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Ethics code: IR.IAU.AHVAZ.REC.1403.209

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Farbod M, Homaei R. Mindfulness-based Intervention for the Enhancement of Self-awareness, Responsibility, and Relationship Quality in Distressed Couples. Avicenna J Neuro Psycho Physiology 2025; 12 (1) :26-32
URL: http://ajnpp.umsha.ac.ir/article-1-507-en.html
Mindfulness-based Intervention for the Enhancement of Self-awareness, Responsibility, and Relationship Quality in Distressed Couples
Marzieh Farbod1 , Rezvan Homaei2
1- Department of Psychology, Ahv.C., Islamic Azad University, Ahvaz, Iran
2- Department of Psychology, Ahv.C., Islamic Azad University, Ahvaz, Iran , rzhomaei@gmail.com
Keywords: Family conflict, Mindfulness, Responsibility, Self-awareness
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Background
Marital life, as one of the most complex and dynamic human relationships, requires various skills to enhance its quality and sustainability [1]. One of the primary skills is self-awareness, defined as the accurate recognition of one's thoughts, feelings, and behaviors in various aspects of life [2]. Self-awareness allows individuals to identify their strengths and weaknesses, manage their emotions, and understand their impact on their behavior and relationships [3]. However, many couples, due to a lack of awareness of their own or their partner's inner needs and desires, experience misunderstandings and frequent conflicts that can lead to decreased marital satisfaction [4].
Responsibility is another crucial factor in maintaining a healthy marital relationship. Partners in a healthy relationship should be able to take responsibility for their behaviors, decisions, and the impact they have on the relationship [5]. Accepting responsibility helps individuals avoid blaming their partners and work together to solve problems [6]. However, a lack of responsibility can lead to increased conflict, avoidance of problems, and ultimately, a weakened relationship. Many couples seeking psychological services complain about an inability to manage problems and accept their share of the blame in conflicts, which is often due to a lack of communication skills and insufficient feelings of responsibility [7].
Interpersonal relationships also hold a special place in marital life. The ability to understand each other, empathize, and respect differences is among the skills that can improve the quality of couples' relationships [8]. However, many couples face problems, such as the inability to communicate effectively, frequent misunderstandings, and decreased empathy. These problems often stem from psychological factors, such as a lack of self-awareness, deficient responsibility skills, and an inability to manage conflicts [9]. Couples seeking psychological services often present with challenges such as severe conflicts, decreased intimacy, and dissatisfaction with relationship quality. These issues not only affect individuals' personal lives but can also impact the mental health of children and families [10, 11]. In such circumstances, providing effective psychological interventions focused on strengthening individual and interpersonal skills seems essential [12].
Moreover, research has demonstrated that self-awareness and responsibility, as two factors related to the quality of couples' relationships, can contribute to reducing conflict and improving relationships [13]. Self-awareness enables individuals to seek a deeper understanding of their own needs and desires rather than blaming their partners [14]. Responsibility helps individuals accept their role in resolving issues and take steps to create positive change in the relationship. Together, these two factors can contribute to the improvement of the quality of couples' relationships and the reduction of tension and conflict [15].
However, one of the primary challenges in this area is the lack of effective training or treatment programs to enhance fundamental skills, such as self-awareness and responsibility, in couples. Many existing psychological interventions focus primarily on reducing conflict or addressing specific issues, often overlooking the development of core intrapersonal and interpersonal skills that can yield more sustainable improvements in relationship quality [16, 17]. To address this gap, mindfulness-based training was selected as the intervention for this study due to its evidence-based efficacy in fostering self-awareness, emotional regulation, and empathy, which are critical for improving marital relationships. Mindfulness, rooted in Eastern teachings, involves purposeful, non-judgmental attention to the present moment [18]. This approach was chosen because it not only enhances self-knowledge and emotion regulation but also strengthens empathy and mutual understanding in interpersonal relationships, directly targeting the deficits often observed in distressed couples [19]. Numerous studies have demonstrated that mindfulness reduces stress, improves emotional regulation, and enhances relationship quality, making it a promising strategy for addressing the multifaceted challenges of married life [20, 21]. By cultivating a heightened awareness of thoughts, emotions, and behaviors, mindfulness empowers couples to break cycles of reactive conflict and foster healthier communication and connection, making it an ideal intervention for this population [17]. Therefore, mindfulness-based training was selected as an effective and comprehensive strategy to improve self-awareness, responsibility, and overall relationship dynamics in couples experiencing marital distress.
Couples seeking psychological services often present with challenges, such as marital conflict, lack of mutual understanding, and relationship dissatisfaction. These difficulties are frequently rooted in poor emotion regulation, limited self-awareness, and ineffective communication skills. Mindfulness-based training can facilitate inner reflection, enabling couples to gain a deeper understanding of their emotions and perspectives and cultivate empathy towards their partners. Additionally, it can foster a sense of responsibility, empowering individuals to acknowledge their role in relationship challenges and take proactive steps toward improvement. Given the potential benefits of mindfulness-based training, it is essential that psychological research and interventions prioritize the development of fundamental skills, such as self-awareness and responsibility. By identifying factors that contribute to healthy relationships and designing effective programs, researchers and clinicians can play a crucial role in mitigating marital distress and promoting family well-being. Ultimately, investigating the impact of self-awareness, responsibility, and relationship quality in couples seeking psychological services can shed light on their specific needs and inform the development of tailored interventions.

