The Effects of Emotion-Focused Couple Therapy on Sexual Dysfunction and Sexual Performance Anxiety in Women with Vaginismus

Background & Objectives: Marital satisfaction is influenced by numerous factors. For example, a safe and pleasurable sexual relationship is among the main characteristics noticed in multiple related investigations. Numerous scholars suggested that sexual satisfaction significantly predicted emotional intimacy in couples. Furthermore, the quality and style of sexual relationship, and its resulted desire, highly impact marital satisfaction and promote mental health in spouses. The lack of intimacy and inability in the revelation and exchange of emotions are observed in couples with sexual dysfunction. Considering the importance of sexual health in improving the psychological health status of individuals and in improving their marital quality, this study aimed to determine the effects of Emotion–Focused Couple Therapy (EFCT) on sexual dysfunction and sexual performance anxiety in women with vaginismus. Methods: This was a quasi–experimental study with pretest–posttest and a control group design. The statistical population of this study consisted of all women with vaginismus referring to psychological counseling centers in district 5 of Tehran City, Iran, in 2019. Of them, 30 (n=15/group) individuals who met the inclusion criteria of the study were selected and randomly assigned to the experimental and control groups. The inclusion criteria of the study were women with vaginismus, providing written informed consent forms to participate in the study, not being co–educated or undergoing any other therapeutic interventions, and presenting no physical or mental illnesses. Moreover, the exclusion criteria of the study included not having vaginismus, reluctance to participate in the research, receiving concurrent training or other therapeutic interventions, and presenting chronic physical and mental illnesses. The necessary data were collected in pretest and posttest phases using the Golombok Rust Inventory of Marital State (GRIMS; Rust et al., 1986) and the Multidimensional Sexual Self–Concept Questionnaire (MDSCQ; Snell, 1997). The experimental group received training based on Johnson's EFCT protocol (2009) in eight 60–80–minute sessions twice a week by the researcher. Descriptive statistics (mean & standard deviation) were used to analyze the collected data. Besides, inferential statistics, including Multivariate Analysis of Covariance (MANCOVA) were used to examine the between–group differences in SPSS. The significance level of the tests was considered 0.05. Results: The MANCOVA results signified a significant difference between the study groups concerning sexual dysfunction (p<0.001) and sexual performance anxiety (p<0.001). Therefore, EFCT significantly reduced sexual dysfunction and sexual performance anxiety in the study subjects. Additionally, the relevant effect sizes were measured to be 0.42 and 0.19 for sexual dysfunction and sexual performance anxiety, respectively; thus, 42% and 19% of individual differences in the posttest scores of sexual dysfunction and sexual performance anxiety belonged to the effects of the provided intervention. Conclusion: Based on the current research findings, EFCT is effective in improving sexual function and reducing sexual performance anxiety in women with vaginismus. Therefore, this approach requires further attention of family therapists and couple therapists to be applied for treating couples' sexual and marital problems.