The Effectiveness of Emotionally-Focused Couple Therapy on Dysfunctional Communication Patterns and Fear of Intimacy in Couples in Conflict

ShirinKam , Mohammed Sadegh; Hamzepoor Haghighi , Tahereh; PirKhaefi , Alireza

Volume 15 - Articles-1404 MEJDS (2025) 15: 98 | Back to browse issues page

Ethics code: IR.IAU.TON.REC.1403.013

Mendeley

Zotero

RefWorks

ShirinKam M S, Hamzepoor Haghighi T, PirKhaefi A. The Effectiveness of Emotionally-Focused Couple Therapy on Dysfunctional Communication Patterns and Fear of Intimacy in Couples in Conflict. MEJDS 2025; 15 (0) :98-98
URL: http://jdisabilstud.org/article-1-3649-en.html

The Effectiveness of Emotionally-Focused Couple Therapy on Dysfunctional Communication Patterns and Fear of Intimacy in Couples in Conflict

Mohammed Sadegh ShirinKam¹

, Tahereh Hamzepoor Haghighi ^*²

, Alireza PirKhaefi³

1- Department of Counseling, To.C., Islamic Azad University, Tonekabon, Iran
2- Department of Psychology, La.C., Islamic Azad University, Lahijan, Iran
3- Department of Clinical Psychology, Ga.C., Islamic Azad University, Garmsar, Iran

Abstract: (532 Views)

Abstract
Background & Objectives: Marriage, as a long–term commitment, plays a fundamental role in ensuring individuals' psychological and social well–being. However, the complexities of marital relationships can lead to conflict, especially when individual differences in perspectives and needs emerge. These conflicts often manifest as anger, frustration, and dissatisfaction, and may eventually result in marital disharmony. Unresolved conflicts not only affect individual and family dynamics but are also linked to cultural and social factors and may contribute to the rising divorce rates in recent years. In this context, effective communication, as one of the key pillars of marital stability, plays a vital role in maintaining intimacy, trust, and satisfaction. Constructive communication patterns enhance the quality of interactions, and couples who engage in open and supportive dialogue tend to cope more successfully with challenges.
In contrast, dysfunctional patterns foster misunderstandings, reduce intimacy, and intensify conflicts. Therefore, identifying and modifying such patterns is a priority in psychological interventions with couples. The present study aimed to examine the effectiveness of emotion–focused therapy (EFT) on dysfunctional communication patterns and fear of intimacy in conflicting couples.
Methods: The quasi–experimental research employed a pretest–posttest with a two–month follow–up design and a control group. The statistical population comprised couples in conflict who visited Misagh and Afaq Counseling Centers in Rasht City, Iran, between December 2023 and January 2024. After purposeful sampling, 34 couples (68 individuals) were selected. The inclusion criteria consisted of obtaining a score above 105 on the Marital Conflict Questionnaire (Sanai Zaker & Barati, 2007), having at least a high school diploma, being over 25 years old, and having at least 2 years of shared life. The exclusion criteria included substance or alcohol addiction, psychiatric medication use, history of infidelity, and incompatibility with the research objectives. Couples were randomly assigned to two groups: experimental (17 couples) and control (17 couples). The experimental group participated in 8 EFT sessions based on Johnson's (2004) protocol. The sessions focused on building a therapeutic alliance, identifying negative interactions, processing underlying emotions, restructuring conflict cycles, fostering mutual acceptance, and generating new solutions. The control group received no intervention. For data collection, the Communication Patterns Questionnaire (Christensen & Sullaway, 1984) and the Fear of Intimacy Scale (Descutner & Thelen, 1991) were used. In the present study, descriptive statistics, including mean, standard deviation, frequency, and percentage, were used to describe the demographic characteristics of the participants, and tables and graphs were used to present the results. To analyze the data, a repeated–measures ANOVA and a Bonferroni post hoc test were used. The significance level for statistical tests was set at 0.05, and data analysis was performed using SPSS version 26.
Results: The results showed significant differences between the groups in dysfunctional communication patterns (p<0.001) and fear of intimacy (p<0.001). In addition, in the experimental group, there was a significant difference between the pretest and posttest (p<0.001) and between the pretest and follow–up (p<0.001) for variables of dysfunctional communication patterns and fear of intimacy. However, there was no significant difference between the posttest and the follow–up for dysfunctional communication patterns (p=1.000) and fear of intimacy (p=0.720), indicating the stability of the intervention results over time.
Conclusion: According to the findings, emotion–focused couple therapy (EFT) is an effective and sustainable approach for improving couples' relationships and reducing dysfunctional communication patterns and fear of intimacy. Therefore, it is suggested that EFT be used in counseling centers and psychological services as an effective and sustainable approach to improve couples' relationships, reduce conflicts, and promote marital intimacy.

