The effectiveness of emotion-focused therapy on psychological distress and depression of married women victims of domestic violence


1 Department of Family Counseling, Allameh Tabataba'i University, Tehran, Iran.

2 Department of Psychology, Karaj Branch, Islamic Azad University, Karaj, Iran.

3 Department of Psychology, University of Tehran, Tehran, Iran.


Introduction: Being a victim of violence can cause psychological distress and depression in women. This research was conducted with the aim of determining the effectiveness of emotion-focused therapy on psychological distress and depression of married women victims due to domestic violence.
Method: A quasi-experimental research method was used with a pre-test-post-test design with a control group. From the statistical population of women victims of domestic violence referring to the counseling centers of the 2nd district of Tehran, 30 people were selected by available sampling and randomly replaced in two groups of 15 people (emotional treatment and control). In order to collect information, the standard questionnaire for measuring violence against women (Haj-Yahia, 2001), psychological distress (Kessler et al., 2002), and depression (Beck, 1996) was used. The experimental group was subjected to emotion-focused therapy; The data were analyzed using covariance test.
Results: The results showed that emotion-oriented therapy has a significant effect on reducing distress and depression of married women who are victims of domestic violence (p<0.001).
Conclusion: For improve of the psychological condition of married women who are victims of domestic violence, it is suggested to use an emotion-focused therapeutic approach.


