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The study of men and masculinity as an important multicultural consideration



Gender issues in multicultural competencies do not generally include the study of men and masculinity. This article outlines a rationale for the inclusion of men and masculinity by drawing parallels with Whiteness and privilege as integral aspects of multicultural competency. Additionally, by including the study of men and masculinity into multicultural competency, issues such as heterosexism, patriarchy, homophobia, and sexism that are aspects of dominant masculinity can be addressed. Simultaneously, training clinicians to work with men may mean more effective and improved services than currently available. The article concludes with several multicultural competencies for clinicians when working with men that use Sue, Arredondo, and McDavis (1992) framework of multicultural competencies.
The Study of Men and Masculinity as an Important
Multicultural Competency Consideration
William Ming Liu
University of Iowa
Gender issues in multicultural competencies do not generally include the
study of men and masculinity. This article outlines a rationale for the
inclusion of men and masculinity by drawing parallels with Whiteness
and privilege as integral aspects of multicultural competency. Addition-
ally, by including the study of men and masculinity into multicultural com-
petency, issues such as heterosexism, patriarchy, homophobia, and sexism
that are aspects of dominant masculinity can be addressed. Simulta-
neously, training clinicians to work with men may mean more effective
and improved services than currently available. The article concludes with
several multicultural competencies for clinicians when working with
men that use Sue, Arredondo, and McDavis (1992) framework of multi-
cultural competencies. © 2005 Wiley Periodicals, Inc. J Clin Psychol
61: 685–697, 2005.
Keywords: multicultural competency; masculinities; privilege; people of color
Linking the study of men and masculinity with multicultural competencies can be con-
tentious, especially among some multicultural proponents. They may ask, “Why focus on
the study of men—isn’t all psychology the study of men and masculinity?” and “How
could men be an oppressed group similar to African Americans, or women for that mat-
ter?” These questions are not unique, but common misnomers about multiculturalism and
multicultural competency. In fact, multicultural competency, or the development of knowl-
edge, awareness, and skills (Sue, Arredondo, & McDavis, 1992; Sue & Sue, 2003), is not
only a focus on underrepresented or marginalized groups but also on the clinician’s under-
standing him or herself and the client and being able to effectively work with culturally
diverse clients. Although cultural diversity has been a term used synonymously with
people of color (Liu & Pope-Davis, 2003), it is assumed, in this article, that men are
Correspondence concerning this article should be sent to: William Ming Liu, Ph.D., University of Iowa,
Psychological and Quantitative Foundations, N328 Lindquist Center, Iowa City, Iowa 52242; e-mail:
JOURNAL OF CLINICAL PSYCHOLOGY, Vol. 61(6), 685–697 (2005) © 2005 Wiley Periodicals, Inc.
Published online in Wiley InterScience ( DOI: 10.1002/jclp.20103
socialized in a specific culture, with values, norms, customs, and expectations, to which
men must adhere. Therefore, working effectively with men means an awareness of mas-
culine cultural values and the clinician’s understanding of his/her own assumptions and
biases about men.
The purpose of this article is to outline a framework for why men and masculinity
should be considered an integral aspect of multicultural competency. As a general over-
view, the intent of the article is to suggest that the forces of culture, history, and social-
ization that are associated with the construction of race are related to gender, especially
how men and masculinity are developed in our society. It is important to provide a broader
rationale for the inclusion of men and masculinity into multiculturalism as combining the
two areas has not been reported previously in the literature. Thus, the article will start
from a cultural and sociohistorical perspective and then move toward specific competen-
cies related to men. To draw a parallel between masculinity and multicultural competen-
cies, the study of Whiteness in multiculturalism will be used for illustration. Using
Whiteness as a framework for the integration of masculinity into multiculturalism shows
how understanding within-group differences is essential to multicultural competency. To
that end, this article will first provide an overview of multicultural competencies and
current guidelines. Second, this article will focus on the parallels between men’s issues
and gender socialization. Third, the article will address the intersection of race and gen-
der, and how the study of men of color is an important multicultural competency. Finally,
the article will use Sue et al., (1992) framework of multicultural competencies to illus-
trate some possible competencies for clinicians in working with men. Throughout the
article, people of color will be used to reference African, Asian, Latino, and Native
Americans, and the terms men and masculinity refer to the new psychology of men and
masculinity (Levant, 1996).
Men and Masculinity, Multicultural Competencies, and Professional Guidelines
Culture has been used interchangeably with race and ethnicity (Helms & Cook, 1999),
and tied to minority or people of color. Historically, multicultural competencies, and
multiculturalism, have focused on the sociopolitical histories and lived experiences of
people of color. The implication of this connection is that multicultural competency focuses
on developing an ability to work with racially ethnic individuals and groups and addresses
oppression and racism experienced by this group. But understanding the social networks
and relationships that reinforce inequality, oppression, privilege, and marginalization is
also an important part of being multiculturally competent (Liu & Pope-Davis, 2003).
Contextualizing therapy within the sociopolitical relationships, and the history of people
and groups, is an essential cornerstone of multiculturalism (i.e., the study of multicultural
issues in psychology) and multicultural competency (i.e., the development of clinical
proficiencies). The intent was to transform the practice and science of psychology to
better meet the needs of the racially ethnic minority individuals currently seeking mental
health services and to keep psychology relevant in the face of a rapidly changing demo-
graphic landscape (Hall, 1997; Liu & Pope-Davis, 2003; Rice, 2001; Sue, 1999; Vera &
Speight, 2003).
