English Abstract
The present study aimed to identify and validate the change processes in Emotionally Focused Couples Therapy (EFCT) and develop an instrument to measure these processes. This mixed-exploratory research was conducted in two main stages, encompassing qualitative, quantitative, and mixed-method approaches. In the first stage, change processes were identified through thematic analysis and validated using triangulation and state space grids. In the second stage, a measurement tool for these processes was developed and validated. In the first stage, a qualitative approach was utilized. Data were collected by observing therapy sessions of three couples with a demand-withdraw attachment dynamic (female-demand/male-withdraw) and conducting interviews with participants (couples and the therapist). Thematic analysis was employed to analyze the data. In the second step of this stage, the identified change processes were validated through two methods: triangulation (a qualitative method) and state space grids (a mixed-method approach). In triangulation, data were gathered from three sources: interviews with 10 therapists, interviews with 10 couples treated with EFCT, and a review of relevant academic literature. These data were analyzed using thematic analysis, and the results were compared and integrated with the initial findings to confirm the final categories. This process resulted in 55 initial codes, 19 subcategories (secondary change processes), and six main categories (primary change processes). The primary change processes included alliance formation, identifying the core issue, gaining insight, experiencing new interactions, acquiring skills, and differentiation. In the second part of this step, state space grids were used to observe and track the identified change processes in the interactions of the three couples undergoing therapy. Visualizing the state space grids of couple interactions provided evidence for validating the identified change processes. In the second stage, the identified change processes from the first stage served as the foundation for developing the questionnaire. Content validity was assessed by five EFCT experts using the Content Validity Ratio (CVR) and Content Validity Index (CVI), resulting in an initial questionnaire with 38 items. To evaluate the reliability of the instrument, internal consistency was measured using Cronbachʹs alpha, split-half reliability, and Guttman’s lambda, all yielding acceptable results. Construct validity was assessed using two methods. The newly developed questionnaire was administered alongside two other instruments—a conflict resolution questionnaire and a modified marital quality scale—to 120 participants. Convergent and divergent validity were established through traditional correlational analysis. Furthermore, confirmatory factor analysis (CFA) was employed to assess model fit and construct validity. The model demonstrated good fit, and both convergent and divergent validity were confirmed. The findings underscore the pivotal role of identifying and validating change processes in EFCT for understanding its therapeutic mechanisms. These insights contribute to theoretical advancement and provide therapists and researchers with tools for designing effective interventions, evaluating therapy progress, and enhancing the theoretical framework of EFCT. The developed instrument serves as a practical complement, enabling the assessment of these processes and paving the way for evidence-based research and interventions.
