evaluate the level of marital satisfaction. This questionnaire has 115 questions and includes 12 subscales: (1) Ideal distortion (2) marital satisfaction (3) personality issues (4) marital relationship (5) conflict resolution (6) financial management (7) leisure activities (8) sexual relationship (9) children and parenting (10) family and friends (11) egalitarian roles (12) ideological orientation. This questionnaire is used to evaluate potential problematic areas or identify strength areas of the marital relationship. Validity of this questionnaire was reported with alpha coefficient of 0.92. Afterward, a short form with 47 questions was provided. In this research, the short form with alpha coefficient of 0.95 was used. Alpha coefficient for these subscales are: Ideal distortion 0.72, marital satisfaction 0.85, personality issues 0.76, marital relationship 0.76, conflict resolution 0.76, financial management 0.81, leisure activities 0.63, sexual relationship 0.69, children and parenting 0.87, family and friends 0.69, egalitarian roles 0.62, and ideological orientation 0.73.  Alpha for this questionnaire in the current research is equal to 0.84.
Jerabek communication skills questionnaire
Ilona Jerabek created this test during 1996-2007, performing on a 30-person sample and has reported alpha equal to 0.67. This questionnaire includes 38 closed questions and for each question there are five choices. For questions 1-17, answers include almost never, rarely, sometimes, relatively much, and often. Moreover, for questions 17-38, choices are: Absolutely false, almost false, neither true nor false, almost true and absolutely true, and scores are 0, 1, 2, 3, and 4, respectively. High scores in test show good communication skills. 
This questionnaire includes the following five scales:
- Insight: This scale includes awareness of feelings, needs, and emotions which is the first step in forming communication skills. Questions 4, 9, 11, 26, and 32 measure this scale
- Verbal expression: Includes talking skills such as expressing emotional data and thoughts, sharing awareness, expressing needs and action plan. Questions 2, 6, 8, 10, 15, 17, 19, 20, 22, and 27 measure this scale
- Assertiveness: Assertive person benefits from communication skills to maintain the sanctity of self; pursue happiness and satisfaction of his/her needs, and defend his privacy without abusing others. Questions 7, 21, 24, 25, 28, 29, 36, 37, and 38 measure this scale
- Listening skills: Includes three categories of skills:
- Attention skills such as involvement in discussion, eye contact, and body language
- Follow-up skills such as short encouragement and short questions
- Reflective skills such as explanation, emotion reflection, selection. Questions 13, 14, 18, 23, 30, and 34 relate to this scale
- Emotional management: Questions 3, 12, 16, 31, 33, and 35 of the questionnaire relate to this scale. 
Alpha for this questionnaire in the current research is 0.78.
The Yang schema questionnaire (short form of third edition)
This questionnaire was created by Yang (2005), a self-reporting tool with 90 items to assess 18 schemas presumed by Yang in five domains. Each item is graded with a 6° spectrum (1 = absolutely false about me to 6 = absolutely true about me). In order to assess the schema in clinical examination, with this questionnaire, during therapy sessions, therapist discusses items with high grades (usually 5 and 6) with the patient so that schemas are determined precisely.
Finding two items with highest grades is enough to confirm that schema exists. Stability of this questionnaire is reported with alpha Cronbach equal to 0.94.  Alpha for this questionnaire in the current research is 0.86.
| Results|| |
Primarily, descriptive indices of findings and then covariance analysis are presented. In [Table 2], average value (standard deviation) for marital satisfaction, quality of marital relationship, and the dimensions of quality of relationship are presented for each test group separately.
Averages for pretest of marital satisfaction, marital relationship quality, and its dimensions show the considerable difference with average for posttests of these variables. Manova covariance analysis with controlling covariate variables was used to study the significance of this difference. Since one of the assumptions of covariance analysis is homogeneity of variances, Levin test was used. Results of this test are displayed in [Table 3].
Results show that since Levin statistics is insignificant (P > 0.05), the assumption of homogeneity of variances is verified. Results of box test for homogeneity of matrices are presented in [Table 4].
Since box test is not significant on P > 0.05 level, we can say that variance/covariance matrices are homogeneous. Results of Wilk's lambda test which is sometimes called U statistics, is presented [Table 5].
Based on [Table 5], we can say that with elimination of covariate effect, schema therapy course has been effective in at least one of the variables such as marital satisfaction, quality of marital relationship, or its dimensions. [Table 6] presents one-way covariance analysis of studied variables.
According to the results of covariance analysis we can say that controlling covariate variable, difference between averages of the two tests and control groups for variables such as marital satisfaction, marital relationship quality, and its dimensions, including insight, verbal expression, assertiveness, listening skills, and emotional management, is significant (P < 0.01). Based on ATA impact coefficient, we can say that 43% of changes in marital satisfaction grades and 87% of changes in quality of marital relationship grades are related to schema therapy course.
