Well, yes. Fewer men are choosing clinical psychology as a profession.
We’ve known this for many years, as graduate programs in psychology — both Master’s level and doctoral — have increasingly become female-dominated. In my graduate class of 1990, over 75% of the class was female. That percentage has only increased in the past two decades.
So Benedict Carey’s new article in the New York Times is a bit of a puzzler. The angle is that because of this gender discrepancy, a good male therapist is increasingly becoming difficult to find:
Researchers began tracking the “feminization” of mental health care more than a generation ago, when women started to outnumber men in fields like psychology and counseling. Today the takeover is almost complete.
And I say, “So what?”
I say that only because while I think everyone should have their choice of therapist gender, there’s virtually no research demonstrating that there’s any relationship between therapist gender, client gender and treatment outcomes. Since there’s no data, it’s hard to get too worked up about a trend that started over 30 years ago.
So instead of data, Carey trots out a few — mostly male — therapists to sound the warning bells:
“There’s a way in which a guy grows up that he knows some things that women don’t know, and vice versa,” said David Moultrup, a psychotherapist in Belmont, Mass. “But that male viewpoint has been so devalued in the course of empowering little girls for the past 40 or 50 years that it is now all but lost in talk therapy. Society needs to have the choice, and the choice is being taken away.”
Actually, without data, we don’t know that “the choice is being taken away.” We know that there are less male therapists than there were 30 years ago. But we don’t know whether that makes any difference. Are fewer men seeking therapy because of it? Are men who do seek therapy from a woman when they wanted to see a male worse off because of it?
These are good questions to ask. But without research, we don’t know the answers.
The single study Carey trots out didn’t look at these questions or the importance of gender in psychotherapy*. Instead, it looked at the relationship between traditional male assumptions of male college students and their attitude toward seeking psychological help (Levant et al., 2011). In fact, the study is moot on the gender of the therapist. It simply concludes:
These results also suggest that, when providing behavioral health counseling to men who endorse traditional masculinity ideology, one might be able to rely on the client’s willingness to follow health recommendations and engage in the proper use of health care resources. In addition, men who make work the top priority in their life might be amenable to interventions aimed at anger and stress reduction and the engagement in preventive self care.
Both men and women therapists can provide these sorts of interventions. But that didn’t stop Levant and Carey from concluding this study actually has something to say about the gender of the therapist:
Such a man on the fence about seeking treatment could be discouraged by the prospect of talking to a woman.
“Many men like this believe that only another man can help them, and it doesn’t matter whether that’s true or not,” Dr. Levant said. “What’s important is what the client believes.”
Indeed, many men may believe that. But we don’t have any research that suggests it is either (a) an actual impediment to seeking psychotherapy treatment or (b) that men who instead enter into a therapy relationship with a female therapist have worse outcomes than if they had entered a therapy relationship with a male therapist.
Without this important, scientific data, all we have are a bunch of opinions. Interesting, certainly. But not the same as the conclusions we could draw from actual data.
Indeed, Carey makes that very same point earlier in the article, before bringing up this unrelated study:
The impact of this gender switch on the value of therapy is negligible, studies suggest. A good therapist is a good therapist, male or female, and a mediocre one is a mediocre one.
That’s pretty much what we know — it doesn’t matter what gender therapist you have. If you want to be successful in psychotherapy, there are other, more important factors to focus on.
It’s like buying a new car. Sure, it would be nice to have it in your favorite color and be able to drive it off the lot today. But your favorite color isn’t available — you’d have to order a similar color and wait 2 months for it to come in. What if you can get the same car sooner, only in a different color? You might just be okay with making that choice.
So what has led us to the current state of affairs where we have a dearth of male therapists? The article presents some ideas as to why this happened — men left due to the decreasing salaries, apparently — and why men might prefer seeing a male therapist over a female one. Talking about certain topics is supposedly easier between two men — such as sex, aggression, self-doubt.
It’s an interesting article, despite its flaws… and worth a read.
Read the full article: Need Therapy? A Good Man Is Hard to Find
Reference
Levant, R.F., Wimer, D.J. & Williams, C.M. (2011). An evaluation of the Health Behavior Inventory-20 (HBI-20) and its relationships to masculinity and attitudes towards seeking psychological help among college men. Psychology of Men & Masculinity, 12(1), 26-41.
* – The usual limitations of using a single study based upon a small group of college students at a single university also apply.
12 comments
I didn’t realize this was happening until I confessed to my female counselor that I had better results talking to a male counselor. She told me that they didn’t have any male counselors on their staff. I was shocked as she told me that they aren’t as popular.
Interesting article, thanks!
Though it stills seems as if there are more male psychiatrists than female so maybe they’d rather have the MD?
It seems Carey’s article is paradoxical in the sense that it perpetuates the same gender stereotypes it simultaneously rallies against. What about the idea of male privilege? I think a more complete view would be integrative of male and female therapists instead of the dated us against them approach.
I don’t know that you need research to back this up. The reality is that some people feel more comfortable talking about personal things with a certain gender. For example, I have had both male and female therapists and I MUCH prefer female, mainly because I feel like I connect with them better on a personal level. Can you quantify that? Seems more of an emotional/personal reaction. There must be people who have the same feeling about male therapists. This article didn’t seem like a slam against women therapists, just pointing out that people (mainly men?) who would like to talk to another man have much fewer options.
