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Azemnia Z, Hasani F, Keshavarzi Arshadi F, Ghahari Ahangar Kalaee S. Comparing the Effectiveness of Adlerian and Emotion-Focused Group Counseling on the Resilience of Women with Marital Conflict. J Police Med 2022; 11 (1) : e35
URL: http://jpmed.ir/article-1-1121-en.html
1- Department of Psychology, Central Tehran Branch, Islamic Azad University, Tehran, Iran
2- Department of Psychology, Central Tehran Branch, Islamic Azad University, Tehran, Iran , hassani.fariba@gmail.com
3- Department of Mental Health, Faculty of Behavioral Sciences & Mental, Iran University of Medical Sciences, Tehran, Iran
English Extended Abstract:   (1075 Views)
... [1, 2]. Marital relationship is an essential factor in creating peace [3]. Several factors can be influential in the quality of this matter and make couples that have marital conflicts over time. Experts have defined conflict as a type of marital relationship in which violent behaviors cause discomfort [4]. ... [5, 6]. The study of resilience tries to find an answer to this question why some people show more tolerance in times of trouble. ... [7, 8]. One of the most important interventions in this field is Adlerian therapy, which has received less attention in the field of family therapy in Iran [9]. ... [10-12]. The goal of Adlerian couple therapy is to increase the self-esteem of each party, as well as to increase social interest and belonging to each other [13]. ... [14-16]. In addition to Adlerian therapy, which plays an essential role in reducing marital problems, one of the necessary treatments for improving marital functions is emotion-focused therapy, which plays an important role in raising the family resilience level of couples [5]. According to the proposed research framework, it can be seen that so far, no research has investigated and compared the effectiveness of Adlerian and emotion-focused intervention on the resilience of women with marital conflicts at the same time [8, 9, 12, 14, 17, 18] and most importantly, the mentioned interventions have not been carried out in multiple or group forms. This type of intervention, in addition to creating more motivation for members to work, can give more opportunities for the therapist to do more interventions in one session.
The present study was conducted to compare the effectiveness of Adlerian and emotion-focused interventions on the resilience of women with marital conflict.
This research is semi-experimental, with a pre-test and post-test design and a control group with a 3-month follow-up.
The statistical population of this research was all the women with marital conflicts who were referred to counseling and psychological services centers in district 12 of Tehran in 2021.
At first, to hold the meetings based on a call and by the available sampling method, among the married women who volunteered to participate in the meetings and the questionnaire on marital conflicts was implemented on them; those who scored between 111 and 191 and more in this questionnaire were selected and 60 women were identified as samples. Based on previous studies [3], these 60 people were randomly assigned to groups (20 in the Adlerian intervention group, 20 in the emotion-focused therapy group, and 20 in the control group).
To collect data, the marital conflicts questionnaire (MCQ) by Sanaei Zaker et al. (2017) and the resilience scale (RISC) by Connor and Davidson (2003) were used. The marital conflicts questionnaire is classified with 54 questions, conflicts of couples in four levels: no conflict with a score of 12 to 90, normal conflict with a score of 90 to 111, excessive conflict with a score of 111 to 191, and very intense conflict with a score higher than 190 [10]. ... [19-23]. In another study, Cronbach's alpha of all questions was 0.75, and its subscales were in the range of 0.69 to 0.73 [24]. 
Tables 1 and 2 include Adlerian group counseling sessions and emotion-focused couple therapy. In this research, ten sessions of emotion-focused therapy based on Johnson and Greenberg's theory and Bowlby's attachment theory were conducted for the experimental group. The validity of these sessions has been confirmed in the research of Imanirad et al. [29]. In the present study, the content validity ratio and the content validity index were used to check the content validity of the training packages. In order to calculate the CVR index, the opinions of experts in the desired field were used, and by explaining the objectives of the test and providing an operational definition related to the content of the questions, they were asked to classify each of the objectives. Then, the content validity ratio was calculated based on the CVR formula. Based on the number of experts who evaluated the objectives, the acceptable CVR value is 0.62. In this research, the content validity ratio (CVR) for all objectives in the training protocols was obtained between 0.9 and 1. Also, according to the number of experts, the acceptable value of CVI is 0.79. In this research, the content validity index (CVI) for all objectives in the educational package was between 0.9 and 1.
The ethical principles of the current research were fully respected; the participants could leave the research whenever they wanted, and all their confidential information in the questionnaire would be preserved and not exploited.
After completing the questionnaires, appropriate descriptive and inferential statistical methods such as mean and standard deviation and mixed variance analysis were used to analyze the data. Also, Bonferroni's post hoc test and SPSS 24 software were used to compare Adlerian intervention and emotion-focused therapy.
The results of demographic surveys showed; the F statistic obtained from comparing the frequencies of the three groups in the age variable was F=0.374, which was not statistically significant (p>0.689), indicating that the three groups were equal in terms of age. (Table 3). Also, the results of the descriptive data at this stage showed the average of the dependent variables of the experimental groups (Adlerian intervention and emotion-focused therapy) according to the measurement stages (pre-test, post-test, and follow-up). Since the values of the Shapiro-Wilks test were not significant in any levels (p>0.05), the scores' distribution was considered normal. Levene's test was also used to check the homogeneity of variances. According to the results, the index of Levene's test was not statistically significant in three levels of evaluation (p<0.05), and the equality of variances was confirmed. The research data did not violate the default of homogeneity of variance-covariance matrices (Box's M); therefore, this default was observed (p>0.05). The significance level of the group and pre-test interaction effect was more significant than 0.05, indicating the homogeneity of the slope of the regression line. Considering that the defaults of mixed variance analysis have been met, this statistical test was used (Table 4). Mauchly's sphericity test obtained a significant