| Discussion and Conclusion|| |
This research was aimed to study the effectiveness of schema therapy on marital satisfaction and marital relationship quality and showed that people who received schema therapy reported more satisfaction in married life, improvement in quality of relationship, and less conflicts which was the result of relationship enhancement. This result is in accordance with those of previous researches that showed schemas and fundamental cognition structures are effective in forming interpersonal relationships such as tendency toward marriage and life partner, , marital intimacy,  and marital satisfaction  and is also useful for predicting the probability of marital conflict and divorce.  To explain these results we can say that the emotional basis of human, forms during childhood in the family system, therefore the couples lead to the formation of severely and early maladaptive schemas in their children's character based on the type of interactions with them, and these schemas, like deposits and early lessons in nature, affect the characteristics, interpersonal relationships, and satisfaction in their adult life.  Findings of this research that exhibit the effect of schemas in marital satisfaction are in accordance with those of Stiles  and Zolfaghari et al.  that showed the relationship between early maladaptive schemas and intimacy in romantic relationship and marital satisfaction. This explains that with increasing early maladaptive schemas, marital satisfaction and intimacy decreases. These findings and their alignment with other researches indicate the undoubtable and decisive role of schemas in couples' marital dissatisfaction. Schemas affect behaviors of the spouses and direct them in the framework of marital relationship. Also, the effectiveness of schema therapy on marital relationship quality shows significance of communication in the family for its strength and stability in dealing with problems and crises. These findings are in accordance with the results of researches performed by Keshtkaran,  Payne,  and Huber et al.  Gottman and Notarius  show that good quality of communication plays a significant role in the stability and durability of family life. Much of the conducted research literature on quality of communication verifies that stability of marriage and family life is dependent on proper communication between the members of the family. Certainly, a family in which members cannot share their feelings, emotions, and decisions, cannot function properly in dealing with problems.
The authors would like to thank the management of centers cooperating with this research and also thanks to all the patients, for their participation who made this research possible.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
| References|| |
Bradbury T, Fincham F, Beach S. Research on the nature and determinants of marital satisfaction: A decade in review. J Marriage Fam 2000;62:964-80.
Heller D, Watson D. The dynamic spillover of satisfaction between work and marriage: The role of time and mood. J Appl Psychol 2005;90:1273-9.
Nichols C, Pace-Nichols A, Becvar S, Napier Y. Handbook of Family Development and Intervention. New York: Wiley; 2000.
Bayrami M, Fahimi S, Akbari E, Amiri Pichakolaei A. Original article predicting marital satisfaction on the basis of attachment styles and. J Fundam Ment Health 2012;14:64.
Esmaeilpour KH, Khajeh V, Mahdavi N. Predicting couples′ marital satisfaction based on relationship beliefs and relationship skills. J Family Res 2013;9:29.
Gholizadeh Z, Barzegari L, Gharibi H, Babapour Kheiroddin J. Investigating the relationship between five personality factors (neo-ffi) and marital satisfaction. Clin Psychol Pers 2011;17:57.
Segrin C, Flora J. Family Communication. Mahwah, New Jersey: Lawrence Erlbaum Associates; 2005.
Ebrahimi A, Janbozorgi M. Relationship of communication skills and marital satisfaction. Period Psychol Interact Relig 2008;1:165-76.
Beck T. Cognitive therapy: Past, present and future. J Counst Clin Psychol 1995;61:2-20.
Ellis A, Flett L, Hewitt C. The role of irrational beliefs in perfectionism. Perfectionism: Theory, Research, and Treatment. Washington, DC: American Psychological Association; 2002.
Hawton K, Salkovskis M, Kirk J, Clark M. Cognitive Behavior Therapy for Psychiatric Problems: A Practical Guide. Translated by Ghasemzadeh H. Tehran: Arjomand; 1994.
Gordon KC, Baucom DH, Epstein N, Burnett CK, Rankin LA. The interaction between marital standards and communication patterns: How does it contribute to marital adjustment? J Marital Fam Ther 1999;25:211-23.
Rezazadeh R. The relationship between communication skills and marital adjustment in students. Contemp Psychol 2008;3:43-50.
Fatemeh M. Study of Effect of Communication Education on Marital Satisfaction and Mental Health [MS thesis]. Tehran: Psychology Institute of Tehran; 1997.
Aslani KH. The role of communication skills in family function on married students. Soc Welfare Q 2005;4:115-36.
Yang E, Klosko S, Weishaar E. Schema therapy, a practitioner′s guide. Translation by Hamidpour H, Andouz Z. Tehran: Arjmand; 2011. p. 368.
Ghiasi M, Molavi H, Neshat H, Salavati M. The factor structure of Persian version of young schema questionnaire-s3 in two groups in Tehran. J Psychol Achiev (J Educ Psychol) 2011;4:93-118.
Khosravi Z, Seyf S, Alieh S. The relationship between schema maintenance process and students′ attitude toward marriage. Res Psychol Health 2008;1:31-40.
Zolfaghari M, Fatehi Zadeh M, Abedi R. Determining relationships between early maladaptive schemas and marital intimacy among Mobarakeh steel complex personnel. J Fam Res 2008;4:247-61.
Yousefi N. Comparison of the effectiveness of family therapy based on schema therapy and Bowen′s emotional system therapy on divorce tendency among divorce applicant clients. J Clin Psychol 2011;3:53-64.
Stiles E. Early Maladaptive Schemas and Intimacy in Young Adults′ Romantic Relationships. Man-Woman Relationships. San Francisco Bay: Alliant International University, California School of Professional Psychology; 2004.
Tahereh K. The relationship between family communication patterns with resiliency among students of Shiraz University. Knowledge Res Appl Psychol 2009;11:69-88.
Payne B. Spiritual Beliefs in Early Family Experiences and Couples′ Co-creation of Spiritual Beliefs During the Early Years of Marriage. The University of Arizona: Doctoral Dissertation, Norton School of Family and Consumer Sciences Division of Family Studies and Human Development; 2010.
Huber H, Navarro L, Womble W, Mumme L. Family resilience and midlife marital satisfaction. Fam J 2010;18:136-45.
Gottman M, Notarius I. Decade review: Observing marital interaction. J Marriage Fam 2000;62:927-47.
[Table 1], [Table 2], [Table 3], [Table 4], [Table 5], [Table 6]