Addressing context, culture, and socialization allows multiculturalism to focus, not
only on minority group issues but also on dominant hegemonic concerns such as White-
ness (i.e., white supremacy) and masculinity. For instance, by spotlighting Whiteness,
multiculturalism assumes that White persons also have a race (Carter, 1995; Helms &
Cook, 1999) and experience socialization into a dominant worldview about race rela-
tions. But even though Whiteness has been integrated into multicultural competencies,
686 Journal of Clinical Psychology, June 2005
White experiences are not the same as people of color. Privilege, entitlement, and eco-
nomic advantage and opportunity are still afforded to the vast majority of Whites but not
people of color (Helms & Cook, 1999). Similarly, men have certain privileges and oppor-
tunities that women do not. Thus, whereas this article posits the need to incorporate men
and masculinity into the study of multiculturalism, the article does not mean to imply that
all cultural constructs and groups are the same.
That being said, some parallels can be drawn between men’s experiences with ther-
apy and people of color (Ridley & Kleiner, 2003; Sue, Ivey, & Pedersen, 1996; Sue &
Sue, 2003). For example, similarities across men and persons of color may be shame and
stigma associated with seeking mental health (Krugman, 1995; Sue & Sue, 2003), fear
that the clinician would not understand the client’s worldview or values (Coleman,
Wampold, & Casali, 1995; Rabinowitz & Cochran, 2002), and a general unfamiliarity
with how psychotherapy works, and the client’s role in therapy (Addis & Mahalik, 2003;
Helms & Cook, 1999). To address the client’s concerns, multicultural competencies encour-
age clinicians to address the potential cultural mistrust in the therapy dyad (Helms &
Cook, 1999), to self-disclose to develop the therapy alliance (Constantine & Kwan, 2003),
and to explain the roles and expectations of clinician and client, and to develop culturally
congruent interventions (Constantine, 2002; Sue & Sue, 2003). Multicultural compe-
tency bridges potential differences between the clinician and client to make therapy effec-
tive, to build a strong working alliance (Ahn & Wampold, 2001; Coleman et al., 1995;
Pope-Davis, Liu, Toporek, & Brittan, 2001), to be culturally sensitive in diagnosis, to
help the clinician be aware of how clients may articulate concerns of power and oppres-
sion, to help integrate these concerns into therapy, and to develop culturally congruent
interventions (Paniagua, 1998; Pope-Davis et al., 2002; Sue, 1999; Sue & Sue, 2003).
Similar interventions may be appropriate for men. Men may appreciate the clinician’s
willingness to discuss the process of therapy, to focus on specific objectives as a way to
develop credibility with the client, and for the clinician to talk about himself or herself as
a means to develop an alliance. Hence, being masculine-focused in therapy does not
mean that the male client wants to talk about masculinity concerns to the exclusion of his
presenting issues, but rather, the clinician should be sensitive to the needs and expecta-
tions of the man in therapy. Forcing masculinity issues in therapy may lead to impasses or
a rupture in the therapeutic alliance, which may be regarded, in this case, as a multicul-
tural therapy impasse because culture was the cause of the problem (Liu & Pope-Davis,
in press).
Essentially, cultural congruency cannot be assumed merely through racially ethnic
matching of the client and clinician; In brief, racial matching of client and clinician does
not guarantee that the therapist will understand the client’s worldview or agree with the
client’s value system. Rather, the research shows clients prefer a counselor who shares
similar worldviews and values or is able to understand the client’s worldview (Constan-
tine, 2002; Coleman et al., 1995; Paniagua, 1998). For instance, a male client may not be
best matched to a male therapist. If no evidence suggests that the male therapist is trained
to work with men and masculinity concerns, a female therapist may be equally effective.
The client may select a male therapist with the hope of increasing the probability that the
therapist and client will have similar values and worldviews.
Because training and education are the most important components in being a mul-
ticulturally competent therapist, recently, theAmerican Psychological Association (APA)
endorsed the Guidelines on Multicultural Education, Training, Research, Practice, and
Organizational Change for Psychologists, referred to as APA Guidelines (APA, 2003).
The APA Guidelines were established to help guide clinicians to be multiculturally com-
petent. In the six guidelines, psychologists are encouraged to recognize the “social, political,
Masculinity and Multicultural Competency 687
historical, and economic contexts” (APA, p. 377, 2003) that impact the lives of clients.
The six guidelines are supposed to help psychologists maintain relevance with an increas-
ingly diverse, racially and ethnically, clientele (Hall, 1997). Briefly, the six guidelines
suggest that psychologists should
1. be culturally aware of ones self and others,
2. recognize the importance of multiculturalism to work effectively with racially
different individuals,
3. use multiculturalism in psychological education,
4. be aware of culture in research,
5. use culturally appropriate skills in psychological practice, and
6. work to transform institutions and organizations to be culturally supportive (APA,
Although the APA Guidelines are written with a focus on race and ethnicity, the multi-
cultural competencies are supposed to be construed as an important consideration for
various cultural groups (e.g., gender and social class). Although each group is unique in
its sociopolitical histories and contexts, they all are similar in that each operates within a
social networks of power; they are all socially constructed; individuals experience dele-
terious effects from existing within these situations and socialization; and there is inter-
dependency between all the constructs (e.g., race, class, gender). Thus, clinicians need to
be aware of these multiple cultural contexts people exist within and be knowledgeable
about how to work effectively in therapy.
