Document Type : Original Article
Authors
1 Corresponding Author, Department of Psychology, Research Institute of Hawzah and University, Qom, Iran.
2 Department of Psychology, Research Institute of Hawzah and University, Qom, Iran.
Abstract
Highlights
Introduction
The family, as the most fundamental social institution, plays a vital role in the health and dynamism of society. Extensive transformations in the last century, such as the transition from extended to nuclear families, an increase in the age of marriage, a decrease in marriage rates, a rise in definitive singleness, changing criteria for spouse selection, and an increase in divorce, indicate significant shifts (Chitsaz, 2023; Rasteh Moghadam & Abbasi, 2023; Kazemipour, 2022). These changes highlight the necessity of paying attention to family interaction and the role of family therapy in preventing failure, conflict, and disharmony within the family (Suhartivi et al., 2009). Family therapy, as a form of counseling and psychotherapy, provides a platform for promoting growth in various aspects of life and requires therapists to possess theoretical and practical competencies and adhere to professional ethical principles (Canino & Inclan, 2001). However, in the field of pathology of family counseling centers, especially in Iran, limited research has been conducted. Foreign studies such as Gerald et al. (2023), Jeffrey (2015), Peace et al. (1996), and Sokoll (2009) have addressed the challenges of counseling centers and solutions such as government support, prevention, innovation in services, the use of interns, and adaptation to current needs. In Iran, the National Youth Organization (2008) and Bajelan (2022) have also reported problems such as multiple supervisory bodies, ambiguity in the nature of counseling, lack of an accreditation and ranking system, weak supervision, the presence of unqualified individuals, and the absence of a localized definition of counseling services. Research by Ghazarian (2000), Jafari (1994), Mikaeil (1994), Akhavan Tafti (2008), Raji (2016), Mohammadi (2006), Hadian et al. (2006), Rastegar et al. (2021), Motaghi et al. (2017), Mirzaeifar et al. (2021), Arshi et al. (2016), and Biglarian et al. (2001) also emphasize the importance of service quality, accurate needs assessment, and client satisfaction. Furthermore, the widespread use of Western theoretical models incompatible with Iranian-Islamic culture is one of the fundamental challenges of family counseling in Iran (Epstein et al., 2012; Dwairy, 2006). Studies such as Liu et al. (2023) and Singh et al. (2020) have shown that culturally congruent interventions are more effective. Accordingly, the present research aims to identify the pathologies of family counseling in Iran and identify theoretical, practical, and structural weaknesses, seeking to provide a comprehensive picture of the current situation and pave the way for improving the quality of counseling services.
Method
The present study was conducted using Shieh and Shannon's (2005) qualitative content analysis method, and data were collected through semi-structured interviews. The unit of analysis was considered to be the theme (Maroufi & Yousefzadeh, 2009). The population included expert professors in the field of family counseling and Ph.D. graduates in psychology and counseling, and samples were selected purposefully. The sample size consisted of 9 university and seminary professors specializing in family counseling with doctoral degrees and over 10 years of professional experience, determined based on the principle of theoretical saturation (Glaser & Strauss, 1967; Brinkmann & Kvale, 2009). Interviews were transcribed, and data were analyzed through a three-stage process of open, axial, and selective coding (Strauss & Corbin, 1990). To enhance the reliability, member checking was used, and the final report was refined based on participants' feedback (Mohammadpour, 2018; Brinkmann & Kvale, 2009).
Results
The findings were organized into several major categories, including "Theories in Family Counseling in Iran", "Critique and Review of Family Counseling", "Pathology of Counselors' Scientific and Ethical Competencies", "Pathology of Family Counseling Centers", and "Main Reasons for Not Referring Counseling". In the domain of theories, the most frequently used theories reported were CBCT, Structural, EFT, and ACT, respectively. The primary reasons cited for using these theories included their relative cultural adaptability, lack of complexity, technique-oriented nature, immediate effectiveness, and reduction in the number of therapy sessions. CBCT was identified as the most common and effective approach, with interviewees emphasizing its role in correcting couples' thought and behavioral patterns. The Structural theory was also found to be more compatible with Iranian-Islamic culture due to its focus on boundaries, roles, and power hierarchies within Iranian families. ACT, by focusing on values and acceptance of emotions, and EFT, by addressing emotional regulation and intimacy, were considered by some experts to have suitable proximity to Iranian-Islamic culture.
In the critique and review section, identified gaps included the absence of a family therapy theory based on indigenous culture, disregard for the importance of religion and spirituality, scarcity of indigenous tools, incongruence between methods based on materialistic theories and Islamic content, reinforcement of feminist ideologies and neglect of gender roles, insufficient use of interventions based on ethical values, inadequate attention to family legal-jurisprudential rules, prioritization of individualistic perspectives, desacralization of the family, and facilitation of divorce. Regarding the scientific and ethical competencies of counselors, the most significant pathologies included distrust in counselors, insufficient skill in adapting methods to Iranian culture, exclusive use of palliative techniques, lack of incorporating spirituality in treatment, mismatch between the scope of activity and educational background, sole reliance on academic courses, weakness in observing the principle of confidentiality and professional ethics, an economic view of clients, non-observance of working within one's scope, failure to refer clients, and limited collaboration with psychiatrists. In the case of family counseling centers, reported issues included a lack of supervision over the centers' processes and counselors, failure to assess session quality, a low number of centers and counselors relative to the population, and improper distribution of centers within the city. The main reasons for not seeking counseling included a lack of counseling culture, inability to afford costs, perceived ineffectiveness of counselors, fear of stigmatization, lack of insurance support, and a false sense of temporary improvement.
Conclusions
The present study revealed that although CBCT, Structural, EFT, and ACT approaches are most commonly used in family counseling in Iran, and CBCT and Structural approaches are considered more effective by experts, the absence of an indigenous theoretical framework based on Iranian-Islamic culture, weaknesses in the cultural adaptation of theories, serious shortcomings in the scientific and ethical competencies of counselors, and structural deficiencies in counseling centers have challenged the quality of services. The results emphasize the necessity of considering religion and spirituality, designing indigenous tools, improving practical training and internships, strengthening the supervisory system, developing an accreditation and ranking system for centers, expanding insurance coverage for counseling services, and promoting a culture of seeking counseling. These findings can provide a basis for scientific and practical policymaking to promote the health of Iranian families and improve the family counseling system in Iran.
Authors' Contributions
All authors participated equally in the design of the study, writing the article, and editing the final versions.
Data Availability Statement
Data available on request from the authors.
Acknowledgements
The authors express their gratitude to all individuals who spiritually and scientifically supported this research, especially the seminary and university experts who contributed to its improvement. They also thank the counselors who participated in the research interviews and patiently and meticulously answered the questions.
Ethical Considerations
Cases such as falsification of data, distortion of results, plagiarism, and any other unethical behavior have been strictly avoided in this study. The authors emphasize that all ethical principles have been observed in conducting and publishing this research. This has been confirmed by all authors.
Funding
This study was conducted without receiving any financial support from government, commercial, or non-profit organizations.
Conflict of Interest
The authors declare that there are no conflicts of interest in connection with this study. In other words, there were no financial or personal interests that could affect the results of the study.
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