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The Effectiveness of Personal Construct Therapy on Marital Satisfaction: A Quasi-Experimental Study

AUTHORS

Hossein Keshavarz-Afshar 1 , Fatimah Nosrati 2 , Esfandiar Azad-Marzabadi 3 , Noshin Eslahi 4 , Mohammad Gholami-Fesharaki 5 , Fahimeh Ghahvehchi-Hosseini 6 , *

AUTHORS INFORMATION

1 Assistant Professor, Department of Educational Psychology and Counseling, University of Tehran, Tehran, Iran

2 Assistant Professor of Psychology and Education of Exceptional Children, University of Tehran, Tehran, Iran

3 Behavioral Sciences Research Center, Baqiatallah University of Medical Sciences

4 Azad University

5 Assistant Professor of Biostatistics, Biostatistics Department, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Islamic Republic of Iran

6 Behavioral Sciences Research Center, Baqiatallah University of Medical Sciences, Tehran, Iran

How to Cite: Keshavarz-Afshar H, Nosrati F, Azad-Marzabadi E, Eslahi N, Gholami-Fesharaki M, et al. The Effectiveness of Personal Construct Therapy on Marital Satisfaction: A Quasi-Experimental Study, Iran Red Crescent Med J. 2017 ; 19(6):e14317. doi: 10.5812/ircmj.14317.

ARTICLE INFORMATION

Iranian Red Crescent Medical Journal: 19 (6); e14317
Published Online: June 3, 2017
Article Type: Research Article
Received: August 14, 2016
Revised: January 31, 2017
Accepted: March 1, 2017
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Abstract

Background: Marital satisfaction is as an important factor in family function. Considering incompatibility between couples, some approaches such as construct therapy could be effective in marital satisfaction.

Objectives: This study aimed to evaluate the effectiveness of personal construct analysis model in marital satisfaction.

Methods: The present research was a quasi-experimental study with pretest-posttest and fallow up design. The population was consisted of couples referring to counseling centers in Tehran (Iran) due to marital conflict during 2011 - 2013. The participants were randomly assigned to two groups (Treatment (T) and Control (C)) of 15 pairs each. The treatment group received 10 weekly sessions of intervention. The data were collected by enrich marital satisfaction short form 47-item questionnaire and analyzed statistically using analysis of variance.

Results: The mean differences in variables including personality issues (T = 2.96, C = -0.6, P < 0.001), communication (T = 4.83, C = -0.07, P < 0.001), conflict resolution (G1 = 2.7, C = -1.03, P < 0.001), financial management (T = 1.2, G2 = -0.77, P < 0.001), leisure activities (T = 0.6, G2 = -0.76, P < 0.001), sexual relationship (T = 0.6, C = -0.76, P < 0.001), children and parenting (T = 2.6, C = -0.54, P < 0.001), family and friends (T = 1.9, C = -0.66, P < 0.001), and religious orientation (T = 0.83, C = -0.37, P < 0.001) were positive in the treatment group and negative in the control group.

Conclusions: The present study demonstrated that personal construct analysis model can be used as an alternative intervention for marital distress.

Copyright © 2017, Iranian Red Crescent Medical Journal. This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (http://creativecommons.org/licenses/by-nc/4.0/) which permits copy and redistribute the material just in noncommercial usages, provided the original work is properly cited.

1. Background

The couples’ sense of satisfaction with marriage and marital relationship plays an important role in the normal family function. Regardless of the fact that the term “marital satisfaction” has been quite challenging to define, its true definition can perhaps be better understood when assessed along the lines with words such as compatibility and happiness, which have been applied to determine marital life quality (1). In fact, although defining and describing marital satisfaction appears as rather simple, the essence of its existence and absence renders it complex in nature. Marital satisfaction is a significant, complex aspect of marital relationship. In other words, among the marital components, satisfaction perceived by couples with their relationship is one of the vital dimensions (2). Nevertheless, statistics of divorce, which can be considered as the most valid index of marital distress, show that marital satisfaction is not easily obtained (3).

Marital satisfaction and dissatisfaction are affected by several factors, including a person’s expectation from life, personality features, emotions, cognition, thoughts and even individual perception of the self and others. Cognitive factors are effective in marital relationships. To specify precisely, marital satisfaction is an emotional-cognitive function that includes the mental evaluation a person has about his/her marital relation (4).

