Volume 7, Issue 4 (November 2020)                   Avicenna J Neuro Psycho Physiology 2020, 7(4): 249-254 | Back to browse issues page


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Hashemi S M, Ghorban Shiroudi S, Khalatbari J, Abolghasemi S. Effectiveness of Integrated Model of Emotionally-Focused Therapy and Gottman's Model in Internal Cohesion and Reduction of Controlling Behaviors in Couples Faced with Marital Infidelity. Avicenna J Neuro Psycho Physiology. 2020; 7 (4) :249-254
URL: http://ajnpp.umsha.ac.ir/article-1-276-en.html
1- PhD Student, Department of Psychology, Tonekabon Branch, Islamic Azad University, Tonekabon, Iran
2- Associate Professor, Department of Psychology, Tonekabon Branch, Islamic Azad University, Tonekabon, Iran. , Drshohrehshiroudi@gmail.com
3- Associate Professor, Department of Psychology, Tonekabon Branch, Islamic Azad University, Tonekabon, Iran.
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Background
Marital infidelity is considered a shocking issue for couples and families and common phenomenon for counselors and therapists [1]. Extramarital affairs create a great deal of confusion for couples. Based on the evidence, it was shown that most individuals expect monogamy and no extramarital affairs from their spouses [2-5]. The main 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 recent centuries. The main premise of controlling is that if individuals feel dissatisfied with a relationship, they will not feel responsible for it; however, they blame others and those out of control [7, 8].
Internal cohesion is considered one of the factors which are effective in the reduction of harms and controlling behaviors among couples faced with marital infidelity [9, 10]. Antonovsky defined the concept of internal cohesion while focusing on the model, which supports factors leading to human health and well-being instead of the ones resulting in diseases [11, 12]. Although this concept has three dimensions, they are practically defined on a single scale theoretically reflecting the general direction of life [13]. Feelings of strong inner cohesion are related to a high capacity for mental and physical coping with stress and challenges occurring throughout an individual's life [14]. Therefore, studies demonstrated that individuals with strong cohesion are more successful in coping with stress [15].
One of the therapies increasing internal cohesion among couples faced with marital infidelity and improving the reduction of controlling behaviors is the integrated model of emotionally-focused therapy (EFT) and Gottman’s model [16]. Accordingly, some efforts have been made to combine specific components of different approaches in a systematic manner and coherent and integrated model. Integrated approaches have 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 [19]. Similarly, Johnson emphasizes relationships, attachment styles, and interaction cycles in EFT [20].
The EFT refers to the important role of emotions and communication in organizing communicational patterns and regards emotions as change 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 study, 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 approach 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 destructive marital conflicts within a year. In addition, Rajaee [27] showed the effect of Gottman's intervention on the reduction of emotional divorce. Razi [28] indicated that teaching Gottman's conflict resolution skills increases marital satisfaction.
Since couples faced with marital infidelities face many psychological, social, and emotional problems and harms, leading to tensions in various dimensions, it is difficult to regulate their emotions, beliefs, thoughts, and interpersonal relationships.
 
Objectives
This study 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 infidelity.
 
Materials and Methods
This quasi-experimental study was carried out on two experimental groups and one control group with a pretest-posttest design. The statistical population of the study included all the women referring to one of the counseling centers in Tehran, Iran, (i.e., Ganj-e-Daroun Flourishing Counseling Center, Third Way Center, 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 after 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, 6 manageability scales, and 20 comprehensibility scales, scored based on a 5-point Likert scale from very low (1) to very high (5). 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 good internal consistency, and the Cronbach's alpha coefficients are 0.935, 0.92, 0.65, and 0.886 for the whole scale, significant subscale, manageable subscale, and comprehensible subscale, respectively [29].
 