level of p<0.001 for resilience dimensions. Therefore, the default of sphericity was rejected. As a result, the default of the sameness of the variances and, more precisely, the homogeneity condition of the covariance matrix was not ensured. Therefore, a violation of the F statistical model was made (Table 5). As a result, alternative tests such as Greenhouse–Geisser conservative test were used to investigate the within-subject effects of treatment. The results recorded in Table 6 showed that the effect of the intragroup variable (time factor) on resilience dimensions was significant (p<0.001). In this way, the effect of inter-group variables (Adlerian intervention and emotion-focused therapy) in increasing resilience dimensions were significant (Table 6). A two-by-two comparison of the average adjustment of test levels (pre-test, post-test, and follow-up) in resilience dimensions is shown in Table 7. In order to determine in which stages the scores of resilience dimensions have significant differences, Bonferroni's post hoc test was used to compare the averages two by two. As the results, the average difference between the pre-test and post-test (intervention effect) and the average difference between the pre-test and follow-up (time effect) was more remarkable and more significant than the average difference between post-test and follow-up (intervention stability effect), which indicated that Adlerian intervention and emotion-focused therapy affected the dimensions of resilience in the post-test phase and the continuation of this effect in the follow-up level was also observed (Table 7).  Also, the results obtained in the post-examination and follow-up level did not clarify which method was the treatment or which treatment method was more practical; therefore, Bonferroni's post hoc test (to compare the effectiveness of the intervention groups) was used to investigate the difference in the effectiveness of Adlerian intervention and emotion-focused therapy on increasing the dimensions of resilience. Based on this, the results showed that the average difference between the Adlerian intervention group and the control group was more significant than the average difference between the emotion-focused treatment and the control group, which indicated that the Adlerian intervention was more effective than the emotion-focused treatment on increasing resilience dimensions (Table 8).
... [30, 31]. The results showed that both treatments significantly increased resilience in the post-test and follow-up phase compared to the control group. In addition, the results of Bonferroni's post hoc test showed that Adlerian intervention was more effective in increasing resilience. This obtained result can be aligned with the research of Amani et al., Braga et al., and Shirafkan and Mahmoudi [16, 18, 32, 33]. In explaining the effectiveness of Adlerian therapy on resilience, the goal of Adlerian intervention is to help people to achieve an objective view of reality by correcting false goals and logic [34]. In this context, the research results also showed that the process elements of Adlerian therapy were able to increase the resilience of women with marital conflicts. Also, according to Adler, every idea a person accepts is displayed through his lifestyle. Adler stated the importance of choice and believed people could make their own choices. What one person may consider fair conditions, another may believe to be completely unfair. Considering that in Adlerian intervention, clients try to gain insight into their personal logic and find the cause of their negative attitudes and behaviors and also, Adlerian approach believes that people's problems have social roots and based on this default, they have social prospects for diagnosis and treatment in group work, therefore, by participating in group meetings, the members learn how to behave and interact appropriately [32], and this causes them to benefit from the support of others when experiencing marital problems in life as well as the help of others in solving marital problems, and this can increase their resilience. They should use the help of others in solving marital problems, which can increase their resilience. Therefore, it is reasonable to say that Adlerian intervention is effective and efficient on the resilience of women with marital conflict.
It is suggested that other researchers repeat this study in other samples, including men, and scientifically examine some of the questions resulting from this study and the background, and answer this question with more certainty whether these interventions can improve marital problems of men with marital conflicts or not.
Since this research was conducted only on women with marital conflicts who referred to psychological counseling and service centers in district 12 of Tehran, caution should be taken by researchers and users in generalizing the results of this research to women with marital conflicts in other cities due to cultural, ethnic and social differences. This research could be done simultaneously on women and men (couples). However, due to the lack of conditions and the lack of cooperation of husbands, it was limited only to the sample of women with marital conflicts. Also, conducting the research at the same time as the coronavirus epidemic (Covid-19) was one of the other limitations of the present research and created difficulty in collecting information.
The current research findings can be used to formulate treatment programs and interventions in counseling and treatment centers; in a way that Adlerian intervention is effective in women's resilience. According to the research findings, Adlerian intervention changes women's behavior with marital conflicts by gaining insight. This change includes simple behaviors resulting from observational learning and imitations and complex behaviors such as lifestyle. The Adlerian intervention also helps women with marital conflicts to accept their role in the marital relationship and reduce blaming behaviors. In this regard, the role of couples in creating new and positive behaviors is vital so that if they accept that their behaviors are the cause of happiness or unhappiness, they can control them. So, applying Adlerian intervention can increase the resilience of women with marital conflicts by increasing cooperation and changing the unreconciled ways of life.
According to the results of the present study, which shows the effectiveness of the mentioned treatment methods, such interventions can be used in the counseling and treatment centers of the police. Also, using the results of the studies, similar classes can be held in these centers to increase awareness and skills for couples and family members.
This article is taken from the Ph.D. thesis of the first author at Islamic Azad University, Central Tehran branch in Iran. All the participants as well as all those who helped in this research are hereby appreciated.
The authors state that there is no conflict of interest in the present study.
The present research had no financially support.

