2018 Eft Model for Marital Problems Article Peer Review

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Hashemi S Chiliad, Ghorban Shiroudi S, Khalatbari J, Abolghasemi Due south. Effectiveness of Integrated Model of Emotionally-Focused Therapy and Gottman'southward Model in Internal Cohesion and Reduction of Controlling Behaviors in Couples Faced with Marital Adultery. Avicenna J Neuro Psycho Physiology. 2020; 7 (4) :249-254
URL: http://ajnpp.umsha.air-conditioning.ir/commodity-i-276-en.html

i- PhD Student, Department of Psychology, Tonekabon Co-operative, Islamic Azad University, Tonekabon, Islamic republic of iran
2- Acquaintance Professor, Department of Psychology, Tonekabon Co-operative, Islamic Azad University, Tonekabon, Iran. , Drshohrehshiroudi@gmail.com
3- Associate Professor, Department of Psychology, Tonekabon Branch, Islamic Azad Academy, Tonekabon, Islamic republic of iran.

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Background

Marital infidelity is considered a shocking issue for couples and families and common miracle for counselors and therapists [1]. Extramarital diplomacy create a dandy deal of confusion for couples. Based on the testify, it was shown that most individuals await monogamy and no extramarital affairs from their spouses [ii-5]. The master victims of this phenomenon in the family environment are first women and then children and finally men [6]. Controlling is a problem that has received more attention in contempo centuries. The chief premise of controlling is that if individuals feel dissatisfied with a human relationship, they will not feel responsible for it; however, they arraign others and those out of control [7, 8].
Internal cohesion is considered one of the factors which are constructive in the reduction of harms and decision-making behaviors among couples faced with marital adultery [nine, 10]. Antonovsky defined the concept of internal cohesion while focusing on the model, which supports factors leading to human health and well-beingness instead of the ones resulting in diseases [11, 12]. Although this concept has 3 dimensions, they are practically defined on a single scale theoretically reflecting the general management of life [13]. Feelings of strong inner cohesion are related to a high chapters for mental and physical coping with stress and challenges occurring throughout an individual'southward life [xiv]. Therefore, studies demonstrated that individuals with strong cohesion are more successful in coping with stress [fifteen].
One of the therapies increasing internal cohesion among couples faced with marital infidelity and improving the reduction of decision-making behaviors is the integrated model of emotionally-focused therapy (EFT) and Gottman'due south model [16]. Accordingly, some efforts have been made to combine specific components of different approaches in a systematic mode and coherent and integrated model. Integrated approaches take unique benefits, including creating a broader basis for intervention and flexibility in the clients' therapy [17] . Today, Gottman and Johnson are known as effective scholars in couple therapy [18] by developing a variety of training programs to strengthen couples' relationships. Gottman's theory is an integrated approach that is based on the doctrinal principles of various systemic, existential, psychoanalytical, and behavioral theories [xix]. Similarly, Johnson emphasizes relationships, attachment styles, and interaction cycles in EFT [20].
The EFT refers to the important office of emotions and communication in organizing communicational patterns and regards emotions equally alter factors [21]. The EFT aimed to help couples achieve latent emotions and facilitate positive interactions. In addition, in a study on EFT for couples whose spouses have breast cancer, with a theoretical basis and descriptive case report, Adamson [22] observed that for a couple with a sick spouse, both spouses experience a great deal of emotional distress. Furthermore, Soltani et al. [23] demonstrated that EFT reduces couples' distress.
Gottman's [24] therapeutic arroyo includes organized programs and methods called regular and logical treatment processes, designed to deepen friendships, strengthen dispute management, and create common sense and purposefulness in couples' relationships [25]. Furthermore, Davis D, Shaver PR, and Vernon [26] investigated the effectiveness of Gottman's approach in relationship satisfaction, quality of friendship, and subversive marital conflicts within a twelvemonth. In improver, Rajaee [27] showed the effect of Gottman's intervention on the reduction of emotional divorce. Razi [28] indicated that teaching Gottman'south conflict resolution skills increases marital satisfaction.
Since couples faced with marital infidelities confront many psychological, social, and emotional problems and harms, leading to tensions in diverse dimensions, it is difficult to regulate their emotions, beliefs, thoughts, and interpersonal relationships.

Objectives
This report aimed to determine the effectiveness of the combined model of EFT and Gottman's model in internal cohesion and reduction of controlling behaviors in couples faced with marital adultery.