Gender and Multicultural Competency
The Construction of Race and Gender
The reasons for linking masculinity with race are to help draw parallels between the two
and to demonstrate how both are important multicultural competencies. Both are regarded
as socially constructed and, therefore, not static but malleable and changeable (Kimmel,
1994, 2001; Messner, 1997; Omi & Winant, 1994). How society defines masculinity and
race are also dependent on the sociopolitical history and era. As Kimmel (2001) notes, the
ideal masculine figure has changed in society and has ranged from an aristocratic arche-
type to the outdoorsman figure. Similarly, the meaning of race and which groups consti-
tute a racial category has changed over time (Omi & Winant, 1994), and the meaning tied
to a particular ethnicity has also fluctuated depending on society’s need. For instance,
Chinese were regarded as hostile aliens and targeted for immigration exclusion when the
economy of the 1800s pitted Whites against non-White workers, but during World War II,
the Chinese were the “good” Asians in comparison to the Japanese (Chan, 1991). The
instability of gender, as well as race, implies that there are ever-changing expectations
and demands on men. Consequently, there is no singular masculinity, but there are plural
masculinities, and men may encounter problems in living as a result of different expec-
tations and socialization experiences.
Both race and gender must address privilege and power. Just as men and women are
different, so are people of color and White people. For example, there was a period where
the incorporation of Whiteness as a multicultural competency was believed to divert
attention from concerns of racially ethnic peoples and the effects of racism. Whiteness
and White people were construed to be the same and homogenous. With the introduction
of White Racial Identity Theory (Carter, 1995; Helms & Cook, 1999), research showed
688 Journal of Clinical Psychology, June 2005
that racial identity attitudes varied among White people and that there were various forms
of Whiteness that ran the continuum from racist to racially accepting (Carter, 1995). The
study of Whiteness revealed how upbringing, early socialization messages, and peer influ-
ences contributed to White people’s racial identification, privilege, and feelings of enti-
tlement (Ancis & Szymanski, 2001; Helms & Cook, 1999). Understanding the contributing
factors contributing to racism lead to psychoeducational interventions to reduce racist
attitudes, challenged White clinicians to become aware of their racial attitudes, and exam-
ined ways in which White and non-White clinical dyads could work effectively together.
Similarly, the new psychology of men and masculinity does not merely examine
differences between men and women but attempts to understand the healthy and unhealthy
ways men are socialized, and critiques gender roles and expectations through a feminist
lens (Levant, 1996). Thus, including men and masculinity as a multicultural competency
may help clinicians to be aware of their own stereotypes, attributions, and expectations of
men; encourage clinicians to confront their own sexism, homophobia, and heterosexism;
and increase the development of interventions and strategies useful with men.
Including Masculinity Into Multicultural Competencies
In the multicultural competency literature, gender has been synonymous with women’s
and feminist issues (Bowman & King, 2003; Reid, 2002). Men generally have been
excluded from discussion. The reason for excluding men may be twofold. First, address-
ing women’s issues within the framework of oppressor–oppressed fit well with the early
multicultural literature that examined non-Whiteness as a form of difference and conse-
quently, marginalization. The research focused on dispelling the inference of non-
Whiteness as inferiority and encouraged clinicians to develop effective interventions,
reduce early terminations, and make therapy inviting through cultural competency. Sec-
ond, men were likely not studied in the same way that Whiteness was not considered a
cultural issue. The ubiquity of Whiteness made it a virtually invisible construct, similar to
masculinity (Kaufman, 1994). The position among early multiculturalists was that, because
we live in a White and male-dominated environment, persons of color have not been
studied extensively or appropriately (Sue & Sue, 2003), and, therefore, the research should
focus primarily on persons of color. But eventually, Whiteness was considered an integral
aspect of multiculturalism, as understanding the marginalization of persons of color could
not be fully comprehended without illuminating the role of White persons and identity.
One problem in suggesting that men and masculinity issues be considered a multi-
cultural competency is its automatic juxtaposition with women’s issues. The comparison
between men’s and women’s issues suggests a dynamic of powerful (i.e., men) versus
powerless (i.e., women). In this pairing, it is difficult to argue that men should be con-
sidered a minority group (Wilkinson, 1996), or a powerless group (Anderson & Acco-
mando, 2002; Kaufman, 1994). And because the criteria for success and power are
masculinized, women are invariably second-class citizens within this social framework,
and to argue otherwise would be seem polemical. Certainly, the intent of the article is not
to say men have the same experiences as women or that men should be considered an
oppressed group who are disadvantaged.
But men and masculinity should be studied as a multicultural issue, specifically
because of issues of power and privilege. Analogous to the incorporation of Whiteness in
multicultural competencies, clinicians need to be aware that the expectation for men to
pursue power comes at a price (Kaufman, 1994; Messner, 1997). Men experience traumas
as boys and adolescents as preparation for a life in pursuit of power and privilege, and
Masculinity and Multicultural Competency 689
consequently, they experience pain, powerlessness, isolation, and ill-health (Courtenay,
2000; Kaufman, 1994; Messner, 1997).
This article suggests that the structures used to induce masculine behavior, hetero-
sexism, patriarchy, homophobia, and sexism, to name a few, are not genetically or innately
male anymore than racism is innately White, but rather these are socialized attitudes and
behaviors men adopt to remain congruent with the expectations of society (Pleck, 1981).
Some multiculturalists may argue this point. But the study of men and masculinity shows
that, whereas men may often benefit from these oppressions, masculinity also has some
psychological and relationship price. Finding healthy ways of relating and undoing net-
works of power and oppression not only benefit women but men as well.
