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Afshari E, Ebrahimi M I, Haddadi A. The Effect of Acceptance and Commitment Group Therapy on Emotional Divorce and Self-efficacy of Working Couples. JCHR 2022; 11 (4) :327-336
URL: http://jhr.ssu.ac.ir/article-1-826-en.html
1- Department of Counseling, Faculty of Humanities, Hamedan branch, Islamic Azad university, Hamedan, Iran
2- Department of Psychology, Faculty of Humanities, Hamedan Branch, Islamic Azad University, Hamedan, Iran , Mse58_2007@yahoo.com
3- Behavioral Disorders and Substance Abuse Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
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The Effect of Acceptance and Commitment Group Therapy on Emotional Divorce and Self-efficacy of Working Couples

Elahe Afshari 1 , Mohammad Ismail Ebrahimi *2 , Arya Haddadi 3
  1. Department of Counseling, Faculty of Humanities, Hamedan branch, Islamic Azad university, Hamedan, Iran
  2. Department of Psychology, Faculty of Humanities, Hamedan Branch, Islamic Azad University, Hamedan, Iran
  3. Behavioral Disorders and Substance Abuse Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
ARTICLE INFO ABSTRACT
Original Article
Received: 26 May 2022
Accepted: 05 December 2022
Background: Emotional divorce happens when a man and a woman live coldly together but do not request a legal divorce. So the aim of this study is to investigate the impact of acceptance and commitment group therapy (ACT) on emotional divorce and self-efficacy of couples.
Methods: This was a controlled experiment. In 2020, Bu Ali town, Hamedan province, had 338 married factory workers. Authors chose 60 emotional divorce sufferers using a questionnaire. 40 persons with average self-efficacy questionnaire ratings were randomly assigned into experimental and control groups. The experimental group received 8 weeks of acceptance and commitment-based treatment, while the control group received no intervention. Gottman's 1994 Emotional Divorce Questionnaire and Scherer et al1982.’s self-efficacy questionnaire were utilized as pre- and post-test. SPSS version 23 analyzed data. Shapiro-Wilk test assessed variable distribution normality. The scores in the experimental and control groups are normal because emotional divorce and self-efficacy are significant (P < 0.05). Leven's test tested the population's two groups' variance equality.
Results: In the post-test phase, the findings of the analysis of covariance showed that acceptance and commitment group therapy resulted in lower scores of emotional divorce (p less than 0.05) and higher levels of self-efficacy (p less than 0.05) in the experimental group in comparison to the control group. Both the emotional divorce variable (P = 0.414, F = 0.682) and the self-efficacy variable (P = 0.601, F = 0.278) were found to have identical variances according to the results of the Leven test (P = 0.601, F = 0.278).
Conclusions: Acceptance and commitment group therapy was able to significantly reduce emotional divorce and increase self-efficacy compared to the control group. Therefore, it is possible to prevent acceptance and commitment therapy to reduce emotional divorce and prevent psychological and social damage.

Keywords: Emotional-divorce, Self-efficacy, Group Therapy, Acceptance and Commitment Therapy

 
 

Corresponding Author:
Mohammad Ismail Ebrahimi
mse58_2007@yahoo.com

How to cite this paper:
Afshari E, Ebrahimi MI, Haddadi A. The Effect of Acceptance and Commitment Group Therapy on Emotional Divorce and Self-efficacy of Working Couples. J Community Health Research 2022; 11(4): 327-336.
