Comparing the Effectiveness of Emotion-Oriented Therapy With Positive Cognitive-Behavioral Therapy on Emotional, Cognitive, and Behavioral Disorders in Married Women Referred to Counseling Centers

Disruption of family functions and problems caused by incompatibility and marital dissatisfaction, directly and indirectly, put harmful effects on the shoulders of couples, families, children, and society. Many spouses experience couple turmoil in their relationships. Although couple turmoil is not a clinical disorder, it causes psychological and physical pain and turmoil. Cognitive dysfunction refers to the attribution of chronic negative attributions and rejection of the positive behaviors of the spouse. Emotional dysfunction is defined as emotional problems, including chronic sadness, indifference, or anger towards one's spouse, rooted in childhood attachment styles. Behavioral dysfunction is defined as difficulty in resolving conflict and avoidance and excessive involvement. Marital conflict causes dysfunctional behavior in the relationship between couples. It seems that one of the effective interventions for emotional, cognitive and behavioral dysfunction is emotion–oriented therapy. Another treatment is positive cognitive–behavioral therapy. In this treatment, clients and therapists are asked to shift their attention from analysis, explanations, and problems to thoughts, feelings, and actions that help clients flourish. So, this study aimed to compare the effectiveness of emotion–focused and cognitive–positive behavioral therapies on emotional, cognitive and behavioral impairment functions.

The research method was quasi–experimental with a pretest–posttest design, a three–month follow–up period and a control group. The study population consisted of married women referred to counseling centers of Tehran municipality cultural–artistic organizations during 2017–2018. The sample consisted of 45 married women selected by purposeful and random sampling. Then, they were randomly divided into three groups of 15 people each (emotion–oriented group, positive cognitive–behavioral therapy group, and control group). The inclusion criteria were as follows: going to the counseling center with the intention of solving the problems related to their marital relations, not applying for divorce, not participating in counseling or psychological sessions at the same time, aged 20–45 years. The exclusion criteria included simultaneous participation in another treatment program and absence in more than two treatment sessions. The study data were gathered via Experiences in Close Relationship Scale–Short Form (ECR–S) (Wei et al., 2007), Relationship Attribution Measure (RAM) (Fincham & Bradbury, 1992), and Organizational Conflict Inventory–II (ROCI–II) (Rahim, 1983). In this research, emotion–oriented therapy consisted of nine 90–minute sessions was performed once a week for the first experimental group. Also, positive cognitive–behavioral therapy included eight 90–minute sessions and was performed once a week for the second experimental group. However, no intervention was provided for the control group. In order to describe the data, central and dispersion indices such as mean and standard deviation were used. To analyze the data, the repeated measurements analysis of variance, Tukey's post hoc test and Bonferroni's post hoc test were used. The mentioned statistical analyzes were done using SPSS version 24 software. The significance level of the tests was considered 0.05.

Results showed that the analysis of variance of emotional dysfunctions (anxious attachment and avoidant attachment) and behavioral and cognitive dysfunctions was significant for time effect (p<0.001), group effect (p<0.001), and interaction of time and group effect (p<0.001). Positive cognitive–behavioral therapy and emotion–oriented therapy were effective in reducing emotional, behavioral, and cognitive dysfunctions (p<0.05). Positive cognitive–behavioral therapy was more effective in reducing cognitive dysfunction (p<0.001) and behavioral dysfunction (p<0.001) in the posttest compared to emotion–oriented therapy. Also, according to the comparison of the averages of the two groups of emotion–oriented therapy and positive cognitive–behavioral therapy regarding the variable of emotional dysfunction, emotion–oriented therapy was more effective in reducing emotional dysfunction in the posttest compared to positive cognitive–behavioral therapy (anxious attachment p=0.021 and avoidant attachment p<0.001). There was a significant difference between the pretest and posttest stages and the pretest and follow–up stages in the mean scores of the emotional dysfunctions (anxious attachment and avoidant attachment) and behavioral and cognitive dysfunctions (p<0.05). However, no significant difference was observed in the average scores of the three mentioned variables between the posttest and follow–up stages, which indicates the continuity and sustainability of the treatments in the three–month follow–up period (p>0.05).

According to findings, emotion–oriented therapy and positive cognitive–behavioral therapy are effective in reducing emotional, cognitive and behavioral dysfunctions. However, positive cognitive–behavioral therapy is more effective than emotion–focused therapy in reducing cognitive and behavioral dysfunctions in the posttest. Also, emotion–focused therapy is more effective than positive cognitive–behavioral therapy in reducing emotional dysfunction in the posttest.