Keywords: Dysfunctional communication patterns, Fear of intimacy, Emotion–focused therapy (EFT)

Full-Text [PDF 332 kb] (17 Downloads)

Type of Study: Original Research Article | Subject: Counseling

References

1. Kalkan M, Ersanli E. The effects of the marriage enrichment program based on the cognitive-behavioral approach on the marital adjustment of couples. Educational Sciences Theory & Practice. 2008;8(3):977-86. [DOI]

2. Azandariani M, Khoynejad G, Akbari Amarghan H. Comparison of the effectiveness of emotion-based therapy and therapy based on acceptance and commitment on emotional self-regulation, psychological well-being and couple tolerance. Islamic Lifestyle with a Focus on Health. 2022;6(2):153–60. [Persian] [Article]

3. HasaniMoghadam S, Ganji J, Nia HS, Aarabi M, Khani S. Communication patterns and related factors among Iranian couples: a cross-sectional study. Sudan Journal of Medical Sciences. 2021;16(1):43–55. [DOI]

4. Aseka EO, Ireri NW, Menecha JB. Relationship between interactional styles and marital satisfaction among christian married couples in two selected churches in Nairobi County, Kenya. Journal of Sociology, Psychology and Religious. 2024;4(2):1–12. [DOI]

5. Bonakdar Mazandarani N, Bagheri F. Investigating the relationship between mental health, sexual self-concept and the role of communication. Journal of Psychology New Ideas. 2021;9(13):1–18. [Persian] [Article]

6. Khorshidi Mianaie H, Karimi fatemeh, Boland H, Ayadi N. Comparison of communication skills cognitive emotion regulation strategies and communication patterns in women with and without experience of domestic violence (an analytical-comparative study). Journal of Family Relations Studies. 2023;3(8):40–6. [Persian] [DOI]

7. Ashrafian-Lak S, Bagheri N. Comparison of family communication patterns and personality characteristics among couples applying for divorce and a control group. Salamat Ijtimai (Community Health). 2020;8(1):28–38. [Persian] [Article]

8. Wang Z, Zhang X, Ye Y. Does marital satisfaction predict children aggression? Insights from parents' and children's psychological distress. Child & Family Social Work. 2024;29(3):615–24. [DOI]

9. Solgi M, Zoghi L. Predicting the quality of married life based on Islamic lifestyle and communication patterns of female teachers. Journal of Islamic-Iranian Family Studies Journal. 2024;4(3):55–79. [Persian] [DOI]

10. Ragul L. Relationship between communication pattern and marital happiness of army couples. Mind and Society. 2023;12(01):67–73. [DOI]

11. Qazi S, Najam S, Mahmood I. Exploring the mediating role of fear of intimacy in the interplay of partner rejection and marital satisfaction among married women. Global Social Sciences Review. 2023;8(4):1–14. [DOI]

12. Manbeck KE, Kanter JW, Kuczynski AM, Maitland DWM, Corey M. Fear-of-intimacy in the interpersonal process model: an investigation in two parts. J Soc Pers Relat. 2020;37(4):1317–39. [DOI]

13. Finzi-Dottan R. The role of fear of intimacy as mediator between self-differentiation and marital relationship satisfaction: a dyadic model. The Family Journal. 2023;31(3):392–8. [DOI]

14. Reaisipour Z, Shafiabady A, Younesi Boroujeni J. The relationship between anger and the marital relationship quality in parents of children with cancer: the mediating role of psychological distress (depression, anxiety, and stress). Journal of Pediatric Nursing. 2021;8(1):35–45. [Persian] [Article]

15. Mehdigholi M, Dokanehi Fard F, Jahangir P. The effectiveness of emotion-oriented couple therapy on marital burnout and resilience of young couples. Applied Family Therapy Journal. 2023;4(2):47–59. [Persian] [DOI]

16. Oyebode O, Ogubuike R, Daniel D, Orji R. Emotion detection from real-life situations based on journal entries using machine learning and deep learning techniques. In: Arai K; editor. Intelligent systems and applications. Cham: Springer Nature Switzerland; 2024. [DOI]

17. Leo K, Langer SL, Porter LS, Ramos K, Romano JM, Baucom DH, et al. Couples communication and cancer: sequences and trajectories of behavioral affective processes in relation to intimacy. J Fam Psychol. 2024;38(2):246–59. [DOI]

18. Imanizad A, Golmohmmadian M, Moradi O, Goodarzi M. The effectiveness of emotion-oriented couple therapy on forgiveness and communication beliefs of couples involved in marital infidelity. Journal of Psychological Science. 2021;20(100):653–65. [Persian] [Article]

19. Momeni A, Ramezani K, Mardpour A. Effectiveness of emotion-focused couple therapy on improving optimism and communication patterns of couples working at state offices of the Ramhormoz County, Iran. Journal of Occupational Health and Epidemiology. 2020;9(4):231–8. [Persian] [DOI]

20. Kamankesh Z, Hosseini SS, Chehri A, Amiri H, Heydarian M. Comparative study of the effectiveness of life skills training and communication skills on marital conflicts and psychological well-being of incompatible spouses referring to psychological service centers in Kermanshas. Razi Journal of Medical Sciences. 2023;30(7):1–13. [Persian] [DOI]

21. Sanai Zaker B. Family and Marriage Scales. Tehran: Besat Publication; 2019. [Persian]

22. Christensen A, Sullaway M. Communication Patterns Questionnaire. Journal of Marriage and the Family. 1984. [DOI]

23. Heavey CL, Larson BM, Zumtobel DC, Christensen A. The Communication Patterns Questionnaire: reliability and validity in assessing constructive and destructive communication in couples. Journal of Marriage and Family Therapy. 1996;22(1):23–32.