Men of Color
One area where masculinity is considered a multicultural competency is when it inter-
sects with race (McCarthy & Holiday, 2004). Epidemiological and psychological research
suggest that for many racially ethnic minority men (men of color), they are in peril. Poor
health, physical and mental, incarceration rates, domestic violence (Vandello & Cohen,
2003), and drug and alcohol abuse have been found at high rates among men of color
(Clark, Anderson, Clark, & Williams, 1999; White & Cones, 1999). Attitudes toward
masculinity (Levant et al., 2003) and women and domestic violence also vary from cul-
ture to culture (Vandello & Cohen, 2003). Further, many men of color also have poor
experiences in the mental health system (Wade, 1993). They may be overdiagnosed with
some pathology (e.g., antisocial personality) while underdiagnosed for others (e.g., adjust-
ment disorders) (Wade, 1993; White & Cones, 1999).
Moreover, developing research has focused on men of color from various racial
groups. For example, research has focused on Asian-American men and addressed issues
such as acculturation, racial identity, and the use of support groups (Chang & Yeh, 2003;
Chang, Yeh, & Krumboltz, 2001; Kim, O’Neil, & Owen, 1996; Liu, 2002a). Among
Latino men, research has focused on machismo and acculturation (Abreau, Goodyear,
Campos, & Newcomb, 2000; Fragoso & Kashubeck, 2000). And with African-American
men, there are foci on racial identity, the important role of breadwinner, and self-concept
and achievement (Diemer, 2002; Mizell, 1999; Wade, 1996). Problematically, virtually
no research has focused on Native American men in psychology (e.g., acculturation,
racial identity) except for an abundance of research related to substance abuse (e.g.,
Kasprow & Rosenheck 1998). There is also a growing research literature that has explored
the multiple intersections of race, gender, and sexual orientation (Eng & Hom, 1998;
Wilson & Miller, 2002) and how these negotiate homophobia and heterosexism (Nayak
& Kehily, 1996), and social class and classism (Liu, 2002b; Pyke, 1996).
Understanding the available research on men of color is important when developing
culturally appropriate interventions. Using African-American men as an example, research
has suggested that African-American men may use their racial identity, religious orien-
tation, and cultural heritage to cope and negotiate a racist environment. The clinician can
help African-American men to develop a critical consciousness of their situation that
allows them to understand their environment and to develop strategies to thrive (Watts,
Abdul-Adil, & Pratt, 2002). Learning to discuss race and racism may help clinicians
reduce cultural mistrust in the therapy dyad and increase African-American men’s posi-
tive attitudes toward therapy (Duncan, 2003). Further, clinicians should also be aware of
the different ways AfricanAmericans may present themselves in public. For instance, the
“cool pose” (Majors & Billson, 1992) suggests that some African-American men, even in
the face of racism, may present themselves as unbothered and stoic. Clinicians unaware
690 Journal of Clinical Psychology, June 2005
of this cultural presentation by some African-American men may perceive this behavior
as pathological or not adaptive and, therefore, dysfunctional. Yet, for someone who is
multiculturally competent in working with African-American men, this person may under-
stand the client’s behavior as survival-based and regard the stoicism as a way to limit
vulnerability in a hostile situation, and therefore functional and adaptive.
Treating White men as raced and gendered is also important. Knowing that White
men also experience the dual pressures and socialization of masculinity and race may
help clinicians develop better interventions. For example, Robinson and Schwartz’s (2004)
research showed that White men who limit their expression of affection for other men and
focus on success, power, and competition, components of Gender Role Conflict (O’Neil
& Egan, 1992), are likely to have negative attitudes toward African Americans. Thus,
White men who have difficulty connecting with other men and who regard other men as
competitors are likely to also endorse racist attitudes toward African Americans ( Robin-
son & Schwartz, 2004). Knowing this result may help a psychologist connect with an
overly ambitious man by empathizing with his worldview and helping the client under-
stand that the clinician is not a competitor. The clinician may also then introduce inter-
ventions that help address the client’s potential negative attitudes toward racially ethnic
minority peoples, once the therapist and client develop a strong working alliance and
Currently, much of the research and theory on men and masculinity is based on the
lives and worldview of White men (Good et al., 1994). Yet, as the research suggests, there
is growing interest in theoretical and research work on men of color. But simultaneously
there should be additional research on White men as raced and gendered persons and a
better understanding of how these two cultural constructs interact. From research and
theoretical work, clinicians may be better able to develop culturally congruent therapy
interventions and strategies and create better working alliances.
Multicultural Competencies in Working With Men
Theoretically, it may make sense to include men and masculinity as a multicultural com-
petency. Masculinity is socially constructed similar to race. For instance, men share sim-
ilar privileges to that of Whiteness, and sexism, homophobia, and heterosexism are used
similar to racism to remind people of their roles, positions in society, and to perpetuate
privilege and power. But in developing and adapting clinical services and interventions to
meet the needs of men, what is specifically asked of the clinician (Sue et al., 1996)? To
demonstrate some potential competencies clinicians need to develop when working with
men, the Sue et al. (1992) framework of multicultural competencies will be used. In this
framework, there are three general domains of competencies: (a) clinician’s awareness of
own assumptions, values, and biases; (b) understanding the worldview of the client; and
(c) developing appropriate interventions and strategies. Within each of these domains are
three sub-categories of competencies: knowledge (i.e., factual information or what the
psychologist understands), awareness (i.e., self and other sensitivity and consciousness
or what the psychologist is aware of ), and skills (i.e., demonstrable proficiency or what
the psychologist can show as an integration of his/her knowledge and awareness). The
Sue et al. (1992) multicultural competency framework is the most widely accepted and
adapted model used for training, supervision, and teaching (Pope-Davis, Coleman, Liu,
& Toporek, 2003). Using this framework, some potential multicultural competencies cli-
nicians must develop to work effectively with men will be provided. The components of
multicultural competency around men are based on the available research and theoretical
work on men and therapy and are not intended to be exhaustive but only illustrative.
