Preventive Care in Nursing and Midwifery Journal
Volume 14, Issue 4 (11-2024)
Prev Care Nurs Midwifery J 2024, 14(4): 55-63 |
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Ethics code: IR.IAU.AHVAZ.REC.1403.168
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Jafari S F, Kazemian Moghaddam K, Gholamzadeh Jofreh M. The effectiveness of self-differentiation training on family process and marital intimacy in couples with marital conflict. Prev Care Nurs Midwifery J 2024; 14 (4) :55-63
URL: http://nmcjournal.zums.ac.ir/article-1-940-en.html
URL: http://nmcjournal.zums.ac.ir/article-1-940-en.html
Department of Psychology, Dezful Branch, Islamic Azad University, Dezful, Iran , kkazemianmoghaddam@gmail.com
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Table 1. Self-Differentiation Training Sessions Summary
Table 3. Repeated-Measures ANOVA Within-Group Effects Three-Time Points Self-Differentiation Training Group
SS: Sum of Squares; MS: Mean Square
Figure 1. Changes in family process and marital intimacy scores in self-differentiation training group
Discussion
The current study aimed to investigate the effectiveness of self-differentiation training on family process and marital intimacy among couples experiencing marital conflict and seeking divorce in Ahvaz. The results indicated that self-differentiation training was effective in improving both family process and marital intimacy, and these effects were sustained at the follow-up stage.
The first finding revealed that self-differentiation training was effective in improving the family process at both the post-test and follow-up stages. This is consistent with findings from Mohammadi et al. [16], who found that self-differentiation training improved women's self-differentiation and marital satisfaction; Saadat Mehr and Khanjani Veshki [18], who reported increased positive feelings towards spouses following self-differentiation training; and Hashemi and Jafari [22], who also found improvements in family process and content among couples undergoing similar training. To explain this finding, it can be argued that couples seeking a consensual divorce often reach this stage due to weak communication skills and an inability to manage conflicts. Self-differentiation training can help them to address marital conflicts and problems in a more rational manner and with healthier boundaries, rather than reacting with intense emotions [22].
Self-differentiation training equips individuals with the ability to better recognize and manage their emotions while maintaining constructive relationships with their partners, which can lead to improved family communication [16]. Furthermore, self-differentiation helps couples to reduce unhealthy emotional dependencies and to respond to family problems independently, without relying on their partner's reactions. This process enables each partner to express their needs and feelings appropriately without creating significant conflict [18]. The outcome of this training can result in increased cooperation and collaboration between partners, ultimately improving family functioning [22]. Self-differentiation training can also contribute to creating a safer and more supportive family environment. Couples who acquire self-differentiation skills are generally better able to maintain calm and stability in stressful situations and can instill positive behavioral patterns in their children [20]. These changes in communication and behavioral patterns reduce tension and increase a sense of psychological security within the family. By improving communication skills and the ability to manage emotions, couples can more effectively fulfill their roles within the family. These changes can play a significant role in reducing the inclination to divorce and increasing the likelihood of maintaining a shared life, especially in situations where the family is facing a crisis [17]. Therefore, self-differentiation training, as an effective intervention, can lead to improved relationships among family members and create a healthier environment for family interactions.
The study also demonstrated that self-differentiation training effectively improved marital intimacy among couples experiencing marital conflict at the post-test assessment. Moreover, the significant difference between pre-test and follow-up scores indicates that these positive effects on marital intimacy were sustained over time. This is consistent with Sassani et al. [23], who found that self-differentiation training improved intimacy (along with compatibility and assertiveness) in married women, and Sehhat et al. [26], who reported increased marital intimacy and adjustment in couples who received self-differentiation training. A key aspect of self-differentiation's impact on marital intimacy relates to its influence on emotional dependency within the relationship. As Sehhat et al. [26] suggest, self-differentiation helps couples develop a better understanding of their own and their partner's needs and feelings, enabling them to establish healthier personal boundaries. This aligns with the idea that self-differentiation empowers individuals to participate more effectively in their marital relationships without losing their identity [21]. From this perspective, reduced reliance on unhealthy emotional dependencies can be seen as an advantage of self-differentiation training, as it fosters a more balanced and mature form of intimacy based on mutual respect and autonomy rather than neediness. However, some researchers suggest that complete independence or a very high level of differentiation might not always be beneficial for marital intimacy [27]. While reducing unhealthy dependency is crucial, a certain degree of interdependence and emotional connection is also essential for a fulfilling intimate relationship. Emami Rizi and Borun [21] indirectly touch upon this by focusing on marital satisfaction, which is likely influenced by both autonomy and connection. Therefore, the goal of self-differentiation training is not to eliminate all forms of dependency but rather to shift from unhealthy, anxious, or avoidant patterns to a more secure and balanced interdependence that promotes healthy intimacy. The result of this process is an increased sense of closeness and intimacy in couples' relationships, as individuals can express their needs and expectations clearly and respectfully.
