Table 1 Summary of counseling sessions for CBT group (n = 22)
Sessions | Objectives | Content of sessions |
|---|---|---|
First | Identifying incompatible thoughts and beliefs, challenging incompatible thoughts and beliefs | Greetings and introducing, stating the objectives and logic of cognitive-behavioral therapy, communicating and collecting background information, introducing the cognitive-behavioral approach, brief training on the anatomy and physiology of the male and female reproductive system, and training on the sexual physiology |
Second | 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 expression Homework: Participants should write their expected changes from the counseling plan as homework for the next session | |
Third | Reviewing 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-efficacy Homework: Revising the cognitive distortions, practicing the identification of the cases of cognitive distortions and dysfunctional beliefs using the thought recording sheet | |
Fourth | Reviewing the previous session, examining the coping strategies with cognitive distortions, reconstructing maladaptive self-talks, and resolving misunderstandings (cognitive skills), training to increase positive self-talks, and training problem-solving skill and its role in reducing factors related to marital conflicts | |
Fifth | Determining 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 model Homework: Write your sexual behaviors based on the ABC model, and paying attention to each other’s sexual needs | |
Sixth | Reviewing 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 exercises Homework: Relaxation exercise and Kegel exercise | |
Seventh | Describing 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 interactions Homework: Exercise to deal with the return of previous behavior and attitudes | |
Eighth | Summarizing the contents and evaluating the different techniques used by the participants, giving feedback about the effectiveness or ineffectiveness of the counseling, solving the existing problems, and evaluating the positive results of the intervention and the level of individuals’ satisfaction with the counseling |