Table 1 Content of counseling sessions

1

Familiarity with the group and method of treatment, anatomy, and physiology, the sexual cycle of men and women

Establishment of professional communication, attracting cooperation, statement of meeting rules, the introduction of research goals and the treatment method, expression of treatment importance, familiarity with male and female genitals and sexual cycle

2

Investigating and explaining the areas of sexual function and its changes during pregnancy, training and practicing emotions and behavior and relaxation training, cognitive errors

Training of identifying emotions, thoughts, and behaviors, paying attention to the positive and negative aspects of couples’ relationships, the need to process positive sexual thoughts along with muscle relaxation during sexual intercourse, correction of cognitive errors, assignment of identifying self-negative thoughts - positive thoughts, concentration and practice of deep breathing and muscle relaxation

3

Continuing exercises to change dysfunctional sexual thoughts, defining intimacy and its dimensions, teaching how to establish intimacy, more spouse participation

Training techniques and activities for sexual intimacy, identifying and respecting spouse’s disparate interests, the effect of sexual security on couples’ relationships, understanding spouse’s needs and trying to satisfy it to increase intimacy, changing negative sexual attitudes by cognitive distortion, sensate focus, breathing and relaxation

4

Study of sexual dysfunctional feelings, thoughts, and behavior during pregnancy, the practice of sexual fantasies, study of conflict resolution methods

The impact of automatic negative thoughts on feelings and behavior, the study of conflict resolution methods, diagnosis and treatment of misconceptions, an increase of sexual information, self-reliance in identifying cognitive errors, teaching sexual fantasy

5

Practice recognizing cognitive errors, describing the pattern of sexual changes during pregnancy, practicing sexual fantasies

Expressing the importance of intercourse, factors that prevent proper sexual intercourse, focusing on sexual feelings and massaging the sexual areas, explaining the steps of problem-solving, at this stage the goal was a pleasure and sexual arousal without vaginal penetration, examining the effect of thoughts on sexual behavior

6

Logical alternatives, explaining the different positions of intercourse during pregnancy, relaxation exercises, and Kegel exercise

Logical thinking and alternatives to logical thoughts. Task: Logical alternatives in treatment model – evidence review, training how to have sex during pregnancy, teaching appropriate positions during pregnancy, relaxation and Kegel exercises during pregnancy, practice relaxation and Kegel

7

Assessing progress in pregnant mothers and assessing their beliefs, factors affecting sexual focus

Review of changes of sexual behaviors, discovering negative thoughts about sex and reviewing negative thoughts through cognitive distortion, foreplay, and romantic relationships, identifying irritable points in the body

8

Summarizing and reviewing training of sexual relations techniques and sexual concentration, prevention of recurrence

Summary and general review of trained materials and skills and answering questions, expressing participants’ experiences, determining follow-up time, Assignment: Cards of coping with prevention from recurrence