Therapy: Band of Brothers

For men who are uncomfortable with the thought of a one-on-one therapy, many therapists say group therapy is a good starting point.

By Darby Saxbe Ph.D., published January 1, 2005 - last reviewed on June 9, 2016

Persuading a man to go into therapy can be tough. And usually, when the decision has been made, it's because a man's wife, best friend or child has twisted an arm or two.

"Typically, men will not come into therapy until the sky has fallen," says Arthur Daglow, a marriage and family therapist in Grand Rapids, Michigan, who has been in practice for 35 years. Men's reluctance may account in part for psychotherapy's gender gap: Female patients outnumber males by at least 20 percent, depending on the condition being treated.

For men who are uncomfortable with the thought of a one-on-one session, many therapists say group therapy is a good starting point. Scott Haltzman, a psychiatrist in Rhode Island, says the male stereotype is mostly true: Guys often aren't interested in sharing their feelings, and many simply don't have an emotional vocabulary that allows them to do so. For such men, sitting down in a group setting—usually with six to ten other individuals—can address feelings of isolation and improve interpersonal skills.

Group treatment can help men overcome the "boys don't cry" attitude that often keeps them away from therapy, says New York University professor David Brook. "Men in our culture may have more fear of intimacy and revealing emotions, and difficulty with empathy or with 'soft' emotions. By helping people share their concerns and fears, groups can ease men past these barriers to treatment."

But it has to be the right kind of group. What many people don't realize, says Haltzman, is that men use therapy differently than do women. "Many men are looking for an immediate reward, not a slow process," he says. Because men prefer a faster-moving, more goal-oriented style of therapy, they may be wary of the introspective nature of some groups. To a client looking for a quick fix, group discussion may initially seem like a forum for navel gazing.

Therapy groups with a narrow focus can be especially appealing to guys, says Haltzman. Many studies have documented successful results among all-male groups treating conditions including alcoholism, domestic violence and post-traumatic stress disorder stemming from military combat. In Michigan, Daglow leads an all-male group for sexual addiction. The group doesn't officially exclude women, he says, but sexual compulsion is simply an issue that more men struggle with, just as his practice's eating disorders therapy group is composed mostly of women.

Daglow makes an important distinction between group therapy and volunteer self-help groups, although both have benefits. "Anyone can go to an [Alcoholics Anonymous] meeting and they'll be welcome," he says. In group therapy, the counselor's role is to monitor cohesion and effectiveness, often staggering the entrance of new members so that there are plenty of "veterans" to show others the ropes.

The leader also provides structure to the meetings and tries to ensure that participants are emotionally secure. Says Daglow, "They need to know that their privacy is protected and that they'll be safe."