Caridade SM, Saavedra R, Ribeiro R, Oliveira AC, Santos M, Almeida IS, Soeiro C. Remote support to victims
of violence against women and domestic violence during the COVID-19 pandemic. The Journal of Adult
Protection. 2021 Aug 17.
2. Usta J, Murr H, El-Jarrah R. COVID-19 Lockdown and the increased violence against women: understanding
domestic violence during a pandemic. Violence and gender. 2021 Sep 1;8(3):133-9.
3. Yekekar S, Aghabakhshi H, Hosseini Haji Bakande S A. Social Themes of Domestic Violence Against Women.
Socialworkmag. 2019; 8 (3) :49-59
4. García-Moreno C, Pallitto C, Devries K, Stöckl H, Watts C, Abrahams N. Global and regional estimates of
violence against women: prevalence and health effects of intimate partner violence and non-partner sexual
violence. World Health Organization; 2013.
5. Campbell JC. Health consequences of intimate partner violence. Lancet. 2002; 359:1331–1336.
6. Dillon G, Hussain R, Loxton D, Rahman S. Mental and physical health and intimate partner violence against
women: A review of the literature. Int J Family Med. 2013; 2013:313909.
7. Malik M, Munir N, Ghani MU, Ahmad N. Domestic violence and its relationship with depression, anxiety and
quality of life: A hidden dilemma of Pakistani women. Pakistan journal of medical sciences. 2021 Jan;37(1):191.
8. Mager KL, Bresin K, Verona E. Gender, psychopathy factors and intimate partner violence. Personal
Disord. 2014; 3:25–267.
9. Kuijpers KF, van der Knaap LM, Winkel FW. Risk of revictimization of intimate partner violence: the role of
attachment, anger and violent behaviour of the victim. J Fam Violence. 2012;27(1):33–44. doi:10.1007/s10896-
10. Iverson KM, Litwack SD, Pineles SL, Suvak MK, Vaughn RA, Resick PA. Predictors of intimate partner violence
revictimization: the relative impact of distinct PTSD symptoms, dissociation and coping strategies. J Trauma
Stress. 2013;26(1):102–110.
11. Heron RL, Eisma M, Browne K. Why do female domestic violence victims remain in or leave abusive
relationships? A qualitative study. Journal of Aggression, Maltreatment & Trauma. 2022 May 28;31(5):677-94.
12. Marchand A, Blanc ME. The Contribution of Work and Non‐ Work Factors to the Onset of Psychological
Distress: An Eight‐ year Prospective Study of a Representative Sample of Employees in Canada. Journal of
occupational health. 2010 May;52(3):176-85.
13. Hamer M, Molloy GJ, Stamatakis E. Psychological distress as a risk factor for cardiovascular events:
pathophysiological and behavioral mechanisms. Journal of the American College of Cardiology. 2008 Dec
14. Kwan Z, Bong YB, Tan LL, Lim SX, Yong AS, Ch’ng CC, et al. Socioeconomic and sociocultural determinants
of psychological distress and quality of life among patients with psoriasis in a selected multi-ethnic Malaysian
population. Psychology, health & medicine. 2017;22(2):184-95.
15. Özkafacı AA, Eren N. Effect of art psychotherapy using marbling art on depression, anxiety, and hopelessness in
female survivors of domestic violence with PTSD. The Arts in Psychotherapy. 2020 Nov 1; 71:101703.
16. Adamu AF, Adinew YM. Domestic violence as a risk factor for postpartum depression among Ethiopian women:
facility based study. Clinical practice and epidemiology in mental health: CP & EMH. 2018; 14:109.
17. Astin MC, Ogland-Hand SM, Coleman EM, Foy DW. Posttraumatic stress disorder and childhood abuse in
battered women: Comparisons with maritally distressed women. Journal of consulting and clinical psychology.
1995 Apr;63(2):308.
18. O’Donnell ML, Creamer M, Pattison P. Posttraumatic stress disorder and depression following trauma:
understanding comorbidity. American Journal of Psychiatry. 2004 Aug 1;161(8):1390-6.
19. Mazza M, Marano G, Del Castillo AG, Chieffo D, Monti L, Janiri D, Moccia L, Sani G. Intimate partner violence:
A loop of abuse, depression and victimization. World journal of psychiatry. 2021 Jun 6;11(6):215.
20. Beck AT, Steer RA, Kovacs M, Garrison B. Hopelessness and eventual suicide: A 10-year prospective study of
patients hospitalized with suicide ideation: Psychometric properties of a self-report version. Journal of clinical
psychology. 1985; 44:499-505.
21. Hayes SC, Hofmann SG. The third wave of cognitive behavioral therapy and the rise of process‐ based care.
World psychiatry. 2017 Oct;16(3):245.
22. Timulak L, Keogh D, Chigwedere C, Wilson C, Ward F, Hevey D, Griffin P, Jacobs L, Irwin B. A comparison
of emotion-focused therapy and cognitive-behavioural therapy in the treatment of generalised anxiety disorder:
study protocol for a randomised controlled trial. Trials. 2018 Dec;19(1):1-1.
23. Vrana G, Greenberg L. Overview of emotion-focused therapy. InEmotion Focused Family Therapy with Children
and Caregivers 2018 Mar 15 (pp. 1-22). Routledge.
24. Greenberg LS, Watson JC. Emotion-focused therapy for depression: Canadian contributions. Canadian Journal
of Behavioural Science/Revue canadienne des sciences du comportement. 2022 Apr;54(2):152.
25. Greenman PS, Johnson SM. Emotionally focused therapy: Attachment, connection, and health. Current Opinion
in Psychology. 2022 Feb 1; 43:146-50.
26. Beasley CC, Ager R. Emotionally focused couple’s therapy: A systematic review of its effectiveness over the
past 19 years. Journal of Evidence-Based Social Work. 2019 Mar 4;16(2):144-59.
27. Johnson SM. Attachment theory in practice: Emotionally focused therapy (EFT) with individuals, couples, and
families. Guilford Publications; 2019.
28. Karreman A, Vingerhoets AJ. Attachment and well-being: The mediating role of emotion regulation and
resilience. Personality and Individual differences. 2012 Nov 1;53(7):821-6.
29. Towler AJ, Stuhlmacher AF. Attachment styles, relationship satisfaction, and well-being in working women. The
Journal of social psychology. 2013 May 1;153(3):279-98.
30. Ganz MB, Rasmussen HF, McDougall TV, Corner GW, Black TT, De Los Santos HF. Emotionally focused
couple therapy within VA healthcare: Reductions in relationship distress, PTSD, and depressive symptoms as a
function of attachment-based couple treatment. Couple and Family Psychology: Research and Practice. 2022
31. Salehpour P, Ahghar Ghodsi, Navabinejad Sh. The effectiveness of cognitive therapy based on mindfulness on
reducing irrational beliefs and emotional divorce of married women referring to counseling centers in Tehran.
Journal of the Faculty of Medicine of Mashhad University of Medical Sciences, 2020, 62(4.1):169-178.
32. Akhavan Bi\\bitgsir Z, Sanaei zaker B, Navabinejad Sh, Farzad V. The effectiveness of emotion-oriented couple
therapy on marital satisfaction and compatibility of couples. Behavioral Science Research, 2017; 14(3): 324-330.
33. Jafarian, Fathi, Arshi. The Effect of Mens emotional intelligence on Violence against women among married
couples. Knowledge &Research in Applied Psychology. 2015;16(4):76-83:
34. Kessler RC, Andrews G, Colpe LJ, Hiripi E, Mroczek DK, Normand SL, Walters EE, Zaslavsky AM. Short
screening scales to monitor population prevalences and trends in non-specific psychological distress.
Psychological medicine. 2002 Aug;32(6):959-76.
35. Green K, Karraki H. Life span developmental psychology: Prospective on stress and coping (pp. 151-174).
Hillsdale, N. J: Lawrence Erlbaum Associates. 2010.
36. Vasiliadis HM, Chudzinski V, Gontijo-Guerra S, Préville M. Screening instruments for a population of older
adults: The 10-item Kessler Psychological Distress Scale (K10) and the 7-item Generalized Anxiety Disorder
Scale (GAD-7). Psychiatry research. 2015 Jul 30;228(1):89-94.
37. Yaghoubi H. Psychometric features of the 10-question version of Kessler's Psychological Distress Questionnaire
(10K-). Quarterly Journal of Applied Psychological Research, 2014; 6(4): 45-57
38. Moss KM, Skouteris H, Wertheim EH, Paxton SJ, Milgrom J. Depressive and anxiety symptoms through late
pregnancy and the first year post birth: an examination of prospective relationships. Archives of Women's Mental
Health. 2009 Oct;12(5):345-9.
39. Schäfer JÖ, Naumann E, Holmes EA, Tuschen-Caffier B, Samson AC. Emotion regulation strategies in
depressive and anxiety symptoms in youth: A meta-analytic review. Journal of youth and adolescence. 2017
40. Saghiha H. The effectiveness of treatment based on emotion-focused approach on tolerance of ambiguity and
death anxiety of breast cancer patients. Master's thesis in psychology, Allameh Tabatabai University. 2020.
Mónaco E, Goldman RN, Montoya-Castilla I. “The scientific flourishing of Emotion-Focused Therapy”: a
bibliometric analysis of EFT articles in Web of Science databases. Person-Centered & Experiential
Psychotherapies. 2022 Jul 24:1-24.