Development of psychotherapy protocol for women's desire/sexual arousal disorder; a qualitative study

Background and Aim: Sexual desire/arousal disorder in women is the most common and destructive sexual problem that couples face and has long been one of the common concerns of couple therapy. Considering the multidimensionality and pervasiveness of women's sexual desire/arousal disorder and its impact on all aspects of married life and the complexity of its pathology, it requires inclusive interventions and needs to provide comprehensive treatment guidelines. The present study was conducted with the aim of developing a psychotherapy protocol for women's sexual desire/arousal disorders Method: The current research was conducted in a qualitative manner, using the theme analysis approach and the three-tier method, in three stages. The first stage of the research was carried out with the aim of investigating the lived experiences of women in order to develop a protocol. In this stage, 30 patients with sexual desire/arousal disorder were selected by targeted sampling method. The research tool at this stage was semi-structured interview. The second stage was an interview with experts, in which 20 experts and psychologists in the field of sexual problems were interviewed in order to discover the influential components in psychopathology and the treatment of women's desire/arousal disorders. In the third stage, which aimed to examine the theoretical and research background in order to identify influential patterns in the etiology and treatment of women's sexual desire/arousal disorder, 40 written sources, including books and research articles, were studied and thematic analyzed until 2022. In all three stages, sampling continued until data saturation. Finally, by integrating the findings of all three parts of the psychotherapy protocol for sexual desire/arousal disorder, it was compiled and validated using the opinions of experts. Results: Psychotherapy protocol for women's sexual desire/arousal disorder containing 7 core categories including awareness and psychological education (with the main categories of providing information and sexual knowledge, developmental analysis of the disorder and adopting a systemic view of the disorder); motivation (with the main categories of hopelessness) creative and acceptance and commitment); value-oriented activation (with the main categories of relaxation training and mindfulness, value-based action and increasing differentiation); cognitive flexibility (with the main categories of examining the effectiveness of sexual thoughts and stereotypes, adjustment and conscious attention to sexual schemas); improving marital skills (with the main categories of teaching sexual and marital restraints, communication skills and conflict resolution); Secure attachment is acquired (with the main categories of restoring the attachment style, increasing the capacity of intimacy and connection) and sensory focus (with the main categories of teaching emotional expression and verbalization of emotional feelings). As a result of these 7 core categories, 15 main categories and 72 sub categories were obtained. The obtained protocol was validated and reliable using psychometric indices. The results indicated the validity (0.99) and reliability (0.94) of the proposed protocol. Discussion: The developed psychotherapy protocol can be used along with other existing interventions for the treatment of women's sexual desire/arousal disorder.