The Sears Craftsman toolbox has a variety of essential tools for a craftsman to use. But the red one with the wheels and lots of draws, with room for dozens and dozens of tools the mechanic might use is my favorite. The same is true for therapy—what appeals to men: a toolbox with lots of draws and tools to use. Counselors working with men need a toolbox full of equally fine tolls to help repair a man's life and relationships.

Gender-specific treatment is long overdue. For years, we have presumed that the focus of most therapy, especially in the field of addiction, was on men's issues. It wasn't! It took the writing of Stephanie Covington and others to address the unique needs of women in recovery from addiction for the treatment field to acknowledge that there may be unique issues as well for men in treatment. It is time for men to discuss with their therapist what it is like to grow up male today as well as issues such as sexuality, work, money, parenting, sexual orientation and substance use and abuse

Historically, men make bad patients--they don't ask for help. A man has to be half dead to see a doctor. The general mystique for men is to be self-reliant, controlled, and strong. Most men only visit a doctor when they are cajoled or forced to do so. Most treatment programs are not sensitive to these issues, initially grilling a male patient with lots of questions, asking him to discuss with someone he has never met secrets he has never shared. And we wonder why the man does not return for the second session?

Treatment methods when working with men should address barriers for men to seek treatment (a societal value that men don't discuss "feelings" or the enabling system that allows men to hide their addiction). Treatment must to adapt the screening and assessment processes to the unique needs of men. What approaches work best with men in treatment? What resources may be appropriate, such as homework, bibliotherapy, reel therapy, art as a therapeutic tool, activities and games, and questionaires? 

It is time for gender-specific treatment services to be developed for both women and men. It is time for the therapeutic community to study the unique needs of both genders. 

About the Author

David J. Powell, Ph.D.

David J. Powell, Ph.D., was an Assistant Clinical Professor of Psychiatry in the Department of Psychiatry at the Yale University School of Medicine.

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