Question

How might you use what we know about gender roles and mental health to reduce/prevent cases of depression, and drug/alcohol abuse? In therapy, what gender issues should a therapist be aware of?

Answer 1

• Gender differences in rates of overall mental disorder, including rare disorders such as schizophrenia and bipolar disorders, are negligible. However, highly significant gender differences exist for depression, anxiety and somatic complaints that affect more than 20% of the population in established economies.
• To reduce gender disparities in mental health treatment, gender sensitive services are essential. If women are to be able to access treatment at all levels from primary to specialist care and inpatient as well as outpatient facilities, services must be tailored to meet their needs.
• To ensure that the assistance available is also meaningful to those seeking treatment, the full range of patients’ psychosocial and mental health needs must be addressed. This involves services adopting a life course approach, by acknowledging current and past gender specific exposures to stressors and risks and by responding sensitively to life circumstances and ongoing gender based roles and responsibilities.
• Gender sensitivity will not improve unless client based preferences inform models of treatment and the provision of care. For women generally, but especially low income ones, services have to be made genuinely accessible. This includes having access to services during the weekend or evening hours, short waiting times and being on public transport routes.
• With regard to the doctor patient relationship, preferred health care providers are those who show a sense of concern and respect and are willing to talk and spend time with patients. Integrated services where social and clinical services are available on one site are also preferred by women.
• Services that attempt to assist women with severe mental illness need to move beyond stereotypical assumptions and roles regarding women and not only provide access to living and social skills but also to vocational training and employment support.
• Gender issues create obstacles or advance progress in therapy sessions.Clients expect male therapists to be more controlling in therapy, while they perceive females to more supportive; therefore, seeing a male therapist is likely to limit initial disclosures by clients.
• It has also been determined that a therapist’s credibility can be reduced based on their gender’s accepted roles. From a therapist’s standpoint, gender has been shown to alter their expectations in clients. Female therapists have been found to be more tolerant and accepting during the therapeutic process- displaying more unconditional positive regard.
• However, male therapists show more sensitivity to gender regarding their behavior and outlook towards clients; they’re more critical of females and hold males to higher expectations. Both client and therapist perceptions of gender have been shown to hinder the interaction between client and therapist.
• Therefore, it is believed gender affects more than just client and therapist relations, but also has the ability to affect therapy diagnosis, treatment selection, length of treatment, and therapeutic outcome.
• In the understanding and practice of psychotherapy, gender is an important but neglected variable. Gender can influence the client’s choice of therapist, the rapport between them, the sequence and material presented for the diagnosis, and the length and final outcome of treatment.
• Prescriptive norms, such as warmth and communality, often are attributed to females whereas males are seen as authoritarian figures. Norms associated with gender play a major role in determining the strength of therapeutic relationships as well as treatment outcomes.
• Patients give many reasons for their choice of therapist. These reasons are often based on stereotyped views such as that men tend to perpetuate leadership values, or that women provide more nurturing kinds of skills.
• Patients express that they feel more comfortable in choosing their therapist based on these traits. This method of choice can also prove beneficial to therapists as it facilitates a more prompt positive therapeutic alliance.