A Comparison of the Effectiveness of Emotion-Focused Couple Therapy and Acceptance and Commitment Therapy on Attachment Behavior in Marital Relationships among Women with Marital Conflicts

Document Type : Research Paper

Authors

1 Department of Psychology and Educational Sciences, Faculty of Literature and Humanities, Yasooj Branch, Islamic Azad University, Yasooj, Iran

2 Assistant Professor, Department of Psychology and Educational Sciences, Faculty of Literature and Humanities, Yasooj Branch, Islamic Azad University, Yasooj, Iran

3 Department of Psychology and Educational Sciences, Faculty of Literature and Humanities, Yasooj Branch, Islamic Azad University, Yasooj, Iran.

Abstract

The objective of this investigation was to evaluate the efficacy of effectiveness of emotion-focused couple therapy and acceptance and commitment therapy in influencing the attachment behavior of women experiencing marital conflicts. The pretest-posttest design was employed in this semi-experimental study, with a follow-up period of two months. In this research, the statistical population consisted of all women who were referred to counseling centers in Tehranin the year 2022. 45 individuals were randomly selected in a multi-stage cluster format and subsequently divided into two experimental groups (N=15 in each group) and a control group (N=15). The experimental groups underwent emotion-focused couple therapy (10 sessions 90 minutes) and acceptance and commitment therapy (10 sessions 90 minutes). The Brief Accessibility, Responsiveness, and Engagement (BARE) Scale and the Marital Conflicts Questionnaire (MCQ) were employed to gather data. The data was analyzed using SPSS software, which employed analysis of variance with repeated measures. The findings indicated that both interventions had a significant effect on the attachment behavior of women experiencing marital conflicts (P<0.05). Furthermore, the Bonferroni post hoc test results demonstrated that emotion-focused therapy is more effective in controlling attachment behavior and that this effect is enduring (P<0.05). It is possible to employ emotion-focused therapy and acceptance/commitment therapy as a treatment method for the attachment behavior of women with marital conflicts, as indicated by the findings of the current study.

