ompared to women,menare muchmorelikely
toresistseeking treatment fromhealth profes-
sionals when theyareexperiencingdifficulties.
For example, they visit theirprimaryphysi-
cians less frequently; they also visitmental
health specialists less often, and they are less likely toenter psychotherapy or counseling than women are.Inthe
case of depression,far more men than women say that
they would neverconsider seeing a therapist; when men
are depressedthey are evenreluctant to seek informal
help fromtheir friends.Moreover, whenmen do seek pro-
fessional help, theytend to askfewerquestions than
women do (see Addis
Why is the average man, regardless of age, socialbackground,and ethnicity,so much more reluctant than
the average woman to utilize health services? One answer
is thatmenare less ablethan womento recognize and
labelfeelings ofdistress and toidentifythese feelings as
emotional problems.In addition,men who subscribeto
masculine stereotypes emphasizing self-reliance andlack
of emotionality also tend to experience more gender-role
conflict when they consider traditional counseling, with itsfocus on emotions and emotional disclosure. For a manwho prideshimself on being emotionally stoic, seeking
f emales are(see The World AroundUs17.1). A substantial
numberof angryparentsbringtheir children to therapists
with demandsthat theirchild's "uncontrollable behavior,"
which they view as independentof the family context, be
"fixed."Theseparentsmaybe surprisedand reluctant to
recognizetheir own roleinshaping theirchild'sbehavior
PEOPLE WHO SEEK PERSONAL GROWTH
group of peoplewho entertherapyhaveproblemsthat
would beconsidered relativelynormal.That is, they appear
tohaveachieved success,havef inancialstability, havegen-
erally acceptingand loving families, and haveaccom-
plished many of theirlife goals. Theyenter therapynotout
of personaldespairor impossibleinterpersonal involve-
ments,butoutof a sensethattheyhavenot livedupto
theirown expectationsand realized theirown potential.
These people, partlybecausetheir problems aremore
manageablethan the problems of others,maymak esub-
Psychotherapy,however, isnot just f or people who
have clearlydefined problems,high levels of motivation,
and anabilitytogainreadyinsight intotheirbehavior.
Psychotherapeutic interventionshavebeenapplied toa
Why Are Men So Reluctant toEnter Therapy?
help for a problem like depressionmaypresent a major
threattohis self-esteem. Seekinghelp also requires giving
upsome control. andmay run counter to the ideologythat
" areal man helpshimself."
How can men be encouraged to seekhelp when they
havedifficulties? One basicproblemis that the kinds of ser-
vices that are available may not be the kinds of services
that men who endorsetraditional masculine roles can read-
ilyaccept.In otherwords,forsome men, there may be a
mismatch betweenwhatis available andwhatthey canpsy-
chologicallytolerate. Part of the solution may betodevelop
treatment approaches thatarebasedon theories ofhow
men are socialized and that provide a better fit for men who
are constrained by gender-role expectations. Another strat-
egy is to use more creative approaches to encourage men
to seek help and support.For example, television commer-
cials forerectiledysfunction useprofessional basketball
players andfootballcoaches to encourage menwithsimilar
problemsto "step up totheplate" andtalk to theirdoctors.
Making men more aware of other "masculine men" whohave been "man enough"to go for help when they needed
it maybe an important step toward educating those whoseadherence to masculine gender roles makes it difficult for
them toacknowledge and seekhelpfortheir problems.
wide variety of chronicproblems.Evena severelydis-
turbed,psychoticclient mayprof itfromatherapeutic
relationshipthattak esinto account his orher levelof func-
tioning and maintains therapeutic subgoalsthatare within
theclient'spresentcapabilities(e.g., seeHogartyet al.,
Itshould beclear from these brief descriptionsthat
there is no"typical"client.Neither isthere a"model"ther-
apy. No currentlyused form of therapyis applicableto all
types of clients, andall of the standard therapies can docu-
mentsomesuccesses. Mostauthorities agree thatclient
variables suchasmotivationtochange and the severity of
symptomsareexceedinglyimportant tothe outcomeof
Levy,2004). As we willsee,the various
therapieshave relatively greater success whena therapist
tak esthe characteristics of a particularclientinto account
in determining treatment approaches.
Who ProvidesPsychotherapeutic Services?
Membersof manydif f erentprof essionshavetraditionally
providedadvice andcounselto individuals in emotional
distress. Physicians,inaddition tocaring for their patients'