Table 1) Adlerian group counseling sessions [13]
Meeting Meeting content
1 Explaining the outlines of the meetings to the group members: emphasizing responsibility, rights of group members, respecting the principle of confidentiality, continuous attention and interaction between members, regular participation of members at the specified time and date of meetings, the necessity of completing assignments between meetings, having an attentive and hopeful approach, Having a cooperative and supportive approach with other members and leadership. Counselor emphasis on the therapeutic relationship rather than focusing solely on the problem, through encouragement rather than analysis
Problem design: Discussing the subject of the meeting and presenting the desired results of this type of treatment to create a positive change in the members.
2 Purpose: to explore individual dynamics, to know the way of life and the factors affecting it
Members are divided into groups according to their birth order in the family (single, older. middle, younger). Each group reports to the main group after discussing the similarities and differences, then we explain the sequential characteristics of children from Adler's point of view and compare the results reached by the group members.
3 Purpose: familiarity and challenge with life's tasks
Consider a moment in your current life, which of the following tasks do you do the most? And these assignments are in line with the goals of life.
Finally, examining the factors of anxiety and psychosis of the members in married life and the contribution of each of the factors in creating "despair"
4 Encountering and confronting members with themselves and living based on human principles
Gaining insight and knowledge of members about themselves and each other
5 Emphasis on self-knowledge and gaining insight: teaching the types of basic mistakes and the role of early memories in confirming the basic mistakes that a person may think are correct (with the explanation that we build our lives on these basic mistakes: lifestyle)
6 Treatment initiation: offering self-empowerment steps by challenging members' lifestyles through interpersonal exchanges and interactions in group therapy sessions, confronting people with themselves and each other and expressing their weaknesses and fair criticism of themselves and each other.
7 Encouraging self-knowledge and insight,
Evaluating life goals to foster social interest, challenging private logic, helping reorientation. Each member should remember one of their recent maladaptive behaviors and define in the group. We want to see how you dealt with the situation? Then, conducting a dialogue between the counselor and the client to identify the goals of attention, power-seeking, revenge, or withdrawal. The goal is to encourage clients to reduce their effect by re-evaluating their future goals and to be guided towards the last reaction, "social interest", which indicates mental health, in other words, to re-evaluate selfish goals.
8 Reorientation: by creating a sense of belonging, creating a sense of security, trust, equality, freedom, independence, success, appropriate responsibilities, power of choice, having the necessary activity, forgiveness, meaning.
Reconstruction of the network of relationships of members with family members and spouses, the use of Adlerian therapy techniques based on the diagnosis of the group leader in order to advance the therapeutic goals for change and lifestyle.
9 practicing and doing assigned tasks, overcoming the feeling of inferiority and emphasizing social interest instead of overcompensating for the feeling of inadequacy in the marital relationship and strengthening people's social interest with feedback and interactions carried out in the group
10 Implementation of the post-exam: checking the results of the topics raised in the meetings through the implementation of the post-exam and determining the time for the follow-up period.

