Effectiveness of Counseling Based on Functional Analytic Psychotherapy with Enhanced Cognitive Therapy on the Sexual Quality of Life of Married Adolescent Women

Gholami, Maryam; Ahmadi, Atefeh; Taebi, Mozhgan; Jahani, Yunes; Alidousti, Katayoun

doi:10.1055/s-0041-1733914

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Original Article • Rev. Bras. Ginecol. Obstet. 43 (07) • July 2021 • https://doi.org/10.1055/s-0041-1733914 copy

Effectiveness of Counseling Based on Functional Analytic Psychotherapy with Enhanced Cognitive Therapy on the Sexual Quality of Life of Married Adolescent Women

Eficácia do aconselhamento baseado em psicoterapia analítica funcional - Com abordagem de terapia cognitiva aprimorada (FECT) na qualidade de vida sexual de mulheres adolescentes casadas

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Objective

Early marriage has many deleterious effects on the health of girls, such as sexual dissatisfaction, an inevitable result of the lack of sufficient knowledge about sexual issues at the time of the marriage. The goal of the present study was to determine the effectiveness of counseling based on functional analytic psychotherapy with enhanced cognitive therapy (FECT) on the sexual quality of life of married adolescent women.

Methods

This clinical trial was conducted between July and October 2019 on 150 married adolescent women who met the inclusion criteria. In the intervention group, FECTwas conducted in sixteen 90-minute sessions twice a week. The Sexual Quality of Life-Female (SQOL-F) questionnaire was used. When the study ended, the control group was given the choice of receiving the same intervention as the intervention group.

Results

The paired t-test showed a significant difference between the mean score of sexual quality of life before (52.33±23.09) and after (88.08±10.51) counseling in the intervention group (p<0.0001). According to the analysis of covariance, there was a significant difference between the score on sexual quality after counseling between the intervention (88.08±10.51) and control (60.32±23.73) groups (p<0.0001). There was also a significant difference between the mean score on the four dimensions of sexual quality of life in the intervention group (p<0.0001).

Conclusion

The results showed that counseling based on FECT improved the sexual quality of life in all dimensions in married adolescent women.

Keywords:
functional analytical psychotherapy (FAP); cognitive behavioral therapy (CBT); sexual quality of life; married women; adolescents

Session	Topic	Content
1	Introduction to the research variables	Introduction, explanation of the goals and rules of the counseling sessions focusing on the sexual response cycle and the benefits of sex based on the FECT approach, and homework*
2	Introduction to the method and variables	Explanation of FECT-based counseling, its benefits and limitations, types of emotions, quality of life, and sexual self-efficacy, and homework
3	Sexual disorders and self-efficacy	Analytic interpretation of and cognitive approach to women's sexual disorders and related psychological problems, the impact of morality and law on sexual quality and self-efficacy, role play, and homework
4	Sexual role and confidence, clinically-relevant behavior	Analytic interpretation of and cognitive approach to sexual roles, physical sexual attraction, sexual confidence, working on clients' clinically-relevant behavior through role play, and homework
5	Gender identity, clinically-relevant behavior	Cognitive errors about gender identity and the factors affecting it, working on the arousal of clinically-relevant behavior through role play, and homework
6	Sexual orientation, clinically-relevant behavior	Gender and sexual orientation, working on strengthening clinically-relevant behavior through role play, and homework
7	Communication skills and addiction	Working on effective marital-communication skills, behaviors that lead to sexual self-efficacy, the impact of various types of addiction on sexual relations, and homework
8	Sex life of men (husbands accompanied their wives in this session)	Cognitive focus on sexual quality of life and sexual disorders among men, and homework
9	Sexual goals	Analytic interpretation and cognitive approach to general and sexual self-efficacy and factors affecting it (such as sexual goals, self-confidence, self-esteem), and homework
10	Sexual satisfaction	Analytic interpretation and cognitive approach to sexual feelings, marital and sexual satisfaction, and their influencing factors, and homework
11	Femininity	Analytic interpretation of femininity and cognitive approach to the difference between dependence and love, how valuable women are (femininity, sexual confidence, the sense of guilt in sex life), and homework
12	Cultural factors	Analytic interpretation and cognitive approach to the cognitive triangle, sexual repression (feelings of pleasure, culture-related sexual errors), and homework
13	Improvement in sex life	Analytic interpretation of and cognitive approach to sexual competence, dealing with unexpected issues in sex life, ways to create variety in sex life, and homework
14	Role play	Interpretation of variables affecting behavior through role play, and homework
15	Review	Review session, review of practical techniques, and homework
16	Review	Review session, review of practical techniques

Variable	Intervention group: N(%)	Control group N(%)	Chi-squared test	p-value
Women education level:			0.31	0.85
First high school	7(14)	6(12)
Second high school	35(70)	34(68)
Diploma and higher education	8(16)	10(20)
Husband's level of schooling:			2.78	0.59
Illiterate	2(4)	0(0)
Elementary	6(12)	4(8)
Diploma	20(40)	20(40)
Associate degree	10(20)	11(22)
Bachelors	12(24)	15(30)
Husbandś education level:			0.60	0.89
Unemployed	5(10)	3(6)
Worker	5(10)	6(12)
Freelancer	30(60)	31(62)
Employed	10(20)	10(20)
Number of children				0.04
0	27(54)	27(54)	–
1	15(30)	15(30)	–
2	7(14)	7(14)	–
3	1(2)	1(2)	–

Variable	Group	Before counseling: mean ± standard deviation	After counseling: mean ± standard deviation	p-value
Sexual psychology	Intervention	50 ± 25.64	84.62 ± 12.68	< 0.0001
Sexual psychology	Control	58.20 ± 23.31	59.06 ± 25.10	0.414
Sexual satisfaction	Intervention	57.68 ± 24.05	93.84 ± 8.20	< 0.0001
Sexual satisfaction	Control	64.12 ± 21.94	64.79 ± 23.53	0.542
Sexual self- humiliation	Intervention	49.20 ± 24.86	87.73 ± 12.07	< 0.0001
Sexual self- humiliation	Control	59.46 ± 25.97	59.33 ± 27.80	0.909
Sexual repression	Intervention	52 ± 22.77	86.93 ± 13.46	< 0.0001
Sexual repression	Control	55.33 ± 23.26	56.80 ± 24.77	0.219
Total sexualquality of life	Intervention	52.33 ± 23.09	88.08 ± 10.51	< 0.0001
Total sexualquality of life	Control	59.57 ± 22.12	60.32 ± 23.73	0.39

Group	Intervention
Sexual quality of life	Mean ± standard deviation	F	p-value^* Note:* Repeated measures analysis of variance (ANOVA).
F-test	52.33 ± 23.09	189.27	< 0.0001
Session 2	60.02 ± 22.89
Session 4	64.97 ± 21.68
Session 6	69.02 ± 20.05
Session 8	72.04 ± 18.13
Session 10	77.64 ± 15.56
Session 12	81.88 ± 13.54
Session 14	84.57 ± 12.10
Session 16	88.08 ± 10.51

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[1] Address for correspondence Katayoun Alidousti, MSc in Midwifery, Department of Midwifery, Razi School of Nursing and Midwifery, Kerman University of Medical Sciences, Kerman, Iran (e-mail: alidoosti@kmu.ac.ir).