Depression of Women Undergoing Divorce Process in Malaysia

The aims of this study are to identify the level of depression among women undergoing the divorce process. The sample was chosen through the purposive sampling technique among women that undergoing the divorce process in Malaysia. Qualitative data were collected through the Beck Depression Inventory-II (BDI-II). The data were then analysed through descriptive analysis. The results showed the reduction in depression levels after the women undergoing the divorce process go through counseling intervention sessions. In conclusion, it is shown that counseling intervention sessions were effective in reducing depression levels among women undergoing the divorce process.


Introduction
According to Hariri & Raihanah (2014) stated that marriage includes trust and responsibilities that need to be implemented by the married couple through legal marriage as allowed by Islamic religous. Based on Hamzah & Jasmi (2020), a long-lasting marriage is an aim for the married couple as the husband and wife need to be ready to hold the responsibilities in marriage life. Divorce among Malays in Malaysia shown an alarming increase as 1/3 divorce cases happened in the first five years in a marriage. Divorce definitely gave negative effects to the family members and leads to poor relationship quality between a parents and the children. According to Marziah & Salina (2019) stated that past researches found that married individual that was not happy with the marriage experienced negative effects such as health problems. This situation also gave huge impacts toward the family and their careers. Unhappy and poor quality marriage will largely impact the childrens' welfare along with their emotional and mental growth too.

Literature Review
Conflict, neglect of responsibilities, and abuse are factors that lead to divorce. In fact, divorce was used as a solution to marriage problems. Divorce at the West especially Europe and United States focus on factors like demography aspect and the effects of divorce toward the adults and the children.
Divorce can increase the risk of mental health problems among adults and children (Amato & James, 2010). According to Shamsiah & Walid (2014) stated that continuous and long duration of marriage's conflicts can lead to stress. Continuous stress lead to mental health problems such as depression symptoms. Women with depression tend to have psychological dysfunctional, low self-appreciation and would likely avoid social interaction. Conflicts involving marriage were also affected the couple's psychological welfare. This shown that depression issue among women undergoing divorce process is serious and appropriate interventions are needed to treat depression symptoms among them, involving psychological, cognitive, emotional and behavioural aspects to become normal and continue living and hold responsibilities of their children. According to Aziz (2019) stated that Mental Health Organization (United States) estimated that 54 out of 400 million Americans have mental health problems due to factors such as depression, bipolar disorder, schizophrenia and post-traumatic stress depression. According to Beck (2008), Cognitive Behavioral Therapy can provide cognitive awareness that leads to an individual's behaviour and emotional changes. This showed that an individual's automatic thinking is caused by negative cognitive distortion and affecting an individual's mind then affects behaviour and emotional functioning. Based on See Mey & Siew (2005) stated that cognitive restructuring is needed to return the mind functional caused by negative mind distortion. This is to prevent depression symptoms as depression, especially among women, is considered as a clinical disease that needs proper attention and suitable intervention treatments. This shows that depression is a serious issue and should not be neglected. Counseling intervention sessions using Cognitive Behavioural Therapy is one of the main interventions. Most therapists applied this technique to restructure the client's behavioural aspect along with the cognitive restructuring process toward negative mind distortion that affecting the client. Behavior Cognitive Theory has two types of model theories which are behavioural theory and cognitive theory (Payne, 2005). The behavioural model needs to focus on behavioural changes and the client's actions while the cognitive model focuses on changes or the client's mind restructure. In fact, conflicts in marriage and divorce have a profound impact on the psychological wellness of couples. According to Ramachandran and Psychogiou (2009), depression is one of the psychiatric illnesses that affect the wife, children, family members and the surrounding community.

Objectives
The objectives of this study are: 3.1 To determine the depression level among women undergoing the divorce process 3.2 To test the effect of counselling intervention sessions in reducing the depression among women undergoing the divorce process

Methodology
This research involves a quantitative research approach. Quantitative research approach was carried out using the Beck Depression Inventory-II (BDI-II) involving pre-test and post-test to observe the decreasing of depression level among women undergoing the divorce process to answer the research objective. This research used a purposive sampling technique as this research involves women undergoing the divorce process with critical depression level according to the Beck Depression Inventory-II (BDI-II) with a scale between 29 to 63 to enable the sample to involve with the counselling intervention sessions. Beck Depression Inventory-II (BDI-II) is an instrument to measure depression level in an individual. This instrument was invented by Aaron Beck in 1961. BDI-II consists of 21 questions with scale 0, 1, 2 and 3 for each question to measure the depression level. This instrument consists of questions related to depressive symptoms such as losing hope and physical symptoms such as fatigue, weight loss and loss of interest in sex. Beck Depression Inventory-II was revised in 1996 according to the Diagnostic Statistical Manual of Mental Disorder IV (DSM-IV) that consists of three editions, whereas the first was published in 1961 and re-revised in 1978. The second edition was published in 1996 as BDI-II. Research sample was given 5 to 10 minutes to answer the Beck Depression Inventory-II (BDI-II) My appetite is much less than before My appetite is much greater than usual I have no appetite at all I crave food all the time Beck Depression Inventory-II (BDI-II) has been widely used in Malaysia for researches on depression problems, such as in an orphanage home in Kota Bharu district, Kelantan by Jamaludin Ramli, Azizi Yahya, Noordin Ahmad and Siti Zainab Bt Md Lazim from Universiti Teknologi Mara, Melaka and the depression research among Form 3 students from a National-type school by See Ching Mey and Lee Siew Siew from Universiti Sains Malaysia. There were a few researches in the West that used the Beck Depression Inventory-II. BDI-II was used among adult clinical patients with chronic depression (Andrew et. al., 2014). There was also research that used BDI-II to measure depression level among women after giving birth. BDI-II needs to be used carefully among these women because of the significant emotional and physical changes. The result showed that women that recently gave birth have a high score in BDI-II and experienced depression symptoms such as sleeping pattern changes and fatigue. Furthermore, they tend to have negative cognitive symptoms such as high self-criticism and self-judgement (Elisabeth et al., 2012).

