طب انتظامی (Jan 2022)
Comparing the Effectiveness of Adlerian and Emotion-Focused Group Counseling on the Resilience of Women with Marital Conflict
Abstract
INTRODUCTION ... [1, 2]. Marital relationship is an essential factor in creating peace [3]. Several factors can be influential in the quality of this matter and make couples that have marital conflicts over time. Experts have defined conflict as a type of marital relationship in which violent behaviors cause discomfort [4]. ... [5, 6]. The study of resilience tries to find an answer to this question why some people show more tolerance in times of trouble. ... [7, 8]. One of the most important interventions in this field is Adlerian therapy, which has received less attention in the field of family therapy in Iran [9]. ... [10-12]. The goal of Adlerian couple therapy is to increase the self-esteem of each party, as well as to increase social interest and belonging to each other [13]. ... [14-16]. In addition to Adlerian therapy, which plays an essential role in reducing marital problems, one of the necessary treatments for improving marital functions is emotion-focused therapy, which plays an important role in raising the family resilience level of couples [5]. According to the proposed research framework, it can be seen that so far, no research has investigated and compared the effectiveness of Adlerian and emotion-focused intervention on the resilience of women with marital conflicts at the same time [8, 9, 12, 14, 17, 18] and most importantly, the mentioned interventions have not been carried out in multiple or group forms. This type of intervention, in addition to creating more motivation for members to work, can give more opportunities for the therapist to do more interventions in one session. AIM(s) The present study was conducted to compare the effectiveness of Adlerian and emotion-focused interventions on the resilience of women with marital conflict. RESEARCH TYPE This research is semi-experimental, with a pre-test and post-test design and a control group with a 3-month follow-up. RESEARCH SOCIETY, PLACE & TIME The statistical population of this research was all the women with marital conflicts who were referred to counseling and psychological services centers in district 12 of Tehran in 2021. SAMPLING METHOD & NUMBER At first, to hold the meetings based on a call and by the available sampling method, among the married women who volunteered to participate in the meetings and the questionnaire on marital conflicts was implemented on them; those who scored between 111 and 191 and more in this questionnaire were selected and 60 women were identified as samples. Based on previous studies [3], these 60 people were randomly assigned to groups (20 in the Adlerian intervention group, 20 in the emotion-focused therapy group, and 20 in the control group). USED DEVICES & MATERIALS To collect data, the marital conflicts questionnaire (MCQ) by Sanaei Zaker et al. (2017) and the resilience scale (RISC) by Connor and Davidson (2003) were used. The marital conflicts questionnaire is classified with 54 questions, conflicts of couples in four levels: no conflict with a score of 12 to 90, normal conflict with a score of 90 to 111, excessive conflict with a score of 111 to 191, and very intense conflict with a score higher than 190 [10]. ... [19-23]. In another study, Cronbach's alpha of all questions was 0.75, and its subscales were in the range of 0.69 to 0.73 [24]. METHOD Tables 1 and 2 include Adlerian group counseling sessions and emotion-focused couple therapy. In this research, ten sessions of emotion-focused therapy based on Johnson and Greenberg's theory and Bowlby's attachment theory were conducted for the experimental group. The validity of these sessions has been confirmed in the research of Imanirad et al. [29]. In the present study, the content validity ratio and the content validity index were used to check the content validity of the training packages. In order to calculate the CVR index, the opinions of experts in the desired field were used, and by explaining the objectives of the test and providing an operational definition related to the content of the questions, they were asked to classify each of the objectives. Then, the content validity ratio was calculated based on the CVR formula. Based on the number of experts who evaluated the objectives, the acceptable CVR value is 0.62. In this research, the content validity ratio (CVR) for all objectives in the training protocols was obtained between 0.9 and 1. Also, according to the number of experts, the acceptable value of CVI is 0.79. In this research, the content validity index (CVI) for all objectives in the educational package was between 0.9 and 1. ETHICAL PERMISSION The ethical principles of the current research were fully respected; the participants could leave the research whenever they wanted, and all their confidential information in the questionnaire would be preserved and not exploited. STATISTICAL ANALYSIS After completing the questionnaires, appropriate descriptive and inferential statistical methods such as mean and standard deviation and mixed variance analysis were used to analyze the data. Also, Bonferroni's post hoc test and SPSS 24 software were used to compare Adlerian intervention and emotion-focused therapy. FINDING BY TEXT The results of demographic surveys showed; the F statistic obtained from comparing the frequencies of the three groups in the age variable was F=0.374, which was not statistically significant (p>0.689), indicating that the three groups were equal in terms of age. (Table 3). Also, the results of the descriptive data at this stage showed the average of the dependent variables of the experimental groups (Adlerian intervention and emotion-focused therapy) according to the measurement stages (pre-test, post-test, and follow-up). Since the values of the Shapiro-Wilks test were not significant in any levels (p>0.05), the scores' distribution was considered normal. Levene's test was also used to check the homogeneity of variances. According to the results, the index of Levene's test was not statistically significant in three levels of evaluation (p0.05). The significance level of the group and pre-test interaction effect was more significant than 0.05, indicating the homogeneity of the slope of the regression line. Considering that the defaults of mixed variance analysis have been met, this statistical test was used (Table 4). Mauchly's sphericity test obtained a significant level of p<0.001 for resilience dimensions. Therefore, the default of sphericity was rejected. As a result, the default of the sameness of the variances and, more precisely, the homogeneity condition of the covariance matrix was not ensured. Therefore, a violation of the F statistical model was made (Table 5). As a result, alternative tests such as Greenhouse–Geisser conservative test were