Introduction
Family is the basic foundation of the social structure in societies formed by the beginning of married life (1). Marriage is the most important bond which occurs between two people and is the beginning of the formation of a supportive-emotional center (2). Family, marriage, having children, cohesion, love and intimacy are beautiful words with a pleasant appearance. This is as long as there is no talk of a threatening factor called "divorce". Divorce is the legitimate collapse of social and legal marital relations, changing the obligations and privileges of the two people involved in this phenomenon (3) . Marriage is affected by several factors, some of which may lead the couple to harmful things such as conflict, struggle, emotional divorce, and eventually formal divorce. Divorce is one of the most important family problems leading to individual, family and social breakdown with more negative effects on women than men (4). It doesn't occur all at once but gradually and in stages. In fact, emotional divorce is the first step in the divorce process which represents marital relationship (5). The premise of a formal and legal divorce is always an emotional divorce. Emotional divorce is not an event, but a process that shaped over time which begins with a gradual change in emotions (6). In emotional divorce, couples live together out of necessity and compulsion (7). The results of Eslami, Yazdanpanah, Andalib and Rahimi research showed that families with emotional divorce are not able to solve their problems and conflicts compared to normal families. The emotional communication of family members is dysfunctional and disrupted. In fact, the effects and consequences of emotional divorce are greater than legal divorce (8)
In an emotional divorce, every couple may believe that they have a serious problem in their married life, and their life has been ruined. They believe that there is no way to improve this relationship and blame themselves for their choice (self-conceptualized). Sometimes, they consider the other one an unworthy person who has ruined his/her happiness, and their youth and emotions are lost because of the presence of such a person in their life (fusion). The feelings and beliefs of the person and his/her bitter past experiences cause him/her to refuse to talk and communicate properly with their wife or husband. This is because they believe they will never achieve the desired result, will be rejected by their partner, and their feelings will hurt (in relation with the past and the future). Moreover, they think they are not able to recognize (values) of life according to the circumstances involved and may do the wrong things that make everything worse (9).
In psychological flexibility training, the authors examine various reasons causing these behaviors, and ultimately, emotional divorce. People are taught to consider themselves observers. By using appropriate exercises and allegories, they learn to accept existing conditions, identify their abilities and possessions (accept), set goals in life, identify values and distinguish them from their goals. In addition, they need to take committed and fruitful steps to achieve them and make the right choice, even if they see their life in the final stage(10).
Self-efficacy is an important cognitive structure in relation to individual performance. It refers to the evaluation of individuals in terms of their ability to play a role. In order to feel effective, individuals need knowledge and information about effective conflict resolution methods. They must trust their abilities and be sure that their performance has a positive impact on each other's behavior (11). People with high self-efficacy are more likely to reject negative feedbacks. Rejecting negative feedback may reduce feelings of commitment and increase marital conflict (12).
Recently, there has been a lot of discussion about mindfulness-based and context-based therapeutic interventions (13). These therapies, known as the third wave of behavioral therapy, include dialectical behavior therapy, performance analysis-based therapy, integrative behavioral couple therapy, mindfulness-based cognitive therapy, and acceptance and commitment therapy (14). All of them focus on acceptance, mindfulness, cognitive fault, value-based living, and personal spirituality (15). Acceptance and commitment therapy is one of the most common third wave behavior therapies, and its goal is to help clients achieve a valuable, complete and satisfying life created through psychological flexibility (16). This treatment is philosophically rooted in pragmatism known as functional contextualism. Its theoretical basis is based on a new theory of language and cognition called "The Theory of the Framework of Mental Relations (17)". The main goal of acceptance and commitment therapy is to increase psychological flexibility. This means the ability of a person to consciously communicate with present, despite all the feelings, thoughts, memories and feelings he/she experiences in the moment. This is in addition to performing behaviors that serve the person's goals and chosen values. Psychological resilience is created through the six main processes of acceptance, cognitive failure, self-as-context, being in present, values, and committed action (18) (16). A study by Haddadi and Ebrahimi (2020) showed that group therapy per se can increase people's communication skills (19,20). This can possibly have a significant impact on emotional divorce and marital relationships; so, it led the researchers to examine the impact of acceptance and commitment group therapy. Jafari and Mohammadi Aria (2017) revealed that treatment based on acceptance and commitment reduces depression and anxiety of the couples with emotional divorce (21). The results of Mehrdoust, Neshatdoust and Abedi (2013) study indicated that acceptance and commitment therapy improves students' self-efficacy beliefs (22)
Working couples have a lower life quality due to heavy workload, more responsibilities and less interaction with each other compared to couples who are not both employed, and therefore, they feel less self-efficient in their lives (23). These people have less opportunity to interact and make emotional connections with each other and face many challenges. As a result, they are more vulnerable to emotional divorce (24). Employees of industrial factories with long working hours and hard jobs are probably much more vulnerable. However, little research has been done in this field. Especially in Iran, no specific activities have been done to improve this situation. Therefore, the aim of this study is to investigate the effectiveness of acceptance and commitment therapy on increasing self-efficacy and reducing emotional divorce in working couples.