One of the outcomes of self-differentiation training is an increased ability to empathize and actively listen to the emotional needs of one's partner. These qualities play a significant role in creating and strengthening marital intimacy [23]. By acquiring these skills, couples can manage their daily interactions in a more constructive and understanding manner, creating a safer and more pleasant space for expressing emotions. With improved self-differentiation skills, couples can better listen to each other and identify each other's emotional needs, consequently reducing previous tensions and misunderstandings and creating a suitable environment for rebuilding trust and affection [26]. These changes can lead to an increase in positive communication between couples, ultimately strengthening their marital intimacy. In conclusion, the hypothesis of this study emphasizes that self-differentiation training can increase marital intimacy among couples seeking a consensual divorce by strengthening emotional and communication abilities. This training, by increasing self-awareness and better emotion management, helps couples establish a closer and more positive relationship. As a result, the likelihood of maintaining the marital relationship increases, and a better environment is created for continuing a shared life.
While this study has certain limitations, it also possesses notable strengths. A key strength lies in its focus on a clinically relevant population—couples experiencing marital conflict and seeking consensual divorce—providing valuable insights into the effectiveness of self-differentiation training in this specific context. Furthermore, the use of validated instruments (the Family Process Scale and the Marital Intimacy Scale) strengthens the reliability and validity of the measurements. The significant and sustained improvements observed in both family process and marital intimacy, as demonstrated by the pre-test, post-test, and follow-up data, offer evidence for the potential benefits of this intervention. However, it is important to acknowledge certain limitations. As with all quasi-experimental studies, the absence of a control group is a significant limitation. This absence reduces the power of causal inference and the validity of the results, as it is difficult to definitively rule out the influence of external variables and environmental factors on the observed improvements. Additionally, the relatively short follow-up period limits our understanding of the long-term effects of the training. The study's focus on couples in Ahvaz also limits the generalizability of the findings to couples in other cities or with different cultural backgrounds, as cultural and social differences may influence the acceptance and impact of self-differentiation training. Finally, the lack of control over the specific types of conflict experienced by the couples may have introduced some variability in the results.
Conclusion
The findings of this study provide compelling evidence for the efficacy of self-differentiation training in enhancing family process and marital intimacy among couples experiencing marital conflict. The significant improvements observed in both domains, as measured by standardized scales, highlight the potential of this intervention to address the root causes of marital discord. These results contribute to the growing body of research supporting the positive impact of self-differentiation on interpersonal relationships. By fostering individual autonomy, healthy boundaries, and effective communication, self-differentiation training empowers couples to navigate conflict constructively and build stronger, more resilient partnerships. Future research may explore the optimal dosage of self-differentiation training, identify specific mechanisms of change, and examine the generalizability of these findings to diverse populations. Additionally, investigating the potential moderating and mediating factors that influence treatment outcomes could further refine the application of this intervention.
Ethical Consideration
The study was approved by the Ethics Committee of Islamic Azad University, Ahvaz branch (code: IR.IAU.AHVAZ.REC.1403.168).
Acknowledgments
We express our sincere gratitude to all the esteemed couples who participated in this study.
Conflict of interest
The authors declare no conflict of interest.
Funding
This study did not receive any financial assistance from public, commercial, or non-profit funding entities.
Authors' contributions
Jafari S.F. contributed to study concept and design, acquisition of data, analysis and interpretation of data, and statistical analysis. Kazemian Moghaddam K. provided administrative, technical, and material support and study supervision. Gholamzadeh Jofreh M. performed critical revision of the manuscript for important intellectual content.
Artificial Intelligence Utilization
The authors did not use any Artificial Intelligence (AI) tools or technologies during the preparation of this manuscript.
Data Availability Statement
The datasets generated and/or analyzed during the current study are not publicly available due to privacy restrictions but are available from the corresponding author upon reasonable request.
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Introduction
The family serves as the foundational unit of society, providing the initial context for an individual's growth and development. One defining aspect of human existence is the ability to build constructive interpersonal interactions characterized by empathy and compassion [1]. Despite this, divorce rates have been on the rise in recent years, attributed to various factors. The negative consequences of marital dissatisfaction often persist beyond divorce, impacting not only the immediate family but also extended social networks, particularly children [2]. Sociological and psychological research consistently demonstrates higher rates of psychological and behavioral disorders among children of divorced parents [3]. The integration of these children into society incurs substantial economic costs and contributes to social and cultural disruption, psychological distress, and a hindrance to societal progress. One of the main causes of these psychosocial issues is often rooted in family dynamics and parental relationships [4].