Masculinity and Multicultural Competency 691
Psychologists’ Awareness of His/Her Assumptions, Values, and Biases
Knowledge. The psychologist understands his/her bias that psychological well-
being is conceptualized as masculine, and mental illness is often synonymous with fem-
ininity (Broverman, Broverman, Clarkson, Rosenkrantz, & Vogel, 1970). Psychologists
understand that dismissing male behavior as boys will be boys minimizes sexism, hetero-
sexism, and homophobic attitudes and behaviors, and reinforces gender inequality (Kim-
mel, 2001).
Awareness. The psychologist is aware of his/her stereotypes of typical and tradi-
tional masculine behavior and attitudes and recognizes them as a part of the client’s
socialization and, therefore, not innate. The psychologist is aware that, whereas a man
may present overtly as healthy with nothing bothering him, he may in fact be experienc-
ing tremendous pain, depression, anxiety, and stress. Similarly, the psychologist is aware
that men’s ways of being are sometimes associated with poor health (Courtenay, 2000).
Skill. If a man prefers not to show emotions or has difficulty labeling his affective
state, he may not be resistance to therapy but, instead, may be reflecting his masculine
socialization, and the psychologist will find ways not to induce shame on the man for
his behavior (e.g., Krugman, 1995; Levant, 1998; Levant et al., 2003). The psychologist
does not minimize health complaints and problems as tertiary to the presenting issues
for men but rather assesses for health complaints as a way to understand the man’s world
(Courtenay, 2000).
Example. The author established clinical services at a local shelter for the homeless
and provided brief supportive therapy to men who are homeless and living at the tempo-
rary shelter. The men in the shelter presented themselves as stoic, cool, and silent, and
nonemotional—generally, at first impression, poor candidates for therapy. When approach-
ing all the men and suggesting that they come in and speak with the psychologist, the
author framed therapy as a time to “just talk and work things out.” Men who come to
therapy are quite and stoic initially, but frequently are very articulate and insightful about
their current circumstances. They understand why they are in the shelter, and what they
need to do to move out of the shelter. The author needed to confront his own bias and
assumption that the men in the shelter were poor clients for therapy, were inexpressive,
and not insightful.
Understanding the Worldview of the Client
Knowledge. The psychologist understands that men experience traumatic socializa-
tion experiences growing up, and these experiences reinforce traditional masculine behav-
iors and attitudes such as heterosexism, sexism, and homophobia (Addis & Mahalik,
2003; Good et al., 1994; Levant, 1996). The psychologist understands that the client may
experience conflicts associated with living up to, trying to live up to, or failing to live up
to the dominant society’s expectations of him as a man (Pleck, 1981).
Awareness. The psychologist is aware that men may feel ashamed and disempow-
ered in therapy because seeking help is a violation of their role as an independent and
self-sufficient person. Moreover, psychologists are aware that the worldview of a college-
age man is likely to be different from a middle-age man, and thus, interventions need to
be sensitive to age and gender (Cournoyer & Mahalik, 1995; O’Neil & Egan, 1992). The
692 Journal of Clinical Psychology, June 2005
psychologist is aware that not all men cry because of sadness, but that men who adhere to
traditional sex roles are less likely to cry than nontraditional men (Ross & Mirowsky,
Skill. The psychologist is able to empathize with the male client’s traumatic social-
ization experiences. For some men of color, the psychologist is able to develop a healthy
working alliance and is able to decrease the level of cultural mistrust associated with
working with a White therapist (Duncan, 2003; Whaley, 2001).
Example. Following the men in the homeless shelter, the author understands that the
men are experiencing a salient loss to their masculine role, that of breadwinner (Liu,
2002b). The men are experiencing a simultaneous social class and masculinity conflict.
The author, in his brief therapy with the men understands their experiences through this
dual cultural lens. He allows and encourages the men to talk freely about, without shame,
and with some humor about canning (recovering aluminum cans for recycling) or dump-
ster diving for food. He attends to the deference many of the men show to those in
authority and works constantly in session for an egalitarian relationship.
Developing Culturally Appropriate Interventions and Strategies
Knowledge. The psychologist has immersed him/herself in the literature of the new
psychology of men and has developed an understanding of men’s biases, needs, and
expectations in therapy. The psychologist has begun supervised, clinical training with
men specifically and used male-centered treatment methods (Brooks, 1998; Rabinowitz
& Cochran, 2002).
Awareness. The psychologist is aware that there are masculinities and not just one
form of masculinity. The psychologist has an awareness of the current models of therapy
when working with men and is flexible in using interventions and strategies (Brooks,
1998; Chang et al., 2001; Kiselica, 2003; Rabinowitz & Cochran, 2002). The psycholo-
gist is aware that self-disclosure may help the client become familiar with the therapist
and build the therapy alliance. The psychologist is aware of the positive effects group
therapy may have on men (Andronico, 1999; Brooks, 1998).
