Understanding the factors which facilitate the engagement of men in psychological therapy

Abstract

In the UK, suicide continues to be the leading cause of death in men under 45 and research has consistently shown that men are less likely than women to seek professional help for mental health problems (National Statistics, 2018; Seidler et al., 2016). Endorsement of traditional views of masculinity, problems identifying emotional difficulties and externalised expressions of distress (e.g. substance misuse, violence etc.) have been identified as barriers to psychological help-seeking in men (Mansfield et al., 2003; Perlick & Manning, 2007). A systematic review identified that increased Mental Health Literacy and conformity to masculinity are predictors of help-seeking in men. Demographic factors such as race and education have also been found to influence this process.
 The current study aimed to assess viewpoints held by men on what factors would be important to them when considering engaging in therapy and whether viewpoints differed depending on demographic factors (e.g. age, ethnicity, sexuality, religion). Forty-five statements were developed from a scoping review by Seidler et al. (2018) providing recommendations for factors that would be important to consider when engaging men in psychological therapy. Forty-seven men who had not previously accessed psychological therapy completed a Q-sort by ranking the statements relating to therapy in accordance with their perceived relative importance.
Q-methodology uses a by-person factor analysis to identify shared and different viewpoints within the sample (Watts & Stenner, 2014). The data analysis was completed in two stages: 1a) analysis and interpretation of factors from Group One (those who had considered psychological therapy), 1b) analysis and interpretation of factors from Group Two (those who had not considered psychological therapy) and 2) a second-order factor analysis combining factors from both groups to understand common and differing viewpoints across both groups. Second-order analysis revealed a three-factor solution that accounted for 45% of the total variance: Factor A ‘The Context of Therapy’, Factor B ‘Gendered Therapy and a Relaxed Approach’ and Factor C ‘The Individuals Experience’. Viewpoints can be understood within the context of previous literature, theories and findings. The dominant viewpoint described men placing value in feeling accepted, supported and safe within psychological therapy, through understanding the process (expectations and treatment goals) and through the relationship with the therapist. Future research would benefit from establishing whether the findings from this study could be used to support men to understand therapy and what to expect in order to promote more positive attitudes towards, and consequently engagement in, psychological therapy.

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ORCID for Nicholas Maguire: orcid.org/0000-0003-4295-8068

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