Comparing the Effect of Integrative-Behavioral and Emotion-Focused Couple Therapies on Marital Adjustment of Couples with Obsessive-Compulsive Disorder

Document Type : Original Article

Authors

1 Department of Psychology, Faculty of Humanities, Islamic Azad University, Science and Research Branch, Tehran, Iran

2 Institute for Research and Development in the Humanities, Tehran, Iran

Abstract

Introduction: The present study was conducted to compare the effectiveness of Integrative Behavioral Couple Therapy (IBCT) and Emotionally Focused Therapy (EFT) on marital adjustment of couples with the Obsessive-Compulsive Disorder (OCD).
Method: This quasi-experimental study was carried out on couples referred to the Psychological Services Center of Oil Hospital in Tehran, 2020. Thirty couples were selected by purposive sampling and were randomly assigned to three groups: IBCT and EFT groups, and the control group. Two experimental groups received 20 sessions of 90-minute treatment. Maudsley Obsessive Compulsive Inventory (MOCI) and Dyadic marital Adjustment Scale (DAS) of Spanier were used to collect data. Data were analyzed using the analysis of covariance.
Results: The results showed that EFT was more effective in increasing marital adjustment than IBCT (P <0.01). Likewise, EFT was more effective than IBCT in increasing the subscales of marital satisfaction, cohesion and affectional expression (P <0.05); while the agreement showed that there was no significant difference between the two therapy groups and the control group (P > 0.05).
Conclusion: The findings of the present study indicate that both approaches of therapy can increase the marital adjustment in couples with OCD. Considering the greater effectiveness of EFT, it is recommended to use this therapy in the training programs of therapists to treat problems of couples.

