The Effect of Cognitive Behavioral Therapy on Self-Control, Mental Health and Mindfulness of Women Suffering from Domestic Violence

Abstract

The aim of this research was the effect of cognitive behavioral therapy on self-control, mental health and mindfulness of women suffering from domestic violence. The research was semi-experimental with a pre-test and post-test design and with a control group. The statistical population included all married women suffering from domestic violence who referred to Andisheh Sabz Center of Qom in 6486 1401, 30 people were selected by available sampling method and assigned in two equal groups of 15 people. In addition to demographic information checklist, data collection was done with self-control questionnaire, mental health questionnaire and mindfulness questionnaire. For the subjects of the experimental groups, 12 sessions, one 1-hour session per week. In addition to descriptive statistics, data analysis was performed with repeated measures analysis of variance. The results showed that in the post-test stage, there is a significant difference between the total score of self-control and its dimensions in the two groups (P<0.05). Also, the results showed that in the post-test stage, there is a significant difference between the mental health score and its dimensions in people participating in intervention programs and control people (P<0.05). Also, the results showed that in the post-test stage, there is a significant difference between the mindfulness score and its dimensions in people participating in intervention programs and control people (P<0.05).

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The Effect of Cognitive Behavioral Therapy on Self-Control,
Mental Health and Mindfulness of Women Suffering from
Domestic Violence
ParisaSabzevari 1, Ahmad Torabi*2,Horrieh Abbasmofrad3,Leila Asgari Doost4,Zahra Taher
Nasab Amiri5, Elham ariya faraz6, Mehri azandariani7
1. PhD in Counseling ، Department of Educational Sciences ,Mashhad Branch, Islamic Azad
University , Mashhad, Iran
2. Master of clinical psychology,Department of psychology,sari Branch ,Islamic azad
university.sari.lran(corresponding Author)ahmadtorabie66@gmail. com
3. PhD student in health psychology, Islamic Azad University, Karaj Branch, Karaj, Iran
4. Master of General psychology,Department of psychology,Mahallat Branch,lslamic azad
university.Mahalat.lran
5. Master of General psychology,Department of psychology,southTehran Branch,lslamic azad
university.southTehran.lran
6. Master of clinical psychology,Department of psychology,Ayatollah Amoli Branch,Islamic azad
university.Amol.Iran
7. PhD in Counseling ، Department of Educational Sciences ,Mashhad Branch, Islamic Azad
University , Mashhad, Iran
Received 2022 February 2; Revised 2022 March 20; Accepted 2022 April 24
Abstract :
The aim of this research was the effect of cognitive behavioral therapy on self-control, mental health
and mindfulness of women suffering from domestic violence. The research was semi-experimental
with a pre-test and post-test design and with a control group. The statistical population included all
married women suffering from domestic violence who referred to Andisheh Sabz Center of Qom in

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1401, 30 people were selected by available sampling method and assigned in two equal groups of 15
people. In addition to demographic information checklist, data collection was done with self-control
questionnaire, mental health questionnaire and mindfulness questionnaire. For the subjects of the
experimental groups, 12 sessions, one 1-hour session per week. In addition to descriptive statistics, data
analysis was performed with repeated measures analysis of variance. The results showed that in the
post-test stage, there is a significant difference between the total score of self-control and its
dimensions in the two groups (P<0.05). Also, the results showed that in the post-test stage, there is a
significant difference between the mental health score and its dimensions in people participating in
intervention programs and control people (P<0.05). Also, the results showed that in the post-test stage,
there is a significant difference between the mindfulness score and its dimensions in people
participating in intervention programs and control people (P<0.05).
Keywords: cognitive behavioral therapy, self-control, mental health, mindfulness, family violence
Introduction
Family is the first social organization in which a person lives, and it is basically a center of help, relief,
and healing, and it should decrease the mental pressure on its members and pave the way for their
growth and prosperity (Mollamohamadi, 2018). One of the mental pressures that is very common today
and endangers the foundations of families is domestic violence (Kumar, 2020). Violence towards
spouse is one of the major problems of many countries including Iran, which brings many negative
cultural, physical, and mental consequences for the victims.A culture's view of family, women and
violence, social structure and laws governing a society, economic status, and peoples' general opinions
and beliefs are among the issues that can help to explain domestic violence in any society on a macro
level (Megan et al., 2020). Domestic violence is the most common form of violence with the highest
probability of repetition and the least report to the police and the most social, psychological, and
economic complications, which can seriously damage the foundations of a family and lead to its
collapse (Yacoubi et al., 2016).Domestic violence refers to the aggressive and domineering behavior of
a family member against another member or members of the same family (Ertan et al., 2020). Given
that domestic violence is one of the common issues that has attracted the attention of many researchers
across the world today, it is still considered a common social harm (Isvand and Pirouzmand, 2019).
Family violence is one of the most important social harms that continue to exist in society despite

