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 Table of Contents  
ORIGINAL ARTICLE
Year : 2017  |  Volume : 3  |  Issue : 3  |  Page : 163-167

Effectiveness of acceptance and commitment-based therapy on the physical and psychological marital intimacy of women


Department of Psychology, Islamic Azad University, Khomein Branch, Araak, Iran

Date of Web Publication29-Nov-2017

Correspondence Address:
Dr. Akbar Heidari
Islamic Azad University, Khomein Branch, Araak
Iran
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jepr.jepr_62_16

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  Abstract 


One of the factors influencing the decline in marital happiness is marital boredom. Today, one of the newest therapies to increase intimacy and decrease boredom among couples is acceptance and commitment-based therapy (ACT). In this therapy, instead of cognitive changes, it is tried to increase the person's psychological relation to their thoughts and feelings through mental flexibility.
AIM: The main objective of the present study is determining the effectiveness of acceptance and dedication based training on the physical and psychological marital intimacy of women came into the counseling center of military headquarter in Isfahan province.
METHOD: This research was a quasi-experimental study with two groups (experimental and control) and it included pre- and post-test stages. The population of the present research comprised women came into the counseling center of military headquarter in Isfahan province in 2015 and the research sample included thirty married women who were selected as the available sample. In this study, the questionnaire of marital intimacy was used to investigate the variables. Cronbach's alpha was used to determine the reliability of the test that was equal to 98.58.
RESULTS: The data were analyzed using descriptive statistics and the mean table. Analysis of the results and standard deviation through covariance analysis using SPSS showed that there was a significant difference between the pre- and post-test scores of the experimental group in comparison with those of the control group (P < 0.001).
CONCLUSION: The results of this study indicated the effectiveness of ACT on increasing physical and psychological marital intimacy of the subjects. Therefore, the use of acceptance and commitment-based training and therapy along with other mental health trainings are recommended.

Keywords: Acceptance and commitment-based training, physical intimacy, psychological intimacy


How to cite this article:
Heidari A, Heidari H, Davoudi H. Effectiveness of acceptance and commitment-based therapy on the physical and psychological marital intimacy of women. Int J Educ Psychol Res 2017;3:163-7

How to cite this URL:
Heidari A, Heidari H, Davoudi H. Effectiveness of acceptance and commitment-based therapy on the physical and psychological marital intimacy of women. Int J Educ Psychol Res [serial online] 2017 [cited 2017 Dec 18];3:163-7. Available from: http://www.ijeprjournal.org/text.asp?2017/3/3/163/219425




  Introduction Top


Reduction of marital life satisfaction causes social relation problems, more loneliness feeling, less life satisfaction, and finally intense family disputes. One of the important factors that affect marital satisfaction is intimacy.[1] Nowadays, intimacy is one of the main worries of psychologists and counseling experts in a way that in a study 1160 therapists were asked to rate the most problematic fields of couples disputes. They introduced relations, unreal expectations of marriage and spouse, lack of intimacy and not showing interest as the most problematic aspects of marital problems, respectively. The absence of spouse intimacy is an indicator of disturbance in marital relations. According to most therapists, the concept of intimacy and closeness is the main challenge in marital relations and it is considered as the main predictors of marital success in marital treatment.[2]

Marital disagreements and disputes create psychological, economic, and social effects both for wife and husband and children in the form of depression, frivolousness and alienation and cause painful damages to the community whether through divorce or exhausting disputes. Therefore, recognition and treatment of couples' relationship problems is of the first degree of importance for every society and ideology.[3] Divorce increase and marital dissatisfaction on one hand and couples' request for the improvement of marital relations on the other hand is an indicator of couples' need to specialized trainings in this field.[4] After more than 30 years of working with couples, Bagaruzy identified nine separate but interrelated components of intimacy that two of them are psychological and physical intimacy.[5] Physical intimacy is the need for physical proximity with the spouse that cannot be mistaken for physical intimacy that leads to sexual arousal. Physical intimacy may be expressed by a simple touch or physical contact like cuddling. Physical intimacy includes experiences such as taking hands, hugging each other, nonsexual touching, kissing that does not lead to sex, sleeping beside the spouse, walking together, etc.[6]