Skill. The psychologist discusses developmentally and culturally relevant material
such as anger or rage, alienation, respect, and the path from adolescence to adulthood
among African-American adolescents in therapy to help build the therapy alliance (Jackson-
Gilfort, Liddle, Tejeda, & Dakof, 2001). Psychologists help men work constructively and
effectively together in group therapy and know that men benefit greatly from the resocial-
ization that may occur within these settings (Kiselica, 2003; Rabinowitz & Cochran,
2002; Richmond & Levant, 2003). The psychologist is willing to allow the male client to
express his emotional experiences in masculine-congruent ways such as twisting a towel
or moving around the therapist’s office (Rabinowitz & Cochran, 2002).
Example. Many of the men in the shelter experience invisibility in their everyday
life. They are not addressed or spoken to by others. Aculturally congruent intervention in
this case is simple, to say hello to everyone and to offer a handshake. The author focuses
on addressing all the men as Mr. rather than a familiar first name. The purpose of the
intervention and strategy is to break the cycle of invisibility the men experience daily and
to address them in a manner congruent with other men.
Masculinity and Multicultural Competency 693
The competencies illustrated in the Sue et al. (1992) framework are examples of
possible multicultural competencies clinicians need to master to work effectively with
men. The competencies suggest that it is not enough to be just a good and proficient
clinician but that being culturally competent is additive to the clinician’s ability to work
effectively with a male client. Certainly the list is not exhaustive but only demonstrates
the possibility of conceptualizing men and masculinity issues as a multicultural compe-
tency. And, much like any other multicultural competency, it is a challenging, but neces-
sary, aspect of effective clinical practice.
The inclusion of men and masculinity issues in multicultural competency allows clini-
cians to understand fully their male clients as multicultural persons. Similar to persons of
color and women, men also experience socialization that forces them into strict roles and
behaviors for which there are consequences. Psychologists wanting to work in a cultur-
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... 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. ...
Recognition of the importance of mental health practitioners’ enactment of ‘gender competency’ when working with men is growing. This article describes the development and theoretical background to a novel online training program for practitioners, called Men in Mind. The training focuses on men’s gender socialization, engaging male clients in therapy, and responding effectively to men’s depression and suicidality. The content of the training was derived from a comprehensive review of available literature, structured into modules with measurable learning outcomes via learning design principles. The training employed a range of andragogic principles and tools (e.g., character vignettes, reflective exercises). Plans for evaluation via a controlled trial, alongside scaling, and implementation are described.
... The concerns that bring men to therapy and the interpersonal processes that occur in single-gender groups of men may be gender-specific. While counseling men in single-gender group settings can be effective (Rabinowitz, 2005), Liu (2005) stresses how "working effectively with men means an awareness of masculine cultural values and the clinician's understanding of his/her own assumptions and biases about men" (p. 686). ...
Full-text available
This article addresses some of the group psychotherapy process issues involved in treating an ethno-religiously homogeneous population of Orthodox Jewish men using a case-study approach. The single-gender group, which consisted of two coleaders from the same community, occurred in a mental health clinic in Jerusalem, Israel. Eight community members attended the weekly 1.5-hour psychodynamic group meetings for a period of 5 years. Examples from those encounters illustrate three important concerns when working with a homogeneous religious group: (a) contagion and amplification of resistance to discussing taboo subjects based on religious principles; (b) indirect communication and the use of first-person plural pronouns and cliches; and (c) the shame and loneliness associated with nonconformity to religious and cultural expectations. Suggestions for clinical practice are provided based on the case study and existing literature about homogeneous groups in group psychotherapy and the treatment of Orthodox Jews.
... Among such strategies is assessing how a man's masculine roles, relations, and identities, in all their depth and diversity, inform and influence his conceptualization of his distress, disclosure of such distress, and reception to others who offer help. 28 ...
Objective: Men can be reluctant to disclose distress and many men have ambivalence toward seeking help for depression, leading to poor uptake of and engagement in psychotherapy. The present study sought to explore whether a previously dissatisfying therapy experience leads to greater doubts about the effectiveness of treatment, in turn impacting on a man's willingness to disclose their distress in future. Method: An online survey of 133 Canadian men was conducted to investigate their current depressive symptoms, previous experience of, and belief in, the effectiveness of psychotherapy and likelihood of disclosing distress to their physician. A regression model with mediation was employed to analyze the relationship between these responses. Results: The regression model highlighted a significant negative association between satisfaction with previous therapy and doubt about the effectiveness of therapy (t = -7.299, 99% confidence interval [-.537, -.254], p < .001). There was also a significant indirect effect, such that doubt about the effectiveness of therapy mediated the association between previous satisfaction and willingness to disclose distress to a physician (t = 3.748, 99% confidence interval [.123, .690], p < .001). Conclusions: Providing treatment for depression that men find engaging and satisfying may improve their confidence that psychotherapy can help, make them more likely to reach out for assistance in the future and in turn, benefit their long-term mental health outcomes.
... Boys and men are also likely to self-express differently (Kelly & Hall, 1992), including with greater use of humor that forges relational closeness (Rose, Smith, Glick, & Schwartz-Mette, 2016). Liu (2005) suggested that failing to treat a client within their conceptualization of masculinity is a reflection of multicultural incompetence. If a clinician assumes a male client is toxically masculine, could beneficial, gender-sensitive treatments (i.e., problem-solving, solution-focused, and integrity/ meaning-oriented) be overlooked? ...
