Intervention
sexual behaviors, cognitive distortions
EVENTS
One of the intervention groups received CBT based on the ABCDE model during eight 60–90 min sessions once a week by the third author under the supervision of the fourth author (psychologist). The basic idea behind the ABCDE model is that our emotions and behaviors (C: Consequences) are not directly determined by activating events (A) but rather by the way these events are cognitively processed and evaluated (B: Beliefs). The disputation (D) of the irrational belief into a rational belief results in new effects (E) [Summary of counseling sessions for CBT group (Expressing the importance of sexual assertiveness in women, examining the causes of the lack of sexual expression and desire in women, and counseling women to identify the reasons for their lack of sexual assertiveness, training the need for self-expression and its benefits in life, investigating women’s sexual preferences and desires and how expressing them to their husbands, training on writing their sexual needs and desires to their partner, and providing solutions to further increase sexual expressionHomework: Participants should write their expected changes from the counseling plan as homework for the next sessionReviewing the previous session, examining the causes of low sexual self-efficacy, identifying the person’s dysfunctional beliefs and unconscious thoughts about her ability in sexual relations, evaluating dominant negative sexual attitudes, introducing cognitive distortions, and assessing illogical sexual beliefs and explaining them, overviewing the sexual attitudes of women with low sexual self-efficacyHomework: Revising the cognitive distortions, practicing the identification of the cases of cognitive distortions and dysfunctional beliefs using the thought recording sheetDetermining the boundaries related to sexual activity, what an individual expects from herself and her partner in a sexual relationship, training the cycle of sexual response, training the technique of self-arousal, training non-sexual sensation, prohibiting sexual relationship until the end of body sensation training, changing negative attitudes towards sexual issues, and cognitive reconstruction of dysfunctional sexual thoughts, and introducing the ABCDE modelHomework: Write your sexual behaviors based on the ABC model, and paying attention to each other’s sexual needsReviewing the previous session, training on how to reach orgasm at the same time based on the sensitive points of the couple, training on sexual fantasy, removing the ban on touching genitals, training on types of sexual intercourse methods, and training relaxation and Kegel exercisesHomework: Relaxation exercise and Kegel exerciseDescribing personality differences, negotiating and agreeing with husband on creating common strategies, training on how to express the emotions of couples to each other, and increasing the verbal intimacy of couples and positive interactionsHomework: Exercise to deal with the return of previous behavior and attitudes