The Effects of Imago Therapy-Based Education on Anxiety Sensitivity, Intolerance of Uncertainty, Mental Health, and Physical Health Indicators in Couples on the Verge of Divorce

Marriage is among the universal foundations of individuals that covers a critical part of their social and personal lives. Thus, divorce can threaten its health and make it vulnerable for family members. Therefore, numerous researchers and psychologists are identifying approaches to reduce divorce; they concluded that satisfying marital and psychological needs, the quality of relationships between couples, and the prevention of divorce are essential. Important psychological factors are involved in married life. The most critical constructs are anxiety sensitivity, uncertainty intolerance, and its health aspects, such as biopsychological health indicators. Furthermore, Imago therapy focuses on the roots of unhappiness and healing the resulting injuries to help couples recover marital satisfaction. Therefore, the present study aimed to investigate the effects of Imago therapy–based education on anxiety sensitivity, uncertainty intolerance, and mental health and physical health indicators in couples on the verge of divorce.

This was a practical and quasi–experimental study with pretest–posttest and a control group design. The statistical sample of the present study was all couples seeking divorce referring to specialized counseling and psychology centers in Mashhad City, Iran (referred by the crisis intervention center of Mashhad Welfare Organization) in 2018. The sample consisted of 30 purposively selected couples per the inclusion criteria. They were randomly divided into the experimental and control groups. The inclusion criteria of the study included couples seeking consensual divorce; the willingness of both couples to receive counseling intervention; couples with a diploma and higher education; couples aged 20–40 years; no previous divorce record for either couple; no present or past mental disorders for any couple; ‌no history of acute physical problems related to the three health indicators studied in this study, including Body Mass Index (BMI), blood pressure, and cholesterol level. The exclusion criteria were couples with an addicted or alcoholic spouse; consuming psychiatric and psychotropic drugs; a history of infidelity or extramarital affairs; the existence of a physical disability or mental disability in one of the spouses; the lack of identification of conditions consistent with the research objectives in couples during treatment. The Expanded Anxiety Sensitivity Index (Taylor & Cox, 1998), Uncertainty Intolerance Questionnaire (Freeston et al., 1994), General Health Questionnaire (Goldberg & Hillier, 1979) were used to collect the necessary data. Moreover, BMI, blood pressure, and cholesterol level were measured in both study groups. Then, Imago therapy was provided for the experimental group (Hendrix, 2010). Eventually, the indicators mentioned above were re–measured, and the differences observed in the posttest of the two control and experimental groups were compared. To analyze the obtained data, descriptive statistics, including mean and standard deviation and inferential statistics, including Independent Samples t–test, and Multivariate Analysis of Covariance (MANCOVA) were used in SPSS at the significance level of 0.05.

The obtained results indicated that by removing the effect of the pretest, the scores mean of the experimental group in the variables of anxiety sensitivity (p</em><0.001), uncertainty intolerance (p</em><0.001), mental health (p</em><0.001), BMI (p</em><0.001), blood pressure (p</em><0.001) and cholesterol level (p</em><0.001) were significantly different from the scores mean of the control group in the posttest; Also, the effect size obtained for the research was as follows: anxiety sensitivity (0.292), intolerance of uncertainty (0.595), BMI (0.240), blood pressure (0.279), cholesterol level (0.532), and mental health improvement (0.199).

According to the current study findings, Imago therapy–based education was effective in reducing anxiety sensitivity, uncertainty intolerance, and the indicators of physical health (including BMI), blood pressure, and cholesterol level) and increasing mental health in couples on the verge of divorce.