Diversity & Equality in Health and Care Open Access

Keywords

Gottman method couple therapy (GMCT); Narrative therapy; Dyadic adjustment scale (DAS); Couple burnout mature (CBM)

Introduction

Conflict is regarded as the interaction between couples who have different views and beliefs about 61 % of divorced individuals have reported that conflict is important role in divorce that is a natural phenomenon in all family relationships [1] marital adjustment is defined as understanding in activities, which are associated with happiness and success in life. Marriage is a condition in which both husband and wife experience in happiness and satisfaction in fact the problem of marital conflict is directly related to the satisfaction of all basic needs and is more than any other category for referral and receiving psychotherapy, counseling and social work [2]. However, the difficulties of the couple are not the only cause of marital conflict, but they determine the negative relationships. Indeed, when couples engage in relations, go to life a series of dreams when in during time, conflict replace to dream then the boredom takes place. Recent one of the leading models is Gottman method couples therapy that basis in friendship, conflict management in the system of common concepts. In terms of Gottman, four factors are important, that undermine 86 percent of the predictive confidence of the divorce. The four horsemen known are criticism, blame, and defensiveness [3]. Gottman believes that by analyzing the relationship of a couple, the possibility of achieving a divorce can be predicted [4] in the meantime, different approaches have been proposed to treat family problems, one of which is a narrative therapy. Polkinghrone [5] notes in his book that the couples of the divorce applicant who attended the narrative therapy courses showed less depression and disappointment than their counterparts in the four - month follow - up. The increasing of marital conflicts, is the negative effect on the mental health of couples and their children and it has led to therapists make plans to help couples conflict each approach has proposed different treatment and training methods based on their specific explanations. Also, attention to this point that there has never been research comparing the efficacy and therapeutic effectiveness of the narrative in Iran. Therefore, the main purpose of this study is to answer the question whether there is a signification effect Gottman method couple therapy and narrative therapy based couple on couples burnout and marital adjustment in couples with conflict?.

Methodology

The present study is the type of semi experiment studies, pre test post test with the control group. The study consisted of all adjustment couples referred the family court, resolution councils and counseling centers in mashhad city during the fall of 2016 24 couples based that 8 couples receive Gottman method couple therapy, eight couples narrative therapy and eight couples were the control group. First, the announcement was made to select the sample 45 couples have the condition to enter the study (fewer than 75 in DAS and more than 73 in CBM) the people have a problem cause of addiction, mental illness, homicide, and marital infidelity had been driven out of the study 24 couples selected random they have been married minimum three years and a maximum of 15 years; their age. In the range of 20 to 40 years and there was their original marriage. Selected 24 couples randomly, then based on 8 meetings 90 minutes for the experimental groups in pre-test and post-test. The control group did not receive any treatment, and they were told that they are waiting list in the process of treatment after three months the therapeutic protocols used in this study include a package Gottman method couple therapy [6] and narrative therapy [7].

Couple burnout matures Pains (CBM): it is a self - report made by Pinez [8] with the aim of measuring the degree of burnout among couples. The questionnaire includes 21 materials, 17 of which include negative phrases, such as fatigue, discomfort, and other 4 substances, including positive expressions, such as being happy and energetic. At this was a Likert scale ranging from one to seven. In addition, 4 materials is done in reverse, test-retest reliability method was 0.76 in a one - month period. The validity of this scale was calculated by the cronbach's alpha method a range between 0.91 and 0.93 in his study, the author obtained the reliability of this scale using the Cronbach's Alpha method of 0.85. Marital adjustment scale (DAS). Marital adjustment scale is designed by Spanier in 1976 [9]. The questionnaire includes 32 materials, at this was a Likert scale ranging from 0 to 6 between zero to 151, scoring 101 and more points to better relationship and lower scores agreeableness the validity of this scale was calculated by cronbach's alpha method 0.96 in Spanier study [9], Khodayarifard et al. [10] and Obtained the reliability of this scale 0.94.