Dysfunctional family dynamics, particularly in the emotional, cognitive, and behavioral domains, often contribute to divorce. For example, when emotional functioning within a family is compromised, couples may experience emotional detachment and indifference, which can erode their connection and increase the likelihood of separation [5]. Contemporary society is characterized by a significant increase in familial challenges. In Iran, the increasing number of couples with problems is causing unstable families, strained marriages, and more divorces [6]. As the cornerstone of society, families are susceptible to disruptions caused by various stressors. A myriad of individual, social, emotional, and psychological factors can undermine the stability and cohesion of this fundamental social institution [7].
Samani's family process and content model offers a comprehensive framework for understanding family dynamics within Iranian cultural contexts [8]. This model posits that family dysfunction is influenced by three interconnected factors: family processes, family content, and the broader social context. Family processes encompass the behaviors and interactions that enable family members to adapt to changing circumstances and needs, including coping skills, flexibility, problem-solving abilities, decision-making, communication, and religious orientation. Family content refers to the resources available to the family, such as income, education, occupation, and physical and mental health. The social context, the third dimension, encompasses the cultural environment and belief systems that surround the family [9]. According to this model, deficiencies in any of these three areas can contribute to family dysfunction. For instance, inadequate family processes, such as poor communication or ineffective problem-solving, can lead to marital conflict and ultimately divorce [8].
Dysfunctional family processes, content, and context can lead to marital problems. In such circumstances, marital intimacy decreases [9]. Marital intimacy can be conceptualized as a psychological state that does not emerge spontaneously but requires effort from both partners. Particularly during the early years of marriage, marital intimacy is highly unstable, rendering relationships more vulnerable [10]. In essence, intimacy is an attitudinal variable and an individual characteristic of both spouses. Marital intimacy is one of the most significant factors contributing to a successful, healthy, and happy marriage [11]. Experts agree that successful marriages necessitate specific skills and abilities, including communication and problem-solving skills [12,13].
The escalating rates of divorce and marital dissatisfaction, coupled with couples' desire for stronger, more fulfilling relationships, underscores the need for specialized interventions and education [14]. In Iran, the divorce rate rose from 94,039 in 2006 to 181,049 in 2016, an average increase of 0.61% per year, highlighting the growing need for effective support systems for couples [15]. Consequently, various therapeutic approaches have been developed to address family and marital problems, with self-differentiation training emerging as a particularly promising intervention [16]. Given the detrimental effects of dysfunctional family processes, low marital intimacy, and high levels of enmeshment and anxiety, self-differentiation training has gained significant attention among family therapists and researchers in recent decades [17]. This approach empowers individuals to differentiate between their cognitive and emotional processes, enabling them to maintain emotional autonomy and make rational decisions in challenging situations [18].
For Bowen, self-differentiation is not merely a therapeutic process but also a therapeutic technique [19]. The goal of self-differentiation training is to foster individuals' ability to regulate their emotions and thoughts independently, based on their personalities rather than being influenced by others [20]. Self-differentiation is a concept used to describe family interaction patterns, aiming to establish appropriate boundaries between family members and to balance individuality with intimacy, considering factors such as age and developmental stage [21]. Self-differentiation training has been widely applied in family therapy and interpersonal relationships. Its benefits include improved family processes and content [22], and enhanced intimacy, adaptability, and assertiveness among married women [23].
Considering the potential of psychosocial interventions to positively impact family processes and content, thereby mitigating the risk of divorce, this research was undertaken. This study has important implications for preventive care in nursing and midwifery, particularly in areas such as premarital counseling, postpartum support, and family health education.
Objectives
It aims to investigate the efficacy of self-differentiation training in enhancing family processes and marital intimacy among couples who are experiencing marital difficulties and contemplating divorce.
Methods
A quasi-experimental pre-test, post-test, and a 45 days follow-up design was employed. The target population comprised all couples experiencing marital conflict and seeking divorce at psychological centers in Ahvaz, Iran, in 2023. Thirty participants were selected using a convenience sampling method and assigned to an experimental group. A priori power analysis was conducted using G*Power to determine the required sample size for a repeated measures ANOVA. Given an anticipated effect size of 0.78, an alpha level of 0.05, and a desired power of 0.95, the analysis indicated a need for a total sample of 30 couples. Inclusion criteria included below-average scores on the Family Process Scale and Marital Intimacy Scale, age between 20 and 45 years, and the absence of concurrent psychological treatment. Exclusion criteria encompassed missing more than two intervention sessions.