24. Bodenmann G, Kaiser A, Hahlweg K, Fehm‐Wolfsdorf G. Communication patterns during marital conflict: a cross‐cultural replication. Personal Relationships. 1998;5(3):343–56. [DOI]

25. Samadzadeh M, Shaieri M, Javidi N. Communication Patterns Questionnair: the reliability and validity. Family Counseling and Psychotherapy. 2013;3(1):124–50. [Persian] [Article]

26. Descutner CJ, Thelen MH. Development and validation of a Fear-of-Intimacy Scale. Psychological Assessment: A Journal of Consulting and Clinical Psychology. 1991;3(2):218–25. [DOI]

27. Scigala DK, Fabris MA, Badenes-Ribera L, Zdankiewicz-Scigala E, Longobardi C. Alexithymia and self differentiation: the role of fear of intimacy and insecure adult attachment. Contemporary Family Therapy. 2021;43(2):165–76. [DOI]

28. Besharat MA. Fear of intimacy scale: questionnaire, instruction and scoring. Developmental Psychology (Iranian Psychologists). 2019;61(16):109–12. [Persian] [Article]

29. Johnson SM. The practice of emotionally focused couple therapy creating connection. Second edition. London: Routledge; 2004. [DOI]

30. Bazargan S, Ramezani Ma, Atashpuor H, Amiri R. Comparison of the effectiveness of the training package for promoting couples' interpersonal relationships based on the emotion-oriented approach and cognitive-behavioral marital counseling on attachment and marital commitment. Counseling Culture and Psycotherapy. 2021;12(48):259–94. [Persian] https://qccpc.atu.ac.ir/article_13115.html?lang=en

31. Hahlweg K, Kaiser A, Christensen A, Fehm‐Wolfsdorf G, Groth T. Self‐report and observational assessment of couples' conflict: the concordance between the communication patterns questionnaire and the KPI observation system. J Marriage Fam. 2000;62(1):61–7. https://doi.org/10.1111/j.1741-3737.2000.00061.x

32. Montajabian Z, Rezai Dehnavi S. Study of the effectiveness of meta cognitive interpersonal therapy on improving dysfunctional communication patterns couples and increase of marital adjustment. Rooyesh. 2021;10(8):135–48. [Persian] [Article]

33. Zhou N, Buehler C. Marital hostility and early adolescents' adjustment: the role of cooperative marital conflict. J Early Adolesc. 2019;39(1):5–27. [DOI]

34. Johnson SM, Talitman E. Predictors of success in emotionally focused marital therapy. J Marital Fam Ther. 1997;23(2):135–52. [DOI]

35. Wiebe SA, Johnson SM, Burgess Moser M, Dalgleish TL, Tasca GA. Predicting follow‐up outcomes in emotionally focused couple therapy: the role of change in trust, relationship‐specific attachment, and emotional engagement. J Marital Fam Ther. 2017;43(2):213–26. [DOI]

36. Zakhirehdari N, Navabinejad S, Koraei A. Comparison of the effectiveness of cognitive-behavioral and emotion- focused couple therapies on marital intimacy of couples. Int J Behav Sci. 2019;13(3):111–7.

37. Soltani A, Molazadeh J, Mahmoodi M, Hosseini S. A study on the effectiveness of emotional focused couple therapy on intimacy of couples. Procedia Soc Behav Sci. 2013;82:461–5. [DOI]

38. Alavi SZ, Amanelahi A, Attari Y, Koraei a. The effectiveness of emotionally focused couple therapy on emotional and sexual intimacy of incompatible couples. Family Counseling and Psychotherapy. 2019;8(2):25–46. [Persian] [Article]

39. Hedayati M, Haji Alizadeh K, Hedayati M, Fathi E. Effectiveness of emotionally focused couples therapy on the marital intimacy of couples coping with breast cancer in women. Iranian Journal of Breast Diseases. 2020;13(3):30–42. [Persian] [DOI]

40. Metzl E. Art therapy with couples: integrating art therapy practices with sex therapy and emotionally focused therapy. International Journal of Art Therapy. 2020;25(3):143–9. [DOI]

41. Firozi M, Golparvar M, Aghaei A. Comparison of the effectiveness of emotionally focused couple's therapy, cognitive-behavioral couple's therapy and gottman systemic-cognitive couple's therapy on affect balance and inefficient expectations of woman with sexual dysfunction. Iranian Journal of Psychiatric Nursing. 2022;10(1):1–17. [Persian] [DOI]

42. Damasio ar. Descartes' error: emotion, reason and the human brain. New York: Grossett/Putnam; 1994.

43. Beasley CC, Ager R. Emotionally focused couples therapy: a systematic review of its effectiveness over the past 19 years. J Evid Based Soc Work. 2019;16(2):144–59. [DOI]