1. Introduction
The divorce rate is rapidly rising in Iran, which has raised the alarm for authorities and experts. On the other hand, despite all the marriages that end in divorce, many marriages are unsuccessful because the couples continue living together despite their various problems, such as financial problems or their personal and cultural beliefs about divorce [1]. 
A large number of couples seeking treatment for marital distress have had difficulty regulating emotions in the context of marital communication or other issues in their lives [2]. Emotion regulation is defined as the ability to fully perceive emotions, accept them, control impulsive behaviors, adopt goal-oriented behaviors when experiencing negative emotions, and employ flexible emotion regulation strategies to provide a desired emotional response to achieve personal goals, as well as provide a constructive response to situational requests [3]. Emotional dysregulation and marital distress interact at the personal level as well as between the couples [4]. In spouses, the emotional regulation process is an effective etiology of personal pathology and distress, continued distress and disorder, relapse, or progression of treatments and prognosis [5]. Self-disclosure, empathic responses, and subsequent compassionate behaviors are all mediated by emotional regulation. Self-disclosure increases emotional intimacy between spouses. Empathic and warm responses from a responsive spouse boost overall marital satisfaction and reinforce subsequent supportive and emotional behaviors [2].
Furthermore, empathy between the couples is an essential requirement of every healthy and happy marriage, so that among the evolutionary factors in the family, they play a more effective role in strengthening the relationships [6]. Empathy, along with other elements in a couple’s relationship, such as the couple’s role and value system, is the basic foundation of the marital relationship’s structure. Over time, empathy helps maintain and develop an intimate relationship between couples. Couples in maladjusted relationships believe that their spouse does not understand them and ignores them due to a lack of empathy. As a result, it has a direct negative impact on the quality and satisfaction of marital life [7]. Empathy involves putting oneself in another’s place to comprehend their emotions. Individuals with a high level of empathy experience positive emotions and interact constructively with others. They can listen, express emotions, and communicate verbally and nonverbally with others [8]. Developing and promoting empathy between couples can help them deal with destructive communication patterns, increase their satisfaction through effective dialogue and conversation, and, as a result, create a safe place to meet emotional needs [9].
In this regard, consulting and seeking help from couple therapists can help couples achieve a desirable and stable marriage full of intimacy, commitment, and satisfaction. In recent years, various interventions for couples and family counseling and psychotherapy have been developed. Each of these interventions has the potential to improve the couples’ interpersonal psychological life in terms of various goals [10]. Two of the most commonly used training programs that emphasize adjustment skills between couples to improve marital satisfaction are Olson’s enrichment training program and Johnson’s relationship enrichment [11, 12].
Olson’s model is quite effective in dealing with family issues; however, very few applied studies have been conducted on this model in Iran. Olson [13] proposed his model using a systematic approach. He classified 16 types of families using a combination of cohesion and flexibility dimensions and called his model circumplex, in which well-balanced families are located in the middle of two cohesion and flexibility dimensions. This model emphasizes the importance of controlling external and environmental factors that can lead to conflict [11]. The main dimensions of this model are cohesion, flexibility, and communication [14]. According to this model, the lack of communicative skills in a marital relationship can lead to a decrease in quality of life and, as a result, the destruction of marital life. The emotional bond and commitment of family members to each other is called cohesion. Its constituents include emotional relationships, family interaction, parent’s relationships, child-parent relationships, interaction in terms of time and location, altruism, interests, and how to spend free time [15]. Masoumi et al. [15] concluded that enrichment training can increase marital intimacy as well as marital and sexual satisfaction in infertile couples. Nazari et al. [16] reported that the couples’ relationship enrichment by Olson’s method was effective in increasing the couples’ marital intimacy.
Johnson’s relationship enrichment program also aims to understand love, needs, and emotions, as well as investigate and control negative patterns of couples and form a positive love bond between spouses [12]. This is one of the methods used in couple therapy that emphasizes the critical role and importance of emotion, communication, and emotional-driven behaviors in organizing interactive patterns [17]. This approach contends a mutual effect between the interaction of spouses and the internal emotional experience [18]. This method aims to access and reprocess the basic emotional reactions that occur during a couple’s interaction. This process results in the formation of more secure attachment styles, different interaction patterns between couples, empathy for each other’s experiences, and the formation of new interaction patterns. This training helps couples end negative patterns in their relationship by creating seven dialogues in which they can communicate more openly and harmonically, be accountable, and communicate with emotional participation and care for each other [12]. Rasouli et al. [19] reported that Johnson’s relationship enrichment program had a positive effect on the couples’ marital quality. Jalali Shahkouh et al. [20] showed that Johnson’s relationship enrichment program was more effective in couples’ marital adjustment for participants of the intervention group compared to the control group.