Full-text available
Ideological bias is a worsening but often neglected concern for social and psychological sciences, affecting a range of professional activities and relationships, from self‐reported willingness to discriminate to the promotion of ideologically saturated and scientifically questionable research constructs. Though clinical psychologists co‐produce and apply social psychological research, little is known about its impact on the profession of clinical psychology. Following a brief review of relevant topics, such as “concept creep” and the significance of the psychotherapeutic relationship, the relevance of ideological bias to clinical psychology, counterarguments and a rebuttal, clinical applications, and potential solutions are presented. For providing empathic and multiculturally competent clinical services, in accordance with professional ethics, psychologists would benefit from treating ideological diversity as another professionally recognized diversity area.
... Those who deviate from the narrow window of socially acceptable masculine behaviors are penalized and regarded as less manly (Vandello et al., 2008). Research supports a person-centered perspective (Wong, Owen, & Shea, 2012) to understanding masculinity, which proposes that masculinity "norms" are constructed upon White men's experiences and may therefore differentially influence men of diverse racial backgrounds (Liu, 2005; see also Griffith & Cornish, 2018;Lu & Wong, 2013). White men in predominantly or historically White social environments may feel particularly vulnerable to masculinity threats and may vigilantly monitor their status as "real [White] men" in these arenas. ...
... The importance of diversity in counseling psychology programs is well-documented (American Psychological Association, 2017; Campbell et al., 2012;Fouad et al., 2009;Fuertes, Spokane, & Holloway, 2013;Mintz & Bieschke, 2009;Packard, 2009; Society for the Psychological Study of Men and Masculinities, 2019). Given that the psychology of men is rarely taught at either undergraduate or graduate levels (O'Neil & Renzulli, 2013), including multicultural counseling courses (Liu, 2005), research suggests that attaining adequate knowledge of men's gender role socialization processes, and acquiring skill in clinical work with males, have important implications for psychological practice with boys (Bruchmüller, Margraf, & Schneider, 2012) and men (Mahalik et al., 2012). Counseling programs offer limited training in men's issues and have relatively no training in men's health-related issues. ...
... This study's findings regarding the role of gender in the context of intersecting multiracial identities as they related to health disparities and health outcomes are critical. Given that the psychology of men is rarely taught at either undergraduate or graduate levels (O'Neil & Renzulli, 2013), including multicultural counseling courses (Liu, 2005), research suggests that attaining adequate knowledge of men's gender role socialization processes, and acquiring skill in clinical work with males, have important implications for psychological practice with boys (Bruchmüller, Margraf, & Schneider, 2012) and men (Mahalik, Good, Tager, Levant, & Mackowiak, 2012). The implications for practice and research that have been noted are of importance to counseling psychology trainees as they enter practicum, internship, and careers as early psychologists. ...
Few counseling and psychological interventions are designed specifically to reduce men’s health risk behaviors (Courtenay, 2011). Socialized identity processes contribute to relational, psychological, and behavioral health outcomes in both negative and positive ways Variables of “positive masculinity” (e.g., responsibility, leadership, generativity, stoicism, strength, and self-efficacy) are linked to health outcomes, which may explain gender-socialized patterns of behavior and their complex relationships to health (Bonhomme, 2007; Levant & Wimer, 2014). Self-compassion and self-efficacy play significant roles in health outcomes and positive health behaviors (e.g., Sirois, Kitner, & Hirsch, 2015), although few researchers have examined the impact traditional masculine gender role ideologies may have on these two constructs. Based on the Self-Regulation Resource Model (SRRM; Sirois, 2015), the present study examined self-efficacy and self-compassion as mediators that further explain how men’s levels of gender role conflict may subsequently influence diabetes-related health outcome variables (e.g., diabetes self-management, diabetes distress, and glucose control) in a population of men with either type 1 or type 2 diabetes. A quantitative, cross-sectional, survey study administered questionnaires to 146 men > 17 years of age diagnosed with either type 1 or type 2 diabetes for > six months. Participants completed the Gender Role Conflict Scale (GRCS), the Diabetes Self-Management Questionnaire (DSMQ), the Diabetes Distress Scale (DDS), the Self-Compassion Scale (SCS), the General Self-Efficacy Scale (GSES), and a measure of HbA1C. Using the causal step approach (Baron & Kenny, 1986) and bias-corrected bootstrapping (Hayes, 2013), multiple regression analyses found that gender role conflict correlated with measures of diabetes self-care and diabetes distress and that self-compassion mediated the relationship between GRC and diabetes-related health outcomes. These results have clinical implications for treating the behavioral and psychological components of men’s diabetes management, including fostering self-compassion and enhancing self-efficacy. A broader discourse within social contexts emerges for practitioners on how to balance accentuating the positive and functional aspects of masculinity, while deconstructing masculine role norms that demonstrate barriers to health management. Further research is necessary to support the causal inferences of this study’s findings and to develop targeted diabetes-specific and pro-masculine health interventions for boys and men.
... This serves as a reminder that while general male-friendly recommendations provide a helpful starting place, it is important to recognize and consider nuances and variations between men's lived experiences, social identities and contexts, gender norms, and individual histories and values. This position aligns with cautions about failing to account for the diversity of masculinities between men and in men ( Liu, 2005) and recognizes the multiplicity of masculinities in a culturally and generationally diverse nation (Moore & Crotty, 2007). ...
Many of the contemporary treatment recommendations and guides for adapting therapy for men originates from the context of the United States. This qualitative study invited 15 Australian therapists, who advertised themselves as working with men, to describe their recommendations for male-friendly counseling. Three themes and 14 subthemes were identified, each explained from an understanding of their male client group’s experiences and common male norms. The themes included ensuring a safe space, to enact masculinity-informed respect, and to enhance client awareness and motivation. Therapists’ suggestions for working with Australian men were congruent with recommendations in the existing literature; however, variations were noted in how traditionally masculine or feminine-consistent their emphasis was.
