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The Study of Men and Masculinity as an Important
Multicultural Competency Consideration
䊲
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:
william-liu@uiowa.edu
JOURNAL OF CLINICAL PSYCHOLOGY, Vol. 61(6), 685–697 (2005) © 2005 Wiley Periodicals, Inc.
Published online in Wiley InterScience (www.interscience.wiley.com). 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,
2003).
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
trust.
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,
1984).
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.
Conclusions
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-
ally congruent manner and to develop appropriate interventions need to immerse them-
selves into the theoretical and research literature on men and to receive clinical supervision
for masculine-centered therapy. By becoming multiculturally competent in therapy, men
may seek out therapy and find therapy effective and beneficial.
References
Abreau, J.M., Goodyear, R.K., Campos, A., & Newcomb, M.D. (2000). Ethnic belonging and
traditional masculinity ideology among African Americans, European Americans, and Lati-
nos. Psychology of Men and Masculinity, 1, 75–86.
Addis, M.E., & Mahalik, J.R. (2003). Men, masculinity, and the contexts of help seeking.American
Psychologists, 58, 5–14.
Ahn, H., & Wampold, B.E. (2001). Where oh where are the specific ingredients? Ameta-analysis of
component studies in counseling and psychotherapy. Journal of Counseling Psychology, 48,
251–257.
American Psychological Association. (2003). Guidelines on multicultural education, training, research,
practice, and organizational change for psychologists. American Psychologist, 58, 377– 402.
Ancis, J.R., & Szymanski, D.M. (2001). Awareness of white privilege among white counseling
trainees. The Counseling Psychologist, 29, 548–569.
Anderson, K.J., & Accomando, C. (2002). “Real” boys? Manufacturing masculinity and erasing
privilege in popular books on raising boys. Feminism & Psychology, 12, 491–516.
Andronico, M.P. (Ed.). (1999). Men in groups: Insights, interventions, and psychoeductional work.
Washington, DC: American Psychological Association.
Bowman, S.L., & King, K.D. (2003). Gender, feminism, and multicultural competencies. In D.B.
Pope-Davis, H.L.K. Coleman, W.M. Liu, & R.L. Toporek (Eds.), Handbook of multicultural
competencies in counseling and psychology (pp. 59–71). Thousand Oaks, CA: Sage.
Brooks, G. (1998). A new psychotherapy for traditional men. San Francisco: Jossey-Bass.
Broverman, I.K., Broverman, D.M., Clarkson, F.E., Rosenkrantz, P.S., & Vogel, S.R. (1970). Sex-
role stereotypes and clinical judgments of mental health. Journal of Consulting and Clinical
Psychology, 34, 1–7.
Carter, R.T. (1995). The influence of race and racial identity in psychotherapy: Toward a racially
inclusive model. New York: John Wiley.
Chan, S. (1991). Asian Americans: An interpretive history. Boston: Twayne.
Chang, T., & Yeh, C.J. (2003). Using online groups to provide support to Asian American men:
Racial, cultural, gender, and treatment issues. Professional Psychology: Research and Prac-
tice, 34, 634– 643.
694 Journal of Clinical Psychology, June 2005
Chang, T., Yeh, C.J., & Krumboltz, J.D. (2001). Process and outcome evaluation of an on-line
support group for Asian American male college students. Journal of Counseling Psychology,
48, 319–329.
Clark, R., Anderson, N.B., Clark, R., & Williams, D.R. (1999). Racism as a stressor for African
Americans: A biopsychosocial model. American Psychologist, 54, 805–816.
Coleman, H.L.K., Wampold, B.E., & Casali, S.L. (1995). Ethnic minorities’ ratings of ethnically
similar and European American counselors: A meta-analysis. Journal of Counseling Psychol-
ogy, 42, 55–64.
Constantine, M.G. (2002). Predictors of satisfaction with counseling: Racial and ethnic minority
clients’ attitudes toward counseling and ratings of their counselors’ general and multicultural
counseling competence. Journal of Counseling Psychology, 49, 255–263.
Constantine, M.G., & Kwan, K.L.K. (2003). Cross-cultural considerations of therapist self-
disclosure. Journal of Clinical Psychology, 59, 581–588.
Cournoyer, R.J., & Mahalik, J.R. (1995). Cross-sectional study of gender role conflict examining
college-aged and middle-aged men. Journal of Counseling Psychology, 42, 11–19.
Courtenay, W.H. (2000). Constructions of masculinity and their influence on men’s well-being: A
theory of gender and health. Social Science and Medicine, 50, 1385–1401.
Diemer, M.A. (2002). Constructions of provider role identity among African American men: An
exploratory study. Cultural Diversity and Ethnic Minority Psychology, 8, 30– 40.
Duncan, L.E. (2003). Black male college students’ attitudes toward seeking psychological help.
Journal of Black Psychology, 29, 68–86.
Eng, D.L., & Hom, A.Y. (Eds.). (1998). Queer in Asian America. Philadelphia: Temple University
Press.