Materials and Methods
This quasi-experimental study was carried out on two experimental groups and one control group with a pretest-posttest pattern. The statistical population of the written report included all the women referring to one of the counseling centers in Tehran, Islamic republic of iran, (i.e., Ganj-due east-Daroun Flourishing Counseling Eye, Third Mode Centre, and welfare-related centers) during 2018-2019 due to marital conflicts, problems related to satisfaction, and need for the improvement of marital relationships. The study population was chosen based on purposive sampling afterwards the random screening.

Internal Cohesion Questionnaire
It is a 50-item questionnaire developed by Kimiai, Arqabai, and Jozi in 2013. This questionnaire has three subscales for the measurement of the levels of individual comprehensibility, manageability, and meaningfulness of events. The significant scales include 23 items, six manageability scales, and 20 comprehensibility scales, scored based on a 5-point Likert scale from very low (1) to very high (five). The minimum and maximum scores are considered 5 and 115, respectively. The higher and lower scores indicate higher and lower internal cohesion, respectively. The Internal Cohesion Questionnaire has a practiced internal consistency, and the Cronbach's blastoff coefficients are 0.935, 0.92, 0.65, and 0.886 for the whole calibration, significant subscale, manageable subscale, and comprehensible subscale, respectively [29].

Controlling Behaviors Questionnaire
The marital decision-making behaviors calibration was adult in 2005 by Graham-Kavan and Archer for the evaluation of decision-making behaviors. This is a 24-detail tool examining the couples' controlling behaviors in marital life. Five more items were added to the scale for the couples who have children. The respondent should determine on a five-signal Likert scale (from 0 to four) to what extent the spouse and his wife perform each one'due south desired behaviors. The minimum and maximum scores are considered 0 and 96, respectively. The Cronbach'southward alpha coefficients are 0.95, 0.82, 0.71, 0.88, 0.69, 0.84, and 0.ninety for the whole scale, children's phrase subscales, economic control subscale, threatening control subscale, controlling through intimidation subscale, emotional control subscale, and command through isolation subscale, respectively [xxx].

Tabular array 1. Pedagogy the integrated Gottman's model and emotionally-focused therapy

Session	Content
Commencement	Establishing professional and empathetic advice; familiarizing with members and asking questions nearly their expectations from attending the training course; stating the goals and rules of the training sessions; completing research questionnaires as a pretest
Second	Familiarizing with the types of zipper styles; familiarizing with the cycle of negative interactions; identifying underlying and unexpressed emotions
Third	Summarizing the concepts of emotionally-focused therapy
Fourth	Familiarizing with a variety of daemon dialogue patterns
Fifth	Familiarizing with the concept of raw situations and the importance of identifying these situations; revisiting a rocky moment
Sixth	Familiarizing with divorce indicators and four riders of destiny; familiarizing with the style of starting arguments
Seventh	Familiarizing with the specifications of various types of marital infidelity and 7 principles of a secure relationship firm introduced by Gottman (1999)
Eighth and 9th	Accepting influence and compromise (i.east., fourth principle); teaching ways to manage solvable bug (i.e., fifth principle), ways to overcome perpetual problems (i.e., sixth principle), and creating shared meaning (i.e., 7th principle)
Tenth	Facilitating the expression of needs and wishes likewise equally new solutions to old problems; healing injuries; consolidating new situations and positive interactive cycle; closing sessions; performing posttest and survey on participants

The inclusion criteria were interest and commitment to active and regular omnipresence at therapy sessions, no history of severe mental and emotional disorders, and no habit, conflicts, and problems related to marital infidelity. The experimental groups participated in 10 sessions of 90 and 120 min, and the techniques and methods of communication imaging and integrated model of EFT and Gottman'south model were presented pace by step through weekly assignments and regular exercises past a consultant.
To notice ethical and professional person principles, the researcher obtained the voluntary consent of all the study subjects for participation in the study. The integrated Gottman's model and EFT was adult by the researcher nether the supervision of professors using theoretical and research backgrounds, concepts of exciting approach, and intervention program developed past Johnson based on the EFT model and Bowlby Attachment Theory [xxx], and some key categories of the Gottman's model (Table 1).
The statistical methods, descriptive methods (east.g., hateful and standard departure), and Levene's test were used to analyze the data. Assay of covariance was utilized to test the hypotheses by SPSS software (version 22).

Results
The descriptive findings included the statistical indicators (e.yard., mean and standard deviation), number of sample subjects, and frequency tabular array and per centum, which are presented for all the variables in the following tables (Tables 1-4).