Table 2) Emotion-focused couple therapy sessions adapted from Johnson [31]
Meeting Aim Description of meetings Assignment
1 Evaluating and establishing continuity and identifying the cycle of negative interactions and determining overall goals Initial assessment of the nature of the problem, assessment of client's expectations and concerns, conceptualization of the problem and presentation of treatment logic and familiarization with the general rules of treatment. Practicing key skills and communication, self-assessment, giving and receiving feedback, paying attention to pleasant emotional states.
2 Continue to evaluate and identify the cycle of negative interactions and determine overall goals Discovering problematic interactions and recognizing the cycle of negative interactions, evaluating attachment problems and obstacles, creating a therapeutic agreement Identifying the cycle of your interactions in different situations
3 Strengthening connection and analysis and modification of emotions Unlocking salient attachment experiences Acknowledging underlying unacknowledged emotions Clarifying key emotional responses Clients' acceptance of the engagement cycle Identifying your fears, practicing safe support and developing a safe bond, expressing specific emotions and feelings, re-experiencing interactions and expressing pure feelings.
4 Intensification of emotional experience Expressing emotions, accepting emotions, deepening engagement with emotional experience, improving interaction methods Sharing their coping behaviors with their spouses, encouraging clients to have emotional and emotional conflicts in their interactions at home
5 Accepting feelings and identifying attachment needs, strengthening the interaction of group members Reconstructing interactions and changing events, symbolizing desires, discovering new solutions to old problems Dedicating time to share behavior, thoughts and emotions with your partner
6 Creating new interactive patterns of emotional possession Intimate engagement of clients with their spouses, acceptance of new situations, making a happy story of relationship Discovering your main emotions, completing the table of how the emotions and behaviors of couples affect each other
7 Creating emotional conflicts, increasing identification of attachment needs. Facilitating the expression of needs and desires in sexual relations Emphasizing the importance of expressing sexual desires and needs, using the technique of tracking and reflecting members' encounters with their attachment styles Encouraging to change interactive patterns using your partners, encouraging to respond more responsibly to the needs of their partners, encouraging to express sexual needs and desires.
8 Focusing on the self and not the other, reframing sexual relationships, deepening the couples' sexual conflicts. Helping group members to focus on themselves, determining and encouraging the needs of group members Practice listening empathetically to your partner's needs, understanding your partner's underlying feelings
9 Loading the sexual and non-sexual interactions of spouses, promoting new methods of couple interaction Directing and designing interactions between couples, replacing the cycle of positive interactions instead of the negative cycle, discovering new solutions for old problems. Encouraging new adaptive responses between couples, supporting new and responsive behaviors
10 Consolidating the situation and new responses, supporting constructive interaction patterns, closing meetings Summarizing and reviewing the contents of the meetings by the members, establishing interactive, intimate and productive conversations, returning the changes to the members Discussing the strengths and weaknesses of the treatment, checking the achievements of each client during the treatment sessions, conducting the post-test