Findings

In this research , mean and standard deviation of the age group of gmct of 32.00 ± 3.759 year in narrative therapy group 31.63 ± 3.284 year and control group was 32.383.117 the results of the analysis of variance one way(ANOVA) show that significant no difference between the mean age of participants and their peers in terms of age (t=0.195 & p=0.824) the duration of the marriage was more than 5 years in 85.5 participants the mean and standard deviation of the duration of the marriage for the GMCT group was 5.38 ± 1.147 narrative group 5.56 ± 1.365 and control group 5.69 ± 1.014the results of the anova showed that there was no significant difference between the mean duration of the marriage participants and their peers (p=0.755, t=0.282).

Table 1 shows the mean and standard deviation and results Shapiro-Wilk examine couple burnout and marital adjustment of the three groups according to Shapiro-Wilk examine (p›0.05) presumption the normal distribution of the data to conduct an analysis of MANOVA is established and the results of the leven test showed that the variance homogeneity in the two variables couple burnout (f=0.477, p=0.624) and marital adjustment (f=1.294, p=0.284)is established. Before the covariance analysis, the regression line between independent variable and the dependent variable were investigated; couple burnout(f=1.311, p=0.281) and marital adjustment (f=0.087, p=0.916) also was investigated homogeneity of the covariance-variance matrices was investigated using M box, the results showed significant for the dependent variables (f=1.080, p=0.372) (Table 1).

Table 1: Descriptive  statistics  and  results  Shapiro-Wilk  examine  couple  burnout  and  marital adjustment of the three groups

Table 2 shows that with the pre-test effect control, according to Wilks' lambda And Pillai'strace test there is a significant difference in the three groups, at least in terms of one of the variables couple burnout and marital adjustment (Table 2).

Table 2: Results of the multi co-variance analysis of couples burnout and marital adjustment of the three groups

Table 3 shows that considering pretest scores as an auxiliary variable, there is a significant difference. Among the experimental and control groups in the two variables couple burnout (f=189.493, p‹0.0001) marital adjustment (f=214.834, p‹0.0001). The impact of marital adjustment was 91 % and 90 % in couple’s burnout. This is due to the difference in the membership of the therapeutic groups. Therefore, it can be confirmed that both therapies have been effective. The statistical power of 1 indicates the adequacy of the sample volume and the acceptable statistical accuracy for this conclusion (Table 3).

Table 3: Results of the co-variance analysis of effects between the mean couples burnout and marital adjustment of the three groups

Table 4 showed the receiving group of GMCT better than the other two groups, receiving the group of narrative therapy better than the control group in post-test 2 variables (p‹0.05) (Table 4).

Table 4: lsd’s comparison the studied variables in the three groups

Conclusion

The research was conducted with the objective comparison of the effectiveness of GMCT with narrative therapy based couple on couples burnout and marital adjustment in couples with conflict. It can be concluded that the therapy is more effective in groups of GMCT that aligns with the results of research, the authors [5,6,11] showed that the treatment in Gottman's method led to a rise in marital satisfaction, reduction of marital troubles to follow up a year. Other findings like in Iran pointed out that the effectiveness GMCT was effective compared to the lack of treatment in explaining this finding, the couple will be able to communicate effectively after participating in the therapeutic sessions to negotiate in their responsibilities, effectively communicate with each other, discuss the causes of disagreement and importance of the expression of their perspective on the best way to manage, and make their decision operation [12]. Wamboldt [13] found that the therapeutic narrative was effective in dealing with the problems of life one of the main reasons for this can be referred to externalizing the problem’s technique, they are asked to see the problem outside themselves so that inside himself there will be a change in the therapy sessions with the help of the partners in the narrative of stable to unstable, internal to external, uncontrollable to controllable. The effectiveness of the GMCT approach to the narrative therapy can be explained that the GMCT theory is an integrated approach including as argued that the woman is affected by husband and husband by woman, supports a system theory or it also supports the existential point of view, when seeing existentialistic dream of life; and when these dreams are described, it supports the story therapy, the method of Gottman supports a psychoanalytic, as dreams usually return to the childhood of a person and attention to the symbolic meanings, And as it seeks to change behavior, it supports the behavioral approach because it believes that the best way to change the rather than trying to change the perception in other hands we known behavior leads to change of thought [14]. White M, Epston D [15] showed trying to eliminate symptoms without talking about them is not very effective and Barrett, et al. [16] was revealed change is more important at the level of excitement than at the level of behavior in the couple. This study was specific limitations like lack of follow up was one of the main limitations of this study it can affect the generalizability of the research.

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