 

Table 2. Mean and standard departure of study variables based on assessment phase in study groups

Group	Variable	Index	Pretest	Posttest	Follow-upwardly
Internal cohesion	Control	Hateful	13.10	80.ten	20.98
		SD	40.90	65.threescore	62.60
	Experimental	Mean	67.11	93.fifteen	93.14
		SD	14.01	43.11	11.02
Understandability	Control	Mean	56.47	54.20	51.93
		SD	8.32	7.30	vii.30
	Experimental	Mean	60.87	81.20	80.07
		SD	7.31	viii.12	seven.88
Manageability	Command	Mean	10.47	12.00	10.00
		SD	2.47	2.36	ii.36
	Experimental	Mean	12.53	17.0	16.20
		SD	3.11	four.18	four.xviii
Significance	Command	Mean	39.20	38.60	36.27
		SD	half-dozen.06	4.42	iii.51
	Experimental	Mean	41.27	54.33	53.67
		SD	8.43	vii.90	seven.86
Controlling behaviors	Command	Mean	53.60	52.93	58.80
		SD	vii.40	7.44	7.xix
	Experimental	Mean	56.73	xvi.53	24.13
		SD	8.66	5.68	v.94
Economic control	Control	Mean	8.87	9.00	ten.13
		SD	two.50	2.48	two.47
	Experimental	Mean	8.67	iii.20	4.27
		SD	1.35	i.70	1.75
Table 1. Connected
Threatening control	Command	Mean	9.00	8.73	nine.47
		SD	2.24	2.34	ane.92
	Experimental	Mean	9.87	2.xl	3.67
		SD	2.39	1.40	1.68
Controlling through intimidation	Control	Mean	seven.20	7.27	8.47
		SD	1.57	1.87	i.81
	Experimental	Mean	8.33	two.87	4.20
		SD	ii.44	1.xxx	one.xv
Emotional command	Command	Mean	9.35	9.27	10.27
		SD	ii.45	2.52	two.52
	Experimental	Hateful	10.33	iii.07	4.47
		SD	two.69	ane.10	0.83
Controlling through isolation	Control	Mean	9.13	8.80	9.87
		SD	2.17	ii.01	1.96
	Experimental	Mean	nine.33	2.40	iii.67
		SD	2.53	1.xl	ane.xl
Children-related control	Control	Mean	9.87	nine.87	10.lx
		SD	2.03	two.03	two.16
	Experimental	Mean	10.xx	2.60	iii.87
		SD	2.87	2.03	2.03

SD: Standard deviation

Tabular array three. Multivariate assay of covariance of internal cohesion and controlling behaviors scores in iii groups

Statistical index/Event	Test	Value	F	Df hypothesis	Df error	Sig	Eta coefficient
Deviation among three groups and pretest effect control	Pillai's Trace	one.06	xiv.25	6.00	76.00	0.001	0.53
	Wilks' Lambda	0.04	52.74	half dozen.00	74.00	0.001	0.81
	Hotelling'southward Trace	24.20	145.22	half dozen.00	72.00	0.001	0.92
	Roy's Largest Root	24.ten	305.twenty	three.00	38.00	0.001	0.96

 

Table iv. Results of univariate analysis of covariance

Statistical index/Variable	Source of modify	SS	Df	MS	F	P	Eta Square
Internal cohesion	Group	13893.73	2	6946.87	41.82	0.001	0.68
	Error	6478.19	39	16.eleven
Controlling behaviors	Group	11703.53	2	5851.77	56.21	0.001	0.79
	Error	1083.89	39	27.79

The three groups were homogeneous based on the distribution of the demographic variables. Earlier performing the analysis of variance, the Shapiro-Wilk and Levene'south tests were used to examine the required assumptions. The Shapiro-Wilk test for the distribution of the study variables in the pre- and posttest stages indicated that the study variables had a normal distribution. The Levene's test was used to predict the homogeneity of the error variances. The results of the Levene's test showed that the homogeneity assumption of variances was accustomed. In improver, examining the homogeneity of regression slopes demonstrated that the assumption of homogeneity of regression slopes was established. Therefore, in that location were the assumptions required for performing multivariate analysis of covariance (MANCOVA). Table 4 tabulates the descriptive indicators with the results of the covariance analysis.
Equally shown in Tabular array 3, there is a significant difference between at least one of the variables of internal cohesion and controlling behaviors of couples faced with marital infidelity who were treated and couple-controlled marital infidelity (P<0.05).
As shown in Table four, there is a significant difference in the variables of internal cohesion and decision-making behaviors of couples faced with marital infidelity of the experimental group, compared to that of the control grouping. As the results indicated, the levels of significance obtained for internal cohesion and controlling behaviors were lower, compared to the significance level of 0.001 obtained from the Bonferroni correction.