Keywords

اسمعیلی، م.، ماردپور، ع.، و زاده باقری، ق. (1402). تعیین تفاوت زوج درمانی هیجان‌مدار و درمان مبتنی بر پذیرش و تعهد بر پرخاشگری ارتباطی پنهان زنان دارای تعارضات زناشویی. فصلنامه پژوهش‌های نوین روانشناختی، 18(72)، 60-49. https://doi.org/10.22034/jmpr.2024.17496
اسمعیلی، م.، ماردپور، ع.، و زاده باقری، ق. (1403). مقایسۀ اثربخشی زوج درمانی هیجان‌مدار و درمان مبتنی بر پذیرش و تعهد بر نیازهای اساسی زناشویی زنان دارای تعارضات زناشویی. نشریه پژوهش پرستاری ایران، ۱۹(۴)، 102-116 https://ijnr.ir/article-1-2805-fa.html
ایران‌نژاد، ز.، حمیدی‌پور، ر.، حیدری، ح.، و داوودی، ح. (1400). اثربخشی آموزش گروهی درمان مبتنی بر پذیرش و تعهد بر دلبستگی، صمیمیت و رضایت جنسی در زنان مبتلا به بی‌میلی جنسی. مجله دانشکدۀ پزشکی دانشگاه علوم پزشکی مشهد، 64(2)، 2875-2865. https://doi.org/10.22038/mjms.2021.18899
بدیهی زراعتی، ف.، و موسوی، ر. (1395). اثربخشی زوج درمانی هیجان‌مدار بر تغییر سبک دلبستگی بزرگسالان و صمیمیت جنسی زوجین. نشریه فرهنگ مشاوره و روان‌درمانی، 7(25)، 90-71.  https://doi.org/10.22054/qccpc.2016.5888
ثنایی‌ذاکر، ب.، براتی، ط.، و بوستانی‌پور، ع. (1387). کتاب مقیاس‌های سنجش خانواده و ازدواج. انتشارات بعثت: تهران.
جولازاده اسمعیلی، ع.، کریمی، ج.، گودرزی، ک.، و عسگری، م. (1398). هم‌سنجی کارایی زوج درمانی مبتنی بر پذیرش و تعهد و زوج‌درمانی متمرکز بر هیجان بر سبک‌های دلبستگی زوجین سازش‌نیافته. فصلنامه علمی و پژوهشی مشاوره و روان‌درمانی خانواده، 9(2)، 30-1. https://doi.org/10.22034/fcp.2020.61414
رسولی، م.، بابایی گرمخانی، م.، و داورنیا، ر. (1397). ارزیابی ویژگی‌های روان‌سنجی مقیاس کوتاه دسترسی‌پذیری، پاسخگویی و همدم‌طلبی(BARE): ابزاری برای سنجش رفتار دلبستگی در روابط زناشویی. مجله علوم پزشکی زانکو، 19(62)، 17-1. http://zanko.muk.ac.ir/article-1-358-fa.html
قربانزاده، س.، کیامرثی، آ.، و ابوالقاسمی، ع. (1402). مقایسه اثربخشی درمان مبتنی بر شفقت خود و زوج‌درمانی هیجان‌مدار بر عملکرد خانواده در زنان با تجربه خشونت خانگی. فصلنامه مطالعات روان‌شناختی، 19(4)، 10-1. https://doi.org/10.22051/psy.2023.43687.2786
قربانزاده، س.، کیامرثی، آ.، و ابوالقاسمی، ع. (1403). مقایسۀ اثربخشی درمان مبتنی بر شفقت‌خود و زوج‌درمانی هیجان‌مدار بر تجربیات آزاردیدگی در زنان قربانی خشونت خانگی در تعامل با خودجرحی. نشریه پژوهش پرستاری ایران، 19(1)، 77-65. http://ijnr.ir/article-1-2809-fa.html
موسوی، ر.، و بدیهی زراعتی، ف. (1395). بررسی اثربخشی زوج‌درمانی هیجان‌مدار (EFT) بر تغییر سبک دلبستگی زوجین. نشریه روانشناسی بالینی و شخصیت، 14(2)، 78-71. https://cpap.shahed.ac.ir/article_2782.html
یوسفی، ن.، و عزیزی، آ. (1397). تبیین مدلی برای پیش‌بینی تعارض زناشویی بر اساس تمایز یافتگی و تیپ‌های شخص. فصلنامه فرهنگ مشاوره و روان درمانی، 9(35)، 78-57. https://doi.org/10.22054/qccpc.2018.31499.1811
References
Allen, S., Hawkins, A. J., Harris, S. M., Roberts, K., Hubbard, A., & Doman, M. (2022). Day‐to‐day changes and longer‐term adjustments to divorce ideation: Marital commitment uncertainty processes over time. Family Relations, 71(2), 611-629. https://doi.org/10.1111/fare.12599
Badihi, F., & Mousavi, R. (2016). Efficacy of emotion-focused couple therapy on the change of adult attachment styles and sexual intimacy of couples. Counseling Culture and Psycotherapy, 7(25), 71-90. https://doi.org/10.22054/qccpc.2016.5888 (In Persian)
Bedair, K., Hamza, E. A., & Gladding, S. T. (2020). Attachment style, marital satisfaction, and mutual support attachment style in Qatar. The Family Journal, 28(3), 329-336. https://doi.org/10.1177/1066480720934377
Candel, O. S., & Turliuc, M. N. (2019). Insecure attachment and relationship satisfaction: A meta-analysis of actor and partner associations. Personality and Individual Differences, 147, 190-199. https://doi.org/10.1016/j.paid.2019.04.037
Catino, M., Rocchi, S., & Marzetti, G. V. (2022). The network of interfamily marriages in’Ndrangheta. Social Networks, 68, 318-329. https://doi.org/10.1016/j.socnet.2021.08.012
