Why Don't Men Like Group Therapy?
Wednesday, July 28, 2004
By Jeanie Lerche Davis
One-on-One and Long-Term Therapy May Help Men Open Up
July 28, 2004 -- Women tend to thrive in group therapy: They grew up sharing emotions. But men often resist going and wilt when they get there. Many just hang it up.
In a new study, a group of Canadian researchers focuses on this Mars-Venus issue: Just how much do men really get from short-term group therapy -- especially after a significant loss, like the death of a spouse?
In his study, women got relief from depression, anxiety, and general distress through group therapy -- while men were "virtually unchanged," writes researcher Anthony S. Joyce, PhD, with the University of Alberta and University of Alberta Hospital Site.
Men are often outnumbered by women in these sessions -- with one or two men in any group. They tend to become fringe members, participating little, dropping out too soon, Joyce explains. It points to the need for "gender sensitivity" in therapy, he writes in the latest issue of Psychotherapy Research.
There's much at stake, since men often turn to alcohol -- and often die soon after such a major loss, says Nadine Kaslow, PhD, a family psychologist with Emory University School of Medicine in Atlanta, tells WebMD. While she was not involved in the study, she offered her insights.
The painful problem: "They depend on their spouse to take care of them and for emotional support," says Kaslow. When that support disappears, men tend to flounder. They aren't used to sharing their emotions, so they don't deal with their grief well -- whether alone or in a group therapy setting. "Yet that's how group therapy can ultimately help men -- providing the emotional support that's missing from their lives," she says.
Inside Group Therapy
Joyce's study involved 47 adults -- 12 of whom were men -- all depressed and seeking counseling following a death. All were having difficulty getting back to their normal lives, at work and in their relationships. They avoided reminders of the loss, they were angry about the death, and they were preoccupied with their loss.
Those are common reactions after a death loss, writes Joyce. However, those patients participating in his study had what's known as "complicated grief" -- an extremely intense, longer-term grief, plus depression and anxiety.
All the patients were assigned to 12 weeks of group therapy.
In the "interpretive group," patients worked through their emotions by talking about the death and traumas associated with it. In the "supportive group," the patients talked about coping with day-to-day struggles, received problem-solving guidance from the therapist, and were praised by the other patients.
[*]Women had a 10% better adjustment to their grief than men; supportive therapy worked best for women.
[*]19% of women had significant improvement in depression and anxiety, whereas 14% significantly improved their general distress.
[*]No men made any significant progress in these areas.
The Importance of Connections
Women are grounded by their connections with others, so group therapy works well for them, explains Joyce. For men, group therapy can stir up anxieties, threatening their sense of self. Men also feel alienated, vulnerable, and overwhelmed by the women's stories and their emotional sharing. The men quickly bail out before they get any benefit, he says.
Male-only groups could be more beneficial, Joyce suggests.
Indeed, men need a different approach, Kaslow tells WebMD. "For men, individual therapy often works better in the beginning, rather than going quickly to group therapy. Also, the therapist must take a different approach with men in individual therapy. Men need to feel empowered by therapy. They need an action plan, rather than just sitting and talking about feelings. They want to feel they are in control."
It's not a short-term process, she notes. "Over time, men may become interested in analyzing their feelings, reflecting on themselves, and feel less awkward opening up. Then they can move on to group therapy. There's plenty of evidence that men can benefit from all kinds of therapy."
Source: Ogrodniczuk, J. Psychotherapy Research; vol 14: pp 231-243. Nadine Kaslow, PhD, family psychologist, Emory University School of Medicine, Atlanta.