Word
According to the results of the present study, the means of the posttest stage indicated that the integrated EFT and Gottman's model had a meaning outcome on controlling behaviors and internal cohesion, compared to those reported for the control group. The results of the present written report are in line with the findings of studies carried out by Wiebe et al. [31], Wiebe et al. [32], and Wiseman et al. [33]. In this regard, Fincham et al. [34] conducted a study on an integrated EFT and Gottman'south model and its effectiveness in the quality of marital relations amid married women. The results of the aforementioned study demonstrated that teaching integrated EFT and Gottman's model significantly increased the quality of the marital relationship and all its six subscales (i.due east., satisfaction, trust, commitment, sexual passion, intimacy, and love). In addition, the effectiveness of the nowadays integrated model training was lasting after a month. Therefore, the results showed that preparation the integrated EFT and Gottman's model was used to improve the quality of marital relations among married women.
The results of the current written report also demonstrated that EFT identifies negative emotions and individual's maladaptive emotions past emphasizing and targeting the behaviors in a stepwise fashion, respectively, and finally tries to change them with some methods and techniques [35]. In this treatment, individuals learn how to place their range of emotions and that of others and how to adjust and manage them. Intense negative emotions are considered among the nigh common causes of damage to women through infidelity. In add-on, these individuals tin be contradistinct through identification, expression, and commutation due to feelings of shame, embarrassment, and anger caused by infidelity [36]. Moreover, it was shown that their emotional responses are accustomed through techniques, such as validation, and the blocked experiences can be expressed without judgment and reproach [37].
Furthermore, internal cohesion amid couples is improved due to the consequence of advisable communication on a couple's relationship damaged by infidelity and core of the Gottman'south approach as the right manner to talk and listen to each other in marital relationships [35]. Obviously, communication bug and inability of couples affected by infidelity to properly and correctly communicate are amidst the virtually of import causes of conflicts leading to dissatisfaction, incompatibility, and lower quality of marital life.
In improver, the couples' awareness of the correct advice skills results in greater satisfaction and compatibility in marital life. Therefore, preparation couples through Gottman's arroyo prevents unhealthy advice patterns in couples and improves their relationships, which in plough increases the compatibility or prevents or reduces the incompatibility of couples, which has the preventive, developmental, and healing roles [37].
The limitations of the nowadays written report were the short duration of the preparation sessions in comparison to the depth of the psychological harm. In addition, it was not possible to command the intervening variables, such equally limited age range and number of children, due to the difficulty of access to the desired subjects. Information technology is recommended that family counselors and psychologists use the therapies presented in the electric current written report, particularly the integrated EFT and Gottman's model, to increase the compatibility and cohesion of couples' relationships.

Conclusions
It can be concluded that the combination of EFT and Gottman'south therapy is an constructive design in couples afflicted by infidelity and can be used as one of the therapeutic or educational methods in couple therapy programs.

Compliance with ethical guidelines
All the ethical principles were observed in the present report. The participants were informed nearly the purpose of the study and implementation of the stages. In addition, informed consent was obtained from all the study subjects. The participants were also bodacious of the confidentiality of their information. Moreover, the subjects were gratuitous to withdraw from the study at whatever fourth dimension, and the results of the study would be bachelor to them if desired.

Acknowledgments
The authors would like to express their gratitude to the participants who profoundly cooperated with this research projection.

Authors' contributions
Conceptualization [Mahdieh Hashemi]; Methodology [Javad Khalatbari]; Investigation [Javad Khalatbari]; Writing Original Typhoon [Shohreh Ghorban Shiroudi]; Writing, Review, and Editing [All authors]; Funding Acquisition [All authors]; Resources [All authors]; Supervision [Javad Khalatbari]

Funding/Support
The current study did non receive any specific grant from funding agencies in public, commercial, or not-for-profit sectors.

Conflicts of Interest
The authors declare that there is no conflict of involvement.

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Article Blazon: Research Article | Subject area: General
Received: 2020/06/12 | Accustomed: 2020/07/12 | Published: 2020/eleven/16

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