Moreover, in the applied psychology field, different approaches have been developed in couple therapy to reduce conflicts and distress among couples (5). It is also worth mentioning that the majority of such approaches have aimed to rectify the relationship between couples and even reduce marital conflicts to increase marital satisfaction as the desired outcome. With respect to the complexity of marital satisfaction and considering the mentioned issues, a vital need is to pay attention to both individual and interpersonal factors. Personal construct psychology, in this case, seems to be quite reasonable in meeting our need. The origin of this approach in psychology has been stated in the best form in Goerge Kely’s theory (6). From Kely’s point of view, the most effective way to understand human behavior is to consider one as a scientist. Based on his assumption, he was able to utilize this insight as a guide in treatment tasks, which in turn paved the way for his theory to be included as a subset of constructivism theories (7).

According to the personal construct theory, human beings intend to create meaning in their lives through experiments and even by refining their theories. Additionally, they tend to constantly search for different approaches in predicting future events (8). The need for anticipation is fundamental and shows itself in every aspect of human behavior. Indeed, it may prove to be rather difficult to ponder upon an action that, at the very least, does not relate to an implicit anticipation about how a fact is organized. Since a great part of human life is associated with social interaction, this desire to anticipate has a special importance in interpersonal events. Therefore, as evident as it may seem, almost all social interactions require a hypothesis to be made along with anticipation (7).

Kelly (9) used the personal construct concept through which these anticipations are made. Construct is a concept that one applies to categorize events and design a set of behaviors.

In personal constructs psychology, a human’s perception of the world is contingent upon individual and complex systems, mainly since humans interpret their experiences (10). Granted that these interpretations and meanings are more or less unique (individuality), they are in part akin to those of other individuals, as well (commonality) (9). In this regard, not only do people create their interpretations of the world and behave accordingly, but they also make hypotheses about other individual’s interpretations. Every single person who interprets another’s interpretation process can thus play a role in that person’s social process.

To make social relationships, including marital relations, people ought to make constructs about the others’ constructs (interpret others’ interpretation, read others’ thought) to be able to understand the others’ behaviors and thoughts. Kelly did not require that people interpret the same event in an identical way, but he said that they must interpret others’ views well (11).

Up until now, personal construct psychology has been used in the areas of anger treatment (12), stress disorder after harm (13), children’s problems (14), substance abuse (15), schizophrenia (16), and problems of intimate interpersonal relations (17). More importantly, attempts have been made by researchers such as Procter (18) in order to develop a family therapy model in accordance with personal construct psychology. By taking the mentioned issues into account, this research delves deep in finding the impact that a personal construct therapy may have on marital satisfaction.

2. Methods

The present study was a quasi-experimental research that included two specific groups. A pretest was performed on both groups one week before starting the couple therapy intervention. The posttest was administered at the last session. A follow-up test was additionally taken from both groups 3 months after the end of the intervention program. The statistical population of the present research included all candidate couples referring to one of the counseling centers of 5th district, Tehran, Iran.

Sample size was calculated as 28 for each group according to Cohen effect size (α = 0.05, β = 0.1, effect size = 0.80). Considering 20% attrition rate, 30 subjects were designated for each group.

Couples taking part in this study were selected among people who read newspaper announcement or referred by doctors. The announcement was published in the board section of a local newspaper: "Married couples are needed: couples who have problems in their marriage are welcome to a research at (location). Those who were interested in were asked to call the clinic for more details. People who called were explained that the study is to determine the effectiveness of a marital therapy and they may be assigned to a treatment group or to a waiting group for 10 weeks. The exclusion criteria were: presence of emotional or physical abuse, substance abuse problems, and primary sexual problems (Figure 1). People who were interested in the participation in the research completed a demographic questionnaire and marital satisfaction scale (ENRICH) as pretest. Then, they were informed about their group of assignment. The Ethics Committee of Research and Technology vice chancellor of Baqiatallah University of Medical Sciences confirmed the study (No. 92141).

2.1. Randomization and Intervention

Out of 47 candidate couples, 36 took part in the study. They were equally allocated to either treatment or waiting control groups using block randomization. 6 of the subjects dropped out from both the groups (3 from each group). After 10 sessions of intervention, the subjects in both groups were evaluated by posttest. A male and a female family counselor volunteered to serve as therapists in return for clinical supervision. They had previous experience in conducting couple therapy. Each therapist was provided with a copy of the personal construct psychology text, which was used as treatment manual (See Table 1).