The Family Process Scale consists of 43 five-point Likert-type items (strongly agree: 5 to strongly disagree: 1), yielding a possible score range of 43 to 215. Scores below 100 were considered weak, 100-160 average, and above 160 strong. Items 1, 5, 7, 8, 20, 28 to 37, and 40 were reverse-scored. The reliability of this questionnaire was confirmed in a psychometric study by Samani et al. with a Cronbach's alpha of 0.85 [8]. In the present study, the Family Process Scale showed an internal consistency with a Cronbach’s alpha of 0.85.
To assess the level of intimacy within couples, the 17-item Marital Intimacy Scale, adapted from Thompson & Walker's Marital Intimacy Questionnaire and using a 7-point Likert scale (1= "never" to 7 = "always"), was employed. Higher scores on this scale indicate greater marital intimacy. Based on prior research, scores were categorized as follows: 17-50 indicated low intimacy, 51-84 moderate intimacy, and 85-119 high intimacy [24]. Amadian et al. reported a Cronbach's alpha of 0.95 [25], and present study found an acceptable alpha of 0.81.
This study, conducted in 2023 at psychological centers in Ahvaz, Iran, received ethical approval from the Ethics Committee of Islamic Azad University (IR.IAU.AHVAZ.REC.1403.168). Following the provision of written informed consent, participants completed the Family Process Scale and the Marital Intimacy Scale, establishing baseline (pre-test) data. These pre-test questionnaires were administered immediately before the start of the first training session. Subsequently, participating couples (both male and female) received an eight-week structured self-differentiation training program at the Ahvaz Family Counseling Center. Each weekly session lasted 90 minutes. The training was delivered by the first author, a certified family therapist with expertise in self-differentiation theory and practice, and was based on Bowen's family systems theory and relevant clinical literature [19]. (Table 1 provides a detailed overview of the intervention content). Immediately following the completion of the eighth and final session of the eight-week program, participants again completed the Family Process Scale and the Marital Intimacy Scale, constituting the post-intervention (post-test) data. Therefore, the post-test questionnaires were administered immediately after the conclusion of the eighth session. A final assessment using the same instruments was conducted 45 days post-intervention to collect follow-up data. Given the nature of the therapeutic training program, blinding of participants and the intervention facilitator was not feasible.
Data analysis
The normality of data was assessed using skewness and kurtosis statistics and the Shapiro-Wilk test. Descriptive statistics, including means and standard deviations (SD), were then calculated. Subsequently, repeated-measures ANOVA was used to evaluate the effects of the self-differentiation training. Where significant main effects were found, LSD post hoc tests were performed to explore pairwise comparisons. Statistical analyses were conducted using SPSS version 27. The significance level for all analyses was set at α = 0.05.
The family serves as the foundational unit of society, providing the initial context for an individual's growth and development. One defining aspect of human existence is the ability to build constructive interpersonal interactions characterized by empathy and compassion [1]. Despite this, divorce rates have been on the rise in recent years, attributed to various factors. The negative consequences of marital dissatisfaction often persist beyond divorce, impacting not only the immediate family but also extended social networks, particularly children [2]. Sociological and psychological research consistently demonstrates higher rates of psychological and behavioral disorders among children of divorced parents [3]. The integration of these children into society incurs substantial economic costs and contributes to social and cultural disruption, psychological distress, and a hindrance to societal progress. One of the main causes of these psychosocial issues is often rooted in family dynamics and parental relationships [4].
Dysfunctional family dynamics, particularly in the emotional, cognitive, and behavioral domains, often contribute to divorce. For example, when emotional functioning within a family is compromised, couples may experience emotional detachment and indifference, which can erode their connection and increase the likelihood of separation [5]. Contemporary society is characterized by a significant increase in familial challenges. In Iran, the increasing number of couples with problems is causing unstable families, strained marriages, and more divorces [6]. As the cornerstone of society, families are susceptible to disruptions caused by various stressors. A myriad of individual, social, emotional, and psychological factors can undermine the stability and cohesion of this fundamental social institution [7].
Samani's family process and content model offers a comprehensive framework for understanding family dynamics within Iranian cultural contexts [8]. This model posits that family dysfunction is influenced by three interconnected factors: family processes, family content, and the broader social context. Family processes encompass the behaviors and interactions that enable family members to adapt to changing circumstances and needs, including coping skills, flexibility, problem-solving abilities, decision-making, communication, and religious orientation. Family content refers to the resources available to the family, such as income, education, occupation, and physical and mental health. The social context, the third dimension, encompasses the cultural environment and belief systems that surround the family [9]. According to this model, deficiencies in any of these three areas can contribute to family dysfunction. For instance, inadequate family processes, such as poor communication or ineffective problem-solving, can lead to marital conflict and ultimately divorce [8].