Findings
The quantitative analysis results were retrieved from the Beck Depression Inventory-II (BDI-II) that was given to clients on pre-session, second session, fourth session and sixth session. The data analysis scores are as shown below: of BDI-II at 60.32% but still at a critical level. But on the fourth session, the percentage of BDI-II is at 42.86% that shows a moderate depression. At the end of the sixth session, clients' BDI-II score is at 23.81% which shows a moderate depression level. Overall, depression experienced by clients shows a reduction of 47.61%. The counseling intervention sessions effects can be seen through the scores changes in the Beck Depression Inventory-II that were administered four times which were at pre-session (45), post-test 1 (38) after given second counselling sessions and post-test 2 (27) after given fouth counseling sessions and post-test 3 (15) given after sixth counseling sessions. Clients' depression level after going through counseling intervention sessions showed a reduction from critical depression level (45 & 38) to moderate depression level (27) and keep decreasing until it reached mild depression level (15). The result showed the decreased from critical depression level to mild depression level by 47.61%. This reduction was the result of successful counseling intervention sessions. The researcher found that these counseling intervention sessions suited with the time frame of critical depression level experienced by the clients although it was still in control and did not achieve mental stress level that needs treatments from the psychiatrists.
The reduction of clients' depression level are also affected by their commitment in going through the six times counselling intervention sessions. Counselor roles also affected the reduction of depression level as the counselor applied basic counselling skills such as listening skill, consulted and helped clients to get awareness in facing their issues. According to Corey (2009), values held by a counselor enables clients to give cooperation and focusing on the counselling intervention sessions implemented by the respective counselor. The decreased depression level experienced by the clients showed that these counselling intervention sessions were suitable among women with depression. In fact, the techniques used are suitable for the education level and clients' intellectual. Clients' commitment lead to the decrease of depression level as supported by Jacobson (2000) in his research stated that clients that completed the tasks showed changes in their depression compared to the clients that did not give commitment.

Discussion & Conclusion
This research clearly showed that there were changes in the Beck Depression Inventory-II (BDI-II) scores used by the researcher to evaluate the depression level experienced by the clients before and after the counselling sessions. BDI-II has been used in the pre-test, post-test 1, post-test 2 and posttest 3 to identified clients' depression level. It showed that the intervention treatments were successfully implemented. These counseling intervention sessions were conducted at the exact time because although clients' depression level was at a critical level, but it was still in control and did not reach the depression level that needed psychiatrists' treatments. Individual counseling intervention session is a systematic process to help an individual based on the basic helping relationship principles by a registered counselor so that the process can achieve a change, improvement and holistic, good and voluntary improvement in client's self dan continuously throughout their life. Individual counselling is a professional relationship between a counselor and a client. This counseling process involves a developmental sequence relationship between a counselor and a client in a certain time frame. This relationship starts from a level and keeps developing to another levels.  (2019), these levels are conducted systematically with an objective or certain means. Barber & DeRubeis (2001) stated that Cognitive Behavior Therapy approach in counseling intervention sessions toward the individual with depression for 12 weeks showed that the depression symptoms have cognitive changes based on the Attributional Style Questionnaire, Depression Anxiety Stress and thought-listing using Ways of Responding Questionnaire measurements. According to researches, an effective cognitive-behavioral approach in counselling intervention sessions can overcome depression problems, anxiety, panic, stress, and others 80 negative emotions that related to the poor internal locus control problems.
Research by Malkinson (2001) had proved that the cognitive behavioural approach had successfully overcome individuals' grief problems where they showed an increased self-belief compared to the past where they were easily influenced by external factors. Counselor needs to believe that clients' mind changes will impact clients' behavioural changes. Cognitive behavioural theory as a therapeutic procedure focuses on emotion and thinking changes but in other dimension, its main purpose is to adapt to certain behavioural changes (Payne, 2005).
In conclusion, this research has answered the research objectives to measure depression level among women the undergoing divorce process and the effect of counselling intervention sessions in reducing the depression level. This approach is suitable to be used by counselors in handling the counselling intervention sessions to reduce the depression levels among women undergoing the divorce process.