ARTICLE INFO

Article Type

Descriptive & Survey Study

Authors

Showani   E. (*)
Zahrakar   K. (1)
Rasooli   M. (1)






(*) Counseling Department, Psychology & Educational Science Faculty, Kharazmi University, Tehran, Iran
(1) Counseling Department, Psychology & Educational Science Faculty, Kharazmi University, Tehran, Iran

Correspondence

Address: Karnas Alley, Mohandes Aziz Aghdam Avenue, Piranshahr City, Western Azerbaijan province
Phone: +984444415253
Fax: -
s.showani@yahoo.com

Article History

Received:  February  15, 2016
Accepted:  May 17, 2016
ePublished:  June 18, 2016

BRIEF TEXT


The injured person, not only deals with mental disorders, but their families are influenced by these persons and are exposed to risk [1].

[2-14]The results show that veteran’s family (especially spouses) suffer from more psychological problems [15]. … [16-17]Interventions based on acceptance and commitment according to the Relational Frame Theory (RFT) explain methods that cause clients language and thoughts in struggle with internal states in a wild-goose chase. Clients learn through this type of treatment that how they can healthy contact with thoughts, memories and avoiding feelings by using metaphors, paradoxes, and experiential exercises[18]…[19-21].

The aim of this study was to investigate the effectiveness of acceptance and commitment based therapy on reduction of marital burnout components in wives of the veterans.

The study is the semi-experimental pretest-posttest study with a control group.

This study was conducted on 2015 among all Piranshahr city veteran`s wife who had referred to the consultation unit of Piranshahr city Martyr and Veterans` Affairs Foundation.

Firstly, among veteran’s wives who were intrested in participating in the study, 70 persons were selected according to convenience sampling based on entering criteria including: having at least primary school education, age range from 25 to 50 years, completing consent form for treatment, lack of psychological disorders,not applying for divorce, tendency to participate in treatment meetings, and lack of counseling and psychological treatment outside of meetings. Among these samples, after taking the couple burnout and marital quality test, 30 people who had got the highest score in couple burnout test and the least score in couple relation quality test were selected and randomly assigned into experimental and control groups (15 per group).

In order to evaluate couple burnout 21-item Couple Burnout Measure (CBM) was used which has been made by Pines in 1996. This tool consists of three subscales of physical burnout, mental burnout and emotional burnout, and by adding these subscales, marital burnout total score is achieved. All questions on seven-degree Likert scale from one to seven are being answered. The highest score is 147, the least is 21, and higher scores indicates more marital burnout. Domestically survey showed that marital burnout measuring scale is acceptable in case of reliability and validity [22]. The experimental group participated in 8 sessions of group therapy based on acceptance and commitment, while the control group received no intervention. . Therapeutic protocol was derived from doctor Kassai ACT workshop (Acceptance and commitment therapy) [23]and the book “therapy based on acceptance and commitment” [23] and a thesis in the field of ACT in the library of Faculty of Education and psychology of Kharazmi University [24] (table 1). Data was analyzed using one-variable and multi-variable analysis of covariance tests. In order to administer the covariance analysis, at first, its assumptions (i.e., normality of data distribution by using Levene and Box tests) were investigated.Kolmogorov-Smirnov test was used to determine the normal distribution of scores that the default normal distribution of data on marital burnout and its components was established in the two tests. The Levene test showed that marital burnout and its components among participants (the experimental group and the control group) is not different and variances are equal. Homogeneity of covariances was examined by the box test that was in default between covariances. Therefore, to test the acceptance and commitment therapy in reducing marital burnout one-variable analysis of variance was used. In addition, for the test of therapy based on acceptance and commitment therapy in reducing marital burnout dimensions (physical burnout, emotional burnout and mental burnout) multi-variable analysis of covariance was used.

The mean age of case studies was 35.83± 4.01 years and in the control group was 34.66 ± 4.77. 15 participants were with Diploma degree (50.0%), 3 persons with primary education (10.0%), 10 persons with junior high school degree (33.3%) and 2 with associate's degree (6.7%). There was no significant difference between experimental group and control group pretest mean scores while reduction in experimental group mean scores of marital burnout posttest was higher in comparison with control group (table2). The difference between marital burnout scores in the post test stage after controlling pre-test scores in both experimental and control groups was significant (P=0.001);In other words acceptance and commitment based therapy was effective on the reduction of marital burnout components in the wives of the veterans. Also, there was a significant difference between the groups in terms of marital burnout dimensions ;as a matter of fact , based on acceptance and commitment therapy in the experimental group rather than the control group, a reduction of physical burnout, mental burnout and emotional burnout was achieved (P=0.001).