Methods
The present study was quantitative in nature, practical in terms of purpose and experimental in terms of method. To test the hypotheses, writers used a pre-test post-test design with a control group. The statistical population consisted of all the couples (both men and women) working in a manufacturing factory in the town of Bou-Ali in Hamadan province in 2020. They were between 30 and 40 years old and had been married for at least 5 years. To select the sample size based on Morgan’s chart (25), 338 Gottman Emotional Divorce questionnaires and 338 Scherer Self-Efficacy questionnaires were distributed among couples. 60 of the participants who answered positively to at least 8 questions in Gottman Emotional Divorce Questionnaire were selected, and then 40 with average scores in Scherer self-efficacy test were selected as the statistical sample. They were randomly divided into two groups of 20 people (control and experimental groups). Inclusion criteria were: age ranges between 30 to 40, positive answer to at least 8 questions in the Gottman Emotional Divorce questionnaire, and average scores on the Scherer self-efficacy test; exclusion criteria were: physical and neurological disease leading to the patient's disability, previous participation in a similar intervention program and absence more than two sessions.
In order to comply with ethical codes, in all stages of this research, ethical considerations have been observed. This was because of ethical principle of scientific fidelity, intellectual right of the authors of the works, and confidentiality and satisfaction of all participants. This research with project code: 171290452632889140016235940 has been approved by the Research and Ethics Committee of the Islamic Azad University of Hamadan branch
Intervention program
After obtaining permission from the Ethics Committee of the Vice Chancellor for Research in Hamadan Azad University, before the start of the class, the authors tested both groups for emotional divorce and self-efficacy. During 8 sessions (60 minutes per session), the therapist offered acceptance and commitment treatment to the experimental group, and the control group did not receive any intervention. At the end of the course, both groups were tested through the emotional divorce and self-efficacy scale. The therapist was a family counseling student trained in this area.
Table 1. ACT on Emotional Divorce and Self-efficacy; Taken from Dousti, Ghodrati and Ebrahimi (1397) (26).
Number of Sessions Goals Description
1: Introduction and explanation of the emotional divorce variable Establishing a friendly relationship with participants, stating instructions, explaining the possibility of experiencing unpleasant feelings during the sessions, stating the goals of sessions Welcoming, stating the educational and work history of the leader, introducing members, asking about the feelings of the members at the same time, explaining about the emotional divorce, au role in it, the reasons and results
2: Self-identification Brief review of the previous session
Acceptance and mindfulness
Values and committed actions
Reviewing the previous session briefly by the leader, with the help of group members
* Practicing conscious breathing using body scan practice
* Talking about values, determining differences between efficient and inefficient behaviors, and identifying them by members
3: Acceptance the life rather than confronting with it
Self-compassion
Brief review of the previous session
Acceptance and failure
Self-compassion
Reviewing the previous session briefly by the leader, with the help of group members
Creating an acceptance strategy using the metaphor of Treasure Island
*Thoughts labeling
* Carrot instead of stick to achieve compassion
4: Familiarity with self-efficacy
Brainstorming
Brief review of the previous session
Values and committed action
Self-compassion and committed action
Reviewing the previous session briefly by the leader, with the help of group members
* Practicing the twentieth wedding anniversary to define values
* Strict teacher practice
* Reviewing the solutions you have worked on so far
 Considering different solutions
Explaining about self-efficacy and its positive effects in life
5: Identification of wrong behaviors Brief review of the previous session
Demonstrating the effect of creative frustration
Fault and committed action
Reviewing the previous session briefly by the leader, with the help of group members
Inviting members to talk about their role in dealing with life's problems and issues
* Creative frustration worksheet
Thoughts labeling
6: Identification of the values and expressing their difference with goals Brief review of the previous session
Values, acceptance and mindfulness
Self-compassion
Reviewing the previous session briefly by the leader, with the help of group members
Passengers on bus metaphor
* Encouraging members to pursue values
* Encouraging support groups
* Self-compassion (inner child)
Homework
7: Group effectiveness Examining the effects of participation in group
Committed action
Awareness attention
Members encouraged to talk about the impact the group has on their lives and the actions they have taken
Steps to take committed action
Practicing at home
8: End of sessions Reviewing all the sessions
Sustainability of the sessions
Preparation for the end of sessions
Reviewing all past sessions and session goals
Expressing members' experiences and exercises during sessions
Members encouraged to follow their exercises after sessions
Research instruments
A) Gottman emotional divorce questionnaire (1994): Gottman emotional divorce questionnaire was developed in 1994 with 24 questions. The questions are answered in the form of yes/no. If the number of yes answers is equal to or higher than 8, there is dissatisfaction with married life and emotional divorce. This means that a person's marital life is exposed to separation and there are signs of emotional divorce in him/her. The reliability of this questionnaire is reported to be 93% in Iran. Factor analysis was performed using Varimax rotation and Scree plot to obtain validity. Thus, four factors were identified: separation and distance from each other, feeling of loneliness and isolation, the need for talk and companionship, and the feeling of boredom and restlessness. The factor loading of all questions ranged from 49% to 80%, which is acceptable (27).