Psychological intimacy includes communication need, sharing important personal issues to the spouse by deep and meaningful disclosure of the true inner self. Psychological intimacy is the need to share and express hopes and dreams, fantasies, dreams and future plans, as well as the sharing of fears, interests, views, uncertainty, problems, and internal conflicts with the spouse. Spouse availability, not being defensive, and ensuring the relation is the necessary condition of this kind of intimacy. Spouse must feel safe to share personal issues without fear of being judged, evaluated, rejection, shame, blame, or punishment.[7] Nowadays, the third wave of behavior therapy is emphasized for solving problematic behaviors. Acceptance and commitment based therapy abbreviated as acceptance and commitment-based therapy (ACT) is one of the treatments that have been dealt with in the third wave of behavior therapy. ACT takes its name from its original message that is “accept what is beyond your control and have commitment to whatever enriches your life.”[8]

Relying on this approach, some researchers have done studies in various fields and have achieved some results that a few of them can be noted. In a study entitled the effect of ACT on female teenager's risky behavior, Ahmadi [9] achieved some results regarding the reduction of hazardous behavior in female teenagers and the effectiveness of ACT. In explaining the effectiveness of ACT in reducing psychological distress, interpersonal distress, acceptance and practice increase, mindfulness, marital quality and marital adjustment of distressed couples, Heydariyan far [10] showed that ACT has a positive impact on all variables and this impact is greater in variables of psychological distress, interpersonal, and acceptance and practice.

In a study analyzing the effectiveness of ACT on anxiety and depression in women with breast cancer, Dehghani [11] achieved some results in reducing cases such as experimental avoidance, anxiety and depression, and the efficacy of ACT in these women. In a study about the effectiveness of ACT on symptoms and obsessive beliefs, quality of life, psychological resilience, depression, anxiety, and cognitive behavioral therapy in patients with mental and practical obsessive compulsive disorder that is therapy resistant, Izadi [8] achieved acceptable results regarding the effectiveness of ACT. Therefore, regarding the importance of variables, the present study tries to clarify whether or not the acceptance and commitment-based training is effective on marital intimacy and boredom.


  Materials and Methods Top


This research is a quasi-experimental study with two groups (experimental and control) and it included pre- and post-test stages. The independent variable was acceptance and commitment-based training which was applied only in the experimental group; and its effect on the posttest scores of the subjects in the experimental group was compared with that of the control group.

The population of the present research comprised of the women who referred to the comfort counseling center of military headquarter in Isfahan province in 2015 and the research sampling method was an available sampling method. The sample consisted of thirty married women who were selected by the comfort counseling center of military headquarter in Isfahan province.

The present research was conducted merely on the women who referred to the comfort counseling center of military headquarter in Isfahan province in 2015, and therefore, the results cannot be generalized to other cities and societies. Another limitation of this study was lack of control on intruding variables such as the subjects' socioeconomic status and income.

As it is considerable in [Table 1] acceptance and commitment-based training format has been shown.
Table 1: Acceptance and commitment.based training format

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The questionnaire of marital intimacy was used for the collection of information. The questionnaire includes 85 items designed by Oliya et al.[12] and its scale is Likert scale and in its nine dimensions of marital intimacy are as follows: emotional intimacy in 11 items, rational intimacy in 8 items, physical intimacy in 6 items, socio-recreational intimacy in 8 items, relational intimacy in 11 items, spiritual intimacy in 9 items, psychological intimacy in 9 items, sexual intimacy in 8 items, and general intimacy in 15 items. To determine the validity of the questionnaire, the views of 5 counseling experts of the Department of Psychology in the University of Isfahan have been used. Moreover, the correlation method of each item with total scores was used to determine the validity of each item. The items whose correlation coefficient with the total score was not significant and the items that were significant at the level of 0.05 were eliminated and 85 items which were correlated with the total score at the level of 0.01 were selected. For simultaneous analysis of Marital Intimacy Questionnaire, Thompson and Walker scale that was equal to 0.92 and was significant at the level of 0.01 was used. Cronbach's alpha was used to determine the reliability of the test that was equal to 98.58.

This study has been conducted by Akbar Heidari who has MA in counseling and has been trained by Professor Raziyeh Izadi and under the supervision of Professor Hassan Heidari. At first, a list of 76 married women who have enrolled in the comfort counseling center was prepared. Then, 30 women were randomly selected and they were randomly divided into two groups of experimental and control each consisting of 15 women. Then, they were called and informed of holding 8 training sessions.

Fifteen couples at the top of the list were selected to participate in the experimental group and the second 15 couples were chosen as the control group. The subjects in the experimental group attended the first session and they were given the pretest questionnaire. The pretest was also given to the control group and it is worth noting that question and answer sessions were weekly held with the subject of preventing social damages in order to prevent the subjects' giving up from the control group. At the end of the last training session based on acceptance and commitment, the posttest questionnaires were given to the experimental group. The control group also completed the questionnaire at the end of the last training session. All the subjects attended their related sessions and there was no cutting down in the number of the subjects in both groups.