… [25] Khakbaz in his study concluded that interventions based on ACT are effective on improving emotional regulation of persons who are dependent to Methamphetamine [26]. Stated studies and research’s results of Peterson et al [27], Woods et al, [28], Twohing et al, [29] and Paul et al [30] who have confirmed the effectiveness of acceptance and commitment , are matched with the findings of this study…[31-38].

It is suggested that similar research should be done in other statistical societies and with follow-up sessions in several months in case of studying the effects of course treatment duration.

One of the limitation of this study is the lack of follow-up stages and therefore the lack of information about the continuity and stability results of the present study.

Acceptance and commitment based therapy is effective on the reduction of marital burnout components in the wives of the veterans.

Thanks to the all of the women who participated in the study and the Foundation of Martyrs and Veterans Affairs, Social Work Unit, in Piranshar city.

Non-declared

Assurance of confidentiality of information and preparation of the case studies in terms of mental and psychological health for participating in the study, were of the moral points.

The funds for this research was provided by the author.

TABLES and CHARTS

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CITIATION LINKS

[1]Parandeh A, Siratinir M, Khaghanizadeh M, Karimi Zarchi A. Effect of Conflict resolution training on quality of life of veteran’s spouses with PTSD. J Mil Med. 2008;8(1);45-51. [Persian]
[2]Nabatian E, Ghamarani A, Zakerian M. Mehdizadeh I. Relationship between spiritual health with quality of life veterans and disabled Birjand. Iran J War Public Health. 2013;5(2):35-9. [Persian]
[3]Dejkam M, Aminoroaya A. Comparing between psychological health of veterans' wives and ordinaries' wives who had refered to Imam Hosein Hospital and Sadr Hospital. Tehran: 1st Scientific Conference of Veterans and Families; 2003. [Persian]
[4]Jungbauer Y, Wittmund B, Dietrich S, Angermeyer MC. The disregarded caregivers: Subjective burden in spouses of schizophrenia patients. Schizophr Bull. 2004;30(3):665-75.
[5]Khodabakhshi Koolaee A, Adibrad N, Saleh Sedgh Poor B. The comparison of relationship beliefs and couples burnout in women who apply for divorce and women who want to continue their marital life. Iran J Psychiatry. 2010;5(1):35-9. [Persian]
[6]Pines AM. How to love a dream to cut Nynjamd. Shadab F, translator. Tehran: Ghoghnoos; 2002. [Persian]
[7]Davarnia R. The effect of brief solution-focused couple therapy (BSFCT) approach on reducing couple burnout dimensions in women. J Urmia Nurs Midwifery Fac. 2015;13(1):36-46. [Persian]
[8]Kayser K. The marital disaffection scale: An inventory for assessing motional estrangement in marriage. Am J Fam Ther. 1996;24(1):68-80.
[9]Sharifi M, Karasoli S, Bashlideh K. The effectiveness of group attribution-retraining in reducing couple burnout and divorce probability in divorce-seeking couples. J Fam Couns Psychother. 2011;1(2):212-25. [Persian]
[10]Yousefi N, Bagherian M. Evaluation criteria for mate selection and marital burnout as predictors divorced spouses and want to continue living together. J Fam Ther Psychother. 2012;1(3):284-301. [Persian]
[11]Karimi P, Karami J, Dehghan F. Relationship between attachment style and conflict resolution styles with marital burnout employees. Sociol Women. 2015;5(4):53-70. [Persian]
[12]Canam C, Acorn S. Quality of life for family caregivers of people with chronic health problems. Rehabil Nurs. 1999;24(5):192-6.
[13]Moalosi G, Floyd K, Phatshwane J, Moeti T, Binkin N, Kenyon T. Cost-effectiveness of home-based care versus hospital carefor chronically ill tuberculosis patients, Francistown, Botswana. Int J Tuberc Lung Dis. 2003;7(9 Suppl 1):S80-5.
[14]Radfar Sh, Haghani H, Tavalaei SA, Modirian E, Falahati M. Evaluation of mental health state in veterans family (15-18 Y/O adolescents). J Mil Med. 2005;7(3):203-9. [Persian]
[15]Sisk DA, Torrance EP. Spiritual intelligence: Developing higher consciousness. New York: Creative Education Foundation; 2001.