Coto-Lesmes, R., Fernández-Rodríguez, C., & González-Fernández, S. (2020). Acceptance and commitment therapy in group format for anxiety and depression. A systematic review. Journal of Affective Disorders, 263, 107-120. https://doi.org/10.1016/j.jad.2019.11.154
Dailey, J., Timulak, L., Goldman, R. S., & Greenberg, L. S. (2024). Capturing the change: A case study investigation of emotional and interactional transformation in emotion-focused therapy for couples. Person-Centered & Experiential Psychotherapies, 23(1), 1-19. https://doi.org/10.1080/14779757.2023.2204480
Dew, J., Trujillo, S., & Saxey, M. (2022). Predicting marital financial deception in a national sample: A person‐centered approach. Family Relations, 71(4), 1497-1514. https://doi.org/10.1111/fare.12654
Esmaeili, M., Mardpour, A., & Zadeh Bagheri, G. (2024). The comparison of effectiveness of emotion-focused couple therapy and acceptance and commitment therapy on marital basic needs among women with marital conflicts. Iranian Journal of Nursing Research, 19(4), 102-116. http://dx.doi.org/10.22034/IJNR.19.4.102 (In Persian)
Esmaeili, M., Maredpour, A. R., & Zadeh Bagheri, G. (2023). The comparison of effectiveness of emotion-focused couple therapy and acceptance and commitment therapy on covert relational aggression among women with marital conflicts. Journal of Modern Psychological Researches, 18(72), 49-60. https://doi.org/10.22034/jmpr.2024.17496 (In Persian)
Feeney, J., & Fitzgerald, J. (2019). Attachment, conflict and relationship quality: Laboratory-based and clinical insights. Current Opinion in Psychology, 25, 127-131. https://doi.org/10.1016/j.copsyc.2018.04.002
Forman, E. M., & Butryn, M. L. (2015). A new look at the science of weight control: How acceptance and commitment strategies can address the challenge of self-regulation. Appetite, 84, 171-180. https://doi.org/10.1016/j.appet.2014.10.004
Ghorbanzadeh, S. S., Kiamarsi, A., & Abolghasemi, A. (2024). Comparison the effectiveness of self-compassion‐focused therapy and emotionally focused couple therapy on abuse experience among women victims of domestic violence in interaction with self-injury. Iranian Journal of Nursing Research, 19(1), 65-77. http://dx.doi.org/10.22034/IJNR.19.1.6 (In Persian)
Ghorbanzadeh, S.S., Kiamarsi, A., & Abolghasemi, A. (2023). Comparison of effectiveness of self-compassion therapy and emotionally focused therapy on family functions of women experienced domestic violence. Journal of Psychological Studies, 19(4), 39-54. https://doi.org/10.22051/psy.2023.43687.2786 (In Persian)
Gong, Q., Kramer, K. Z., & Tu, K. M. (2023). Fathers’ marital conflict and children’s socioemotional skills: A moderated-mediation model of conflict resolution and parenting. Journal of Family Psychology, 37(7), 1048-1059. https://doi.org/10.1037/fam0001102
Goodwin, C. L., Forman, E. M., Herbert, J. D., Butryn, M. L., & Ledley, G. S. (2012). A pilot study examining the initial effectiveness of a brief acceptance-based behavior therapy for modifying diet and physical activity among cardiac patients. Behavior Modification, 36(2), 199-217. https://doi.org/10.1177/0145445511427770
Greenman, P. S., & Johnson, S. M. (2022). Emotionally focused therapy: Attachment, connection, and health. Current Opinion in Psychology, 43, 146-150. https://doi.org/10.1016/j.copsyc.2021.06.015
Hayes, S. C., Strosahl, K. D., &Wilson, K.G. (2012). Acceptance and commitment therapy: The process and practice of mindful change (2nd ed.). New York: Guilford Press. https://psycnet.apa.org/record/2012-00755-000
