Review: Recommendations for male‐friendly counselling with adolescent males: A qualitative systematic literature review

Abstract

BackgroundThere are growing calls to tailor counselling practices for adolescent males, a population reluctant to engage in psychological treatment despite concerning rates of mental illness. The objective of this systematic review (PROSPERO: CRD4202125547) was to collate and synthesise recommendations for individual counselling with adolescent males (12–18 years).MethodThe databases Psychology and Behavioural Science Collection, PsycArticles, PsycINFO, Academic Search Complete, EBSCO eBook Collection, Wiley Science Collection, Taylor and Francis Collection and ProQuest One Academic were searched for articles published between 1995 and November 2021. The quality of evidence was assessed using the JBI critical appraisal checklists, and thematic analysis was employed to synthesise findings across the literature.ResultsA total of 1625 texts were identified, of which 16 met the inclusion criteria. Generated themes included (a) therapist knowledge of masculinity, gender socialisation, and male‐relational styles; (b) necessity of therapists to address masculinity in the therapeutic space; and (c) customising engagement and treatment practices to appeal to adolescent males.ConclusionsThe themes highlighted the unique developmental, and sociocultural considerations practitioners should be aware of when working with young men. Through a multicultural counselling competency framework, masculinity and adolescent male identity are expressions of diverse sociocultural identities that psychological assessment and intervention should ideally be tailored to suit. The findings of the review suggest that empirical research focusing on the experiences of adolescent males receiving psychological treatment is sparse. Further research is needed to inform the development of practicable, gender‐sensitive adaptions to counselling practice for young men.

‘It's all about rapport’: Australian therapists' recommendations for engaging adolescent males in counselling and psychotherapy

“…Addressing issues of therapist authority, alignment with caregiver concerns and the focus of goals and content discussed in therapy appear to be important considerations for developing a collaborative therapeutic alliance for both therapists and adolescent clients (Binder et al., 2008; Gibson et al., 2016). Choice and autonomy are positioned by therapists in our study as key facilitators of retaining young men in counselling and align with previous guidance advocating egalitarian relationships and shared decision‐making in therapy with males (Boerma et al., 2023; Seidler et al., 2018).…”

“…However, primary data in these reviews were scarce, with the bulk of included texts being commentaries emanating from the United States. This is consistent with a review of male‐friendly counselling with adolescent males, which highlighted a gap in both primary qualitative research and research outside the United States for this population (Boerma et al., 2023). As such, region‐specific primary research from other Western nations is presently lacking.…”

“…As conformity to harmful stereotypical masculine gender norms, such as toughness, dominance and avoidance of emotions, appears strongest in adolescence for males (Kågesten et al, 2016), we contend that therapists in the current study view addressing masculine norms that may impede engagement in therapy an essential task to initially complete. Thus, although generalisability should not be claimed, we do claim broader relevance for the findings as they align with current guidelines for psychological practice with boys and men (APA, 2018), scholarly reviews (Boerma et al, 2023) and therapists' and clients' perspectives (Gibson et al, 2016;Johansson & Olsson, 2013). Future research may explore the themes of intersectionality and masculinity in greater depth and compare their relative importance to both practitioners and young men receiving psychotherapy, perhaps in paired-dyad studies.…”

“…The final theme highlighted masculinity‐informed adaptions that may be applied to enhance adolescent males' engagement in the tasks of therapy. Masculinity is a central component of young men's psychological treatment (Boerma et al., 2023), and previous qualitative research has highlighted the importance adolescent males place in maintaining a sense of control in therapy to uphold internalised masculine ideals, as well as the perceived vulnerability they may experience when relinquishing that control to health professionals (Gibson et al., 2016). Yet, young men are predominantly referred by and for the concerns of others (de Haan et al., 2013).…”