Olson’s enrichment training program teaches skills that help meet the basic needs of the family, such as love, kindness, belonging, trust, loyalty, security, and pleasure. Compassionate sensitivity can be a crucial factor in promoting security and validating couples’ relationships and creating constructive intimacy and a healthy atmosphere for personal growth [11]. In contrast, Johnson’s relationship enrichment uses an emotional approach. In the emotional approach, it is assumed that conflict in married life occurs when spouses are unable to satisfy each other’s attachment needs for safety, security, and satisfaction; in other words, disturbed marital relationships indicate the failure of couples to establish a relationship with an insecure attachment pattern. Considering the major role of emotions in attachment theory, this treatment refers to the important role of emotions and emotional communication in organizing interactive patterns and specific key experiences in close relationships and considers emotions as a factor of change [12].
Participating in treatment intervention programs to reduce communication problems with the spouse and increase marital satisfaction is a human and professional necessity. Ignorance of marital issues and conflicts also causes instability of the family foundation and psychological, social, and economic consequences. Given the complex nature of marital relationships and the effects of emotions, needs, fears, and attachments on couples’ relationships, it is essential to introduce effective interventions to help couples. Therefore, to treat and solve marital problems, methods must be revived to increase intimacy and compatibility in the relationship. Despite recent studies on the effectiveness of various training programs with different approaches, a few studies have addressed difficulties in emotional regulation and marital empathy in maladjusted couples using Olson’s enrichment training program and Johnson’s relationship enrichment program. Evaluation and comparison of two therapeutic interventions Olson’s enrichment training program and Johnson’s relationship enrichment on some psychological characteristics of maladjusted couples, such as emotion regulation and marital empathy are the vital innovations of the present study, which have not been addressed in previous studies. Hence, this study provides an opportunity to investigate the effectiveness of this approach as well as design and provide efficient services and interventions for maladjusted couples. The present study aimed to determine the effectiveness of Olson’s enrichment training program and Johnson’s relationship enrichment on emotion regulation and empathy in maladjusted couples.
2. Methods
This study was a quasi-experimental pre-test-post-test design with a control group. The research population included all maladjusted couples who were referred to Ahvaz counseling centers in 2021. The sample included 45 couples meeting the inclusion criteria and was selected via the convenience sampling method. We included 15 couples in each group using G-power software with effect size (1.63) and alpha (0.05) and power of a test (0.90) [21]. The inclusion criteria included a score below the average on the emotion regulation scale and couple empathy questionnaire, at least a high school diploma, being married for at least one year, being 20 to 45 years of age, and dissatisfaction with at least one of the spouses with marital life. The exclusion criteria also included stressful accidents, such as divorce or death of relatives or close friends within the past three months, using other treatments during the study, missing more than two sessions or more, and providing incomplete answers to the questionnaires.
Study tools
Difficulties in Emotion Regulation Scale (DERS): This scale was designed by Gratz and Roemer [22]. It included 36 items and 6 subscales, i.e., non-acceptance of emotional responses, difficulties engaging in goal-directed behavior, impulse control difficulties, lack of emotional awareness, limited access to emotion-regulation strategies, and lack of emotional clarity. The items of this scale are scored based on a 5-point Likert scale (1=never to 5=always). The total score on this scale ranges from 36 to 180, and higher scores indicate more difficulty in emotion regulation. Cronbach’s alpha of this questionnaire was 0.81 [23]. Regarding validity, studies have suggested sufficient construct and predictive validity for the difficulties in the emotion regulation scale (DERS) [24]. 
Basic Empathy Scale (BES-A): Batson developed this 8-item scale. This scale is a list of empathic emotions (empathy, sympathy, worry, being affected, commiserate, warmth and closeness, merciful and considerate). The items of this scale are scored based on a 6-point Likert scale (1=not at all to 6=very much). The total score on this scale ranges between 8 and 48, and higher scores indicate higher levels of empathy. In this research, a score below the median (median score=24) was considered as the inclusion criterion [25]. Cronbach’s alpha of this questionnaire was 0.87 [6]. The validity of this tool was confirmed in the study of Carre et al. [26].
Study procedure
The researcher explained the research procedure to the directors of Ahvaz’s specialized counseling and psychology clinics and then asked them to refer couples with marital problems to the researcher. During the interviews, the main reasons for visiting the counseling clinic were the low quality of marital life and high conflict. Following the investigations, 45 qualified couples were identified. After conducting the required coordination, they were randomly assigned to two experimental groups and one control group (n=15). Afterward, two experimental groups were separately subjected to Olson’s enrichment training program and Johnson’s relationship enrichment. Before the intervention, the pretest stage was completed by both spouses by filling out the above scales. The mean responses of both spouses were used as the basis of the analysis. The participants in the first experimental group were then given Olson’s enrichment training program, while the participants in the second experimental group were given Johnson’s relationship enrichment by a researcher, specifically trained in this regard. The interventions were carried out at the counseling center of Islamic Azad University, Ahvaz Branch, while the control group received no intervention. At the end of the research, to observe ethical considerations, the control group received a course of treatment interventions. Following the interventions, a post-test was given to the experimental and control groups.
Intervention programs
Olson’s Enrichment Training Program: Olson’s enrichment training program consisted of eight 120-minute sessions held twice a week. Treatment intervention sessions were conducted by a psychotherapist who had taken specialized courses and workshops. Table 1 lists a summary of Olson’s enrichment training program intervention sessions.


