Effectiveness of Emotion-Focused Therapy on Psychological Hardiness and Fear of Pregnancy in Women Aged 20-30

Abdelaziz, E. M., Alshammari, A. M., Elsharkawy, N. B., Oraby, F. A., & Ramadan, O. M. E. (2025). Digital intervention for tokophobia: A randomized controlled trial of internet-based cognitive behavioral therapy on fear of childbirth and self-efficacy among Egyptian pregnant women. BMC Pregnancy and Childbirth, 25(1), 233. https://doi.org/10.1186/s12884-025-07341-5

Alavi, S. H., Ghasemi Motlagh, M., & Bakhshipour, A. (2022). The effectiveness of emotion-focused therapy on emotional, cognitive, motivational, and biological symptoms of major depressive disorder. Razavi International Journal of Medicine, 10(2), e1153. https://doi.org/10.30483/RIJM.2022.254325.1153 [Persian]

Amini, Z., & Alavi, M. H. (2024). The efficacy of emotion-focused techniques on childbirth fear and emotional regulation in primiparous women: A randomized controlled trial. Journal of Midwifery and Reproductive Health, 12(3), 145–162. https://doi.org/10.18502/jmrh.v12i3.15842 [Persian]

Amirshahi, M., Saremi, A., Nouri, R., Karbalaei, M., & Hosseini-Sadat, R. (2024). Comparing the effectiveness of emotionally focused therapy and cognitive-behavioral therapy on sexual function and health-promoting behaviors in women with PCOS. International Journal of Behavioral Sciences, 18(1), 29–36. https://doi.org/10.30491/ijbs.2024.422403.2040 [Persian]

Başkaya, Y. H., & İlçioğlu, K. (2023). Effect of lifestyles on fear of pregnancy: Development and psychometric testing of the fear of pregnancy scale. European Journal of Obstetrics & Gynecology and Reproductive Biology, 285, 115–122. https://doi.org/10.1016/j.ejogrb.2023.04.009

Bayrampour, H., Ali, E., McNeil, D. A., Benzies, K., MacQueen, G., & Tough, S. (2016). Pregnancy-related anxiety: A concept analysis. International Journal of Nursing Studies, 55, 115–130. https://doi.org/10.1016/j.ijnurstu.2015.10.023

Burgio, S., Cucinella, G., Perino, A., Baglio, G., Crifasi, L., Krysiak, R., Kowalcze, K., & Gullo, G. (2024). Effectiveness of Psychological Counseling Intervention in High-Risk Pregnancies in Italy. Journal of Personalized Medicine, 14(9), 976. https://doi.org/10.3390/jpm14090976

Chen, Y., Zhang, L., Liu, Y., & Wang, J. (2021). Social support, resilience, and mental health during pregnancy: A longitudinal study. International Journal of Environmental Research and Public Health, 18(7), 3735. https://doi.org/10.3390/ijerph18073735

Chen, Y., Zhang, L., Liu, Y., & Wang, J. (2021). Social support, resilience, and mental health during pregnancy: A longitudinal study. International Journal of Environmental Research and Public Health, 18(7), 3735. https://doi.org/10.3390/ijerph18073735

Clough, P. J., Earle, K., & Sewell, D. (2002) Mental Toughness: The Concept and Its Measurement. In I. Cockerill (Ed.), Solutions in Sport Psychology (pp. 32-43). London: Thomson.

Çubukçu, B., & Ağapinar Şahin, S. (2025). The effect of pregnant women's childbirth beliefs on fear of childbirth. Women's Studies International Forum, 108, 103017. https://doi.org/10.1016/j.wsif.2024.103017

Foroughe, M., Ashley, A., Neela, I., Darking, S., Bell, S., & Cordeiro, K. (2024). Emotion-focused therapy for youth: Clinical outcomes of a single-site, randomized waitlist-controlled trial. *Person-Centered & Experiential Psychotherapies, 23*(3), 277–295. https://doi.org/10.1080/14779757.2023.2294309

Goldman, R. N., & Sharbanee, J. M. (2024). New developments in Emotion-focused therapy. *Person-Centered & Experiential Psychotherapies, 23*(3), 275–276. https://doi.org/10.1080/14779757.2024.2380571