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intellectual and cultural progresses.Among the various types of domestic violence, women's violence
against men has received less attention (Mittal & Singth, 2020). Domestic violence is strongly effective
on decreasing psychological well-being (Perin, 2018), marital satisfaction (Walter et al., 2016), marital
intimacy (Karen et al., 2017), and quality of married life of couples (Shah Hosseini et al., 2018), and
quality of parent-child relationship (Pourmand et al., 2016).
In order to increase the compatibility of couples and decrease marital distress in their married life and
improve the mental health of couples and, as a result, improve family functioning, there are various
therapeutic approaches, including cognitive-behavioral therapies (CBT) (McCrady et al., 2016). This
therapy is an overarching term for a general set of therapies (Twohig, 2012). Cognitive-behavioral
couple therapy (CBCT) is the combination of cognitive and behavioral factors in the treatment of
couples with marital problems.The cognitive foundations of cognitive-behavioral couple therapy
emphasize mutual recognition of couples and consider recognition as an integral part of the process of
couples' change. Finally, the philosophical basis of this perception is that change in behavior alone is
not enough to correct dysfunctional interactions, but rather the way of thinking of people in
incompatible behavioral patterns and relationships should be emphasized (Lv et al., 2021). In a study,
Siddique, Chung, Brown & Miranda (2012) compared the effectiveness of cognitive-behavioral couple
therapy and medication therapy on depression and mental health of married women.The results
indicated that cognitive-behavioral couple therapy was more effective in decreasing the symptoms of
depression and improving their mental health. Therefore, this method of therapy helps clients to
achieve a more valuable and more satisfying life through psychological flexibility (Forman and Butryn,
2015). One of the variables that appears to be affected by cognitive behavioral therapy is self-control.
Self-control expresses the conformity of one's behavioral characteristics to the existing conditions and
situation (Avazpour and Touzande, 2021) and it means how flexible or stable a person is in their
situation (Moser et al., 2020). People who can prioritize realistic goals and balance emotions and
reason when making decisions are self-controlled (Moayyeri, 2020). People who lack self-control are
vulnerable to tempting and seductive moments (Demirtaş, 2020).Thus, they suffer from panic and
stress and lose their calm in sensitive situations such as the occurrence of dangerous diseases, (Yang et
al., 2021). People in corona conditions should have higher self-control in order to overcome their very
high stress (Schnell & Krampe, 2020). Another variable that appears to be affected by cognitive
behavioral therapy is mental health.

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On the other hand, in recent years, the approach of positive psychology has a special opinion on the
positive dimensions of human existence, that positive thoughts and emotions have a unique effect on
the mental and physical health of a person. In this approach, the ultimate goal is to identify the
constructs and methods that contribute to human well-being, happiness, and growth. Therefore, the
factors that cause a person to adapt more and more to the needs and threats of life are the most
fundamental constructs under the research of this approach (Sacco et al., 2021).Mental health is one of
the factors that can be studied for its effect and relationship with the performance of marital
relationships. In recent years, the pathological approach to the study of human health has been
criticized. Contrary to this view that defines health as the absence of disease, the new approach
emphasizes "being good" instead of "being bad or sick" (Din Mohammadi et al., 2021). From this point
of view, the absence of symptoms of mental illnesses is not an indicator of health, but adaptability,
happiness, self-confidence and positive characteristics of this kind indicate health, and the main goal of
a person in life is to flourish their capabilities (Roslan et al., 2017).The mental health of couples leads
to expanding the capabilities of couples and their growth, strengthening the communication skills of
couples (Javadi Vala et al., 2021), resolving conflicts between couples (Tasew et al., 2021), expanding
the personal goals of couples and families (Allahvardipour et al., 2021), and increasing intimacy
between couples (Kataoka et al., 2018). One of the variables that appears to be affected by cognitive
behavioral therapy is mindfulness.
Mindfulness is defined as awareness that arises from paying attention on purpose, in the present
moment, and nonjudgmentally (Simon et al., 2018). Mindfulness includes a receptive and judgment-
free awareness of what is happening now. Conscious people perceive internal and external realities
freely and without distortion and have a great ability to face a wide range of pleasant or unpleasant
thoughts, emotions, and experiences(Zarnaghash et al., 2015).Of course, mindfulness is not just for
decreasing suffering, but it emphasizes the capacity of mindfulness for individual growth, compassion,
and what causes individual and interpersonal growth. The effect of mindfulness is not only related to
illness. Mindfulness of positive and negative emotions activates different mental mechanisms that
affect mental health (Donnell et al., 2020).
The highest rate of violence is among women aged 25 to 35 years, proportionally, as the age increases,
the level of violence decreases. Approximately 70% of the women who were subjected to violence had
an educational level of diploma or lower than diploma, which is the highest value in the table. The

