Background & aim: Dedication to spouse, marriage, and family is one of the most significant factors that has attracted considerable attention in contemporary family and marriage studies to ensure continuity of marriage and the strength of family ties. In the present analysis .The current study aimed at investigating the effectiveness of reality therapy based on choice theory on marital intimacy and satisfaction in Iranian couples. Methods: This pretest-posttest control group design was performed on 40 subjects who referred to counseling centers in Ahvaz in 2018 and were firstly selected by convenience sampling and then randomly assigned to two experimental and control groups (N=20 each). Thompson and Walker's Intimacy Scale and ENRICH marital satisfaction inventory were used for data collection. The experimental group underwent ten 60-minute sessions of reality therapy based on Glasser's choice theory adapted from Amani study (2015); nonetheless, the control group did not receive any interventions. Results: The obtained results demonstrated that reality therapy based on choice theory was effective in increasing intimacy and marital satisfaction among couples (p <0.01). Conclusion: As evidenced by the results of the current study, it is suggested that reality therapy based on choice theory could be incorporated into educational programs for couples and family therapy. Adopting such procedure, therapists can treat communication problems and enrich the intimate relationships among couples and families.
The Effectiveness of Cognitive Behavioral Therapy on Marital Intimacy and Identification of the Basic Psychological Needs among Couples Referring to Counseling Centers
Abstract Methotrexate and dactinomycin are efficient drugs in the treatment of patients with low‐risk gestational trophoblastic neoplasia (LRGTN). To compare the effectiveness of these two drugs in LRGTN, 46 patients were randomised to receive weekly intramuscular methotrexate at 30 mg/m 2 ( n = 28) or intravenous dactinomycin at 1.25 mg/m 2 every 2 weeks ( n = 18). Fourteen patients (50%) in the methotrexate group and 16 patients (89%) in the dactinomycin group achieved complete response. Greater patient convenience and a lower number of required visits make dactinomycin superior to other alternatives.
The efficacy of single-agent chemotherapy for patients with low risk gestational trophoblastic neoplasia (LRGTN) with methotrexate or dactinomycin is well established, but efforts continue to reduce the toxicity, the patients’ time and cost of treatment. In a randomized clinical trial, we evaluated and compared the efficacy, toxicity and cost effectiveness of pulse-methotrexate versus pulse-dactinomycin as single-agent therapy in LRGTN. Forty low risk GTN patients were randomly assigned to receive pulse-methotrexate (30 mg/m 2 weekly intramuscularly) (20 cases) or pulse-dactinomycin (1.25 mg/m 2 every two weeks intramuscularly) (20 cases). Treatment continued if no major toxicity was encountered and beta human chorionic gonadotropin (β-hCG) values were lower than 5mIU/m 2 in three consecutive weeks. Seventy percent of methotrexate group and 90% of dactinomycin group responded to treatment (100% remission was achieved with no recurrence in one-year follow-up). The mean time to response was 43 days for methotrexate and 66 days for dactinomycin group (P-value = 0.001). Patients achieved remission after receiving an average of 8 courses of therapy in methotrexate versus 6 courses in dactinomycin group (P-value = 0.002). The average cost of treatment per course was about 7 US$ for methotrexate and 62 US$ for dactinomycin group (P-value < 0.001). There were no cases of major toxicity in methotrexate or dactinomycin groups. Overall, both methotrexate and dactinomycin were associated with good remission rate. Based on our results, LRGTN treatment with dactinomycin is somewhat more effective than that with methotrexate, but methotrexate is more cost-effective for both patients and the health system. As the effectiveness of both pulse-methotrexate and pulse-dactinomycin does not differ significantly, pulsedactinomycin is recommended as first-line treatment.
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