The present study tested the mediating effects of fathers’ violence on the relationships among Korean young adults’ perceptions of their fathers’ gender role conflict, the quality of their relationships with their fathers, and depressive symptoms. Three hundred fifty six Korean university students in South Korea participated in the study. The hypothesized model was tested by using structural equation modelling. Results indicated fathers’ violence fully mediated the relationship between fathers’ perceived gender role conflict for Success, Power and Competition and paternal relationship quality, and partially mediated the relationship between fathers’ perceived Restrictive Emotionality and paternal relationship quality. Fathers’ perceived Restrictive Emotionality was also associated with their own depressive symptoms. Results were contextualized within dynamics of South Korean society and culture.
Religion, Spirituality, and Masculinity provides concrete, practical suggestions for mental health professionals. Drawing from decades of clinical experience working with men and interdisciplinary insights from psychology, sociology, religion, and more, the authors explore some of the most salient aspects of men’s mental and spiritual health. Chapters focus on topics such as men’s relationships to religion and to masculinity, shame, and forgiveness, and concerns such as pornography use and drifting between religious affiliations. In addition to relevant theory and research, each chapter includes a case study and clear, science-informed strategies that can be incorporated into everyday practice in ways that improve men’s health and wellbeing.
Omi and Winant examine the creation and negotiation of race's role in identify construction, contestation, and deconstruction. Since no biological basis exists for the signification of racial differences, the authors discuss racial hierarchies in terms of a "racial formation," which is a process by which racial categories are created, accepted, altered, or destroyed. This theory assumes that society contains various racial projects to which all people are subjected. The role that race plays in social stratification secures its place as a political phenomenon in the United States. This stratification is tantamount to what Omi and Winant call "racial dictatorship," which has three effects. First, the identity "American" is conflated with the racial identity "white." Second, the "color line" becomes a fundamental division in American society. Finally, oppositional racial consciousness became consolidated in opposition to racial dictatorship.
Review of book: Men in Groups: Insights, Interventions, and Psychoeducational Work, Michael P. Andronico (Ed.), 1996, Washington DC: American Psychological Association, 410 pp. Reviewed by Christopher T. Kilmartin.
Much of the multicultural counseling research has pointed out the need for counselors to become culturally competent to appropriately address the needs of an emerging diverse community. To date, however, this body of research has largely focused on counselor competencies, with little attention being given to the client perspective of multicultural counseling competencies. This article discusses the importance of integrating the client perspective within the historical context of the multicultural literature by examining client preferences and expectations, as well as the adequacy of the current empirical data. The authors also raise the issue of politics inherent in multiculturalism and discuss how this affects the research. A number of recommendations are made as a guide for future research.
A meta-analysis of studies that assessed ethnic minorities' perceptions of and preferences for ethnically similar counselors and European American counselors showed that ethnic minorities tended to prefer ethnically similar counselors over European American counselors. However, the perceptions of and preferences for counselors were influenced by the cultural affiliation of the participants and the research methods used. More precise methods for determining the degree to which ethnic minorities' preferences for ethnically similar counselors is a function of inferences concerning attitudes, values, and skill needs to be developed.
Conference Paper
When a man loses the ability to be the "breadwinner," what types of conflicts does he experience? More important, how can counselors understand the full depth of his concerns if social class is not explored? However, the extant literature on social class and counseling applications is meager. Hence, the author explains the social class worldview model and modem classism theory as frameworks to understand subjective social class experiences. Although the models are theoretical, the author provides case vignettes to illustrate how clinicians can gather and interpret social class information and integrate it into client profiles and treatment.
The construct of multicultural competence has gained much currency in the counseling psychology literature. This article provides a critique of the multicultural counseling competencies and argues that counseling psychology's operationalization of multicultural competence must be grounded in a commitment to social justice. Such a commitment necessitates an expansion of our professional activities beyond counseling and psychotherapy While counseling is one way to provide services to clients from oppressed groups, it is limited in its ability to foster social change. Engaging in advocacy, prevention, and outreach is critical to social justice efforts, as is grounding teaching and research in collaborative and social action processes.
Various authors have noted that interethnic group and intraethnic group racism are significant stressors for many African Americans. As such, intergroup and intragroup racism may play a role in the high rates of morbidity and mortality in this population. Yet, although scientific examinations of the effects of stress have proliferated, few researchers have explored the psychological, social, and physiological effects of perceived racism among African Americans. The purpose of this article was to outline a biopsychosocial model for perceived racism as a guide for future research. The first section of this article provides a brief overview of how racism has been conceptualized in the scientific literature. The second section reviews research exploring the existence of intergroup and intragroup racism. A contextual model for systematic studies of the biopsychosocial effects of perceived racism is then presented, along with recommendations for future research.
This study examined gender role conflict in college-aged and middle-aged men. Eighty-eight college-aged men and 89 middle-aged men completed 5 measures that assess gender role conflict and psychological well-being. Multivariate analysis of variance results indicated that, compared with college-aged men, middle-aged men were less conflicted about success, power, and competition, but were more conflicted between work and family responsibilities. Canonical analysis indicated two significant roots between (a) gender role conflict and psychological well-being and (b) age group, gender role conflict, and psychological well-being. The discussion focuses on implications for counseling, limitations, and future research.