Goldman, R. N., & Sharbanee, J. M. (2024). New developments in Emotion-focused therapy.  Person-Centered & Experiential Psychotherapies, 23 (3), 275–276. https://doi.org/10.1080/14779757.2024.2380571

González, A., Martínez, P., & Pérez, S. (2022). The relationship between psychological hardiness and pregnancy-related anxiety: A longitudinal study. Journal of Psychosomatic Obstetrics & Gynecology, 43(1), 21–28. https://doi.org/10.1080/0167482X.2021.1992356

González, A., Martínez, P., & Pérez, S. (2022). The relationship between psychological hardiness and pregnancy-related anxiety: A longitudinal study. Journal of Psychosomatic Obstetrics & Gynecology, 43(1), 21–28. https://doi.org/10.1080/0167482X.2021.1992356

Greenberg LS, Goldman RN. (2020). Case formulation in emotion-focused therapy. Ramazani MA, Sharifzadeh M, Rasouli SS, translators. Tehran: Virayesh Publications. [in Persian].

Greenberg LS. (2021). Forgiveness and letting go in emotion-focused therapy. Dortaj F, translator. Tehran: Arjmand Publications. [in Persian].

Greenberg, L. S. (2008). The clinical application of emotion in psychotherapy. In M. Lewis, J. M. Haviland-Jones, & L. F. Barrett (Eds.), Handbook of emotions (3rd ed., pp. 88–101). Guilford Press.

Greenberg, L. S. (2015). Emotion-focused therapy: Coaching clients to work through their feelings. American Psychological Association. https://doi.org/10.1037/14692-000

Hajihatamloo, H., Ebrahimi, M., Alinejad, V., et al. (2025). Anxiety, self-compassion, perceived social support and resilience in two groups of primiparous pregnant women fully and not attending childbirth preparation classes. BMC Psychology, 13, 467. https://doi.org/10.1186/s40359-025-02723-y

Hajihatamloo, H., Ebrahimi, M., Alinejad, V., et al. (2025). Anxiety, self-compassion, perceived social support and resilience in two groups of primiparous pregnant women fully and not attending childbirth preparation classes. BMC Psychology, 13, 467. https://doi.org/10.1186/s40359-025-02723-y

He, D., Zhang, J., Wang, G., Huang, Y., Li, N., Zhu, M., Meng, Y., & Luo, B. (2025). Prevalence and factors associated with fear of childbirth in late pregnancy: A cross-sectional study. Frontiers in Public Health, 13, 1589568. https://doi.org/10.3389/fpubh.2025.1589568

Heidari, S., Esfandiarinejad, P., Barzegar, M., & Azadiekta, M. (2019). Psychometric Properties of Fear of Preterm Delivery Questionnaire and its Relationship with Marriage Duration among Couples. Quarterly Journal of Health Psychology, 8(31), 23–36. https://doi.org/10.30473/hpj.2019.6313 [Persian]

Hosseini, L., Nazarzadeh, M., & Jahanfar, S. (2018). Interventions for reducing fear of childbirth: A systematic review and meta-analysis of clinical trials. Women and Birth, 31(4), 254–262. https://doi.org/10.1016/j.wombi.2017.10.007 [Persian]

 Huizink, A. C., de Medina, P. G., Mulder, E. J., Visser, G. H., & Buitelaar, J. K. (2002). Coping in normal pregnancy. Annals of Behavioral Medicine, 24(2), 132–140. https://doi.org/10.1207/S15324796ABM2402_11

İsbir, G. G. (2023). Fear of childbirth and emotional-focused approaches. Journal of Education and Research in Nursing, 20(1), 64–70. https://doi.org/10.5152/jern.2023.57442

İsbir, G. G. (2023). Fear of childbirth and emotional-focused approaches. Journal of Education and Research in Nursing, 20(1), 64–70. https://doi.org/10.5152/jern.2023.57442

İsbir, G., İnci, F., Önal, H., & Yıldız, P. D. (2022). The prevalence and associated factors of fear of childbirth among pregnant women. Journal of Reproductive and Infant Psychology, 40(6), 591–603. https://doi.org/10.1080/02646838.2022.2043826