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lowest level of violence is also among women who have a postgraduate education or higher (Bozorgi
and Khodadadi, 2020).Also, the high prevalence of domestic violence in women can lead to suicide
(Isvand and Pirouzmand, 2019), marital infidelity (Lisman & Holman, 2021), chronic pain syndrome,
depression, and on the other hand, it causes drug abuse and sexually transmitted diseases, and various
family and social problems (Bolhari et al., 2017). Domestic violence accounts for approximately 5 and
19% of the total burden of diseases in women aged 15 to 44 in developing and developed countries,
respectively (Rosoulian et al., 2015).Families in which there is a lot of violence raise opinionated and
abnormal children with no self-confidence, and the efficiency of parents is also at a low level.
Moreover, these people gradually become isolated and show weakness in social relations (Ahmadi et
al., 2019).
Therefore, in the present research, the question to be addressed is what effect does cognitive behavioral
therapy have on self-control, mental health, and mindfulness of women suffering from domestic
violence?
Shabahang et al. (2021) in research entitled the effectiveness of online cognitive-behavioral
intervention on health anxiety, anxiety sensitivity, and somatosensory amplification in healthy people
with high levels of anxiety associated with covid-19 reached the conclusion that cognitive-behavioral
intervention leads to a reduction of health anxiety, anxiety sensitivity, and somatosensory
amplification, and reduction of violence of the participants in the experimental group. Zheng et al.
(2021) in research entitled the effectiveness of cognitive behavioral therapy on the mood and quality of
life of patients reached the conclusion that cognitive behavioral therapy had a positive and significant
effect on reducing the aggression and violence of patients.Sadrzadeh et al. (2019) in research entitled
investigating the causes of domestic violence in pregnant women referring to Mashhad's trauma centers
concluded that the most important causes of domestic violence from the point of view of pregnant
women were husband's unemployment and economic problems, previous history of hospital admission
due to domestic violence and addiction of spouse. 16 patients left the hospital with personal consent
and 30 patients were hospitalized. The number of cases of personal consent was significantly higher in
patients affected by domestic violence than other traumas.Among the most important underlying causes
of domestic violence in the current study, we can mention the history of violence in the individual or
family, as well as unemployment and economic problems. Perrin (2018) in research entitled domestic
violence and psychological well-being of couples concluded that domestic violence of couples has the