Objectives
The present research aimed to contribute to filling the existing gaps in this field and improving the quality of life for couples experiencing marital conflict.

Materials and Methods
Design and Participants
This study was a quasi-experimental design with a pre-test, post-test, and control group. The population consisted of all couples with marital conflicts who referred to psychological service centers in Dezful County, Iran, in 2023. The sample consisted of 30 couples, selected using a convenience sampling method. The sample group was randomly assigned to either experimental (15 couples) or control (15 couples) groups. The inclusion criteria for the study included informed consent to participate, a high school education or higher, an age between 20 and 45 years, no history of substance abuse, no concurrent participation in other treatment programs, and no individual counseling or medication. Exclusion criteria included receiving concurrent psychological treatments, unwillingness to continue cooperation in the research, and more than two absences from the therapy sessions.

Procedure
A counseling center was randomly selected from among family counseling centers. Eligible couples experiencing marital conflict or emotional divorce were recruited from the center's files. Before the intervention, all participants completed pre-test questionnaires assessing self-awareness, responsibility, and communication patterns. The experimental group then received eight 60-minute mindfulness-based therapy sessions, conducted twice weekly, while the control group received no intervention. The mindfulness-based therapy was delivered as a structured program, integrating mindfulness principles and practices with elements of couples therapy to address the specific needs of the participants. Key components of this integration included training in mindful communication, emotion regulation techniques, and exercises designed to foster empathy and acceptance within the relationship. A summary of the mindfulness training sessions is provided in Table 1. Post-test assessments were administered to both groups following the intervention. To ensure ethical guidelines, participants were informed of the confidentiality of their responses and their right to withdraw from the study at any time. After the study's conclusion, the control group also received the mindfulness-based intervention.

Instrument
Self-Awareness Questionnaire
The Self-Awareness Questionnaire, developed by Fenigstein et al. [22], was designed to measure self-awareness. The questionnaire assesses three dimensions of self-awareness: private self-awareness, public self-awareness, and social anxiety. It consists of 23 items rated on a 5-point Likert scale ranging from "not at all like me" (scored 0) to "very much like me" (scored 4). Reverse scoring was applied to items 3, 9, and 12. The Cronbach's alpha reliability coefficient for this questionnaire has been reported to be above 0.79 in previous research [23]. In the present study, Cronbach's alpha was calculated to be 0.82.

California Responsibility Scale
The California Responsibility Scale consists of 42 items designed to measure the level of responsibility in individuals aged 12 and older. The scale uses a 5-point Likert scale ranging from "strongly agree" (scored 5) to "strongly disagree" (scored 1). This scale is suitable for assessing a significant aspect of interpersonal psychology, such as duty, responsibility, reliability, and social integrity, to measure the level of acceptance and bias towards social norms. Scores higher than 126 on this scale indicate higher levels of responsibility [24]. Cronbach's alpha, calculated in a previous study by Atef-Vahid et al. [25], was estimated to be higher than 0.95 for this questionnaire. In the present study, Cronbach's alpha was calculated to be 0.89.
 

Table 1. A summary of the mindfulness training sessions
Session Content
1 Introduction to mindfulness, benefits of mindfulness practices for daily life, and their impact on relationship quality and positive emotions. Instruction on non-judgment and avoiding impulsive reactions. A three-minute mindfulness breathing exercise.
2 Identification and labeling of emotions. Mindful attention to emotions and their management as a prerequisite for mindful communication. Emotional regulation (managing negative thoughts and feelings).
3 A 3-minute mindfulness breathing exercise. Loving-kindness meditation practice toward oneself and one's partner. Mindful communication training with a commitment to nonviolent speech.
4 Increasing positive emotions in couples through a pleasurable activities log. Practice of radical acceptance, as well as positive and negative judgment.
5 Training in basic effective communication skills with mindful attention. Practice of deep listening and mindful pausing.
6 Mindfulness-based training in marital relationships and intimacy. Review and reflection on what couples have learned and experienced. Session concluded with a meditation on love and compassion.
7 Cognitive restructuring: Observing thoughts and feelings and applying descriptive labels to understand them. This understanding fosters the realization that thoughts are not always accurate reflections of reality.
8 Self-management: Observing improved self through mindfulness practice can enhance the use of coping skills.
 