Dysfunctional family processes, content, and context can lead to marital problems. In such circumstances, marital intimacy decreases [9]. Marital intimacy can be conceptualized as a psychological state that does not emerge spontaneously but requires effort from both partners. Particularly during the early years of marriage, marital intimacy is highly unstable, rendering relationships more vulnerable [10]. In essence, intimacy is an attitudinal variable and an individual characteristic of both spouses. Marital intimacy is one of the most significant factors contributing to a successful, healthy, and happy marriage [11]. Experts agree that successful marriages necessitate specific skills and abilities, including communication and problem-solving skills [12,13].
The escalating rates of divorce and marital dissatisfaction, coupled with couples' desire for stronger, more fulfilling relationships, underscores the need for specialized interventions and education [14]. In Iran, the divorce rate rose from 94,039 in 2006 to 181,049 in 2016, an average increase of 0.61% per year, highlighting the growing need for effective support systems for couples [15]. Consequently, various therapeutic approaches have been developed to address family and marital problems, with self-differentiation training emerging as a particularly promising intervention [16]. Given the detrimental effects of dysfunctional family processes, low marital intimacy, and high levels of enmeshment and anxiety, self-differentiation training has gained significant attention among family therapists and researchers in recent decades [17]. This approach empowers individuals to differentiate between their cognitive and emotional processes, enabling them to maintain emotional autonomy and make rational decisions in challenging situations [18].
For Bowen, self-differentiation is not merely a therapeutic process but also a therapeutic technique [19]. The goal of self-differentiation training is to foster individuals' ability to regulate their emotions and thoughts independently, based on their personalities rather than being influenced by others [20]. Self-differentiation is a concept used to describe family interaction patterns, aiming to establish appropriate boundaries between family members and to balance individuality with intimacy, considering factors such as age and developmental stage [21]. Self-differentiation training has been widely applied in family therapy and interpersonal relationships. Its benefits include improved family processes and content [22], and enhanced intimacy, adaptability, and assertiveness among married women [23].
Considering the potential of psychosocial interventions to positively impact family processes and content, thereby mitigating the risk of divorce, this research was undertaken. This study has important implications for preventive care in nursing and midwifery, particularly in areas such as premarital counseling, postpartum support, and family health education.
Objectives
It aims to investigate the efficacy of self-differentiation training in enhancing family processes and marital intimacy among couples who are experiencing marital difficulties and contemplating divorce.
Methods
A quasi-experimental pre-test, post-test, and a 45 days follow-up design was employed. The target population comprised all couples experiencing marital conflict and seeking divorce at psychological centers in Ahvaz, Iran, in 2023. Thirty participants were selected using a convenience sampling method and assigned to an experimental group. A priori power analysis was conducted using G*Power to determine the required sample size for a repeated measures ANOVA. Given an anticipated effect size of 0.78, an alpha level of 0.05, and a desired power of 0.95, the analysis indicated a need for a total sample of 30 couples. Inclusion criteria included below-average scores on the Family Process Scale and Marital Intimacy Scale, age between 20 and 45 years, and the absence of concurrent psychological treatment. Exclusion criteria encompassed missing more than two intervention sessions.
The Family Process Scale consists of 43 five-point Likert-type items (strongly agree: 5 to strongly disagree: 1), yielding a possible score range of 43 to 215. Scores below 100 were considered weak, 100-160 average, and above 160 strong. Items 1, 5, 7, 8, 20, 28 to 37, and 40 were reverse-scored. The reliability of this questionnaire was confirmed in a psychometric study by Samani et al. with a Cronbach's alpha of 0.85 [8]. In the present study, the Family Process Scale showed an internal consistency with a Cronbach’s alpha of 0.85.
To assess the level of intimacy within couples, the 17-item Marital Intimacy Scale, adapted from Thompson & Walker's Marital Intimacy Questionnaire and using a 7-point Likert scale (1= "never" to 7 = "always"), was employed. Higher scores on this scale indicate greater marital intimacy. Based on prior research, scores were categorized as follows: 17-50 indicated low intimacy, 51-84 moderate intimacy, and 85-119 high intimacy [24]. Amadian et al. reported a Cronbach's alpha of 0.95 [25], and present study found an acceptable alpha of 0.81.
This study, conducted in 2023 at psychological centers in Ahvaz, Iran, received ethical approval from the Ethics Committee of Islamic Azad University (IR.IAU.AHVAZ.REC.1403.168). Following the provision of written informed consent, participants completed the Family Process Scale and the Marital Intimacy Scale, establishing baseline (pre-test) data. These pre-test questionnaires were administered immediately before the start of the first training session. Subsequently, participating couples (both male and female) received an eight-week structured self-differentiation training program at the Ahvaz Family Counseling Center. Each weekly session lasted 90 minutes. The training was delivered by the first author, a certified family therapist with expertise in self-differentiation theory and practice, and was based on Bowen's family systems theory and relevant clinical literature [19]. (Table 1 provides a detailed overview of the intervention content). Immediately following the completion of the eighth and final session of the eight-week program, participants again completed the Family Process Scale and the Marital Intimacy Scale, constituting the post-intervention (post-test) data. Therefore, the post-test questionnaires were administered immediately after the conclusion of the eighth session. A final assessment using the same instruments was conducted 45 days post-intervention to collect follow-up data. Given the nature of the therapeutic training program, blinding of participants and the intervention facilitator was not feasible.