Keywords


  1. Parnell KJ, Hammer JH. Deciding on couple therapy: The role of masculinity in relationship help-seeking. Psychology of Men & Masculinity. 2018;19(2):212. http://doi.org/10.1037/men0000098
  2. McNulty JK, Russell VM. When “negative” behaviors are positive: A contextual analysis of the long-term effects of problem-solving behaviors on changes in relationship satisfaction. Journal of personality and social psychology. 2010;98(4):587. http://doi.org/10.1037/a0017479
  3. Abramowitz JS, Baucom DH, Boeding S, Wheaton MG, Pukay-Martin ND, Fabricant LE, et al. Treating obsessive-compulsive disorder in intimate relationships: A pilot study of couple-based cognitive-behavior therapy. Behavior therapy. 2013;44(3):395-407. http://doi.org/10.1016/j.beth.2013.02.005
  4. Sugarman MA, Kirsch I, Huppert JD. Obsessive-compulsive disorder has a reduced placebo (and antidepressant) response compared to other anxiety disorders: a meta-analysis. Journal of affective disorders. 2017;218:217-26. http://doi.org/10.1016/j.jad.2017.04.068
  5. Kaplan BJ. Kaplan and sadock’s synopsis of psychiatry. Behavioral sciences/clinical psychiatry. Tijdschrift voor Psychiatrie. 2016;58(1):78-9.
  6. Lebowitz ER, Panza KE, Bloch MH. Family accommodation in obsessive-compulsive and anxiety disorders: a five-year update. Expert review of neurotherapeutics. 2016;16(1):45-53. http://doi.org/10.1586/14737175.2016.1126181
  7. Angelakis I, Gooding P, Tarrier N, Panagioti M. Suicidality in obsessive compulsive disorder (OCD): a systematic review and meta-analysis. Clinical psychology review. 2015;39:1-15. http://doi.org/10.1016/j.cpr.2015.03.002
  8. Singh A, Kumar R, Mishra S, Kumar P, Singh B. Marital Adjustment and Quality of Life of The Person with Obsessive Compulsive Disorder: A Brief Overview. International Journal of Indian Psychology. 2022; 10(1): 978-983. doi:10.25215/1001.100
  9. Huppert JD, Simpson HB, Nissenson KJ, Liebowitz MR, Foa EB. Quality of life and functional impairment in obsessive–compulsive disorder: a comparison of patients with and without comorbidity, patients in remission, and healthy controls. Depression and anxiety. 2009;26(1):39-45. doi: 10.1002/da.20506
  10. Belus JM, Baucom DH, Abramowitz JS. The effect of a couple-based treatment for OCD on intimate partners. Journal of Behavior Therapy and Experimental Psychiatry. 2014;45(4):484-8. http://dx.doi.org/10.1016/j.jbtep.2014.07.001
  11. Okesina FA. Marital Adjustment and Communication Styles among Married Adults in Ilorin, Kwara State, Nigeria. Canadian Journal of Family and Youth/Le Journal Canadien de Famille et de la Jeunesse. 2022;14(1):162-79. doi: https://doi.org/10.29173/cjfy29750
  12. Sahu S, Mujawar S, Garg D, Chaudhury S, Saldanha D. Quality of life and marital adjustment in spouses of schizophrenia patients. Industrial Psychiatry Journal. 2020;29(2): 323–328. doi: 10.4103/ipj.ipj_176_20
  13. Kumar A. A comparative study of marital adjustment among patients with obsessive-compulsive disorder and normal controls. IAHRW International Journal of Social Sciences Review. 2019;7(5-III):1719-21.
  14. Dimkpa DI. Marital adjustment roles of couples practicing child adoption. Eur J Soc Sci. 2010;13(2):194-200.
  15. Ebenuwa-Okoh EE. Correlates of Marital Adjustment among Married Persons in Delta State of Nigeria. Studies on Home and Community Science. 2010;4(3):175-8. https://doi.org/10.1080/09737189.2010.11885318
  16. Batool SS, Bakht S. Religiosity and Stress as Predictors of Severity of OCD, and Difference in Marital Adjustment of OCD and Non-OCD Individuals. Journal of Pakistan Psychiatric Society. 2020;17(3).
  17. Lewis RA, Spanier GB. Theorizing about the quality and stability of marriage. Contemporary theories about the family: research-based theories/edited by Wesley R Burr[et al]. New York: Free Press; 1979.
  18. Hezel DM, Simpson HB. Exposure and response prevention for obsessive-compulsive disorder: A review and new directions. Indian journal of psychiatry. 2019;61(Suppl 1):S85. http://doi.org/10.4103/psychiatry.IndianJPsychiatry_516_18
  19. Reid JE, Laws KR, Drummond L, Vismara M, Grancini B, Mpavaenda D, et al. Cognitive behavioural therapy with exposure and response prevention in the treatment of obsessive-compulsive disorder: A systematic review and meta-analysis of randomised controlled trials. Comprehensive psychiatry. 2021;106:152223. http://doi.org/10.1016/j.comppsych.2021.152223
  20. Brandes O, Stern A, Doron G. “I just can't trust my partner”: Evaluating associations between untrustworthiness obsessions, relationship obsessions and couples violence. Journal of Obsessive-Compulsive and Related Disorders. 2020;24:100500. https://doi.org/10.1016/j.jocrd.2019.100500
  21. Johnson S, Zuccarini D. Integrating sex and attachment in emotionally focused couple therapy. Journal of marital and family Therapy. 2010;36(4):431-45. https://doi.org/10.1111/j.1752-0606.2009.00155.x