Johnson’s Relationship Enrichment Intervention: Johnson’s relationship enrichment intervention sessions included eight 120-minute sessions held twice a week. Therapeutic intervention sessions were conducted by a psychotherapist who had completed specialized courses and workshops. Table 2 lists a summary of Johnson’s relationship enrichment intervention sessions.


Statistical analyses
The data were analyzed using multivariable analysis of variance (MANCOVA) and Bonferroni post hoc test in SPSS software, version 26.
3. Results
Table 3 presents the pretest and posttest Mean±SD of emotion regulation and marital empathy among maladjusted couples.


The linear relationship between the dependent variable and the covariate is the most fundamental assumption for covariance analysis. The pretests of emotion regulation and marital empathy were considered covariates in this study, and their posttests were considered dependent variables. The correlation coefficients obtained between the pretest and posttest (emotion regulation and marital empathy) were 0.56 and 0.53, respectively. These correlation coefficients established the assumption that the relationship between the covariates and the dependent variables is linear. The pretests of emotion regulation and marital empathy were considered covariates in this study. The coefficient of correlation was calculated to be 0.02. As a result, the assumption of multicollinearity among covariates was established. The Kolmogorov–Smirnov test was used to examine the normality of the distribution of the variable scores, and the results confirmed this assumption. Levene’s test was employed to assess the assumption of groups’ variance convergence in the dependent variables. F-statistic for emotion regulation and marital empathy was 1.579 and 0.804, respectively. Therefore, the assumption of variance convergence was confirmed. To assess the assumption of covariance matrix convergence, the F value for Box’s M test was 1.07, thus, this assumption was confirmed (P=0.07). The assumption of the absence of collinearity between dependent variables was examined. Accordingly, the value of the variance inflation factor (VIF) obtained for dependent variables confirmed this assumption (VIF<10). The results of the multivariable analysis of variance (MANCOVA) revealed that these groups differ significantly in at least one dependent variable (F(12, 62)=26.28, λ=0.027, P<0.001).
Table 4 lists that the ratio of F of one-way analysis of covariance (ANCOVA) was obtained for emotion regulation (F=62.85 and P<0.001) and marital empathy (F=36.19 and P<0.001).