Table 1. Framework of the Couple Therapy Sessions Based on Personal Constructs (Derived from (9))
SessionsContents
1Relationship establishing, initial evaluation, and presenting treatment logic
Step1: establishing a good relationship with clients and presenting rules, objectives, and numbers of sessions
2Family plan
Objectives:
Informing couples about communication models, people’s limits and family members’ emotional situation to each other
Promoting couples’ awareness about the existence of possibilities to create concerned changes to achieve special objectives
3Attention to comments and criticism
Objectives:
Increasing couples’ ability for listening to their spouses
Listening to wife/husband’s criticisms with respect
Developing and stabilizing this attitude in wife/husband that he/she is honorable as a sole and unique individual
4Putting yourself in the place of the other one
Objectives:
Respecting different opinions
Program planning for promoting wife/husband roles
5Family values
Objectives:
Determining couples’ interest in playing wife/husband roles
Finding factors that make playing wife/husband roles difficult for them
6Family root and identity
Objectives:
Reminding instances that each couple knows about his/her partner’s ancestors
Reflecting this issue of how family history impacts family
7Affection and authority in family
Objectives:
Reminding and reviewing the way of expressing love and affection in family
Discovering each family’s reaction to anger and disappointment
Discovering the way of expressing affections in family
8Design of constant roles
Objectives:
Presenting a system for new interpretations of couples’ family life
Increasing couples’ awareness about objectives and desirable changes in the future
9Constant role design
Objectives:
Increasing motivation to change behavior
Practicing healthy behaviors through imagery and role playing
Overcoming barriers to changing behavior
Making important changes in life
10Final conclusion
Objectives:
Review of completed tasks and mistakes correction
Final conclusion by the help of couples
2.2. Instrument

The tool for data gathering was the 47-item short form of the ENRICH marital satisfaction scale as a standard questionnaire. Soleimanian (19) have calculated and reported the internal correlation of the long form as 0.93 and the short form as 0.95. Mahdavian (20) estimated the values of 0.93 for men and 0.94 for women by working on the test validity using Pierson’s correlation coefficient and the retest method with an interval of 1 week. The coefficients for subscales of idealistic distortion, marital satisfaction, communication, conflict resolution, personality issues, leisure activities, financial management, sexual relationship, family and friends, children and parenting, religious orientation, and equalitarian roles in male and female groups were 0.72, 0.76, 0.76, 0.85, 0.81, 0.76, 0.63, 0.87, 0.69, 0.72, and 0.62, respectively. Alpha coefficient of the 48-item questionnaire in Mirkhashi’s research was obtained as 0.92.

2.3. Statistical Analysis

All statistical analyses were carried out in SPSS18 (SPSS Inc., Chicago IL). Continuous variables were expressed as mean ± SD. The data were checked for normal or non-normal distribution. Categorical variables were presented as frequency (percentage).

Normal distribution of numeric variables was assessed with Kolmogorov-Smirnov test.

In this study, ordinary and Bootstrap test, t test or Mann-Whitney U test, Paired Sample t test or Wilcoxon Signed Ranks Test, and ANCOVA and Chi square tests were applied to compare the two groups. A P value < 0.05 was considered to be significant.

3. Results

In this study, the youngest couple was 22 years old and the eldest one was 45 years old. The average length of marriage of participants was 3.62 years.

As shown in Table 2, there were no significant differences in demographic variables between subjects assigned to treatment and control groups.

Table 2. The Demographic Variables According to the Groupsa
VariablesGroupP Value
Personal construct (n = 30)Control (n = 30)
Continuous variablesMeanSDMeanSD
Age30.076.3031.304.520.391
length of marriage3.622.853.532.190.297
Categorical variablesNo.%No.%
Sex (Male)15501550%> 0.999
University education1963.31756.70.792

Abbreviation: SD, Standard Deviation.

aContinuous data analyzed using independent sample t-test or Mann -Whitney U. Categorical variables analyzed using Chi square test.

The mean differences between the pretest and posttest scores in the control (C) and treatment (T) groups are presented in Table 3. As can be seen, the mean differences of variables including personality issues (T = 2.96, C = -0.6), communication (T = 4.83, C = -0.07), conflict resolution (G1 = 2.7, C = -1.03), financial management (T = 1.2, G2 = -0.77), leisure activities (T = 0.6, G2 = -0.76), sexual relationship (T = 0.6, C = -0.76), children and parenting (T = 2.6, C = -0.54), family and friends (T = 1.9, C = -0.66), and religious orientation (T = 0.83, C = -0.37) were positive in the treatment group and negative in the control group.