B) Scherer et al.'s self-efficacy questionnaire (1982): The Scherer, Maddux, Mercadante, Prentice-Dunn, Jacobs, and Rogers Self-Efficacy Questionnaire was developed in 1982 (28). Its scale is based on the 5-point Likert scale: strongly disagree 1, disagree 2, neutral 3, agree 4, strongly agree 5. Therefore, the highest score of this questionnaire is 85 and the lowest score is 17. Questions 16, 14, 12, 11, 7, 5, 4, 2 are scored in reverse. The validity and reliability of the questionnaire has been proven to be 79%. Moreover, the reliability coefficient of the scale was reported 76% using the test halving method, 79% using Cronbach's alpha, and 83% through the Spearman-Brown method. Therefore, this scale is statistically acceptable (29).
Statistical analyses
. In order to analyze the data obtained from the questionnaires, the authors used descriptive and inferential statistics. Shapiro-Wilk test was used to evaluate normality distribution of quantitative variables. According to the level of significance (P <0.05) regarding emotional divorce and self-efficacy, the authors confirmed the normality of the distribution regarding scores in the experimental and control groups. Leven's test was used to examine the presumption of variances' equality between the two groups in the population. The data were statistically analyzed using SPSS program version 23.
Results
 Descriptive findings including mean and standard deviation of age, emotional divorce, and self-efficacy of the experimental and control groups in the pre-test, post-test stages are presented in Tables 2 and 3. The results of Leven test for the emotional divorce variable (P = 0.414, F = 0.682) and self-efficacy variable (P = 0.601, F = 0.278) confirmed variances' equality.
Table 2. Displays the demographic information for the samples.
Indicator Frequency          percentage
Gender Male 24 60
Female 16 40
Job Manager
Accountants
Employee
service worker
4
7
15
6
10
17.5
37.5
15
Other 8 20
Table 2. Descriptive Findings Related to the Participants' age in the Experimental and Control Groups
Indicator Group Mean Standard deviation
Age Experimental group 33.70 2.77
Control group 34.30 3.13

Table 2 indicates the average age of the participants. The mean age of the experimental group was 33.70 ± 2.77 and the mean age of the control group was 34.30 ± 3.13.
Table 3 shows the mean and standard deviation of emotional divorce and self-efficacy of the experimental and control groups in the pre-test and post-test stages.
Table 3. The Mean and Standard Deviation of Emotional Divorce and Self-efficacy of the Experimental and Control Groups, in pre-test and post-test stages
Pre-test Post-test
Variable Mean SD Mean SD
Experimental Emotional divorce 13.65 2.64 10.15 3.08
Self-efficacy 46.35 6.56 55.90 6.12
Control Emotional divorce 12.95 3.50 13.00 3.83
Self-efficacy 52.25 5.70 51.20 5.54
First, the presuppositions of covariance analysis, including Levene's test and the normality of the distribution of variables, were checked (30). Shapiro-Wilk test was used to evaluate the distribution normality of variables. According to the level of significance (P <0.05) regarding emotional divorce and self-efficacy, the authors confirmed the normality of the distribution regarding scores in the experimental and control groups. Leven's test was used to examine the presumption of variances' equality between the two groups in the population.The results of Leven test for the emotional divorce variable (P = 0.414, F = 0.682) and self-efficacy variable (P = 0.601, F = 0.278) indicated the realization of the presumption of confirmed variances' equality.
