New Approaches in Educational Management and Health Sciences

New Approaches in Educational Management and Health Sciences

The Effect of Schema-Based Couple Therapy on the Level of Depression in Women Affected by Spousal Infidelity

Document Type : Original Article

Authors
ُSolmaz Ammari 1
Ezat Deyreh 2
Moloud Keykhosrovani 2
Kamran Ganji 3
1 PhD in General Psychology, Department of Psychology, Bushehr Branch, Islamic Azad University, Bushehr, Iran
2 Department of Psychology, Bushehr Branch, Islamic Azad University, Bushehr, Iran.
3 Department of Psychology, Malayer Branch, Islamic Azad University, Malayer, Iran.
10.22034/edus.2025.545183.1006
Abstract
Background and Aim: Depression is one of the most common psychological disorders among women and has various individual, familial, and social consequences. The present study was conducted with the aim of determining the effect of couple therapy based on the schema model on depressive symptoms in women affected by spousal infidelity.
Methods: This semi-experimental study included all women affected by spousal infidelity who referred to counseling centers and psychological service clinics affiliated with the Welfare Organization of Bushehr in 2021. Using convenience sampling, 30 women who were willing to participate in the study (with written informed consent) were selected and randomly assigned to experimental and control groups. The Beck Depression Inventory (BDI; Beck et al., 2013) was used to collect data. The experimental group received schema-based couple therapy sessions based on Young’s approach (10 sessions, 120 minutes each) in a group format. Data analysis was conducted using SPSS version 21, and repeated measures ANOVA was applied.
Results: The findings showed that schema-based couple therapy was effective in improving depression in the experimental group. Furthermore, the effectiveness of this therapeutic approach was maintained over time from the post-test to the follow-up phase. Multiple comparison tests indicated that depression scores in the experimental group significantly decreased in the post-test and follow-up compared to the pre-test.
Conclusion: Based on the findings, schema-focused couple therapy, by targeting the deep-rooted relational and emotional problems, is an effective intervention for reducing depression in women affected by spousal infidelity. This therapeutic approach helps identify and modify maladaptive schemas, thereby improving quality of life and marital relationships. It is recommended that counseling and therapy centers adopt this approach as a standard intervention protocol in cases of marital infidelity and its psychological consequences to achieve more sustainable treatment outcomes
Keywords
Couple Therapy
Depression
Women
Spousal Infidelity

Ethics Approval ID: IR.BPUMS.REC.1399.169

  1. Lebow JL. Editorial: Integration in Couple and Family Therapy. Fam Process. 2019;58(3):527-531. doi: 10.1111/famp.12476
  2. Liu L, Wang H, Chen X, Zhang Y, Zhang H, Xie P. Gut microbiota and its metabolites in depression: from pathogenesis to treatment. EBioMedicine. 2023;90:104527. doi: 10.1016/j.ebiom.2023.104527
  3. Belus JM, van Heerden A, van Rooyen H, Bradley VD, Magidson JF, Hines AC, et al. Supporting Treatment for Anti-Retroviral Therapy (START) Together: Protocol for a pilot, randomized, couple-based intervention to promote women's ART adherence and men's engagement in HIV care in KwaZulu-Natal, South Africa. Contemp Clin Trials Commun. 2022;29:100970. doi: 10.1016/j.conctc.2022.100970 .
  4. Zhang Y, Chen Y, Ma L. Depression and cardiovascular disease in elderly: Current understanding. J Clin Neurosci. 2018;47:1-5. doi: 10.1016/j.jocn.2017.09.022
  5. Chi P, Tang Y, Worthington EL, Chan CLW, Lam DOB, Lin X. Intrapersonal and interpersonal facilitators of forgiveness following spousal infidelity: A stress and coping perspective. J Clin Psychol. 2019;75(10):1896-1915. doi: 10.1002/jclp.22825
  6. Aviram A, Nadan Y. Online clinical supervision in couple and family therapy: A scoping review. Fam Process. 2022;61(4):1417-1436. doi: 10.1111/famp.12809
  7. Khalifian C, Rashkovsky K, Mitchell E, Bismark A, Wagner AC, Knopp KC. A novel framework for ketamine-assisted couple therapy. Front Psychiatry. 2024;15:1376646. doi: 10.3389/fpsyt.2024.1376646
  8. Eira Nunes C, Antonietti JP, Darwiche J. Engaging in coparenting changes in couple therapy: Two contrasting cases. J Marital Fam Ther. 2022;48(4):998-1016. doi: 10.1111/jmft.12591
  9. Park LT, Zarate CA Jr. Depression in the Primary Care Setting. N Engl J Med. 2019;380(6):559-568. doi: 10.1056/NEJMcp1712493
  10. Beurel E, Toups M, Nemeroff CB. The Bidirectional Relationship of Depression and Inflammation: Double Trouble. Neuron. 2020;107(2):234-256. doi: 10.1016/j.neuron.2020.06.002
  11. Cuijpers P, Quero S, Dowrick C, Arroll B. Psychological Treatment of Depression in Primary Care: Recent Developments. Curr Psychiatry Rep. 2019;21(12):129. doi: 10.1007/s11920-019-1117-x
  12. Monroe SM, Harkness KL. Major Depression and Its Recurrences: Life Course Matters. Annu Rev Clin Psychol. 2022;18:329-357. doi: 10.1146/annurev-clinpsy-072220-021440
  13. Belus JM, Msimango LI, van Heerden A, Magidson JF, Bradley VD, Mdakane Y, et al. Barriers, Facilitators, and Strategies to Improve Participation of a Couple-Based Intervention to Address Women's Antiretroviral Therapy Adherence in KwaZulu-Natal, South Africa. Int J Behav Med. 2024;31(1):75-84. doi: 10.1007/s12529-023-10160-7
  14. Pentel KZ, Baucom DH, Weber DM, Wojda AK, Carrino EA. Cognitive-behavioral couple therapy for same-sex female couples: A pilot study. Fam Process. 2021;60(4):1083-1097. doi: 10.1111/famp.12696
  15. Hogue A, Schumm JA, MacLean A, Bobek M. Couple and family therapy for substance use disorders: Evidence-based update 2010-2019. J Marital Fam Ther. 2022;48(1):178-203. doi: 10.1111/jmft.12546
New Approaches in Educational Management and Health Sciences
Volume 2, Issue 2
August 2025
Summer 2025
Pages 13-19

  • Receive Date 27 April 2025
  • Revise Date 10 May 2025
  • Accept Date 22 June 2025