Data analysis
The normality of data was assessed using skewness and kurtosis statistics and the Shapiro-Wilk test. Descriptive statistics, including means and standard deviations (SD), were then calculated. Subsequently, repeated-measures ANOVA was used to evaluate the effects of the self-differentiation training. Where significant main effects were found, LSD post hoc tests were performed to explore pairwise comparisons. Statistical analyses were conducted using SPSS version 27. The significance level for all analyses was set at α = 0.05.
Table 1. Self-Differentiation Training Sessions Summary
| Sessions | Summary |
| 1 | Establishing rapport and introductions; utilizing icebreakers and session initiation techniques; outlining session objectives, rules, and regulations; fostering commitment to continued participation; emphasizing the significance of marriage; and introducing participants to the systemic-triangular model. |
| 2 | Commencing self-awareness exploration through assignments designed to identify personal strengths and weaknesses, and accurately label emotions. Incorporating exercises and assignments related to self-awareness. Explaining the concept of self-differentiation using examples and real-life scenarios, highlighting characteristics of differentiated and undifferentiated individuals. Teaching genogram construction and providing a family genogram example. Explain the purpose and function of genograms and emphasize their importance throughout the course. |
| 3 | Correlating current life challenges with the concept of differentiation. Examining the distinction between rational and emotional behaviors through participant-provided examples and scenarios. Managing emotions and teaching problem-solving skills. |
| 4 | Exploring the factors influencing triangulation. Identifying various forms of triangulation. Examining the impact of triangulation on the perpetuation of problems and family relationships. Discussing the intergenerational transmission of triangles (genograms). |
| 5 | This session focused on teaching de-triangulation techniques and strategies for managing relational triangles. Participants were guided to reduce emotional distance and explore the impact of their family of origin on their current life through the use of constructed genograms. |
| 6 | Communication styles were the focus of this session. Participants were helped to identify their communication patterns and understand the concept of circular causality in marital interactions. The "butterfly effect" model was introduced. |
| 7 | The seventh session focused on teaching effective communication skills for couples. Participants learned about interpersonal boundaries and how to differentiate between rational and irrational beliefs about others. Strategies for fostering behaviors that strengthen the couple's identity and increase intimacy were discussed. |
| 8 | This final session involved answering participants' questions and summarizing the key points covered throughout the course. A post-session evaluation was conducted to gather participants' feedback and thoughts on the program. The session concluded with expressions of gratitude. |
Results
Regarding age distribution, a majority of participants (53.33%) were aged between 33 and 45 years, while 46.67% were between 20 and 32 years old. The mean (SD) age of female participants was 27.49 (6.61) years, and the mean (SD) age of male participants was 35.85 (8.44) years.
Table 2 presents the mean scores and standard deviations for family process and marital intimacy at pre-test, post-test, and follow-up assessments.
Regarding age distribution, a majority of participants (53.33%) were aged between 33 and 45 years, while 46.67% were between 20 and 32 years old. The mean (SD) age of female participants was 27.49 (6.61) years, and the mean (SD) age of male participants was 35.85 (8.44) years.
Table 2 presents the mean scores and standard deviations for family process and marital intimacy at pre-test, post-test, and follow-up assessments.
Table 2. Means Standard Deviations Family Process Marital Intimacy
| Variables | Pre-test | Post-test | Follow-up |
| Mean (SD) | Mean (SD) | Mean (SD) | |
| Family process | 89.60 (9.70) | 170.40 (11.49) | 174.87 (7.37) |
| Marital intimacy | 45.67 (5.59) | 80.63 (3.89) | 80.27 (5.01) |
To ensure the validity of the repeated-measures ANOVA, the assumptions of normality and homogeneity of variance were assessed. Outlier analysis using skewness and kurtosis confirmed data normality. Levene's test indicated that the homogeneity of variance assumption was met for both family process (F=1.68, p=0.201) and marital intimacy (F=0.85, p=0.36). Mauchly's test indicated that the assumption of sphericity was met for both family process and marital intimacy. A repeated-measures ANOVA was conducted to evaluate the impact of self-differentiation training on family process and marital intimacy and based on the ANOVA test, the interventions showed significant changes in two variables (p<0.001) (Table 3).