Irannezhad, Z., Hamidipoor, R., Heidari, H., & Davoudi, H. (2021). The effectiveness of acceptance and commitment therapy (ACT) group training on attachment, intimacy and sexual satisfaction in women with sexual reluctance. Medical Journal of Mashhad University of Medical Sciences, 64(2), 2865-2875. https://doi.org/10.22038/mjms.2021.18899 (In Persian)
Johnson, S. M. (2012). The practice of emotionally focused couple therapy: Creating connection (2rd Edition). Routledge. https://www.routledge.com/The-Practice-of-Emotionally-Focused-Couple-Therapy-Creating-Connection/Johnson/p/book/9780815348016
Johnson, S. M., & Whiffen, V. E. (Eds.). (2003). Attachment processes in couple and family therapy. Guilford Press. https://psycnet.apa.org/record/2004-00020-000
Joulazadeh Esmaeili, A. A., Karimi, J., & Goodarzi, K., & Asgari, M. (2020). Comparison of the effectiveness of acceptance and commitment-based Couple Therapy and emotionally focused couple therapy on unadjusted couples' attachment styles. Family Counseling and Psychotherapy, 9(2), 1-30. https://doi.org/10.22034/fcp.2020.61414 (In Persian)
Kashdan, T. B., Disabato, D. J., Goodman, F. R., Doorley, J. D., & McKnight, P. E. (2020). Understanding psychological flexibility: A multimethod exploration of pursuing valued goals despite the presence of distress. Psychological Assessment, 32(9), 829-850. https://doi.org/10.1037/pas0000834
Khurshid, S., Peng, Y., & Wang, Z. (2019). Respiratory sinus arrhythmia acts as a moderator of the relationship between parental marital conflict and adolescents’ internalizing problems. Frontiers in Neuroscience, 13, 00500. https://doi.org/10.3389/fnins.2019.00500
Kula, O., Machluf, R., Shahar, B., Greenberg, L. S., & Bar-Kalifa, E. (2024). The effect of therapists’ enactment interventions in promoting vulnerability sharing in emotion focused couple therapy. Psychotherapy Research, 34(6), 748-759. https://doi.org/10.1080/10503307.2023.2245961
Lee, E. J., & Han, S. (2023). Patterns of marital conflict among middle‐aged couples and their effects on family satisfaction: A latent class analysis. Family Relations, 72(4), 1942-1954. https://doi.org/10.1111/fare.12827
Lu, F., Huang, X., Xu, E., Chung, C. N., & He, X. (2022). Instrumental love: Political marriage and family firm growth. Management and Organization Review, 18(2), 279-318. https://doi.org/10.1017/mor.2021.75
Makinen, J. A., & Johnson, S. M. (2006). Resolving attachment injuries in couples using emotionally focused therapy: Steps toward forgiveness and reconciliation. Journal of Consulting and Clinical Psychology, 74(6), 1055–1064. https://doi.org/10.1037/0022-006X.74.6.1055
Marren, C., Mikoška, P., O'Brien, S., & Timulak, L. (2022). A qualitative meta‐analysis of the clients' experiences of emotion‐focused therapy. Clinical Psychology & Psychotherapy, 29(5), 1611-1625. https://doi.org/10.1002/cpp.2745
Monacis, L., De Palo, V., Griffiths, M. D., & Sinatra, M. (2017). Social networking addiction, attachment style, and validation of the Italian version of the Bergen Social Media Addiction Scale. Journal of Behavioral Addictions, 6(2), 178-186. https://doi.org/10.1556/2006.6.2017.023
Mousavi, R., & Badihi, F. (2017). Investigation of effectiveness of Emotion-Focused Couple Therapy (EFCT) on Couples' Attachment Styles. Clinical Psychology and Personality, 14(2), 71-78. https://cpap.shahed.ac.ir/article_2782.html?lang=en (In Persian)
Neumann, A. P., Wagner, A., & Remor, E. (2018). Couple relationship education program “Living as Partners”: Evaluation of effects on marital quality and conflict. Psicologia: Reflexão e Crítica, 31, 26. https://doi.org/10.1186/s41155-018-0106-z
Nisanci, Z., & Nisanci, A. (2023). Between-reporter agreement among couples: Exploring nonlinear patterns in marital conflict. Journal of Interpersonal Violence, 38(1-2), 16-36. https://doi.org/10.1177/08862605221118963