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ability to predict the psychological well-being of couples. Karen (2017) in research entitled the effect
of domestic violence on marital intimacy and physical/psychological well-being concluded that there is
a significant relationship between marital intimacy and domestic violence and that there is also a
significant relationship between physical/psychological well-being and domestic violence.Walter
(2016) in research entitled predicting psychological well-being and marital satisfaction based on
domestic violence concluded that domestic violence has a positive effect on psychological well-being
and that marital satisfaction has a positive effect on psychological well-being.Seddiqi (2019) in her
research entitled evaluation of the effect of group cognitive behavioral therapy on the mental health of
working women affected by domestic violence reached the conclusion that group cognitive behavioral
therapy has an effect on improving mental health, decreasing anxiety and sleep disorders, improving
social functioning, reducing depression and reducing physical symptoms of working women affected
by domestic violence.
Methodology
This research is semi-experimental and applied that was conducted with a pre-test-post-test design with
a control group, and after determining and randomly placing the experimental and control groups (1
experimental group and 1 control group), cognitive-behavioral couple therapy was applied to the
experimental group in the form of 12 sessions, each session lasting 1 hour (60 minutes), and a week
after the completion of the therapy sessions, the experimental and control groups were subjected to a
post-test.The statistical population of this research included all the women admitted to Andisheh Sabz
Center with the subject of filing a case of domestic violence in 2022 who referred to this center to
receive counseling and psychotherapy services. Simple random sampling method was used in this
study. Thus, 30 samples were randomly selected from the clients. The inclusion criteria were: being a
woman, being married for at least 5 years, not taking any psychotherapeutic drugs, not attending any
other psychotherapeutic course, and obtaining a high score in Haj Yahya's domestic violence
questionnaire and individual consent in participating in psychotherapeutic courses.Finally, they were
randomly assigned to two equal groups of 15 people. The sample size was calculated by the mean
comparison formula with a confidence coefficient of 95% and a test power of 80%. The criteria for
exclusion from the research included the individual's lack of consent and willingness, the individual's
suffering from one of the chronic (medical-psychiatric) problems and the use of certain medications,
not filling the questionnaires completely, being absent in the intervention sessions for more than two

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sessions, participating in therapy sessions similar to the present study at the same time or 6 months ago
and the subject's lack of willingness and consent.
The implementation method is such that first the necessary coordination was made with the officials of
Andisheh Sabz Center by explaining the purpose of the research, the method of its implementation,
compliance with ethical considerations and the method of publishing the results in the city. Then, we
went to the center and the intended sample was determined after 1 month. Then, the pre-test was
conducted in this center during two sessions. The sessions were conducted separately and
independently for each group according to approved health protocols. Then, 10 days after the
completion of the intervention sessions, the post-test stage was conducted for all sample subjects.
The hypotheses followed in the present research are as follows:
- Cognitive behavioral therapies affect the self-control of women suffering from domestic
violence.
- Cognitive behavioral therapies affect the mental health of women suffering from domestic
violence.
- Cognitive behavioral therapies affect the mindfulness of women suffering from domestic
violence.
Tools
A)Domestic violence questionnaire (Haj Yahya, 1998)
The data collection tool in the present research is Haj Yahya's domestic violence questionnaire (1998).
It has 32 items based on 4 factors. The first factor, which includes articles 1 to 16, measures
psychological violence, the second factor, which includes articles 17 to 27, measures physical violence,
the third factor, which includes articles 28 to 30, measures sexual violence, and the fourth factor, which
includes articles 31 and 32, measures economic violence.In the research of Amiri Shamili (2014), the
validity of the questionnaire was calculated through face validity, so that the questionnaire measuring
violence against women was translated by the researcher, and its face validity was confirmed based on
the CVR and CVI indices (all values are high and close to one). In Amiri Shamili's research (2014),
Cronbach's alpha coefficient was used to calculate reliability, and its value was 0.86.

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B) Mental health questionnaire: GHQ
The 28-question general health questionnaire was presented by Goldberg and Hillier (1979) and has 4
subscales and each scale has 7 questions. The mentioned scales are:
1. Scale of physical symptoms
2. Scale of anxiety symptoms and sleep disorder
3. Scale of social functioning
4. Scale of depression symptoms
Out of the 28 items in the questionnaire, items 1 to 7 are related to the scale of physical symptoms.
Items 8 to 14 examine the symptoms of anxiety and sleep disorder, and items 15 to 21 are related to the
evaluation of symptoms of social functioning, and finally items 22 to 28 measure the symptoms of
depression. To sum up the scores, A is given zero, B is given 1, C is given 2, and D is given 3. In each
scale, a score of 6 or above and a total score of 22 or above indicates morbid symptoms. Alian and
Ghasemi (2016) have confirmed the validity and reliability of this questionnaire in their research.
C) Self-control questionnaire
This questionnaire has been provided by Tanji (1999). Tanji's self-control questionnaire has 13
questions and its purpose is to measure the level of people's control over themselves. Also, this
questionnaire is one-dimensional. The response range was of the Likert type (very high=5, high=4,
occasionally=3, rarely=2, never=1). However, this method of scoring has been reversed in questions 2,
3, 4, 5, 7, 9, 10, 12, and 13. In order to obtain the total score of the questionnaire, add up the total
scores of all the questions together.The maximum score for Tanji's self-control questionnaire is 65 and
the minimum is 13. A higher score indicates a higher self-control and vice versa. Validity and
reliability of Tanji's self-control questionnaire have been calculated and confirmed in Mousavi
Moghadam et al.'s research (2014). In the research of Tanji et al. (2004), the validity of this scale has
been confirmed by evaluating its correlation with the scales of academic achievement, adaptability,
positive relationships, and interpersonal skills. Also, its reliability has been obtained at 0.83 and 0.85
on two statistical samples using Cronbach's alpha test.
D) Mindfulness
MAAS mindfulness questionnaire