Analysis of covariance was used to examine the effect of acceptance and commitment group training on emotional divorce and self-efficacy of the participants. The results are presented in Table 4.
As table 4 reveals there is a significant difference between the experimental group and the control group in terms of dependent variables at P <0.05. Hence, there is a significant difference between the two groups regarding at least one of the dependent variables (emotional divorce and self-efficacy). To investigate this difference, the researchers performed ANCOVA analysis on the text of MANCOVA. The results are listed in Table 4.
Table 4. Summary of the Analysis of Multivariate Covariance Test Regarding Emotional Divorce and Self-efficacy
Effect Value F Degree of hypothesis freedom Degree of error freedom P
Pillai's Trace 0.380 10.750 2 35 <0.001
Wilks' Lambda 0.620 10.750 2 35 <0.001
Hotelling 0.612 10.750 2 35 <0.001
Roy's largest root 0.612 10.750 2 35 <0.001
Table 5. Summary of the Analysis of Covariance for Emotional Divorce and Self-Efficacy of the Two Groups
Variable Source of Variation Total squares Degree of freedom Mean squares F P Impact factor
Emotional divorce Group 64.880 1 64.880 5.226 0.028 0.127
Error 446.956 36 12.415
Total 5901.000 40
Self-efficacy Group 168.696 1 168.696 4.702 0.037 0.116
Error 1293.737 36 35.937
Total 116222.000 40
According to Table 5, acceptance and commitment group therapy has reduced the average of emotional divorce and increased the average of self-efficacy. This difference was significant at P <0.05 in both experimental and control groups. In fact, this treatment is effective on emotional divorce and self-efficacy of the participants. The effect rate was 0.127 for emotional divorce and 0.116 for self-efficacy. This means 12.7% of the variance of emotional divorce and 11.6% of the variance of self-efficacy are caused by acceptance and commitment group therapy.
Table 6. Covariance analysis of the effects of acceptance and commitment group training on reducing emotional divorce with pre-test control
Source of Variation Dependent variables SS Degree of freedom Mean squares F P Eta coefficient
Group Emotional Divorce 72.998 1 72.4998 6.030 0.019 0.140
Error Emotional Divorce 447.917 37 12.106
The contents of the above table show that acceptance and commitment group training can significantly reduce the amount of emotional divorce, because the calculated F (6.030) is significant at P<0.05 level. Therefore, by controlling the effects of the pre-test, the difference in the post-test scores in the two groups is statistically significant, and this significance is in favor of the experimental group. Therefore, the effect of acceptance and commitment group training on reducing emotional divorce is confirmed
Discussion
The aim of this study was to investigate the impact of acceptance and commitment group therapy on emotional divorce and self-efficacy of couples working in Bu Ali industrial town of Hamadan. Post-test indicates that the mean scores of emotional divorce in post-test compared to the control group decreased significantly, and the mean scores of self-efficacy in the post-test compared to the control group increased significantly. Thus, acceptance and commitment group therapy has been effective on emotional divorce and self-efficacy. The result is consistent with the results of research by Jafari and Mohammadiarya (21), Mehrdoust et al. (31), Amani, Issa Nejad and Alipour (32); Eskafi, Torkaman (33), Masuda et al. (34) and Stewart and Kaplan (35).