The data were explained by descriptive statistics, mean table, and standard deviation; and SODS, Version 20, Mehrpsrdaz Company was used for analyzing the data in covariance analysis method because the research was a kind of two group study with pre- and post-test.


  Results Top


The age mean of the sample was 29 and most of the subjects had diploma degree and a few of them were MA holders. Most of the participants were homemakers (20 homemakers, 9 employees) and one person had not specified her job status.

According to [Table 2] and [Table 3], after regulating the scores of experimental and control group, it is identified that the scores of physical and psychological marital intimacy are different and this difference is obvious in experimental group.
Table 2: Mean and primary standard deviation of research variables in pretest

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Table 3: Regulated mean and standard deviation of research variables in posttest

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In this study, the assumptions of normality of remainders were evaluated using the Kolmogorov–Smirnov test. The results showed that the remainders were normal for all variables. Furthermore, Box's test was used for testing the assumption of similarity of covariance matrix. As it is seen according to [Table 4], the assumption of similarity of covariance matrix is not ruled out.
Table 4: Test results of Box's test to check the equality of covariance in two groups

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Levine test was used to test the assumption of similarity of covariance in both groups. According to [Table 5], there is not a significant difference between experimental and control groups in none of the variables (P > 0.05).
Table 5: Test results of Levine for analyzing the assumption of similarity of covariance in both groups

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[Table 6] shows that, there is a significant difference between the scores of psychological intimacy in the experimental and control group and acceptance and commitment-based training was effective on increasing psychological intimacy and it predicts 18% of its variance. Hence, it can be concluded that the research hypothesis was confirmed that is acceptance and commitment-based training was effective on increasing psychological intimacy.
Table 6: Results of covariance analysis of the effect of training on the psychological intimacy

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[Table 7] shows that there is a significant difference between the scores of physical intimacy in the experimental and control group and acceptance and commitment-based training has been effective on increasing physical intimacy. Therefore, it can be concluded that the research hypothesis that claims the acceptance and commitment-based training is effective on increasing physical intimacy was confirmed.
Table 7: Results of covariance analysis of training effect on increasing physical intimacy

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  Discussion Top


The purpose of this study has been analyzing the effectiveness of the acceptance and commitment-based training on increasing the effectiveness of psychological intimacy and physical intimacy. The results of the analysis of covariance showed that acceptance and commitment-based training was effective on increasing psychological and physical intimacy. The findings of this study have been consistent with the results of investigations by Oliya et al.[12] They also showed that training the couples enhances their psychological intimacy. In this kind of need, therapists increase the couples' awareness of their need to talk, communicate and having connection with their spouse through expressing their deep personal issues and they also teach the couples in a way that they can improve their psychological intimacy by expressing their hopes, dreams, fears, worries, doubts and inner conflicts. Furthermore in 2006, Hunson and Lonbland taught conflict solutions to the couples who have difficulties in their relations and their study revealed that conflict solutions trainings improve couples' relations and increase their abilities in solving problems.[8]

Also regarding the physical dimension of intimacy, the finding of this study was in line with the results of the studies by Izadi et al.[13] and Ahmadi.[9] This need refers to having physical proximity with the wife. Physical intimacy may be in the form of a simple touch or in the form of physical contact such as hugging.[10] Many couples consider physical intimacy as similar to sexual intimacy whereas when the couples are informed of the separation of these two kinds of relations, they can reinforce their sexual intimacy in relation.[14] In many of marriage training programs, the importance of relation practices, enhancing intimacy between couples, the concept of couples' expectations from each other and the effect of these expectations on their relations is emphasized; and as the couples are informed of the importance and ways of physical intimacy, their relation is strengthens. In addition, this awareness enhances their perspective and deepens their understanding.[15]


  Conclusion and Recommendations Top


On the whole, it can be concluded that sometimes discrepancies reveal themselves differently from what was mentioned and this leads to nuptial dissatisfaction, intimacy reduction, and eventually divorce. In certain cases, most of marital discord is because of couples' disagreement over life problem solving and lack of effective communication with each other despite having economic problems or addictions. It seems that these conflicts are neither due to the lack of interest between couples nor due to fundamental differences; on the contrary, couples may unwillingly face problems in their relations due to their wrong mindset that causes marital disputes, reduction of satisfaction, and even divorce.

One of the reasons that prevent correct relation between couples is the existence of thoughts in their minds which lead to failure in achieving intimacy. Our unsuccessful attempt for overcoming or preventing pain and suffering causes deeper despairs; and only through correct acceptance of our emotions, we can save our lives. Understanding the issues that are bothering the person and at the same time doing things that are really valuable for the person are the central issues in ACT. When people make every effort not to feel pain (with anger or forcing others to change), their lives are out of control.