 
Communication Patterns Questionnaire (CPQ)
The Communication Patterns Questionnaire (CPQ) is a self-report measure designed to assess couples' communication patterns during marital conflict. The 35-item questionnaire employs a 9-point Likert scale to evaluate behaviors across three stages of conflict: onset, discussion, and aftermath. The CPQ yields scores on three dimensions: mutual constructive communication, mutual avoidance of communication, and demand-withdraw patterns. The latter scale further differentiates between male-demand/female-withdraw and female-demand/male-withdraw dynamics [26]. Samadzadeh et al. [27] reported a Cronbach's alpha of 0.76 for the overall scale, indicating satisfactory internal consistency. In the present study, Cronbach's alpha was calculated to be 0.81.

Data Analysis
Data were analyzed using descriptive statistics (mean, standard deviation) and inferential statistics, specifically analysis of covariance (ANCOVA).

Results
The mean age and standard deviation of the participants were 31.64 (SD=4.28) in the experimental group and 33.20 (SD=4.96) in the control group, respectively. A total of 12 participants (80.0%) in the experimental group and 11 participants (63.3%) in the control group had children. The experimental group consisted of nine females (60.0%) and six males (40.0%), while the control group involved eight females (53.3%) and seven males (46.7%). Table 2 presents the means, standard deviations, and test results for the study variables at the pre-test and post-test stages.
 

Table 2. Mean and standard deviation of variables in experimental and control groups
Variables Groups Pre-test Post-test
Mean SD Mean SD
Self-awareness Mindfulness training 37.20 3.46 56.33 9.17
Control 35.66 9.94 36.13 9.84
Responsibility Mindfulness training 114.33 13.65 137.93 18.22
Control 111.73 11.12 114.93 10.41
Relationship improvement Mindfulness training 150.66 16.60 187.20 12.95
Control 164.46 13.45 164.93 11.70
 
As demonstrated in Table 2, the mean scores for self-awareness, responsibility, and relationship improvement in the mindfulness-based intervention group showed significant changes from pre-test to post-test, whereas no significant changes were observed in the control group. To examine the significance of differences between the two groups, an analysis of covariance was conducted. Before conducting the covariance analysis, the assumptions were examined. First, to ensure the absence of influential outliers in the study variables, the Kolmogorov-Smirnov normality test was used. The results confirmed the normality assumption of the data distribution. Additionally, Levene's test was employed to examine the homogeneity of variances. The results indicated homogeneity of variances for self-awareness (F=2.6556, P=0.114), responsibility (F=2.4768, P=0.103), and relationship improvement (F=2.53, P=0.123). Subsequently, to compare the experimental and control groups based on post-test scores, while controlling for the pre-test scores, a covariance analysis was used to determine the effect of the mindfulness-based intervention on self-awareness, responsibility, and relationship improvement in couples. The results of the post-test are presented in Table 3.
 

Table 3. Results of analysis of covariance on post-test scores of research variables
Variables SS df MS F P η2
Self-awareness 2062.22 1 2062.22 43.81 0.001 0.63
Responsibility 3228.50 1 3228.50 52.17 0.001 0.67
Relationship improvement 4173.75 1 4173.75 31.08 0.001 0.55
 
As indicated in Table 3, the mindfulness-based intervention significantly impacted self-awareness, responsibility, and relationship improvement, accounting for 63.0%, 67.0%, and 55.0% of the variance, respectively. Significant pre-to-post test differences were found for self-awareness (η²=0.63, F=43.81, P<0.001), responsibility (η²=0.67, F=52.17, P<0.001), and relationship improvement (η²=0.55, F=31.08, P<0.001), after controlling for pre-test scores. These findings indicate that mindfulness-based training is effective in enhancing self-awareness, responsibility, and relationship quality in couples.

