Men and psychological help seeking
Written by listed counsellor/psychotherapist: Michael Betts MSc, MBACP (Accred), MBPsS
10th May, 20110 Comments
Consultation rates are consistently lower for men than they are for women in seeking help for psychological difficulties, especially emotional difficulties and depressive symptoms. (Moller-Leimkuhler, 2002).
Some research has focussed on the factors that might attract men to mental health services. Rochlen and Hoyer (2005) summarise current knowledge in marketing mental health services to men, acknowledging that developing strategies to promote mental health to men is full of immediate obstacles including the idea that counselling is in direct conflict with a the culture of masculinity. They identified in previous research in marketing mental health to men, that men with more traditional gender role identities may express preferences towards more structured or directive interventions such as career counselling or classes. The primary interventions suggested are increasing awareness, improving interest and changing inhibiting values. They identify the need for more focus groups, structured interviews and other qualitative approaches to extrapolate the specific needs of the target audience, to focus on sources of men’s resistance.
Mckelley and Rochlen (2007) examine the possibility that coaching (an umbrella term which includes life coaching) is a viable alternative to traditional therapy, identifying a high number of coaching clients tend to be men. They identify that although research has consistently found that mental health treatments have shown to be equally effective for men and women, that men’s underutilization of mental health services is a consistent finding within help-seeking literature. Their article explores what aspects of coaching may appeal more to men than traditional counselling services, by speculating which aspects of gender role socialisation and help-seeking attitudes and behaviours may be resolved by offering coaching. Mckelley and Rochlen (2007) look at different goals within coaching, such as intrapersonal goals, which would look at aspects of your life such as finding a better work life balance or interpersonal goals such as managing conflict and relationships at work and in your social life or performance based goals such as improving efficiency and time management at work. They highlight that current research suggests participants who have experienced coaching have reported feeling more emotionally competent and are more aware of their impact on others. There are a range of possible applications of coaching which Mckelley and Rochlen (2007). There are some apparent differences highlighted in this research between traditional counselling and coaching. As highlighted within this study, one of challenges that coaching could potentially broach is the central challenge of matching the culture of therapy and the constraints of masculinity. However as Mahalik, Good and Englar-Carlson (2003) identified, aspects of masculinity, that may create resistance to seeking traditional counselling, may also be at the source of difficulties experienced by men. It may be the case that in offering an alternative to counselling such as coaching, that men are not facing the difficulties that are causing their emotional distress. For example men who experience difficulty in expressing uncomfortable emotions or in closeness, choosing aspects of life coaching such as setting specific goals at work could be a function to avoid facing these difficulties. Mckelley and Rochlen (2007) also identify a number of potential limitations of the coaching approach, for example that of professional boundaries and confidentiality, for instance a life coach may attend a dinner appointment with you.
Studies have also begun to explore the opinions of physicians as to the role of counselling services. Jeffrey, Smith and Robertson (2006) describe a crisis in men’s health in and state that there is limited research exploring attitudes, beliefs of health professionals towards men’s access to services promoting well being. In their study Jeffrey, Smith and Robertson (2006) conducted a focus group with three physicians in regular contact with male patients, with a view to exploring both how physicians make sense of men’s avoidance of counselling services and to ascertain their views on pairing a mental health assessment alongside a physical check up. In discussing how mental health counselling can progress more successfully with male patients, they found there to be three major themes around which the discussion revolved: Male Socialisation Processes, whereby physicians recognised the dichotomy between the emotionally expressive, vulnerable process of counselling and the strong, independent, stoical qualities expected of men. Secondly, the influence of stigma, when the action of being emotionally expressive is further compounded by the stigma of admitting a flaw in your character, which for this reason the physicians believed was more difficult than admitting physical difficulties. Thirdly, ignorance of the consultation process, whereby men may misattribute what happens, within the counselling process e.g. someone demanding very personal information from them. The focus group also discussed the possibility of pairing a mental health assessment with general medical check-ups to begin to normalise some of these processes within the wider public domain. A short questionnaire was sent to 125 physicians with a total of 80% agreeing that some form of combination of mental health assessment with annual physical check-ups would be a good idea. In contrast to the study by Mckelley and Rochlen (2007) which explores viable alternatives to traditional counselling, this study considers a process of normalising the counselling process through integrating mental health assessments with physical check-ups. Jeffrey, Smith and Robertson (2006) found that a greater percentage of female physicians reported that they would not be comfortable in promoting this service to male patients and their families, and hypothesised a potential fear of derision from male patients if they were to offer this service to their male patients.
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