Controlling Behaviors Questionnaire
The marital controlling behaviors scale was developed in 2005 by Graham-Kavan and Archer for the evaluation of controlling behaviors. This is a 24-item 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 5-point Likert scale (from 0 to 4) to what extent the spouse and his wife perform each one’s desired behaviors. The minimum and maximum scores are considered 0 and 96, respectively. The Cronbach's alpha coefficients are 0.95, 0.82, 0.71, 0.88, 0.69, 0.84, and 0.90 for the whole scale, children's phrase subscales, economic control subscale, threatening control subscale, controlling through intimidation subscale, emotional control subscale, and control through isolation subscale, respectively [30].
 
Table 1. Teaching the integrated Gottman's model and emotionally-focused therapy
Session Content
First Establishing professional and empathetic communication; familiarizing with members and asking questions about 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 attachment 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 seven principles of a secure relationship house introduced by Gottman (1999)
Eighth and Ninth Accepting influence and compromise (i.e., fourth principle); teaching ways to manage solvable problems (i.e., fifth principle), ways to overcome perpetual problems (i.e., sixth principle), and creating shared meaning (i.e., seventh principle)
Tenth Facilitating the expression of needs and wishes as well as 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 attendance at therapy sessions, no history of severe mental and emotional disorders, and no addiction, 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's model were presented step by step through weekly assignments and regular exercises by a consultant.
To observe ethical and professional 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 developed by the researcher under the supervision of professors using theoretical and research backgrounds, concepts of exciting approach, and intervention program developed by Johnson based on the EFT model and Bowlby Attachment Theory [30], and some key categories of the Gottman’s model (Table 1).
The statistical methods, descriptive methods (e.g., mean and standard deviation), and Levene's test were used to analyze the data. Analysis of covariance was utilized to test the hypotheses by SPSS software (version 22).
 
Results
The descriptive findings included the statistical indicators (e.g., mean and standard deviation), number of sample subjects, and frequency table and percentage, which are presented for all the variables in the following tables (Tables 1-4).
 
Table 2. Mean and standard deviation of study variables based on assessment stage in study groups
Group Variable Index Pretest Posttest Follow-up
Internal cohesion Control Mean 13.10 80.10 20.98
SD 40.90 65.60 62.60
Experimental Mean 67.11 93.15 93.14
SD 14.01 43.11 11.02
Understandability Control Mean 56.47 54.20 51.93
SD 8.32 7.30 7.30
Experimental Mean 60.87 81.20 80.07
SD 7.31 8.12 7.88
Manageability Control Mean 10.47 12.00 10.00
SD 2.47 2.36 2.36
Experimental Mean 12.53 17.0 16.20
SD 3.11 4.18 4.18
Significance Control Mean 39.20 38.60 36.27
SD 6.06 4.42 3.51
Experimental Mean 41.27 54.33 53.67
SD 8.43 7.90 7.86
Controlling behaviors Control Mean 53.60 52.93 58.80
SD 7.40 7.44 7.19
Experimental Mean 56.73 16.53 24.13
SD 8.66 5.68 5.94
Economic control Control Mean 8.87 9.00 10.13
SD 2.50 2.48 2.47
Experimental Mean 8.67 3.20 4.27
SD 1.35 1.70 1.75
Table 1. Continued
Threatening control Control Mean 9.00 8.73 9.47
SD 2.24 2.34 1.92
Experimental Mean 9.87 2.40 3.67
SD 2.39 1.40 1.68
Controlling through intimidation Control Mean 7.20 7.27 8.47
SD 1.57 1.87 1.81
Experimental Mean 8.33 2.87 4.20
SD 2.44 1.30 1.15
Emotional control Control Mean 9.35 9.27 10.27
SD 2.45 2.52 2.52
Experimental Mean 10.33 3.07 4.47
SD 2.69 1.10 0.83
Controlling through isolation Control Mean 9.13 8.80 9.87
SD 2.17 2.01 1.96
Experimental Mean 9.33 2.40 3.67
SD 2.53 1.40 1.40
Children-related control Control Mean 9.87 9.87 10.60
SD 2.03 2.03 2.16
Experimental Mean 10.20 2.60 3.87
SD 2.87 2.03 2.03
SD: Standard deviation
 