Table 3. Repeated-Measures ANOVA Within-Group Effects Three-Time Points Self-Differentiation Training Group
| Variables | SS | df | MS | F | p | η2 |
| Family process | 138189.9 | 1 | 138189.9 | 918.40 | 0.001 | 0.96 |
| Marital intimacy | 24199.6 | 1 | 24199.6 | 559.43 | 0.001 | 0.95 |
There was a significant difference between the pre-test, post-test, and follow-up scores for the family process variable (p<0.001). To further examine the differences between the pre-test, post-test, and follow-up stages for the variables, the LSD post hoc test was employed. As shown in Table 4, there was a significant difference between the pre-test and post-test scores for the family process variable (p<0.001). This indicates that self-differentiation training was effective in improving the family process among couples experiencing marital conflict. Moreover, the significant difference between the pre-test and follow-up scores for the family process variable (p<0.001) suggests that the effects of self-differentiation training on the family process were sustained over time.
Table 4. LSD Post Hoc Test Within-Group Effects Self-Differentiation Training Group
There was a significant difference between the pre-test, post-test, and follow-up scores for the marital intimacy variable (p<0.001). This finding supports the conclusion that self-differentiation training was effective in increasing marital intimacy among couples experiencing marital conflict (Figure 1). | Scales | Phases | Mean difference | SE | P | |
| Family process | Pre-test | Post-test | 80.80 | 2.74 | 0.001 |
| Follow-up | 85.27 | 2.22 | 0.001 | ||
| Post-test | Follow-up | 4.47 | 0.078 | 0.074 | |
| Marital intimacy | Pre-test | Post-test | 34.96 | 1.24 | 0.001 |
| Follow-up | 24.60 | 1.37 | 0.001 | ||
| Post-test | Follow-up | -0.36 | 1.16 | 0.757 | |
Figure 1. Changes in family process and marital intimacy scores in self-differentiation training group
Discussion
The current study aimed to investigate the effectiveness of self-differentiation training on family process and marital intimacy among couples experiencing marital conflict and seeking divorce in Ahvaz. The results indicated that self-differentiation training was effective in improving both family process and marital intimacy, and these effects were sustained at the follow-up stage.
The first finding revealed that self-differentiation training was effective in improving the family process at both the post-test and follow-up stages. This is consistent with findings from Mohammadi et al. [16], who found that self-differentiation training improved women's self-differentiation and marital satisfaction; Saadat Mehr and Khanjani Veshki [18], who reported increased positive feelings towards spouses following self-differentiation training; and Hashemi and Jafari [22], who also found improvements in family process and content among couples undergoing similar training. To explain this finding, it can be argued that couples seeking a consensual divorce often reach this stage due to weak communication skills and an inability to manage conflicts. Self-differentiation training can help them to address marital conflicts and problems in a more rational manner and with healthier boundaries, rather than reacting with intense emotions [22].
Self-differentiation training equips individuals with the ability to better recognize and manage their emotions while maintaining constructive relationships with their partners, which can lead to improved family communication [16]. Furthermore, self-differentiation helps couples to reduce unhealthy emotional dependencies and to respond to family problems independently, without relying on their partner's reactions. This process enables each partner to express their needs and feelings appropriately without creating significant conflict [18]. The outcome of this training can result in increased cooperation and collaboration between partners, ultimately improving family functioning [22]. Self-differentiation training can also contribute to creating a safer and more supportive family environment. Couples who acquire self-differentiation skills are generally better able to maintain calm and stability in stressful situations and can instill positive behavioral patterns in their children [20]. These changes in communication and behavioral patterns reduce tension and increase a sense of psychological security within the family. By improving communication skills and the ability to manage emotions, couples can more effectively fulfill their roles within the family. These changes can play a significant role in reducing the inclination to divorce and increasing the likelihood of maintaining a shared life, especially in situations where the family is facing a crisis [17]. Therefore, self-differentiation training, as an effective intervention, can lead to improved relationships among family members and create a healthier environment for family interactions.
The study also demonstrated that self-differentiation training effectively improved marital intimacy among couples experiencing marital conflict at the post-test assessment. Moreover, the significant difference between pre-test and follow-up scores indicates that these positive effects on marital intimacy were sustained over time. This is consistent with Sassani et al. [23], who found that self-differentiation training improved intimacy (along with compatibility and assertiveness) in married women, and Sehhat et al. [26], who reported increased marital intimacy and adjustment in couples who received self-differentiation training. A key aspect of self-differentiation's impact on marital intimacy relates to its influence on emotional dependency within the relationship. As Sehhat et al. [26] suggest, self-differentiation helps couples develop a better understanding of their own and their partner's needs and feelings, enabling them to establish healthier personal boundaries. This aligns with the idea that self-differentiation empowers individuals to participate more effectively in their marital relationships without losing their identity [21]. From this perspective, reduced reliance on unhealthy emotional dependencies can be seen as an advantage of self-differentiation training, as it fosters a more balanced and mature form of intimacy based on mutual respect and autonomy rather than neediness. However, some researchers suggest that complete independence or a very high level of differentiation might not always be beneficial for marital intimacy [27]. While reducing unhealthy dependency is crucial, a certain degree of interdependence and emotional connection is also essential for a fulfilling intimate relationship. Emami Rizi and Borun [21] indirectly touch upon this by focusing on marital satisfaction, which is likely influenced by both autonomy and connection. Therefore, the goal of self-differentiation training is not to eliminate all forms of dependency but rather to shift from unhealthy, anxious, or avoidant patterns to a more secure and balanced interdependence that promotes healthy intimacy. The result of this process is an increased sense of closeness and intimacy in couples' relationships, as individuals can express their needs and expectations clearly and respectfully.