Discussion
This study investigated the efficacy of mindfulness-based training in enhancing self-awareness, responsibility, and relationship quality among couples experiencing marital conflict who were seeking counseling services. The first finding demonstrates that mindfulness-based training effectively enhanced self-awareness among couples experiencing marital conflict. This finding aligns with previous research by Ismaeilzadeh and Akbari [17] and Forouzesh Yekta et al. [28]. Mindfulness, a novel psychological intervention, emphasizes non-judgmental awareness of present-moment thoughts, feelings, and experiences. This cultivates self-awareness by fostering accurate and unbiased observation of internal states and external responses. Couples seeking counseling often struggle with self-understanding and the impact of their behaviors on relationships [17]. Mindfulness training provides a valuable tool for developing this awareness. By practicing mindfulness, individuals learn to observe and understand their thoughts and emotions without reactive impulses, reducing self-criticism and enabling reflective consideration of past behaviors. This finding facilitates conscious planning for future interactions, empowering individuals to act with intention rather than on autopilot [28].
Mindfulness-based training equips couples with the tools to cultivate self-awareness by fostering attention to emotions, thoughts, and behavioral patterns through practices like mindful breathing and body scanning. This increased self-awareness can lead to positive behavioral changes and improved relationship dynamics [29]. Moreover, mindfulness enhances individuals' understanding of their values and goals, enabling couples to work collaboratively towards strengthening their relationship. By developing mindfulness skills, couples can recognize the impact of stressors, maladaptive beliefs, and negative emotions on their relationship, empowering them to take proactive steps toward improvement [17].
Mindfulness-based training was found to significantly enhance responsibility among couples experiencing marital conflict, aligning with previous research by Wang et al. [30]. Responsibility, a cornerstone of healthy relationships, involves a commitment to one's duties, expectations, and roles. Couples seeking counseling often exhibit avoidance behaviors, blame-shifting, and a reluctance to accept personal responsibility for relationship issues. Mindfulness training cultivates a heightened awareness of one's actions and promotes non-judgmental acceptance, fostering a sense of responsibility. By encouraging present-moment awareness, mindfulness empowers individuals to confront challenges directly rather than resorting to avoidance strategies. This increased mindfulness can lead to greater accountability for one's actions and a willingness to address mistakes constructively.
Mindfulness practices cultivate self-reflection, enabling couples to scrutinize their behaviors and recognize their impact on the relationship. This heightened self-awareness can shift the focus from blame to personal responsibility, empowering individuals to take ownership of their role in marital issues [30]. By reducing blame and fostering empathy, mindfulness training promotes a deeper understanding of partners' needs and expectations, encouraging conscious acceptance and fulfillment of marital roles and responsibilities [29]. Furthermore, mindfulness equips individuals with effective strategies for managing challenges and stressors, empowering them to seek constructive solutions rather than resorting to avoidance or blame, aligning their actions with long-term goals and values.
Mindfulness-based training was found to significantly improve relationship quality among couples experiencing marital conflict, aligning with previous research [13]. Marital relationships are complex and influenced by various psychological and behavioral factors. Couples often seek counseling to address issues, such as conflict, misunderstanding, and ineffective communication. Mindfulness training can enhance relationship quality by fostering present-moment awareness, emotional regulation, and empathy. By reducing the influence of negative thoughts and focusing on the present, mindfulness helps couples avoid maladaptive emotional responses and promotes constructive communication [17].
Mindfulness practices cultivate empathy by fostering self-awareness and understanding of one's partner's perspective. This enhanced empathy promotes supportive behaviors and reduces judgment and criticism, thereby strengthening interpersonal bonds [20]. Mindfulness training also improves communication quality by encouraging active listening and reducing misunderstandings. By focusing on the present moment, couples can engage in more mindful and effective conversations, building trust and emotional intimacy. Moreover, mindfulness is effective in reducing conflict and regulating emotions. Mindfulness practitioners are better equipped to manage negative emotional responses, preventing escalation and promoting constructive problem-solving [21]. In stressful situations, mindfulness can help individuals maintain composure and make rational decisions, rather than reacting impulsively.
One limitation of this study is that it was conducted with couples seeking counseling services in Dezful City, Iran. Therefore, caution should be exercised when generalizing the findings to couples seeking counseling services in other cities. Additionally, the study did not examine gender differences, and self-report measures were used. This raises the possibility of social desirability bias, which could have distorted the responses.

Conclusions
The findings of the present work demonstrate the efficacy of mindfulness-based training in significantly enhancing self-awareness, responsibility, and marital satisfaction among couples experiencing marital distress. By cultivating mindfulness, individuals can develop a deeper understanding of their thoughts, emotions, and behaviors, leading to more mindful communication, empathy, and effective conflict resolution. Furthermore, mindfulness practices can foster a sense of accountability, empowering individuals to take ownership of their actions and their role in relationship dynamics. The positive impact of mindfulness-based training on marital satisfaction is particularly noteworthy, as it promotes emotional regulation, reduces stress, and enhances communication skills.

Ethical Considerations
This research adhered to the ethical guidelines established by the Ethics Committee of Islamic Azad University of Ahvaz Branch, Iran (approval code: IR.IAU.AHVAZ.REC.1403.209).

Acknowledgments
The authors gratefully acknowledge the participation of all individuals who contributed their time and insights to this study.

Authorsʼ contributions
All authors participated in the drafting and revision of the manuscript and are accountable for its content.

Funding/Support
No specific grant was received from any funding agency in the public, commercial, or non-profit sectors to support this research.

Conflicts of Interest
The authors declare that there are no conflicts of interest.

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Article Type: Research Article | Subject: Clinical Psychology
Received: 2024/12/10 | Accepted: 2025/06/29 | Published: 2025/07/19
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