Jalilvand, H., Mokhtari Zanjani, M., & Emamgholi Khooshehchin, T. (2024). The effect of counseling with a positive approach on anxiety about giving birth to an infant with anomalies in pregnant mothers over 35 years of age. Pregnancy, Childbirth, and Midwifery Care Journal, 14(4), 42–51. http://nmcjournal.zums.ac.ir/article-1-929-en.html [Persian]

Kalok, A., Kamisan Atan, I., Sharip, S., Safian, N., & Shah, S. A. (2025). Factors influencing childbirth fear among Asian women: A scoping review. Frontiers in Public Health, 12, 1448940. https://doi.org/10.3389/fpubh.2024.1448940

Kiamarthi A. (1997). Construction and validation of a scale for measuring psychological hardiness and examining its relationship with Type A personality, locus of control, self-esteem, somatic complaints, and academic performance in male and female students of Islamic Azad University, Ahvaz Branch [dissertation]. Ahvaz: Islamic Azad University, Ahvaz Branch; 1997. Persian.

Lee, M., & Kim, B. (2023). Effect of the employees’ mental toughness on organizational commitment and job satisfaction: Mediating psychological well-being. Administrative Sciences, 13(5), 133. https://doi.org/10.3390/admsci13050133

Lyberg, A., & Severinsson, E. (2010). Midwives’ supervisory styles and leadership role as experienced by Norwegian mothers in the context of a fear of childbirth. Journal of Nursing Management, 18(4), 391–399. https://doi.org/10.1111/j.1365-2834.2010.01088.x

Maluka, S. O., Joseph, C., Fitzgerald, S., Salim, R., & Kamuzora, P. (2020). Why do pregnant women in Iringa region in Tanzania start antenatal care late? A qualitative analysis. BMC Pregnancy and Childbirth, 20, 126. https://doi.org/10.1186/s12884-020-2823-4

Mijalevich-Soker, E., & Taubman–Ben-Ari, O. (2025). Fear of childbirth among pregnant women during crises: The role of resilience and social support. Journal of Reproductive and Infant Psychology. Advance online publication. https://doi.org/10.1080/02646838.2025.2489545

Mirjalili, Z., Sayadi, S., Melai, H., & Babai Nejad, A. (2025). Determining the validity and reliability of the innovation ecosystem with emphasis on the role of E-government in hospitals in Yazd Province in 2023. Journal of Community Health Research, 14(1), 57–67. http://jhr.ssu.ac.ir/article-1-1104-en.html.[Persian]

Mobasher, Z., Bagheri, N., Abbasi, M., & Tanha, Z. (2022). Comparison of the effectiveness of cognitive-behavioral therapy and combination therapy on self-compassion and emotional self-regulation in heart patients. Journal of Modern Medical Information Sciences, 7(4), 33–43. https://doi.org/10.52547/jmis.7.4.33 [Persian]

Mohammadi Hasel, K., Abdolhoseini, A., & Ganji, P. (2011). Hardiness training and perceived stress among college students. *Procedia - Social and Behavioral Sciences, 30*, 1354–1358. https://doi.org/10.1016/j.sbspro.2011.10.263 [Persian]

Mortazavi, F., Mehrabadi, M., & Karrabi, R. (2021). Effectiveness of solution-focused counseling therapy on pregnancy anxiety and fear of childbirth: A randomized clinical trial. Nursing Practice Today, 8(3), 244–254. https://doi.org/10.18502/npt.v8i3.5624

Nilsson, C., Hessman, E., Sjöblom, H., Dencker, A., Jangsten, E., Mollberg, M., Patel, H., Sparud-Lundin, C., Wigert, H., & Begley, C. (2018). Definitions, measurements and prevalence of fear of childbirth: A systematic review. BMC Pregnancy and Childbirth, 18(1), 28. https://doi.org/10.1186/s12884-018-1659-7

Omrani, S. A., Baratian, M., Zare Hosseinzadegan, Z., & Jodari Seyedi, Z. (2021). The effectiveness of emotion-focused therapy on psychological hardiness and sleep quality in individuals with a history of COVID-19 hospitalization. Applied Family Therapy Journal, 2(5), 215–228. https://doi.org/10.22034/aftj.2022.325945.1363 [Persian]

Özakkaş, T. (2017). Emotion-focused individual therapy training. Institute of Psychotherapy Education Publications.

