Men’s Psychotherapy Dropout is Associated with Conformity to Traditional Masculinity Ideologies

Abstract

Objective: High conformity to traditional masculinity ideologies (TMI) is associated withlower use of psychotherapy, higher self-stigmatization and poor mental health outcomes amongst men. However, the role of conformity to TMI in relation to psychotherapy dropout is still unclear.Aim: The present study aims to clarify the relationship between conformity to TMI and premature termination of psychotherapy (dropout) in men.Method: Data was used from an anonymous online survey in German-speaking Europe. Participants with previous psychotherapy experience provided information on sociodemographics, mental health, TMI, and their past experiences with psychotherapy. Discontinuation of psychotherapy was assessed by self-report and further differentiated into discontinuation with or without consulting the therapist. Men with an unconsulted therapy ending were defined as psychotherapy dropouts. Conformity to TMI was assessed using the Conformity to Masculine Norms Inventory.Results: Of the 266 men (mean [SD] age, 46.1 [13.6]) with psychotherapy experience, 30.5% (n = 81) reported having discontinued psychotherapy at least once, whereas 17.7% (n = 47) of the total sample reported dropout. These 47 men showed significantly higher conformity to TMI than men who did not report past dropout. The sub-scales of self-reliance and playboy showed the strongest associations with psychotherapy dropout.Conclusions: Dropout from psychotherapy was significantly associated with higher conformity to TMI. Therapists should consider, and where necessary, work to flexibly adapt to TMI which may influence how men engage in mental health care. Such an approach would likely improve men’s ongoing engagement in psychotherapy, promoting opportunities to prevent avoidable psychotherapy dropout for men most at risk of deleterious mental health outcomes.

Effects of Diagnosing Major Depressive Disorder in Men on Externalizing Depression Symptoms and Conformity to Traditional Masculinity Ideologies

“…First, they experience higher levels of self-stigmatization (Latalova et al, 2014) and report more suffering from depression and substance use (O'Neil, 2013;Wong et al, 2017). Second, they are less likely to begin psychotherapy (Eggenberger et al, 2022) and, even after starting, have higher dropout rates (Schneeberger et al, 2023). Lastly, men with high endorsement of TMI also have a higher risk of dying from suicide (Coleman et al, 2020).…”