the effects of sexual counseling with the model EX-PLISSIT of sexual perecption of women on the verge of marriage, a randomized controlled clinical trial

Abstract

Background: Considering the prevalence of sexual dysfunctions among Iranian women and the effects of sexual self-concepts on their sexual performance, this study aimed to analyze the effects of EX-PLISSIT sex counseling on sexual self-concepts of brides-to-be. Method: This randomized controlled clinical trial was conducted on 64 women visiting the premarital counseling centers of Tabriz, Iran, in 2022. The 15 -year-old brides-to-be were selected as participants and were then assigned to intervention (32) and control (32) groups with a randomized block design. Participants in the intervention group attended four 60–90-minute individual counseling sessions with an interval of one week in accordance with the EX-PLISSIT model, whereas those in the control group received only routine premarital counseling. The researcher interviewed all participants before and four weeks after the intervention and then completed the Multidimensional Sexual Self-Concept Questionnaire and the Sexual Dysfunctional Belief Questionnaire. Results: Results showed no significant differences between the intervention and control groups in terms of demographics and the baseline scores of sexual self-concept and sexual dysfunction beliefs. The post-intervention mean score of negative sexual self-concept was significantly lower in the intervention group than in the control group (mean difference=-5.8, 95% confidence interval: -3.3 to -8.2, p<0.001), and the post-intervention mean score of situational self-concept was significantly higher in the intervention group than the control group (mean difference=3.0, 95% confidence interval: 0.9 to 5.1, p=0.004). However, results indicated no significant differences between the two groups in the post-intervention mean score of positive sexual self-concept (mean difference=-0.5, 95% confidence interval: -5.1 to 4.0, p=0.815). In addition, the post-intervention mean score of sexual dysfunction beliefs was significantly lower in the intervention group than in the control group (mean difference=-15.3, 95% confidence interval: -20.1 to -10.5, p<0.001). Conclusion: The findings indicated the positive effects of EX-PLISSIT sex counseling on negative and situational sexual self-concept and sexual dysfunction beliefs in brides-to-be. Hence, this model is recommended to be used in combination with other sex counseling methods in order to improve the sexual health of brides-to-be.