Dear Editor-in-Chief
The dual career phenomenon has become increasingly prevalent worldwide. It has been reported that job-family conflicts may lead to a wide range of negative consequences, thereby decreasing marital satisfaction with and enjoyment of life moments (1–2). Couples' sexual satisfaction is dependent on their perception of the sex life. Sexual satisfaction is a variable that can be distinguished from sexual function and is something beyond sexual pleasure (3).
Considering the number of domestic and Iranian studies on marital and sexual problems of dual-career couples (4–5), it can be said that context and culture play an important role in how and causes of marital problems, especially sexual and marital problems of dual-career couples.
We aimed to develop a psycho-educational model based on the lived experiences of dual career couples who are dissatisfied with sexual relations and its effectiveness on sexual satisfaction. This research was done based on mixed method in 2021. The qualitative part was performed using phenomenological method and 13 couples were enrolled for semi-structured interviews using purposive sampling method. In a small part of this study, a single case plan (AB plan) was used, and three couples were selected from those who referred to counseling centers in Ardabil, after obtaining informed consent and other ethical considerations (IR.ARUMS.REC.1298.598). The Sexual Satisfaction Questionnaire was designed by Larson (6). This questionnaire has 25 questions and measures sexual satisfaction based on a five-option Likert scale.
Based on the results obtained in the qualitative analysis section, the experiences of sexual dissatisfaction of dual-career couples can be classified into 10 main themes, which led to the preparation of a psycho-educational package with the following contents.
Table 1 shows the number of sessions, the content and the therapeutic model used. The results of the quantitative section indicated that the designed psycho-educational model has led to an increase in sexual satisfaction of dual-career couples. The reliable change index after treatment for the first to third couples is equal to 2.83, 2.71 and 2.74, respectively, these values are higher than the standard value of Z = 1.96.
Table 1:
Educational-psychological sessions
| Content | Therapeutic model used | Session |
|---|---|---|
| Framing sessions, articulating goals, identifying key problems, reaching a single definition of the problem | - | First |
| Increasing sexual self-esteem through cognitive correction, activating behavior, communicating with sexual organs, activating positive feedback from the spouse | Cognitive-behavioral-communication enrichment | Second |
| Challenging mythical sexual thoughts and beliefs, expressing core emotions, combating negative sexual spontaneous thoughts and sexual cognitive distortion (mind reading), self-acceptance, homework | Cognitive-behavioral-emotion-focused communication enrichment | Third |
| Increasing their level of differentiation in marital relationships, reducing insecure attachment by achieving unrecognized feelings that underlie interactive situations. | emotion-focused therapy and Bowen intergenerational family therapy | Fourth |
| Attracting couples' attention to the way they interact with each other and reflecting their interaction patterns, expressing attachment needs and identifying denied needs, facilitating the expression of needs and wants and creating emotional conflict, developing early emotional experiences in attachment and recognizing inner needs and relationships, Creating new attachments with a secure bond between spouses. Awareness of couples about the impact of fear and their defense mechanisms on cognitive and emotional processes. | emotion-focused therapy and insight focused therapy | Fifth |
| Strengthening the gender role and sexual identity of the couple, awareness about triangulation with children and work by each couple and trying to de-triangle, enrich the relationship, change the defective structure of the family, homework | Structural therapy and enrichment of communication | Sixth |
| Increased sexual intimacy (jokes, daily sexual conversation, activating non-verbal sexual behavior, quality of physical contact, sexual emotions, reminiscent behaviors), homework | Enriching sexual relationship | Seventh |
| Strengthening verbal and non-verbal communication, eliminating problematic verbal and non-verbal communication, awareness of the role of expectations growth, their role and meeting expectations and needs in sexual-marital satisfaction, providing homework | Enriching sexual relationship | Eighth |
| Increasing work-family balance through Clarifying goals, values and expectations of a role in the job, family and children, communication skills training. Establishing a fair relationship (balance between individual, marital, family needs and a fair relationship between husband and wife) and balance at work and family. Negotiation, contracting and problem solving, increasing support and understanding of the spouse and awareness of the role of spouse support in job-marital adjustment | Communication enrichment and conflict management | Ninth |
| Conflict management training, bringing couples closer to a financial position based on division of labor or financial partnership | Communication enrichment and conflict management | Tenth |
Finally, it can be concluded that achieving sexual and marital satisfaction and finally mental health and reducing divorce is a process that begins with pathology in the cultural context and are achieved by emphasizing indigenous culture through developing a counseling package for appropriate intervention by therapists and counselors.
Acknowledgements
The authors thank all the couples who helped us with this research.
References
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