A Comparative Study of the Effectiveness of Sex Therapy Using Cognitive-Behavioral, Mindfulness-Based, and Integrative Approaches on Sexual Satisfaction and Sexual Desire in Married Women with Sexual Dissatisfaction

The aim of this research is to compare the effectiveness of sex therapy using cognitive-behavioral, mindfulness-based, and integrative approaches on sexual satisfaction and sexual desire in married women with sexual dissatisfaction. This study is a semi-experimental research with a pre-test and post-test design, classified as applied research in terms of its purpose. Data were collected through a survey using a validated questionnaire. The research population included all married women with sexual dissatisfaction who had sought counseling and psychological services through advertisements on the Divar website and social media networks and were selected through convenient sampling. After initial interviews and entry criteria assessment, which included being married, experiencing sexual dysfunction for at least six months, and being married for at least one year, a total of 40 participants were randomly divided into four groups (cognitive-behavioral, mindfulness-based, integrative, and control groups). The research instruments included the Sexual Desire Questionnaire (Apt & Halbert, 1992) with a Cronbach's alpha coefficient of 0.82 and the Hudson Index of Sexual Satisfaction Questionnaire (ISS) (1981) with a Cronbach's alpha coefficient of 0.87. Forty-five individuals volunteered to participate in the study, of which 42 attended in-person based on the advertisements, and 40 were selected based on entry and exit criteria. They were randomly assigned to four 10-member groups (cognitive-behavioral, mindfulness-based, integrative, and control groups). Subsequently, each experimental group received six 120-minute group therapy sessions. Initially, before any intervention, individuals received necessary explanations about the research objectives, and informed consent was obtained. In the first phase, a pre-test was administered before the intervention, and then the experimental groups underwent their respective interventions, with the first group receiving eight cognitive-behavioral sessions and the second group receiving six mindfulness-based sessions. After a 30-day interval following the interventions, a post-test was administered to all groups. For hypothesis testing, analysis of variance and post hoc tests were used. The results indicate that there are significant differences (p < 0.05) in sexual satisfaction and sexual desire among married women with sexual dissatisfaction in the integrative, cognitive-behavioral, and mindfulness-based groups compared to the control group, with the integrative group showing the highest improvement. However, there is no significant difference (p > 0.05) in sexual satisfaction and sexual desire between the mindfulness-based and cognitive-behavioral groups. Therefore, sex therapy in the treatment of generalized sexual dysfunction in sexual relationships, as well as reducing sexual dissatisfaction and increasing sexual desire and intimacy, is beneficial. Based on the findings of this research, psychologists and counselors working in the field of family therapy can use practical guidelines to intervene in situations arising from sexual dissatisfaction as a supportive treatment.