Table 3) Average and standard deviation of age in sample people in three groups
Group Index Statistic
Adler group 30.80±6.03 0.374 0.689
Exciting group 31.90±40.93
Control group 32.20±5.14

Table 4) The average resilience in the experimental group
and the control group, separated by measurement levels
The dependent variables group level
Pre-test Post-test Follow-up
mean standard deviation mean standard deviation mean standard deviation
Individual competence Adler group 15.25 1.251 19.45 2.781 19.30 2.598
Exciting group 15.25 1.070 18.40 2.210 18.20 1.908
control group 15.75 1.070 15.85 1.226 15.90 1.252
Tolerance of negative emotions Adler group 14.00 0.725 20.45 1.538 20.30 1.559
Exciting group 14.25 0.910 18.65 1.496 18.55 1.504
control group 13.95 0.826 14.10 0.852 14.05 0.887
Positive acceptance of change Adler group 10.45 0.887 14.50 1.235 14.35 1.182
Exciting group 10.25 0.716 13.20 1.005 13.05 1.146
control group 10.55 0.826 10.70 0.979 10.70 1.031
control Adler group 5.55 0.826 9.20 1.056 9.10 1.021
Exciting group 5.70 0.865 8.75 1.446 8.60 1.429
control group 5.80 0.894 5.95 0.887 6.00 0.918
Spiritual effects Adler group 4.05 0.759 6.90 0.852 6.75 0.910
Exciting group 3.90 0.788 6.25 0.851 6.20 0.834
control group 3.55 0.605 3.75 0.876 3.75 0.486

Table 5) Mauchly’s sphericity test results of resilience dimensions
The dependent variables Mauchly’s sphericity Chi-square test Degrees of freedom P
Individual competence 0.112 122.83 2 0.001
Tolerance of negative emotions 0.187 93.947 2 0.001
Positive acceptance of change 0.219 85.047 2 0.001
Control 0.151 106.028 2 0.001
Spiritual influences 0.218 85.269 2 0.001

Table 6) Results of variance analysis of repeated measurement
 of dimensions of resilience in three levels of implementation
The dependent variables Sources Change F
P Influence coefficient Statistical power
Individual competence Time 92.436 0.001 0.619 0.999
group 9.862 0.001 0.257 0.999
time × group 22.339 0.001 0.439 0.999
Tolerance of negative emotions Time 315.435 0.001 0.847 0.999
group 109.440 0.001 0.793 0.999
time × group 81.771 0.001 0.741 0.999
Positive acceptance of change Time 208.215 0.001 0.785 0.999
group 45.059 0.001 0.613 0.999
time × group 49.436 0.001 0.634 0.999
Control Time 173.860 0.001 0.753 0.999
group 33.035 0.001 0.537 0.999
time × group 38.153 0.001 0.572 0.999
Spiritual influences Time 151.140 0.001 0.726 0.999
group 75.043 0.001 0.725 0.999
time × group 30.569 0.001 0.518 0.999

Table 7) The results of Bonferroni test of dimensions of
 resilience in the pre-test, post-test and follow-up levels
The dependent variables levels Adjusted mean Steps differences Average differences P
Individual competence pre-exam 15.417 Pre-test-post-test 2.483- 0.001
After the test 17.900 Pre-test-follow-up 2.383- 0.001
Follow up 17.800 Post-test-follow-up 0.100 0.001
Tolerance of negative emotions pre-exam 14.067 Pre-test-post-test 3.667- 0.001
After the test 17.733 Pre-test-follow-up 3.567- 0.001
Follow up 17.633 Post-test-follow-up 0.100 001/0
Positive acceptance of change pre-exam 10.417 Pre-test-post-test 2.383- 0.001
After the test 12.800 Pre-test-follow-up 2.283- 0.001
Follow up 12.700 Post-test-follow-up 0.100 0.001
Control pre-exam 5.683 Pre-test-post-test 2.283- 0.001
After the test 7.967 Pre-test-follow-up 2.217- 0.001
Follow up 7.900 Post-test-follow-up 0.067 0.001
Spiritual effects pre-exam 3.833 Pre-test-post-test 1.800- 0.001
After the test 5.633 Pre-test-follow-up -1.733 0.001
Follow up 5.567 Post-test-follow-up 0.067 0.001

Table 8) Pairwise comparison with Bonferroni post hoc test of resilience dimensions
The dependent variable comparison groups Average differences standard deviation P
Individual competence Adlerian intervention group Control
2.167 2.59 0.001
Emotional therapy group 1.450 2.51 0.001
Tolerance of negative emotions Adlerian intervention group Control
4.217 2.59 0.001
Emotional therapy group 3.117 2.31 0.001
Positive acceptance of change Adlerian intervention group Control
2.450 2.15 0.001
Emotional therapy group 1.517 1.43 0.001
Control Adlerian intervention group Control
2.033 1.55 0.001
Emotional therapy group 1.767 2.25 0.001
Spiritual effects Adlerian intervention group Control 2.217 1.6 0.001
Emotional therapy group 1.767 1.53 0.001

Article number: e35
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Article Type: Original Research | Subject: Police Related Trauma
Received: 2022/08/22 | Accepted: 2022/10/1 | Published: 2022/11/5

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