Fragoso, J.M., & Kashubeck, S. (2000). Machismo, gender role conflict, and mental health in
Mexican American men. Psychology of Men and Masculinity, 1, 87–97.
Good, G.E., Borst, T.S., & Wallace, D.L. (1994). Masculinity research: A review and critique.
Applied and Preventative Psychology, 3, 3–14.
Hall, C.C.I. (1997). Cultural malpractice: The growing obsolescence of psychology with the chang-
ing U.S. population. American Psychologist, 52, 642–651.
Helms, J.E., & Cook, D.A. (1999). Using race and culture in counseling and psychotherapy: Theory
and process. Needham Heights, MA: Allyn & Bacon.
Jackson-Gilfort, A., Liddle, H.A., Tejeda, M.J., & Dakof, G.A. (2001). Facilitating engagement of
African American male adolescents in family therapy: A cultural theme process study. Journal
of Black Psychology, 27, 321–340.
Kasprow, W.J., & Rosenheck, R. (1998). Substance use and psychiatric problems of homeless
Native American veterans. Psychiatric Services, 49, 345–350.
Kaufman, M. (1994). Men, feminism, and men’s contradictory experiences of power. In H. Brod &
M. Kaufman (Eds.), Theorizing masculinities (pp. 142–163). Thousand Oaks, CA: Sage.
Kim, E.J., O’Neil, J.M., & Owen, S.V. (1996). Asian-American men’s acculturation and gender-role
conflict. Psychological Reports, 79, 95–104.
Kimmel, M.S. (1994). Masculinity as homophobia: Fear, shame, and silence in the construction of
gender identity. In H. Brod & M. Kaufman (Eds.), Theorizing masculinities (pp. 119–141).
Thousand Oaks, CA: Sage.
Kimmel, M.S. (2001). The gendered society. New York: Oxford University Press.
Kiselica, M.S. (2003). Transforming psychotherapy in order to succeed with adolescent boys: Male-
friendly practices. Journal of Clinical Psychology, 59, 1225–1236.
Krugman, S. (1995). Male development and the transformation of shame. In R.F. Levant & W.S.
Pollack (Eds.), A new psychology of men (pp. 91–128). New York: Basic Books.
Levant, R.F. (1996). A new psychology of men. Professional Psychology: Research and Practice,
27, 259–265.
Masculinity and Multicultural Competency 695
Levant, R.F. (1998). Desperately seeking language: Understanding, assessing, and treating norma-
tive male alexithymia. In W.S. Pollack & R.F. Levant (Eds.), New psychotherapy for men
(pp. 35–56). New York: John Wiley.
Levant, R.F., Richmond, K., Majors, R.G., Inclan, J.E., Rossello, J.M., Heesacker, M., et al. (2003).
A multicultural investigation of masculine ideology and alexithymia. Psychology of Men and
Masculinity, 4, 91–99.
Liu, W.M. (2002a). Exploring the lives of Asian American men: Racial identity, male role
norms, gender role conflict, and prejudicial attitudes. Psychology of Men and Masculinity, 3,
107–118.
Liu, W.M. (2002b). The social class-related experiences of men: Integrating theory and practice.
Professional Psychology: Research and Practice, 33, 355–360.
Liu, W.M., & Pope-Davis, D.B. (2005). The working alliance, therapy ruptures and impasses, and
counseling competencies: Implications for counselor training and education. In R.T. Carter
(Ed.), Handbook of racial-cultural psychology and counseling ( Vol. 2, pp. 148–167). New
York: John Wiley and Sons.
Liu, W.M., & Pope-Davis, D.B. (2003). Moving from diversity to multiculturalism: Exploring
power and its implications for multicultural competence. In D.B. Pope-Davis, H.L.K. Cole-
man, W.M. Liu, & R.L. Toporek (Eds.), Handbook of multicultural competencies in counsel-
ing and psychology (pp. 90 –102). Thousand Oaks, CA: Sage.
Majors, R., & Billson, J.M. (1992). Cool pose: The dilemmas of Black manhood in America. New
York: Lexington Books.
McCarthy, J., & Holliday, E.L. (2004). Help-seeking and counseling within a traditional male
gender role: An examination from a multicultural perspective. Journal of Counseling and
Development, 82, 25–30.
McQueen, C., & Henwood, K. (2002). Young men in “crisis”: Attending to the language of teenage
boys’ distress. Social Science and Medicine, 55, 1493–1509.
Messner, M.A. (1997). Politics of masculinities: Men in movements. Thousand Oaks, CA: Sage.
Mizell, C.A. (1999). African American men’s personal sense of mastery: The consequences of the
adolescent environment, self-concept, and adult achievement. Journal of Black Psychology,
25, 210–230.
Moller-Leimkuhler, A.M. (2002). Barriers to help-seeking by men: A review of sociocultural and
clinical literature with particular reference to depression. Journal of Affective Disorders, 71,
1–9.
Nayak, A., & Kehily, M.J. (1996). Playing it straight: Masculinities, homophobias and schooling.
Journal of Gender Studies, 5, 211–230.