One of the outcomes of self-differentiation training is an increased ability to empathize and actively listen to the emotional needs of one's partner. These qualities play a significant role in creating and strengthening marital intimacy [23]. By acquiring these skills, couples can manage their daily interactions in a more constructive and understanding manner, creating a safer and more pleasant space for expressing emotions. With improved self-differentiation skills, couples can better listen to each other and identify each other's emotional needs, consequently reducing previous tensions and misunderstandings and creating a suitable environment for rebuilding trust and affection [26]. These changes can lead to an increase in positive communication between couples, ultimately strengthening their marital intimacy. In conclusion, the hypothesis of this study emphasizes that self-differentiation training can increase marital intimacy among couples seeking a consensual divorce by strengthening emotional and communication abilities. This training, by increasing self-awareness and better emotion management, helps couples establish a closer and more positive relationship. As a result, the likelihood of maintaining the marital relationship increases, and a better environment is created for continuing a shared life.
While this study has certain limitations, it also possesses notable strengths. A key strength lies in its focus on a clinically relevant population—couples experiencing marital conflict and seeking consensual divorce—providing valuable insights into the effectiveness of self-differentiation training in this specific context. Furthermore, the use of validated instruments (the Family Process Scale and the Marital Intimacy Scale) strengthens the reliability and validity of the measurements. The significant and sustained improvements observed in both family process and marital intimacy, as demonstrated by the pre-test, post-test, and follow-up data, offer evidence for the potential benefits of this intervention. However, it is important to acknowledge certain limitations. As with all quasi-experimental studies, the absence of a control group is a significant limitation. This absence reduces the power of causal inference and the validity of the results, as it is difficult to definitively rule out the influence of external variables and environmental factors on the observed improvements. Additionally, the relatively short follow-up period limits our understanding of the long-term effects of the training. The study's focus on couples in Ahvaz also limits the generalizability of the findings to couples in other cities or with different cultural backgrounds, as cultural and social differences may influence the acceptance and impact of self-differentiation training. Finally, the lack of control over the specific types of conflict experienced by the couples may have introduced some variability in the results.
Conclusion
The findings of this study provide compelling evidence for the efficacy of self-differentiation training in enhancing family process and marital intimacy among couples experiencing marital conflict. The significant improvements observed in both domains, as measured by standardized scales, highlight the potential of this intervention to address the root causes of marital discord. These results contribute to the growing body of research supporting the positive impact of self-differentiation on interpersonal relationships. By fostering individual autonomy, healthy boundaries, and effective communication, self-differentiation training empowers couples to navigate conflict constructively and build stronger, more resilient partnerships. Future research may explore the optimal dosage of self-differentiation training, identify specific mechanisms of change, and examine the generalizability of these findings to diverse populations. Additionally, investigating the potential moderating and mediating factors that influence treatment outcomes could further refine the application of this intervention.
Ethical Consideration
The study was approved by the Ethics Committee of Islamic Azad University, Ahvaz branch (code: IR.IAU.AHVAZ.REC.1403.168).
Acknowledgments
We express our sincere gratitude to all the esteemed couples who participated in this study.
Conflict of interest
The authors declare no conflict of interest.
Funding
This study did not receive any financial assistance from public, commercial, or non-profit funding entities.
Authors' contributions
Jafari S.F. contributed to study concept and design, acquisition of data, analysis and interpretation of data, and statistical analysis. Kazemian Moghaddam K. provided administrative, technical, and material support and study supervision. Gholamzadeh Jofreh M. performed critical revision of the manuscript for important intellectual content.
Artificial Intelligence Utilization
The authors did not use any Artificial Intelligence (AI) tools or technologies during the preparation of this manuscript.
Data Availability Statement
The datasets generated and/or analyzed during the current study are not publicly available due to privacy restrictions but are available from the corresponding author upon reasonable request.
Type of Study: Orginal research |
Subject:
other
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