Table 3. Pretest and Posttest scores of Study Variables According to the Groupsa
VariablesPretestPosttestP Value 1bDiffP Value 2c
Mean hSDh hMean SD
Personality Issues
Personal Construct10.271.6813.231.48< 0.00012.96< 0.0001
Control11.371.6710.771.550.007-0.6
P value0.007P value< 0.0001
Communication
Personal Construct10.671.9515.501.53< 0.00014.83< 0.0001
Control10.871.8710.801.580.836-0.07
P value0.560P value< 0.0001
Conflict Resolution
Personal Construct12.101.9014.801.69< 0.00012.7< 0.0001
Control12.501.7811.471.810.001-1.03
P value0.619P value< 0.0001
Financial Management
Personal Construct14.673.2415.872.47< 0.00011.2< 0.0001
Control14.572.7413.802.580.002-0.77
P value0.923P value0.007
Leisure Activities
Personal Construct16.472.0017.071.870.0010.6< 0.0001
Control15.831.7415.071.410.002-0.76
P value0.168P value< 0.0001
Sexual Relationship
Personal Construct13.732.4815.931.91< 0.00012.2< 0.0001
Control13.572.0112.902.120.029-0.67
P value0.219P value< 0.0001
Children and Parenting
Personal Construct12.131.7614.731.60< 0.00012.6< 0.0001
Control13.472.1012.932.160.044-0.54
P value0.031P value< 0.0001
Family and Friends
Personal Construct13.302.3815.201.92< 0.00011.9< 0.0001
Control14.031.7313.371.810.008-0.66
P value0.204P value0.001
Religious Orientation
Personal Construct13.972.1414.801.90< 0.00010.830.001
Control14.701.9114.331.880.173-0.37
P value0.204P value0.478

Abbreviation: SD, Standard Deviation.

aP value: base line and posttest scores based on the groups analyzed using independent sample t-test or Mann -Whitney U.

bP value 1: The difference between pretest and posttest scores in each group analyzed using Paired Sample t-test or Wilcoxon Signed Ranks Test.

cP value 2: Unequal variables between the two groups analyzed using ANCOVA.

4. Discussion

The current study aimed to determine the effectiveness of personal construct therapy in marital satisfaction among couples referring to counseling centers in Tehran.

The results showed that construct therapy is effective in increasing marital satisfaction of couples who had marital conflicts.

Personal construct psychology believes that marital dissatisfaction is a set of dysfunctional constructs that project themselves in the form of impenetrable predictions. These dysfunctional constructs intend to be confirmed as couples look for evidence to support their constructs in life and even impose such constructs on new information, ultimately leading to the formation of conditional beliefs and thoughts signifying tremendous impacts on their performance in cognitive, affective, and interpersonal areas (9).

It seems that personal constructs approach, due to working on psychological themes and personal constructs of couples with marital incompatibility, are relatively helpful in modifying beliefs and thoughts. Construct therapy provides an opportunity for couples to understand each other’s meaning of the world and perhaps for the very first time realize mutual perceptions about each other. This can inadvertently be the first step in treating marital incompatibility. The other explanation that can be mentioned for personal construct effectiveness in promoting marital satisfaction is that the treatment focuses on communicative levels of marital messages. In this regard, Gregory Batson has argued that we constantly have relations in two content and communicative levels with each other. Even animals dispute among themselves in a fun manner and transmit this message that (this is a game). We constantly communicate with each other about our roles in relations through gesture, appearance situation, face state, and tone as lingual messages. The constructs covering the relationships do not need a verbal label necessarily. Talking about how people interpret relations and encouraging awareness often create an opportunity for tackling problems and long-term challenges. In communication and conversation with one another, people more often do not use personal constructs. To be exact, a woman used the term “miserly” for her husband or a man used the term “useless” for himself. These constructs were revolving around actions, and forming them about each other can obtain all of them easily in recurrent models of interpretation and explanation. It is possible that people complaining about a reactive action, with a supportive way of the label, make those labels sustainable to some extent (9).

The results of this study are in line with those of studies of Kremsdorf (21), Epstein, Chen (22), Zolfaghari and Fatehi-Zadeh (23), Molhtari, Hoseinian, Bahrami et al. (2009), Yoosefi, Etemadi and Bahrami et al. (24), and Beck and Imery (25).

The results of this research in particular can be applied in counseling centers, and specific personal construct analysis models can be regarded as a new step in applying these treatments on couples. Considering that this treatment was performed on couples in Tehran, it is recommended that a similar study be performed in different cities to examine its effectiveness in various angles of marital life. One of the limitations was the small sample size, which makes it difficult to generalize the findings.

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