Comparing the effectiveness of acceptance and commitment therapy with its online version on psychological flexibility and psychological distress of women affected by marital infidelity

Document Type : Original Article

Authors

1 Professor, Department of Psychology, Faculty of Educational Sciences and Psychology, Shahid Chamran University of Ahvaz, Ahvaz, Iran.

2 PhD student in Psychology, Faculty of Educational Sciences and Psychology, Shahid Chamran University of Ahvaz, Ahvaz, Iran.

3 Associate Professor, Department of Psychology, Faculty of Educational Sciences and Psychology, Shahid Chamran University of Ahvaz, Ahvaz, Iran.

Abstract

Introduction: The aim of the research was to compare the effectiveness of acceptance and commitment therapy with its online version on psychological flexibility and psychological disturbance of women affected by marital infidelity. Method: The present research was conducted as a semi-experimental study with three groups and in three phases: pre-test-post-test-follow-up. The statistical population included women affected by marital infidelity who had referred to psychological counseling centers under welfare supervision in Shiraz city in 2022. 45 people were selected as a statistical sample using the available sampling method. The control group did not receive any intervention. The face-to-face group underwent 8 sessions of therapy based on acceptance and commitment. A site was designed for the internet group, which was provided to them based on acceptance and commitment therapy in 8 sessions. Dennis and Vanderwaal (2010) cognitive flexibility and Kessler (2003) psychological distress questionnaires were used. Analysis of covariance and Bonferroni were used to analyze the findings. Resullts: Both face-to-face and online methods of therapy based on acceptance and commitment were effective on psychological flexibility and psychological disturbance of women affected by marital infidelity. No significant difference was observed between the effectiveness of face-to-face and online methods of treatment based on acceptance and commitment on psychological flexibility and psychological disturbance. Conclusion: Treatment based on acceptance and commitment can be of great help in helping couples affected by marital infidelity.

Keywords

Main Subjects


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