[16]Han B, Haley WE. Family caregiving for patients with stroke: Review and analysis. Stroke. 1999;30(7):1478-85.
[17]Hayes SC, Lillis J. Acceptance and commitment therapy. Washington, DC: American Psychological Association; 2012.
[18]Cosio D, Schafer T. Implementing an acceptance and commitment therapy group protocol with veterans using VA's stepped care model of pain management. J Behav Med. 2015;38(6):984-97.
[19]Cardaciotto L, Herbert JD, Forman EM, Moitra E, Farrow V.. The assessment of present-moment awareness and acceptance: the Philadelphia Mindfulness Scale. Assessment. 2008;15(2):204-23.
[20]Hayes SC, Bissett RT, Korn Z, Zettle RD, Rosenfarb IS, Cooper LD, et al. The impact of acceptance versus control rationales on pain tolerance. Psychol Rec. 1999;49(1):33-47.
[21]A-Tjak JG, Davis ML, Morina N, Powers MB, Smits JA, Emmelkamp PM. A meta-analysis of the efficacy of acceptance and commitment therapy for clinically relevant mental and physical health problems. J Psychother Psychosom. 2015;84(1):30-6.
[22]Abbasi M, Dargahi Sh, Ghasemi Jobaneh R, Ashtari Mehrjardi A. Effective of emotional regulation on psychological wellbeing and marital satisfaction of Iranian infertile couples. J Res Health. 2016;5(4):60-9.
[23]Izadi R, Abedi M. Acceptance and commitment based therapy. Tehran: Jungle; 2014. [Persian]
[24]Navidi F, Adibrad N, Sabaghian Z. Surveying and comparison the relationship between couple burnout with organizational climate factors in male and female nurses. Psychol. 2007;11(3);275-8. [Persian]
[25]Bagholi H. Effectiveness in reducing the severity of symptoms and treatment based on acceptance and commitment to improving the quality of life in patients with obsessive-compulsive disorder [Dissertation]. Tehran: University of Social Welfare and Rehabilitation Sciences; 2014. [Persian]
[26]Khakbaz H. Effectiveness of group therapy is based on acceptance and commitment on the emotional adjustment of the people dependent on methamphetamine rehabilitation [Dissertation]. Tehran: University of Social Welfare and Rehabilitation Sciences; 2014. [Persian]
[27]Peterson BD, Eifert GH, Feingold T, Davidson S. Using acceptance and commitment therapy to treat distressed couples: A case study with two couples. Cogn Behav Pract. 2009;16(4):430-42.
[28]Woods DW, Wetterneck CT, Flessner CA. A controlled evaluation of acceptance and commitment therapy plus habit reversal for trichotillomania. Behav Res Ther. 2006;44(5):639-56.
[29]Twohing MP, Hayes SC, Masuda A. A preliminary investigation of acceptance and commitment therapy as a treatment for chronic skin picking. Behav Res Ther. 2006;44(10):1513-22.
[30]Paul RH, Marx BP, Orsillo SM. Acceptance-based psychology in the treatment of an adjudicated exhibitionist: A case example. Behav Ther. 1999;30(1):149-62.
[31]Hafmann SG, Asmundson GJ. Acceptance and mindfulness-based therapy: New wave or old hat?. Clin Psychol Rev. 2008;28(1):1-16.
[32]Georg LA. Treating parent-adolescent conflict: Is acceptance the missing like for an integrative family therapy?. Cogn Behav Pract. 2004;11(3):305-14.
[33]Carmody J, Baer RA, LB Lykins E, Olendzki N. An empirical study of the mechanisms of mindfulness in mindfulness-based stress reduction program. J Clin Psychol. 2009;65(6):613-26.
[34]Harris R. ACT with love: Stop struggling, reconcile differences, and strengthen your relationship with acceptance and commitment therapy. 1st edition. Oakland: New Harbinger; 2009.
[35]Forman EM, Chapman JE, Herbert JD, Goetter EM, Yuen EK, Moitra E. Using session-by-session measurement to compare mechanisms of action for acceptance and commitment therapy and cognitive therapy. Behav Ther. 2012;43(2):341-54.
[36]Navabinezhad Sh. Marriage counseling and family therapy. Tehran: Parents and Teachers Association; 2011. [Persian]
[37]Ghohari SH, Zahrakar K, Nazari AM. Prediction of Marital Burnout based on differentiation and sexual intimacy in nurses. J Nurs Res. 2015;10(2):72-80. [Persian]
[38]Bodenmann G, Shantinath SD. The couples coping enhancement training (CCET): A new approach to prevention of marital distress based upon stress and coping. Fam Relat. 2004;53(5):477-85.