I am fascinated by this controversy both because the cry of veiled reverse discrimination comes just days after an equally loud cry of misogyny in the psych world and because both instances sit firmly at the intersections of race and gender. In the case of the former, an API Psychology Professor claims black women are inherently uglier than other women, prompting first women and then men to weigh in on the racist misogyny behind pseudo-psych-science and in this case, a white man argues that men won’t go to therapy because there aren’t enough male therapists and that we should all be worried. Where are similar discussion about the absence of people of color in the profession or their lack of availability in entire communities or even several adjoining cities and towns? Are people of color any less likely to be poorly served by white therapists who have only taken 1-2 classes on diversity than men are by women who have studied the history of psychology which until recently assumed a male normative subject? It seems to me that thinking intersectionally about these issues reveals ongoing race and gender issues in the profession that have yet to be addressed or shifted in classrooms or conferences. Moreover, despite the shift in the gender of clinicians, similar shifts have not occurred in their race or sexual orientation, nor in the curriculum itself which still privileges the white male unmarked subject, nor in the people in positions of power overseeing Departments, Psych Wards, publication review, etc. So that ultimately, what we should be doing is having much deeper and much widerspread conversations about inequality across the board and what it means for the ways we think about wellness as clinicians and as people seeking therapy.
The one thing the article and the comments show me is that gender issues in therapy still have the power to stir up indignation on all sides! There is no evidence that the gender of the therapist is a crucial variable in outcome.Yet that is not the point raised in the original article (which I didn’t think was particularly well done.)Men sometimes prefer male therapists just as women sometimes prefer females. So what. Some of the comments I’ve read here and elsewhere imply that men seeking male therapists because they believe they’d be more comfortable discussing sensitive issues with a man are just whining. Would the same be said of a woman seeking a female therapist? I don’t think so. I do think therapy needs to be made more accessible to all. That’s primarily an economic and political problem.
Fewer male therapists, John, not less. 🙂
While there may sufficient evidence to defend the claim that gender does not affect therapy outcome, I believe there is some bias in the claim, as I cannot imagine it being made in the case where an increasing majority of therapists were male. In such a reversed situation, the popular position that it is important to swing the pendulum would seem to be driven by a concern for gender equality, and yet it would likely be defended by the argument that the gender of the therapist is critical to therapy initiation and outcome, at least for clients dealing with certain issues, such as women dealing with sexual and physical abuse by men.
Either way, I am skeptical of the claim that gender does not affect therapy outcome, simply because it unavoidably and powerfully shapes the client-therapist relationship. It may matter more in certain approaches like interpersonal therapy, and less so for others like CBT. Also, I cannot see how therapist gender could not be a factor in cases where gender is a major factor in the formation of a client’s central neuroses. I am not saying that it is not possible for both genders to be equally effective in such cases, given a client’s willingness to work with either gender, but it may very well affect potential client’s decision to enter therapy or clients’ openness in therapy, something that would be very difficult to obtain data for. If a client believes he or she needs a therapist of a certain gender, then that is true simply because they they believe it, unless—what is very difficult—the client can develop enough trust early on in spite of that belief to openly explore and call into question the belief itself.
I am also concerned with the larger cultural causes and effects of the trend. Is it influenced by gender stereotypes of women as nurturing and being skilled in relationships and men as otherwise? Will it further reinforce overdependence on women (for both men and women) for nurture and secure attachment, and the belief that men cannot or do not know how to offer what associated with the feminine in relationships? These are questions probably better addressed by the other social sciences.
Grohol may think an appropriate reaction to this situation is “so what?” But there are serious questions that have been posed about what it indicates and what effects is may have, and as he himself says, “without research, we don’t know the answers.” “So what?” seems like a dismissal of concerns raised and a justification for not addressing the questions at hand, and that’s what the rhetoric of the article amounts to. Rather, the concerns driving opinions and questions Grohol so easily shrugs need to be taken seriously so that the issue is sufficiently studied.
From my view, there’s a sacredness to the male and female genders. Some will be attracted to seek help from males, others from females, and seeking help from either, IS a big deal.
For you, Dr. Grohol, to say “so what,” in my view, minimizes the value of seeking male help and undermines the the sacredness and value that males contribute when helping.
To say that seeking a male therapist is like changing the colors of buying a new car, is another minimizing statement. Dr. Grohol, you say “Sure, it would be nice to have it in your favorite color and be able to drive it off the lot today…You might just be okay with making that choice.”
For me, this minimizes the entire relationship between the therapist and the client itself, regardless of male or female gender. Do you remember the angst that people go through to FIND a good, solid fit, regardless of male/female, to that they can get genuine, honest help to change their lives, to ease their pain?
I think the Times’ article was less opinionated than your article and your “so what?” reflects an opportunity to look further into the original definitions of psychology itself, (Gk. psykhe- “breath, spirit, soul”) and hopefully will provide and opportunity for you to reflect on the value that you contribute as a male on the planet.
Without solid research data, all we have are differing opinions about whether gender is important when choosing a therapist. I don’t view the therapy relationship as “sacred” — that smacks too much of religion to me. It is a close, professional relationship that should be informed by research. In this case, the research simply doesn’t support gender as being an important factor in positive client outcomes.
There is data; it’s called empirical.
This is not an equity issue. This is not a qualifications issue.It’s a clinical one. Demographics “can†be critical. Gender is just one of them.
My MD tells me the pharm reps always come armed with data. Professional journals presents “him†with another set of data. However, the primary filter of any research is between his ears. He’s swimming in the petri dish of a pretty hefty sample size every day.
In the past we needed more female councilors because of equality, when the tables are turned suddenly the attitude is “so what”? This kind of nasty apathy is not constructive. And no my friend, we dont need any data to understand that this attitude is more destructive than anything else.
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