Hence, a significant difference was observed between the experimental groups and the control group in terms of dependent variables.
Table 5 presents a significant difference between the experimental groups and the control group regarding emotion regulation, which indicates the effectiveness of the intervention in improving emotion regulation in maladjusted couples (P<0.001).


However, no significant difference was observed between the experimental groups, which indicate a lack of significant difference between the effectiveness of the two training methods. Accordingly, a significant difference was observed between the experimental groups and the control group concerning martial empathy, which demonstrates the effectiveness of the intervention in improving empathy between maladjusted couples (P<0.001). In addition, the group that underwent emotion-focused couple therapy based on Johnson’s approach obtained better results.
4. Discussion 
The present study aimed to determine the effectiveness of Olson’s enrichment training program and Johnson’s relationship enrichment on emotion regulation and empathy of maladjusted couples in Ahvaz City. The study findings showed a significant difference between the control group and the experimental groups in the mean emotion regulation based on Olson’s model. However, no significant difference was observed between Olson’s enrichment training program and Johnson’s relationship enrichment in the mean emotion regulation. These findings revealed no significant difference between experimental groups in regulating emotions. This finding is consistent with the research results of the previous study [27, 28]. One of the novel concepts addressed by couple therapists is the role of emotion regulation processes in marital satisfaction, family satisfaction, and damages related to failure in these processes [29]. Although experiencing and regulating emotions is a personal phenomenon, an increasing number of studies have been conducted on the role of interpersonal relationships in improving emotional states. Emotion regulation is defined as the ability to fully perceive emotions, accept them, control impulsive behaviors, adopt goal-oriented behaviors when experiencing negative emotions, and employ flexible emotion regulation strategies to provide a desired emotional response to achieve personal goals, as well as provide a constructive response to situational requests. Emotion regulation signifies one’s ability to name and manage emotions, use effective strategies to change emotions, and trust self to modify these emotions [30].
The martial life enrichment program focuses on training couples in communication, conflict resolution, financial management, marital satisfaction, free-time activities for couples, religious beliefs of each couple, parent-child relationship, family-friend relationship, realistic expectations of each couple from each other, sexual expectations, and the role of relatives in marital life. Olson’s preparedness/enrichment program is one of the most popular enrichment programs that pursue six main goals, expanding couple’s capabilities and growth, strengthening communicative skills of couples, training ten steps to resolve couples’ conflicts, expanding personal goals of couples and families, expanding financial budgeting plans, and discovering main family problems [13]. Johnson’s enrichment program is one of the methods of enriching the relationship of maladjusted couples. This training program helps couples end negative patterns in their relationship by creating seven dialogues and enables them to communicate more openly and harmonically, be accountable, and communicate with emotional participation and care for each other [31]. According to the studies, a large number of couples seeking treatment for marital distress have difficulty regulating emotions in the context of marital communication or other issues in their lives [32]. Moreover, the findings of Weibe et al. [28] indicated that treatments that focus on emotions help couples to easily establish safe bonds and enhance their intimacy. The findings of these studies can be used to reduce negative patterns in couples’ relationships and create solutions to enrich their relationships, regulate emotions, and improve marital satisfaction. As a result, Olson’s and Johnson’s approaches to relationship enrichment can be applied to effectively improve emotion regulation in maladjusted couples.