Table 3. Multivariate analysis of covariance of internal cohesion and controlling behaviors scores in three groups
Statistical index/Effect Test Value F Df hypothesis Df error Sig Eta coefficient
Difference among three groups and pretest effect control Pillai's Trace 1.06 14.25 6.00 76.00 0.001 0.53
Wilks' Lambda 0.04 52.74 6.00 74.00 0.001 0.81
Hotelling's Trace 24.20 145.22 6.00 72.00 0.001 0.92
Roy's Largest Root 24.10 305.20 3.00 38.00 0.001 0.96
 
Table 4. Results of univariate analysis of covariance
Statistical index/Variable Source of change 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 16.11      
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. Before performing the analysis of variance, the Shapiro-Wilk and Levene's 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 accepted. In addition, examining the homogeneity of regression slopes demonstrated that the assumption of homogeneity of regression slopes was established. Therefore, there were the assumptions required for performing multivariate analysis of covariance (MANCOVA). Table 4 tabulates the descriptive indicators with the results of the covariance analysis.
As shown in Table 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 4, there is a significant difference in the variables of internal cohesion and controlling behaviors of couples faced with marital infidelity of the experimental group, compared to that of the control group. 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.
 
Discussion
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 significant effect on controlling behaviors and internal cohesion, compared to those reported for the control group. The results of the present study 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's model and its effectiveness in the quality of marital relations among 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.e., satisfaction, trust, commitment, sexual passion, intimacy, and love). In addition, the effectiveness of the present integrated model training was lasting after a month. Therefore, the results showed that training the integrated EFT and Gottman's model was used to improve the quality of marital relations among married women.
The results of the current study also demonstrated that EFT identifies negative emotions and individual’s maladaptive emotions by 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 identify their range of emotions and that of others and how to adjust and manage them. Intense negative emotions are considered among the most common causes of harm to women through infidelity. In addition, these individuals can be altered through identification, expression, and substitution due to feelings of shame, embarrassment, and anger caused by infidelity [36]. Moreover, it was shown that their emotional responses are accepted through techniques, such as validation, and the blocked experiences can be expressed without judgment and reproach [37].
Furthermore, internal cohesion among couples is improved due to the effect of appropriate communication on a couple's relationship damaged by infidelity and core of the Gottman’s approach as the right way to talk and listen to each other in marital relationships [35]. Obviously, communication problems and inability of couples affected by infidelity to properly and correctly communicate are among the most important causes of conflicts leading to dissatisfaction, incompatibility, and lower quality of marital life.
In addition, the couples’ awareness of the right communication skills results in greater satisfaction and compatibility in marital life. Therefore, training couples through Gottman’s approach prevents unhealthy communication patterns in couples and improves their relationships, which in turn increases the compatibility or prevents or reduces the incompatibility of couples, which has the preventive, developmental, and healing roles [37].
The limitations of the present study were the short duration of the training sessions in comparison to the depth of the psychological harm. In addition, it was not possible to control the intervening variables, such as limited age range and number of children, due to the difficulty of access to the desired subjects. It is recommended that family counselors and psychologists use the therapies presented in the current study, especially 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's therapy is an effective pattern in couples affected 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 study. The participants were informed about 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 assured of the confidentiality of their information. Moreover, the subjects were free to withdraw from the study at any time, and the results of the study would be available to them if desired.
 
Acknowledgments
The authors would like to express their gratitude to the participants who greatly cooperated with this research project.
 
Authors' contributions
Conceptualization [Mahdieh Hashemi]; Methodology [Javad Khalatbari]; Investigation [Javad Khalatbari]; Writing Original Draft [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 not 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 interest.
 
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Article Type: Research Article | Subject: General
Received: 2020/06/12 | Accepted: 2020/07/12 | Published: 2020/11/16

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