After starting a family, every couple strives to have a rich and happy life. But sometimes, some couples face many internal and external problems in life causing them to have painful experiences. In such situations, some couples ignore their values. Moreover, low level of self-efficacy makes them feel incapable of building their lives and refuse to take effective actions. In this situation, ACT therapy is the savior of many lives. Its basic processes include: acceptance, failure, communication with present, self-as-context, effective action, identification of values, and finally, mindfulness and planning to achieve goals. They help people to move from the inflexibility hexagon which has ruined their lives to flexibility hexagon, and take effective actions to improve their lives. Authors conclude that achieving and maintaining individuals' performance criteria increases self-efficacy, and inability to achieve and maintain these criteria reduces self-efficacy. This is consistent with the results of the research by Mehrdoust et al. (31) Self-efficacy can affect almost all aspects of life. It seems necessary to do more research in this area. Couples with poor self-efficacy cannot properly express their feelings and emotions in their relationship. They do not trust their abilities and believe that they are not able to solve problems and exert any influence on events (36). They have accepted that whatever they do will not make a difference in their lives (self-conceptualized). Acceptance and commitment therapy is effective in reducing emotional divorce, which is consistent with the results of Jafari and Mohammadiarya (21),  Amani, Issa Nejad, and Alipour (32); Eskafi, Torkaman (33).
People with poor self-efficacy believe that the difficulties and problems of life are beyond their capabilities and endurance, and that their efforts will not yield any results (fusion). That is why they feel frustrated and have difficulty in their relationships. It is not surprising that in such situations they are sad and strongly worried, and the feeling of depression and failure in life affects their performance in family and social relationships (37). They focus more on failures and negative consequences of their past behaviors (contact with the past). They engage in inefficient actions such as resorting to alcohol, drugs, and isolation (experiential avoidance). Their inability to achieve a happy life makes them unable to identify their values. Because of their poor self-efficacy, they find themselves more incapable of doing something. As a result, couples take passive and impulsive actions. Not only this does not improve their marital relationships, but also damages their social relationships and sometimes their emotions.
In teaching psychological flexibility, the researchers first emphasize self-efficacy of couples, and then, examine various causes of helplessness and the feeling of inability to solve life problems themselves. They help couples consider themselves observers and honestly examine their behaviors (self-observer), recognize their irrational beliefs that prevent them from making the right decisions and get rid of them by using effective exercises (failure), know their circumstances and abilities, and accept their weaknesses (acceptance). Using practical exercises and metaphors, they can look at past failures and mistakes as an experience for life, rather than a hindrance to their progress.
By teaching mindfulness, the authors teach them (being in the present) and help them discover the (values) of their lives and know what their real desire is in life. Is this the life they want? If not, identify their goals and values and take (committed) and effective actions to achieve. This is also mentioned in Stewart and Kaplan's research (35). In this regard, the present study aims to investigate the possible effect of ACT treatment on emotional divorce and couples' self-efficacy. Given the successful results obtained from ACT therapy so far in various fields, the authors wanted to know whether or not acceptance and commitment therapy can cure emotional divorce and improve couples' self-efficacy?
Findings indicated that the population under study enjoyed their lives more with ACT training and mindfulness learning. Participants repeatedly expressed satisfaction regarding identifying their values and believed that they had been able to find their way in life. They also gained more peace in life by learning to accept failure, and ultimately, felt more empowered and self-efficient. They reported more satisfaction in living with their spouses too.
One of the limitations of this study was that during the coronavirus epidemic, the post-test was performed with a one-month delay. Although the researcher tried to minimize the impact of this issue with virtual training, the occurrence of unpredictable issues was beyond control. The effects of some variables such as gender and type of job required further studies which researchers were not able to conduct. In addition to the great deal of stress caused by this disease which reduces people's self-efficacy and feelings of mental weakness, authors had financial and quarantine problems. Another problem was couples' being together for longer amount time (Members of the group have repeatedly expressed dissatisfaction with this issue) and many other issues. These have certainly influenced the results of the research. It is suggested that similar studies be conducted in other statistical communities. The results of this study and similar studies can be used with follow-ups in long-term policies for couples and families.
Conclusion
In general, the findings of this study showed ACT on couples had positive impact regarding the degree of dissatisfaction and coldness of the relationship between them, as well as belief in their own abilities to improve their life. Therefore, ACT can be considered a good way to improve relationship between couples and reduce emotional divorce, and increase life satisfaction, self-efficacy and belief in their abilities.
Acknowledgments
The researchers wish to thank all the individuals who participated in the study.
Conflict of interest
The authors declared no conflicts of
interest.

Authors’ contributions
All authors contributed for conducting this
paper.



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Review: Research | Subject: General
Received: 2022/05/26 | Accepted: 2022/12/5 | Published: 2022/12/19

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