Paulos-Guarnieri, L., Linares, I. M. P., & El Rafihi-Ferreira, R. (2022). Evidence and characteristics of acceptance and commitment therapy (ACT)-based interventions for insomnia: A systematic review of randomized and non-randomized trials. Journal of Contextual Behavioral Science, 23, 1-14. https://doi.org/10.1016/j.jcbs.2021.11.001
Rasouli, M., Babaei Gharmkhani, M., & davarniya, R. (2018). The evaluation of the psychometric properties of brief accessibility, responsiveness, and engagement scale (BARE): A tool for measuring attachment behavior in couple relationships. Zanko Journal of Medical Sciences, 19(62), 1-17. http://zanko.muk.ac.ir/article-1-358-en.html (In Persian)
Ruhlmann, L. M., Gallus, K. L., & Durtschi, J. A. (2018). Exploring relationship satisfaction and attachment behaviors in single-and dual-trauma couples: A pilot study. Traumatology, 24(1), 27. https://doi.org/10.1037/trm0000129
Sanaizakir, B., Barati, T., & Bostanipour, A. (2008). Family and marriage reference book. Tehran: Ba'ath Publications. (In Persian)
Sandberg, D. A., Valdez, C. E., Engle, J. L., & Menghrajani, E. (2019). Attachment anxiety as a risk factor for subsequent intimate partner violence victimization: A 6-month prospective study among college women. Journal of Interpersonal Violence, 34(7), 1410-1427. https://doi.org/10.1177/0886260516651314
Sandberg, J. G., & Knestel, A. (2011). The experience of learning emotionally focused couples’ therapy. Journal of Marital and Family Therapy, 37(4), 393-410.  https://doi.org/10.1111/j.1752-0606.2011.00254.x.
Sandberg, J. G., Busby, D. M., Johnson, S. M., & Yoshida, K. (2012). The brief accessibility, responsiveness, and engagement (BARE) scale: A tool for measuring attachment behavior in couple relationships. Family Process, 51(4), 512-526. https://doi.org/10.1111/j.1545-5300.2012.01422.x
Sandberg, J. G., Novak, J. R., Davis, S. Y., & Busby, D. M. (2016). The brief accessibility, responsiveness, and engagement scale: A tool for measuring attachment behaviors in clinical couples. Journal of Marital and Family Therapy, 42(1), 106-122. https://doi.org/10.1111/jmft.12151
Şenol, A., Gürbüz, F., & Dost, M. T. (2023). Emotion-focused couple therapy: A review of theory and practice. Psikiyatride Güncel Yaklaşımlar, 15(1), 146-160. https://doi.org/10.18863/pgy.1090793
Wang, J. Y., Luo, G. Y., Lv, X. Q., Liang, C. M., ... & Cao, Y. X. (2023). Resilience of infertile families undergoing in vitro fertilization: An application of the double ABC-X model. Applied Nursing Research, 69, 151656. https://doi.org/10.1016/j.apnr.2022.151656
Werner, H., Young, C., Hakeberg, M., & Wide, U. (2020). A behavioural intervention for young adults with dental caries, using acceptance and commitment therapy (ACT): Treatment manual and case illustration. BMC Oral Health, 20, 233. https://doi.org/10.1186/s12903-020-01213-4
Wright, S. R., Graham, C. D., Houghton, R., Ghiglieri, C., & Berry, E. (2023). Acceptance and commitment therapy (ACT) for caregivers of children with chronic conditions: A mixed methods systematic review (MMSR) of efficacy, process, and acceptance. Journal of Contextual Behavioral Science, 27, 72-97. https://doi.org/10.1016/j.jcbs.2022.12.003
Yoosefi, N., & Azizi, A. (2018). Explaining a model to predict marital conflict based on differentiation and personality types. Counseling Culture and Psycotherapy, 9(35), 57-78. https://doi.org/10.22054/qccpc.2018.31499.1811 (In Persian)
Volume 17, Issue 2
July 2026
Pages 31-50
  • Receive Date: 19 June 2023
  • Revise Date: 11 September 2023
  • Accept Date: 19 September 2023
  • First Publish Date: 03 November 2024
  • Publish Date: 01 July 2026