Instead of responsible acting for achieving the goals that are truly accessible, they are involved in efforts to avoid. ACT is a real step by step process to a peaceful life that is the acceptance of what we cannot change and having the courage to change what we can change. ACT teaches people accept their thoughts and feelings (regardless of how painful they are) and choose new ways for life and responsible acts. Therefore, it might be concluded that being aware of the correct ways of communication through acceptance and commitment-based training programs can prevent tensions which cause marital disputes or reduce marital intimacy including psychological and physical intimacy and ultimately it can increase intimacy.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Darab M. Islamic-Oriented Development Model of Consultation and Intervention Effect of Marital Boredom Model Based on Happiness and Marital Boredom in Baharistan. Isfahan University of Isfahan; 2013.  Back to cited text no. 1
    
2.
Rezaei J. The Impact of Islamic Lifestyle-Oriented Education with an Emphasis on the Commitment and Sincerity of the Couple's Famiy Arak. Isfahan: Isfahan University; 2011.  Back to cited text no. 2
    
3.
Danesh A. Investigate the Relationship between Marital Satisfaction and Sexual Satisfaction. First Congress of Family Pathology in Iran; Tehran: Shahid Behshti University; 2006.  Back to cited text no. 3
    
4.
Etemadi O, Navabinejad S, Ahmadi A, Farzad V. Investigate the effectiveness of cognitive-behavioral couple therapy on marital intimacy referred to counseling centers in Isfahan. Q J Psychological Stud 2006;2:69-87.  Back to cited text no. 4
    
5.
Bagarozzi DA. Enhancing Intimacy in Marriage. Isfahan: Islamic Azad University (Khorasgan Branch); 2014.  Back to cited text no. 5
    
6.
Batlani Isfahani S. The Impact of Attachment-Based Therapy on Sexual Satisfaction and Intimacy in Isfahan. Isfahan: Uinversity of Isfahan; 2007.  Back to cited text no. 6
    
7.
Qasemi H. Developing Couple's Communication Pattern Based on Doctrines Islam, and Compare the Effect Interfering with Communication Skills-Based Intervention, on the Compatibility and the Martyr Marital Intimacy Affiliated to the Foundation Kermanshah Province. Isfahan: University of Isfahan; 2013.  Back to cited text no. 7
    
8.
Izadi R. Comparison Effectiveness of Acceptance and Commitment Therapy (ACT) and Cognitive Behavioral Therapy (CBT) on Symptoms and Obsessive Beliefs, Quality of Life, Psychological Resilience, Depression and Anxiety in Patients with Treatment-Resistant Obsessive-Compulsive. Isfahan: University of Isfahan; 2012.  Back to cited text no. 8
    
9.
Ahmadi Z. The Effect of Treatment Acceptance-Based and Commitment on High-Risk Behavior in Female Adolescents. Isfahan: University of Isfahan; 2014.  Back to cited text no. 9
    
10.
Heyderian Far N. Determine the Effectiveness of Acceptance and Commitment Based Therapy (ACT) in the Treatment of Distressed Couples. Ahvaz: Shahid Chamran University of Ahvaz; 2013.  Back to cited text no. 10
    
11.
Dehghani B. To Compare the Effectiveness Acceptance and Commitment Based Therapy (ACT) on Avoidance Experience, Anxiety and Depression in Women with Breast Cancer. Isfahan: University of Isfahan; 2013.  Back to cited text no. 11
    
12.
Oliya N, Fatehi Zadeh M, Bahrami F. The effect of marital enrichment on increasing intimacy in couples. J Fam Res 2006;2:120-35.  Back to cited text no. 12
    
13.
Izadi R, Abedi M. Acceptance and Commitment. 3rd ed. Tehran: Jangal Publication; 2014.  Back to cited text no. 13
    
14.
Zare Pour M, Asoudeh M. Couples's Mental Health: The Role of Marital Intimacy Dimensions, and Communication Patterns. Second National Conference on Family Psychology. Marvdasht: Islamic Azad University of Marvdasht; 2011.  Back to cited text no. 14
    
15.
Sabouhi R. Developing a Couple Counseling Package Based on Acceptance and Commitment-Based Approach. Isfahan: University of Isfahan; 2014  Back to cited text no. 15
    



 
 
    Tables

  [Table 1], [Table 2], [Table 3], [Table 4], [Table 5], [Table 6], [Table 7]



 

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