Men and psychotherapy.

Abstract

It has been well supported that men underutilize mental health services (see Chapter 31, this chapter); however, this is not due to a lack of need for such assistance (Addis & Mahalik, 2003;Cochran, 2005). In fact, men and women are equally as likely to develop a mental disorder throughout their lifetime, with men having higher rates of substance abuse and antisocial personality disorder and women being more likely to experience affective disorders (Kessler et al., 1994). Additionally, the emotional expression by men when coping with distress (e.g., anger) may alter traditional ways of understanding some disorders, such as the blunted or sullen affect typically associated with depression. To complicate matters, for many men, asking for psychological help may be in conflict with how they were socialized to think of themselves (i.e., tough, silent), including socialization processes that promote the belief that men should be selfreliant as well as physically and emotionally tough (Addis & Mahalik, 2003). Consequently, there is general consensus among mental health professionals that significant social-cultural barriers inhibit men from seeking psychological help.Once men decide to begin psychotherapy, the socialization processes that inhibited their helpseeking behaviors do not cease (Owen, Thomas, & Rodolfa, 2013). For some men, the tendency to be emotionally restrictive and the fear of acting in an effeminate manner (Scher, 1990) can inhibit emotional engagement in therapy (Cochran, 2005;Levant, 1998). For instance, men who seek help are significantly less likely than women to ask questions about their treatment (Courtenay, 2000). This could be due to the internalized stigma toward receiving services, wherein men may feel inferior or inadequate for seeking help (Vogel, Wade, & Haake, 2006). In turn, clients endorsing higher levels of self-stigma toward seeking help have been associated with low-quality working alliances and fewer session outcomes (Owen et al., 2013). Clearly, there are several components of masculine socialization that may present barriers during the treatment process for those men who do seek help.Despite advances to better understand how best to work with men (see Mahalik, Good, Tager, Levant, & Mackowiak, 2012), the empirical support for therapeutic interventions with men remains limited (Levant, Halter, Hayden, & Williams, 2009). As such, in this chapter, we attempt to cover three important issues. First, we provide a review of the literature on empirical treatments that include samples focusing on men. This was done within the tradition of systematic review and meta-analysis, with some clear limitations noted below. Second, we provide an explication of therapists' multicultural orientation (Owen, 2013) as a framework for working with the cultural norms of men. In doing so, we highlight particular masculine norms that have garnered empirical attention. Third, we provide an integration of current psychotherapy approaches within the lens of masculine norms. Providing a current, empirically supp...

Engaging Men in Psychological Treatment: A Scoping Review

“… Strokoff, Halford, and Owen (2016) conducted a review of 15 studies employing male-targeted psychological treatment approaches and identified only a single, small randomized study examining a treatment specifically tailored for men. This study investigated the use of a brief alliance-building intervention, known as gender-based motivational interviewing (GBMI), in a community-based sample of men with symptoms of anxiety and depression and no statistically significant effects were reported ( Syzdek, Addis, Green, Whorley, & Berger, 2014 ).…”

Teaching Gender Competency with Men in Mind: Foundations of an Online Training Program for Mental Health Practitioners

“…Indeed, there is an emergent knowledge base of techniques for engaging male clientele (Mahalik et al, 2012; Seidler et al, 2018a; Owen et al, 2010). Across these studies, the need for appropriate psychoeducation and familiarization with therapy processes, adopting a transparent, and flexible structure to therapy, alongside a strengths-based empowerment orientation have been emphasized as male-friendly strategies (Richards & Bedi, 2015; Seidler et al, 2018a; Strokoff et al, 2016). At the same time, this does not mean therapy with men should be void of emotional exploration; indeed more masculine men have noted the importance of such interventions (Owen et al, 2010).…”

“…We define gender competency when working with male clients in mental healthcare as reflecting the capacity to effectively demonstrate practical awareness of the interaction between masculinities and men’s mental health, via implementation of adaptations to treatment according to each man’s experience. More specifically, gender competency with men promotes viewing each man’s cultural experience as a broad, complex lived reality of plural “masculinities” that intersect and coalesce over time (Connell, 1995), which potentially contribute to his presenting problem(s), innate coping, and subsequent therapy experience and needs (Liu, 2005; Seidler et al, 2019c; Strokoff et al, 2016). Additionally, gender competency with male clients should include demonstrable evidence that practitioners recognize therapy as a pertinent context for the interaction between the client’s and practitioner’s respective gendered values, attitudes, and behaviors.…”

Men’s Mental Health Services: The Case for a Masculinities Model

“…The outdated homogenization of men fails to address the complexities of men’s mental health needs, primarily their problematic ambivalence, engagement, and mistrust with, and drop out from, mental health treatment (Johnson et al, 2012; Pederson & Vogel, 2007). In broadening the clinical perspective to understanding and integrating a masculinities framework, it follows that the male clients will be approached with an openness that supports their engagement (Strokoff, Halford, & Owen, 2016). A masculinities model is arguably the best way forward as it provides a contemporary, theoretical framework for addressing the diversity inherent in men’s mental health needs.…”