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This questionnaire was designed by Brown and Ryan (2003) to measure mindfulness, which has 15
items and the items are in cognitive, emotional, interpersonal, physical, and other general areas. It is
scored on a six-point Likert scale. This scale provides an overall score for mindfulness that ranges from
15 to 90, with a higher score indicating greater mindfulness. This scale was standardized in the student
population in 2014 by Abdi and Ghabeli. The reliability of this scale has been reported as 0.76 and its
validity has been confirmed.
D) Content of sessions
Table 1. Summary of cognitive-behavioral couple therapy sessions (CBT)
Session
Training content
(purpose)
Method of intervention
Assignment
First
Communication
Getting familiar with the
cognitive-behavioral model and
intervention aims
-
Second
Behavioral skills
Role playing, knowing patterns of
reinforcement and punishment,
increasing positive behavioral
exchange and decreasing negative
exchange
Performing two positive behaviors
and reducing one negative
behavior, daily attention list
Third
Behavioral skills
Dependency contracts, role
reversal
Agreement to exchange favorable
behaviors
Fourth
Behavioral skills
Daring, behavioral testing and its
practice
Applying behavioral testing
Fifth
Behavioral skills
Active listening, sender and
receiver skills
Correcting communication skills
the sixth
Behavioral skills
Determining specific negative
interactions, practicing effective
communication
Practicing effective
communication skills

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the
seventh
Cognitive factors
Down arrow, identifying
automatic thoughts and emotions
Completing a daily recording of
inefficient thoughts
Eighth
Cognitive factors
Recognizing schemas, cognitive
processes
Discovering important relationship
schemas
ninth
Cognitive factors
Explaining the spouse's behavior,
recognizing cognitive errors
Correcting cognitive errors
Tenth
Cognitive factors
Documentation patterns,
explaining unrealistic expectations
Practicing tell me what you like
Eleventh
Problem solving
skills
Evaluation and practice of
problem solving, activity planning
Practicing activity planning
Twelfth
Conflict resolution
skills
Identifying and practicing conflict
resolution methods
Resolving a specific conflict
(Source: Barron and Storch, 2021)
Findings
Descriptive findings related to the variables of the present research are given in Tables 2, 3, and 4:
Table 2. Mean and standard deviation of mental health and its dimensions separately sorted by group
and stages of measurement
Variable
Group
Number
Pretest
Posttest
M ± SD
M ± SD
Physical symptoms
CBCT
15
15.07±0.55
12.93±1.13
Control
15
12.67±1.11
12.19±0.76
Anxiety symptoms
CBCT
15
15.10±1.19
11.45±2.65
Control
15
12.16±1.73
11.88±1.14
Social function
CBCT
15
12.13±1.15
16.02±2.87

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Control
15
11.00±0.27
10.55±0.15
Depression symptoms
CBCT
15
14.51±2.89
11.19±6.65
Control
15
12.83±3.11
12.62±2.05
The results of Table 3 show that the mean score of people in the cognitive behavioral therapy couple
group in the variable of physical symptoms in the pretest stage is 15.07 (12.67) and 12.93 (12.19) in the
posttest stage. The mean score of people in the cognitive-behavioral couple therapy group in the
variable of anxiety symptoms is 15.10 (and 12.16) in the pretest stage and 11.45 (and 11.88) in the
posttest stage. The mean score of people in the cognitive-behavioral couple therapy group in the
variable of social function is 12.13 (and 11.00) in the pretest stage and 16.02 (and 10.55) in the post-
test stage.The mean score of people in the cognitive-behavioral couple therapy group in the variable of
depression symptoms is 14.51 (and 12.83) in the pretest stage and 11.19 (and 12.62) in the posttest
stage. The mean score of the variables in the control group does not show a noticeable change from the
pretest to the posttest stages.
Table 3. Mean and standard deviation of self-control and its dimensions separately sorted by group and
stages of measurement
Variable
Group
Number
Pretest
Posttest
M ± SD
M ± SD
Self-control
CBCT
15
30.45±0.68
46.70±1.09
Control
15
30.98±1.42
30.34±0.97
The results of Table 3 show that the mean score of people in the cognitive behavioral therapy couple
group in the variable of self-control is 30.45 (30.98) in the pretest stage and 46.70 (30.34) in the
posttest stage. The mean score of the variables in the control group does not show a noticeable change
from the pretest to the posttest stages.
Table 4. Mean and standard deviation of mindfulness and its dimensions separately sorted by group
and stages of measurement
Variable
Group
Number
Pretest
Posttest