The study findings showed a significant difference between the control group and the experimental groups in the mean empathy based on Olson’s model. In addition, a significant difference was observed between Olson’s enrichment training program and Johnson’s relationship enrichment in the mean marital empathy. This finding is consistent with the research results of a previous study [33, 34, 35]. To explain these findings, it can be stated that empathy between spouses is one of the conditions for a healthy marriage and that it is the most influential factor among the evolutionary factors of a family. Empathy involves putting oneself in another’s place to comprehend their emotions. Individuals with high levels of empathy experience positive emotions and interact constructively with others. They can listen, express emotions, and communicate with others verbally and nonverbally. Since the marriage enrichment approach was developed as a program to resolve couples’ problems and conflicts, several issues have arisen in this regard. Although each of the described programs has a different perspective and method of execution, they all aim to develop strong communication and interpersonal skills and prevent the distress of military life. One of the most popular enrichment programs is Olson’s preparedness/enrichment program. Marriage enrichment is a life-long process. In terms of the role of couples in the family, the marriage enrichment model is quite flexible, democratic, and egalitarian. Personal happiness and success are prioritized over family orientation in this model [34]. Setting goals and planning for special behavioral changes are required for marital growth. The problems that require training and improving the relationship are identified in the couples’ enrichment model; however, the main focus is on the strengths and growth between them, not the problems. The basic premise of this approach is that each couple has unique strengths that can be used to foster growth and trust. Thus, it is critical to identify and emphasize strengths, as it generates enough energy for couples to progress toward their goals. On the other hand, the couple therapy approach is referred to as emotion-focused treatment. Due to numerous advances in understanding the role of emotion in human function and treatment, emotion has been recognized as a critical and axial factor in adaptive and maladaptive functions, resulting in several changes in treatment methods [10]. Emotion-focused couples therapy is a short-term, structured approach to treating and improving distressed relationships that focuses on stable negative interactive cycles caused by deep emotional venerability, as well as reducing couples’ distress through emotional intervention, particularly attachment-focused emotional responses.
Every study has some limitations that negatively affect the results. Since the statistical population in this study consisted of only maladjusted couples who were referred to Ahvaz counseling centers, the results should be cautiously generalized to other regions. Furthermore, because this study used both treatment models and compared them, it is recommended that future studies use multiple therapists to administer the treatments. As a result, the results can be more reliable, and the bias associated with the results can be reduced. Given that this study was conducted on married people with poor marital adjustment, it is suggested that similar studies be conducted on smaller populations (women or men separately) because expanding the range of such studies can be beneficial in preventing family problems, as well as mental and psychological damages. In addition, it is recommended to investigate the therapeutic effects of these two approaches in other studies with a follow-up stage.
5. Conclusion
According to the results of this study, Olson’s enrichment training program and Johnson’s relationship enrichment were effective in improving emotion regulation and marital empathy among maladjusted couples. Olson’s enrichment training program and Johnson’s relationship enrichment workshops can effectively help maladjusted couples mitigate emotional problems. Therefore, therapists are recommended to use this intervention to solve the marital problems of couples and improve the health of families.

Ethical Considerations
Compliance with ethical guidelines
The study was approved by the Ethical Committee of Islamic Azad University, Ahvaz Branch (Code: IR.IAU.AHVAZ.REC.1400.060).

Funding
This article was extracted from a part of the Ph.D. dissertation of Marzieh Zolfaghari Kahkesh in the Department of Counseling, Islamic Azad University, Ahvaz Branch, Iran.

Authors' contributions
Conceptualization and supervision: Masoud Shahbazi; Methodology: Marzieh Zolfaghari Kahkesh, Amin Koraei; Investigation, writing–original draft, and writing–review and editing: Masoud Shahbazi, Seyedeh Zahra Alavi; Data collection: Marzieh Zolfaghari Kahkesh, Masoud Shahbazi; Data analysis: Masoud Shahbazi, Amin Koraei.

Conflict of interest
All the authors declare no conflict of interest.


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