Omi, M., & Winant, H. (1994). Racial formation in the United States: From the 1960s to the 1990s.
New York: Routledge Press.
O’Neil, J.M., & Egan, J. (1992). Men’s gender role transitions over the life span: Transformations
and fears of femininity. Journal of Mental Health Counseling, 14, 305–324.
Paniagua, F.A. (1998).Assessing and treating culturally diverse clients: Apractical guide (2nd ed.).
Thousand Oaks, CA: Sage.
Pleck, J.H. (1981). The myth of masculinity. Cambridge, MA: MIT Press.
Pope-Davis, D.B., Coleman, H.L.K., Liu, W.M., & Toporek, R. (Eds.). (2003). The handbook of
multicultural competencies in counseling and psychology. Thousand Oaks, CA: Sage.
Pope-Davis, D.B., Liu, W.M., Toporek, R., & Brittan, C. (2001). How do we identify cultural
competence in counseling: Review, introspection, and recommendations for future research.
Cultural Diversity and Ethnic Minority Psychology, 7, 121–138.
Pope-Davis, D.B., Toporek, R.L., Ortega-Villalobos, L., Ligiero, D.P., Brittan-Powell, C.S., Liu,
W.M., et al. (2002). A qualitative study of clients’ perspectives of multicultural counseling
competence. The Counseling Psychologist, 30, 355–393.
696 Journal of Clinical Psychology, June 2005
Pyke, K.D. (1996). Class-based masculinities: The interdependence of gender, class, and interper-
sonal power. Gender and Society, 10, 527–549.
Rabinowitz, F.E., & Cochran, S.V. (2002). Deepening psychotherapy with men. Washington, DC:
American Psychological Association.
Reid, P.T. (2002). Multicultural psychology: Bringing together gender and ethnicity. Cultural Diver-
sity and Ethnic Minority Psychology, 8, 103–114.
Rice, J.K. (2001). Poverty, welfare, and patriarchy: How macro-level changes in social policy can
help low-income women. Journal of Social Issues, 57, 355–374.
Richmond, K., & Levant, R. (2003). Clinical application of the gender role strain paradigm: Group
treatment for adolescent boys. Journal of Clinical Psychology, 59, 1237–1245.
Ridley, C.R., & Kleiner, A.J. (2003). Multicultural counseling competence: History, themes, and
issues. In D.B. Pope-Davis, H.L.K. Coleman, W.M. Liu, & R.L. Toporek (Eds.), Handbook of
multicultural competencies in counseling and psychology (pp. 3–20). Thousand Oaks, CA:
Sage.
Robinson, D.T., & Schwartz, J.P. (2004). Relationship between gender role conflict and attitudes
toward women and African Americans. Psychology of Men and Masculinity, 5, 65–71.
Ross, C.E., & Mirowsky, J. (1984). Men who cry. Social Psychology Quarterly, 47, 138–146.
Sue, D.W., Arredondo, P., & McDavis, R.J. (1992). Multicultural counseling competencies and
standards: A call to the profession. Journal of Counseling and Development, 20, 644– 688.
Sue, D.W., Ivey, A.E., & Pedersen, P.B. (Eds.). (1996). A theory of multicultural counseling and
therapy. Pacific Grove: Brooks/Cole Publishing.
Sue, D.W., & Sue, D. (2003). Counseling the culturally diverse: Theory and practice (4th ed.). New
York: John Wiley.
Sue, S. (1999). Science, ethnicity, and bias: Where have we gone wrong? American Psychologist,
54, 1070–1077.
Vandello, J.A., & Cohen, D. (2003). Male honor and female fidelity: Implicit cultural scripts that
perpetuate domestic violence. Journal of Personality and Social Psychology, 84, 997–1010.
Vera, E.M., & Speight, S.L. (2003). Multicultural competence, social justice, and counseling psy-
chology: Expanding our roles. The Counseling Psychologist, 31, 253–272.
Wade, J.C. (1993). Institutional racism: An analysis of the mental health system. American Journal
of Orthopsychiatry, 63(4), 536–544.
Wade, J.C. (1996). African American men’s gender role conflict: The significance of racial identity.
Sex Roles, 34(1/2), 17–33.
Watts, R.J., Abdul-Adil, J.K., & Pratt, T. (2002). Enhancing critical consciousness in young African
American men: Apsychoeducational approach. Psychology of Men and Masculinity, 3, 41–50.
Whaley,A.L. (2001). Cultural mistrust and mental health services for African Americans: A review
and meta-analysis. The Counseling Psychologist, 29, 513–531.
White, J.L., & Cones, J.H. III. (1999). Black man emerging: Facing the past and seizing a future
America. New York: W.H. Freeman and Co.
Wilkinson, H. (1996). Men: The most powerful “minority” ever. Reproductive Health Matters, 4,
155–157.
Wilson, B.D.M., & Miller, R.L. (2002). Strategies for managing heterosexism used amongAfrican
American gay and bisexual men. Journal of Black Psychology, 28, 371–391.
Masculinity and Multicultural Competency 697