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M ± SD
M ± SD
Mindfulness
CBCT
15
46.69±0.77
72.49±1.25
Control
15
45.62±1.38
45.21±1.29
The results of Table 4 show that the mean score of people in the cognitive behavioral therapy group in
the variable of mindfulness is 46.69 (45.62) in the pretest stage and 72.49 (45.21) in the posttest stage.
The mean score of the variables in the control group does not show a noticeable change from the
pretest to the posttest stages.
Table 5. Results of Shapiro-Wilk and Kolmogorov-Smirnov tests for the normality of distribution of
scores
Dependent variables
Shapiro-Wilk test
Kolmogorov-Smirnov test
Statistic
Sig. level
Statistic
Sig. level
Self-control
0.061
0.223
0.116
0.364
Mental health
0.310
0.544
0.285
0.597
Mindfulness
0.187
0.399
0.139
0.443
One of the necessary assumptions for using parametric tests is normal distribution of scores of the
sample group or groups in a population. This assumption is based on that it is assumed that the
distribution of scores in the population is normal and if there is skewness or kurtosis in the sample
groups, it is due to random sampling of people. The assumption of normality is rejected if the
probability of randomness of the difference between the distribution of the sample groups and the
normality of the scores in the population becomes less than 0.05.
Table 6. Results of Box's M test based on the homogeneity of the variance-covariance matrices
Dependent variables
Box's M test statistic
F test statistic
Sig. level
Self-control
2.624
1.342
0.260
Mental health
1.810
0.765
0.425
Mindfulness
4.766
0.701
0.249

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Box's M test was also used to check the homogeneity of the variance-covariance matrix. According to
the data in Table 6, the results of this test show that because the significance level obtained is greater
than 0.05, the research data did not question the assumption of equality of variance-covariance
matrices. Since the variance-covariance matrices have homogeneity, the variance test can be used in
this research.
Table 7. Results of Levene's test on the assumption of homogeneity of error in variances
Dependent variables
F statistic
Sig. level
Self-control
0.686
0.488
Mental health
1.543
0.639
Mindfulness
1.674
0.512
Another assumption for using analysis of variance is equality of variance of groups. The assumption of
equality of variances is based on that the variance of scores for two groups in the population is equal
and that there is no statistically significant difference. In this research, Levene's test was used to check
the assumption of equality of variances before carrying out the analysis of variance, the results of
which are given in Table 7.
Table 8. Results of homogeneity of regression line slope
Dependent variables
Source of
variations
F statistic
Sig. level
Self-control
Pretest*group
0.271
0.076
Mental health
Pretest*group
1.562
0.495
Mindfulness
Pretest*group
0.112
0.351
According to the results listed in Table 8, the significance level of the interaction effect of the group
and the pretest is greater than 0.05; therefore, the assumption of homogeneity of the regression line for