Pascual-Leone, A., & Nardone, S. (2024). Emotion-focused therapy. In F. T. L. Leong, J. L. Callahan, J. Zimmerman, M. J. Constantino, & C. F. Eubanks (Eds.), APA handbook of psychotherapy: Theory-driven practice and disorder-driven practice (pp. 125–140). American Psychological Association. https://doi.org/10.1037/0000353-008

Rondung, E., Magnusson, S., & Ternström, E. (2022). Preconception fear of childbirth: Experiences and needs of women fearing childbirth before first pregnancy. Reproductive Health, 19(1), 202. https://doi.org/10.1186/s12978-022-01512-9

Rouhe, H., Salmela-Aro, K., Halmesmäki, E., & Saisto, T. (2015). Group psychoeducation with relaxation for severe fear of childbirth improves maternal adjustment and childbirth experience—A randomized controlled trial. Journal of Psychosomatic Obstetrics & Gynecology, 36(1), 1–9. https://doi.org/10.3109/0167482X.2014.987934

Sandvik, A. M., Gjevestad, E., Aabrekk, E., Øhman, P., Kjendlie, P. -L., Hystad, S. W., & Johnsen, B. H. (2020). Physical fitness and psychological hardiness as predictors of parasympathetic control in response to stress: A Norwegian police simulator training study. Journal of Police and Criminal Psychology, 35(4), 504–517. https://doi.org/10.1007/s11896-020-09388-w

Sanjari, S., Rafati, F., AmirFakhraei, A., Mohammadi Soleimani, M. R., & Karimi Afshar, E. (2021). Evaluation of Factor Structure and Validation of Electronic form of CAQ Fear of Delivery Questionnaire in Pregnant Women. Quarterly Journal of Health Psychology, 10(38), 57-70. doi: 10.30473/hpj.2021.53031.4830 [Persian]

Sarani, A., Azhari, S., Mazlom, S. R., & Aghamohammadian Sherbaf, H. (2015). The relationship between psychological hardiness and stress coping during pregnancy. Journal of Midwifery and Reproductive Health, 3(3), 408–417. https://doi.org/10.22038/jmrh.2015.4432 [Persian]

Shahidi, S., Hassanzadeh, R., & Mirzaian, B. (2021). The effectiveness of acceptance and commitment therapy on psychological hardiness and distress tolerance in female patients with psoriasis. Journal of Adolescent and Youth Psychological Studies, 2(2), 164–173. doi: 10.52547/jspnay.2.2.164 [Persian]

Torabiyan, A., Gholipour, M., Yektaparast, S., Ghodsi, B., & Tarnas, G. (2024). Effectiveness of Emotion-Focused Therapy on Self-Efficacy and Posttraumatic Growth in Women with Breast Cancer. Applied Family Therapy Journal, 5(3), 124–132. https://doi.org/10.61838/kman.aftj.5.3.13 [Persian]

Wang, L., Zhang, Y., & Li, J. (2025). Antenatal group education and its impact on social support and maternal outcomes: A randomized controlled study. Midwifery, 130, 103702. https://doi.org/10.1016/j.midw.2025.103702

Wu, C., Zhang, J., Zhao, L., Li, Y., Yan, Y., Wei, Y., Zhang, Z., & Guo, S. (2024). Psychometric evaluation of the Chinese version of the fear of pregnancy scale: A translation and validation study. Frontiers in Public Health, 12, 1364579. https://doi.org/10.3389/fpubh.2024.1364579

Yarmohammadi, T., Teymouri, S., & Rajaei, A. (2024). The effectiveness of emotion-focused therapy on psychological security in women involved in domestic violence. Iranian Journal of Educational Research, 3(1), 195–206. https://doi.org/10.22034/3.1.195 [Persian]

Yin, X., Liu, Y., & Chen, H. (2024). Sociodemographic and cultural correlates of fear of childbirth: Evidence from Asian countries. Women and Birth, 37(2), e124–e132. https://doi.org/10.1016/j.wombi.2023.05.004

Zhang, Q., Li, T., & Huang, J. (2024). Psychological resilience, social support, and fear of childbirth among pregnant women: A cross-sectional study. BMC Pregnancy and Childbirth, 24, 565. https://doi.org/10.1186/s12884-024-06574-7