  22. Farshchiyan Yazdi M, Bagherzadeh Golmakani Z, Mansouri A. Comparison of the Effectiveness of Emotionally Focused Therapy and Self-Compassion Skills Training on Differentiation of Self and Sexual Intimacy of Women Affected by Marital Infidelity. Razavi International Journal of Medicine. 2021;9(3):34-43. https://doi.org/10.30483/rijm.2021.254236.1079
  23. Beasley CC, Ager R. Emotionally focused couples therapy: A systematic review of its effectiveness over the past 19 years. Journal of Evidence-Based Social Work. 2019;16(2):144-59. https://doi.org/10.1080/23761407.2018.1563013
  24. Dimidjian S, Martell CR, Christensen A. Integrative behavioral couple therapy. Clinical handbook of couple therapy. 2008:73-103.
  25. Kalai C, Eldridge K. Integrative Behavioral Couple Therapy for intercultural couples: Helping couples navigate cultural differences. Contemporary Family Therapy. 2021;43(3):259-75. https://digitalcommons.pepperdine.edu/etd/738
  26. Blanchard VL, Hawkins AJ, Baldwin SA, Fawcett EB. Investigating the effects of marriage and relationship education on couples' communication skills: a meta-analytic study. Journal of Family Psychology. 2009;23(2):203. http://doi.org/10.1037/a0015211
  27. Dehghani Y. The effectiveness of acceptance and commitment group therapy on depression and quality of life in women with dialysis patients. Journal of Clinical Psychology. 2016;8(3):1-10. http://doi.org/10.22075/jcp.2017.2240
  28. Greenberg L. Emotion and cognition in psychotherapy: The transforming power of affect. Canadian Psychology/Psychologie canadienne. 2008 Feb;49(1):49. https://doi.org/10.1037/0708-5591.49.1.49
  29. Jacobson NS, Christensen A. Studying the effectiveness of psychotherapy: How well can clinical trials do the job?. American Psychologist. 1996;51(10):1031–1039. https://doi.org/10.1037/0003-066X.51.10.1031
  30. Hodgson RJ, Rachman S. Obsessional-compulsive complaints. Behaviour research and therapy. 1977;15(5):389-95. https://doi.org/10.1016/0005-7967(77)90042-0
  31. Mahin H. The relationship between obsessive-compulsive symptoms, incontinence and the components of anxiety, depression and dysmorphia in outpatient psychiatric patients. Persian Language and Literature. 2011; (183 & 184): 267-302.
  32. Spanier GB, Cole CL. Toward clarification and investigation of marital adjustment. International journal of sociology of the family. 1976:121-46.
  33. Isanejad O, Alizade Z. The effectiveness of couples coping enhancement training (CCET) on marital adjustment and marital coping strategies. Journal of Applied psychological research. 2020;11(1):67-85. http://doi.org/10.22059/japr.2020.277483.643200
  34. Haghani M, Abedi A, Fatehizade M, Aghaei A. A Comparison of the Effectiveness of Combined Systemic Couple Therapy (Bowen) and Emotion-focused Therapy (Johnson) Packages and Integrated Couple Therapy on the Quality of Marital Life of Couples Affected by Infidelity. Sadra Medical Journal. 2019;8(1):11-28. http://doi.org/10.30476/smsj.2020.82902.1040
  35. Poursardar F, Sadeghi M, Goodarzi C, Roozbehani M. Integrative treatments and couple therapy: Comparison of the effectiveness of integrative approaches, therapy emotionally focused couple therapy and therapy integrative behavioral couple therapy on forgiveness in couples with marital conflict. Family Counseling and Psychotherapy. 2019;8(2):69-96. https://fcp.uok.ac.ir/article_61018_12c310a0569ea747a0bf4e2c3a955612.pdf?lang=en
  36. Goldman RN, Greenberg LS, Angus L. The effects of adding emotion-focused interventions to the client-centered relationship conditions in the treatment of depression. Psychotherapy Research. 2006;16(5):537-49. https://doi.org/10.1080/10503300600589456
  37. Johnson SM, Greenberg LS. Emotionally focused couples therapy: An outcome study. Journal of Marital and Family Therapy. 1985;11(3):313-7.
  38. Johnson SM. The contribution of emotionally focused couples therapy. Journal of Contemporary Psychotherapy. 2007;37(1):47-52. https://doi.org/10.1007/s10879-006-9034-9
  39. Hedayati M, Haji Alizadeh K, Hedayati M, Fathi E. Effectiveness of Emotionally Focused Couples Therapy on the Marital Intimacy of Couples Coping with Breast Cancer in Women. Iranian Journal of Breast Diseases. 2020;13(3):30-42. https://doi.org/10.30699/ijbd.13.3.30
  40. Wiebe SA, Johnson SM. A review of the research in emotionally focused therapy for couples. Family Process. 2016;55(3):390-407. https://doi.org/10.1111/famp.12229
  41. Rajabi G, Hayatbakhsh L, Taghipour M. Structural Model of the Relationship between Emotional Skillfulness, Intimacy, Marital Adjustment and Satisfaction. Family Counseling and Psychotherapy. 2015;5(1):68-92. https://fcp.uok.ac.ir/article_11241_8ab00e9e5ee2b83269c7490508ddcd26.pdf?lang=en
  42. Perissutti C, Barraca J. Integrative behavioral couple therapy vs. Traditional behavioral couple therapy: A theoretical review of the differential effectiveness. Clínica y Salud. 2013;24(1):11-8. https://doi.org/10.5093/cl2013a2
  43. Christensen A, Atkins DC, Baucom B, Yi J. Marital status and satisfaction five years following a randomized clinical trial comparing traditional versus integrative behavioral couple therapy. Journal of Consulting and Clinical Psychology. 2010;78(2):225. https://doi.org/10.1037/a0018132