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the research variables is accepted. Since the assumption of homogeneity of the regression line slope is
established, it becomes possible to use the analysis of variance test.
Table 9. Result of Mauchly's sphericity test for mental health dimensions
Variables
Mauchly's
sphericity
Chi-square
statistic
Sig. level
Physical symptoms
0.365
27.191
0.001
Anxiety symptoms
0.571
21.212
0.001
Social function
0.415
23.727
0.001
Depression
0.465
22.652
0.001
According to Table 9 regarding Mauchly's sphericity test, the significance level value for each of the
mental health dimensions is 0.001; therefore, the assumption of sphericity is rejected. As a result, the
assumption of the equality of the variances and, more precisely, the condition of homogeneity of the
covariance matrix was not ensured, and there wasa violation of the F statistical model. As a result,
alternative tests, i.e. Greenhouse-Geisser conservative test, were used to investigate within-
subjecteffects of the therapy, the results of which are shown in Table 10.
Table 10. Results of analysis of variance of repeated measurement for research variables in three stages
of implementation
Variables
Variation
sources
F
statistic
Sig.
Effect
coefficient
Statistical
power
Physical symptoms
Group
24.720
0.001
0.371
0.999
Time
5.611
0.007
0.211
0.833
Interaction of
time and group
6.380
0.001
0.371
0.908
Anxiety symptoms
Group
45.620
0.001
0.521
0.999
Time
21.106
0.001
0.501
0.999
Interaction of
time and group
6.392
0.002
0.233
0.923

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Social function
Group
26.392
0.001
0.598
0.999
Time
9.809
0.001
0.318
0.976
Interaction of
time and group
9.200
0.001
0.305
0.978
Depression
Group
26.658
0.001
0.598
0.999
Time
9.992
0.001
0.318
0.976
Interaction of
time and group
9.200
0.001
0.305
0.978
Results of Table 10 show that the intervention method by cognitive-behavioral couple therapy has
caused a significant difference in the three stages of measurement in the scores of physical symptoms
(F=24.720; Sig=0.001), anxiety symptoms (F=45.620; Sig=0.001), social function (F=26.392;
Sig=0.001), and depression in the two groups, which means that the intervention method by cognitive-
behavioral couple therapy has a significant effect on improving the mental health dimensions.
Result of Mauchly's sphericity test for self-control to prove the second hypothesis is given in Table 11:
Table 11.Result of Mauchly's sphericity test forself-control
Variables
Mauchly's
sphericity
Chi-square
statistic
Degree of
freedom
Sig. level
Self-control
0.134
14.66
2
0.022
According to Table 11 regarding Mauchly's sphericity test, the significance level value for the variable
of self-controlis 0.001; therefore, the assumption of sphericity is rejected. As a result, the assumption of
the equality of the variances and, more precisely, the condition of homogeneity of the covariance
matrix was not ensured, and there wasa violation of the F statistical model. As a result, alternative tests,
i.e. Greenhouse-Geisser conservative test, were used to investigate within-subject effects of the
therapy, the results of which are shown in Table 12.

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Table 12. Results of variance analysis of repeated measurement for self-control in three stages
ofimplementation
Variables
Variation
sources
F
statistic
Sig.
Effect
coefficient
Statistical
power
Self-control
Group
4.989
0.001
0.478
0.999
Time
35.017
0.012
0.193
0.786
Interaction of
time and group
17.645
0.005
0.457
0.996
Results of Table 12 show that the intervention method by cognitive-behavioral couple therapy has
caused a significant difference in the three stages of measurement in the scores of self-control
(F=4.989; Sig=0.001)in the two groups, which means that the intervention method by cognitive-
behavioral couple therapy has a significant effect on improving self-control.
Result of Mauchly's sphericity test for mindfulness to prove the third hypothesis is given in Table 13:
Table 13. Results of analysis of variance of repeated measurement for research variables in three stages
of implementation
Variables
Mauchly's
sphericity
Chi-square
statistic
Degree of
freedom
Mindfulness
0.169
15.22
0.034
According to Table 13 regarding Mauchly's sphericity test, the significance level value for the variable
of mindfulness is 0.001; therefore, the assumption of sphericity is rejected. As a result, the assumption
of the equality of the variances and, more precisely, the condition of homogeneity of the covariance
matrix was not ensured, and there was a violation of the F statistical model. As a result, alternative
tests, i.e. Greenhouse-Geisser conservative test, were used to investigate within-subject effects of the
therapy, the results of which are shown in Table 12.