used to investigate the within-subject effects of treatment. The results recorded in Table 6 showed that the effect of the intragroup variable (time factor) on resilience dimensions was significant (p<0.001). In this way, the effect of inter-group variables (Adlerian intervention and emotion-focused therapy) in increasing resilience dimensions were significant (Table 6). A two-by-two comparison of the average adjustment of test levels (pre-test, post-test, and follow-up) in resilience dimensions is shown in Table 7. In order to determine in which stages the scores of resilience dimensions have significant differences, Bonferroni's post hoc test was used to compare the averages two by two. As the results, the average difference between the pre-test and post-test (intervention effect) and the average difference between the pre-test and follow-up (time effect) was more remarkable and more significant than the average difference between post-test and follow-up (intervention stability effect), which indicated that Adlerian intervention and emotion-focused therapy affected the dimensions of resilience in the post-test phase and the continuation of this effect in the follow-up level was also observed (Table 7). Also, the results obtained in the post-examination and follow-up level did not clarify which method was the treatment or which treatment method was more practical; therefore, Bonferroni's post hoc test (to compare the effectiveness of the intervention groups) was used to investigate the difference in the effectiveness of Adlerian intervention and emotion-focused therapy on increasing the dimensions of resilience. Based on this, the results showed that the average difference between the Adlerian intervention group and the control group was more significant than the average difference between the emotion-focused treatment and the control group, which indicated that the Adlerian intervention was more effective than the emotion-focused treatment on increasing resilience dimensions (Table 8). MAIN COMPARISON to the SIMILAR STUDIES ... [30, 31]. The results showed that both treatments significantly increased resilience in the post-test and follow-up phase compared to the control group. In addition, the results of Bonferroni's post hoc test showed that Adlerian intervention was more effective in increasing resilience. This obtained result can be aligned with the research of Amani et al., Braga et al., and Shirafkan and Mahmoudi [16, 18, 32, 33]. In explaining the effectiveness of Adlerian therapy on resilience, the goal of Adlerian intervention is to help people to achieve an objective view of reality by correcting false goals and logic [34]. In this context, the research results also showed that the process elements of Adlerian therapy were able to increase the resilience of women with marital conflicts. Also, according to Adler, every idea a person accepts is displayed through his lifestyle. Adler stated the importance of choice and believed people could make their own choices. What one person may consider fair conditions, another may believe to be completely unfair. Considering that in Adlerian intervention, clients try to gain insight into their personal logic and find the cause of their negative attitudes and behaviors and also, Adlerian approach believes that people's problems have social roots and based on this default, they have social prospects for diagnosis and treatment in group work, therefore, by participating in group meetings, the members learn how to behave and interact appropriately [32], and this causes them to benefit from the support of others when experiencing marital problems in life as well as the help of others in solving marital problems, and this can increase their resilience. They should use the help of others in solving marital problems, which can increase their resilience. Therefore, it is reasonable to say that Adlerian intervention is effective and efficient on the resilience of women with marital conflict. SUGGESTIONS It is suggested that other researchers repeat this study in other samples, including men, and scientifically examine some of the questions resulting from this study and the background, and answer this question with more certainty whether these interventions can improve marital problems of men with marital conflicts or not. LIMITATIONS Since this research was conducted only on women with marital conflicts who referred to psychological counseling and service centers in district 12 of Tehran, caution should be taken by researchers and users in generalizing the results of this research to women with marital conflicts in other cities due to cultural, ethnic and social differences. This research could be done simultaneously on women and men (couples). However, due to the lack of conditions and the lack of cooperation of husbands, it was limited only to the sample of women with marital conflicts. Also, conducting the research at the same time as the coronavirus epidemic (Covid-19) was one of the other limitations of the present research and created difficulty in collecting information. CONCLUSIONS The current research findings can be used to formulate treatment programs and interventions in counseling and treatment centers; in a way that Adlerian intervention is effective in women's resilience. According to the research findings, Adlerian intervention changes women's behavior with marital conflicts by gaining insight. This change includes simple behaviors resulting from observational learning and imitations and complex behaviors such as lifestyle. The Adlerian intervention also helps women with marital conflicts to accept their role in the marital relationship and reduce blaming behaviors. In this regard, the role of couples in creating new and positive behaviors is vital so that if they accept that their behaviors are the cause of happiness or unhappiness, they can control them. So, applying Adlerian intervention can increase the resilience of women with marital conflicts by increasing cooperation and changing the unreconciled ways of life. CLINICAL & PRACTICAL TIPS in POLICE MEDICINE According to the results of the present study, which shows the effectiveness of the mentioned treatment methods, such interventions can be used in the counseling and treatment centers of the police. Also, using the results of the studies, similar classes can be held in these centers to increase awareness and skills for couples and family members. ACKNOWLEDGMENTS This article is taken from the Ph.D. thesis of the first author at Islamic Azad University, Central Tehran branch in Iran. All the participants as well as all those who helped in this research are hereby appreciated. CONFLICT of INTEREST The authors state that there is no conflict of interest in the present study. FUNDING SOURCES The present research had no financially support.
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