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Table 14. Results of variance analysis of repeated measurement formindfulness in three stages
ofimplementation
Variables
Variation
sources
F
statistic
Sig.
Effect
coefficient
Statistical
power
Mindfulness
Group
4.856
0.001
0.492
0.895
Time
35.369
0.016
0.226
0.802
Interaction of
time and group
17.952
0.035
0.467
0.862
Results of Table 14 show that the intervention method by cognitive-behavioral couple therapy has
caused a significant difference in the three stages of measurement in the scores of mindfulness
(F=4.856; Sig=0.001)in the two groups, which means that the intervention method by cognitive-
behavioral couple therapy has a significant effect on improving mindfulness.
Conclusion
Mental health in married women suffering from domestic violence participating in cognitive-behavioral
couple therapy is different from the control group. The first finding of the present study showed that in
the posttest stage, the intervention programs used, i.e. couple therapy using the cognitive-behavioral
method, were effective in improving the mental health dimensions. Therefore, the first hypothesis of
the present study is confirmed.Seddiqi (2019) in her research entitled evaluation of the effect of group
cognitive behavioral therapy on the mental health of working women affected by domestic violence
reached the conclusion that group cognitive behavioral therapy has an effect on improving mental
health, decreasing anxiety and sleep disorders, improving social functioning, reducing depression and
reducing physical symptoms of working women affected by domestic violence, which is consistent
with the present finding.Angin et al. (2021) in research entitled applying cognitive-behavioral therapy
to help survivors of dating violence: a pilot study has reached the conclusion that cognitive-behavioral
therapy has had a significant effect on improving women's mental health dimensions, which is
consistent with the present research. Lakin et al. (2021) in research entitled psychological interventions
for survivors of intimate partner violence: an overview of the evidence and implementation

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6502
considerations have reached the conclusion that cognitive behavioral therapy has had a significant
effect on improving women's mental health dimensions, which is consistent with the present research.
The explanation that can be given for this hypothesis is that the cognitive-behavioral couple therapy
approach strives to create a balance in the couple's demands and then bring the couple's assessment of
their demands closer together. If couples have a similar assessment of the resources and demands of
their lives, it is considered as a strength in married life, which provides the basis for improving the
quality of married life and, as a result, their mental health.
Self-control in married women suffering from domestic violence participating in cognitive-behavioral
couple therapy is different from the control group. The first finding of the present study showed that in
the posttest stage, the intervention program used, i.e. cognitive-behavioral couple therapy, was
effective in improving self-control. Therefore, the second hypothesis of the present study is
confirmed.Habigzang et al. (2018) in research entitled evaluation of the impact of a cognitive-
behavioral intervention for women in domestic violence situations in Brazil have reached the
conclusion that self-control in married women suffering from domestic violence participating in
cognitive-behavioral couple therapy is different from the control group, which is consistent with the
present research.
The explanation that can be given for this hypothesis is that the cognitive-behavioral couple therapy
approach strives to create a balance in the couple's demands and then bring the couple's assessment of
their demands closer together. It also leads to each couple being more resilient in their situation. This
means that they become more sensitive to social situations and adjust their appearance according to the
current situation, as a result, their self-control increases.
Also, mindfulness in married women suffering from domestic violence participating in cognitive-
behavioral couple therapy is different from the control group. The first finding of the present study
showed that in the posttest stage, the intervention program used, i.e. cognitive-behavioral couple
therapy, was effective in improving mindfulness. Therefore, the third hypothesis of the present study is
confirmed.Pitt et al. (2020) in research entitled implementation of a cognitive behavioral intervention
on mindfulness for women who have experienced domestic violence and abuse have reached the
conclusion that in the posttest stage, the used intervention program, i.e. couple therapy using cognitive-
behavioral method, was effective in improving mindfulness, which is consistent with the present
research.

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The explanation that can be given for this hypothesis is that the cognitive-behavioral couple therapy
approach strives to create a balance in the couple's demands and then bring the couple's assessment of
their demands closer together. It also leads to each couple perceiving internal and external realities
freely and without distortion, and having a great ability to face a wide range of thoughts, emotions and
pleasant or unpleasant experiences, as a result, their mindfulness also increases.
It is recommended that the authorities of the health system pay special attention to violence against
working women and hold meetings and conduct cognitive behavioral training in order to follow up and
decrease it. It is also recommended to conduct a follow-up stage in future research. It is recommended
to evaluate the effectiveness of couple therapy using the method of acceptance and commitment as well
as cognitive behavioral therapy on other constructs in the field of marriage, including marital burnout,
pursuing-distancing, and marital forgiveness, and to compare it with the results of other
psychotherapies, especially Glasser's reality therapy and emotion-oriented approaches.
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