Developing a taxonomy of helpful and harmful practices for clinical work with boys and men.

This study drew upon the knowledge base of member practitioners of the American Psychological Association (APA) to develop a taxonomy of helpful and harmful practices for treatment with boys and men. Four hundred seventy-five APA-member practitioners solicited from practice-related divisions provided responses to 4 open-ended questions about helpful and harmful practices in working with boys and men. Ten themes emerged from qualitative analyses. Beneficial and sensitive practices included addressing gender socialization and gender-sensitive issues as they apply to boys and men in psychological practice. Harmful practices included biased practices, stereotypes, and a lack of awareness and training around gender and diversity issues as they apply to boys and men. We discuss the specific themes that emerged from analysis of the responses, how these findings are situated within previous work examining helpful and harmful practices, limitations to the study, suggestions for research, and implications for training psychologists.

Analysis of smoking patterns and contexts among college student smokers.

Many who smoke in college do so infrequently and smoking conditions are not well understood. We examined smoking patterns among college fraternity and sorority members (N = 207) from a Midwestern university in three successive fall semesters in 2006-2008. Participants completed calendar-assisted retrospective assessments of 30-day smoking at up to five assessment points over 96 days. Overall smoking rates declined over the course of each semester and higher smoking on weekends was observed, with more variability among daily smokers. The most frequent categories of events to cue recall of smoking were socializing, work, and school. Findings can be used to target prevention efforts.

Race/ethnicity, color-blind racial attitudes, and multicultural counseling competence: the moderating effects of multicultural counseling training.

Increasing trainees' multicultural counseling competence (MCC) has been a hot topic in counseling. Scholars have identified predictors (e.g., race/ethnicity, color-blindness) of MCC, and educators provide multicultural training for trainees. Using a sample of 370 psychology trainees, this study examined whether multicultural training (a) moderated racial/ethnic differences on MCC and (b) changed the relationship between color-blindness and MCC. Results indicated a significant interaction effect of race/ethnicity (i.e., White vs. ethnic minority) and multicultural training on multicultural awareness, but not on multicultural knowledge. Specifically, at lower levels of training, racial/ethnic minority trainees had significantly higher multicultural awareness than their White counterparts; at higher levels of training, no significant difference was found. Described differently, more training significantly enhanced Whites' multicultural awareness, but did not enhance racial/ethnic minority trainees' awareness. Additionally, there was a significant interaction effect of color-blindness and multicultural training on multicultural knowledge, but not on multicultural awareness. The association between color-blindness and multicultural knowledge was stronger at higher levels of multicultural training than at lower levels of training. Alternatively, the effect of training on enhancing knowledge was stronger for those with lower color-blindness than for those with higher color-blindness.

Motivational interviewing for smoking cessation in college students: a group randomized controlled trial.

OBJECTIVE: To examine the efficacy of four individually-delivered Motivational Interviewing counseling sessions for smoking cessation versus a matched intensity comparison condition. METHOD: From 2006-2009, students attending college in the Midwest smoking at least 1 of 30 days were recruited regardless of their interest in quitting. 30 fraternities and sororities were randomized, resulting in 452 participants. RESULTS: No significant differences were found for 30-day cessation between treatment and comparison at end of treatment (31.4% vs 28%, OR=1.20, 95% CI 0.72,1.99) or at follow-up (20.4% vs 24.6%, OR=0.78, 95% CI 0.50,1.22). Predictors of cessation at follow-up, regardless of condition, included more sessions attended (OR 1.2, 95% CI 1.1,1.8) and more cigarettes smoked in 30 days at baseline (OR 4.7, 95% CI 2.5,8.9). The odds of making at least one quit attempt were significantly greater for those in the smoking group at end of treatment (OR 1.75, 95% CI 1.11,2.74) and follow-up (OR 1.66, 95% CI 1.11,2.47). Modeling showed reduction in days smoked for both groups. At end of treatment, more frequent smokers in the treatment condition had greater reductions in days smoked. CONCLUSION: Motivational Interviewing for smoking cessation is effective for increasing cessation attempts and reducing days smoked in the short run.

Strategies to recruit and retain college smokers in cessation trials.

Techniques to recruit and retain college fraternity and sorority members who reported past 30-day smoking into a cessation trial are described. Recruitment efforts included relationship-building, raffles, and screening survey administration during existing meetings. Surveys were administered to 76% (n = 3,276) of members in 30 chapters, 79% of eligible members agreed to participate, and 76% of those completed assessments and were enrolled in the trial (n = 452). The retention rate was 73%. Retention efforts included cash incentives, flexible scheduling, multiple reminders, chapter incentives, and use of chapter members as study personnel. Retention was not related to demographic, behavioral, or group characteristics. The strategies of partnership, convenience, and flexibility appear effective and may prove useful to investigators recruiting similar samples.

Moving toward mainstream: perspectives on enhancing therapy with men.

Psychotherapists began sharing their clinical experiences with men's gender-related psychological issues and the challenges of addressing them in therapy during the late 1970s and early 1980s (e.g., O'Neil, 1981; Scher, 1979; Skovholt, 1978). However, it has taken several decades for these messages and the accompanying research to yield advances that are being adopted into more mainstream psychotherapeutic practices. Over the recent three decades, the theory, research, and clinical wisdom about psychotherapy with men can be viewed as falling into several main clusters. Specifically, there is literature and research providing: - General information on masculine socialization and the psychology of men. - Information about specific issues that men and male clients bring to therapy. - Information about the expectations and experiences of specific groups of men (e.g., men of differing racial/ethnic backgrounds, geographical regions, age cohorts, spiritual/religious beliefs, differing physical ability statuses). - Suggestions for addressing men's reluctance to seek psychotherapy and the challenges associated with forming therapeutic working alliances with men when they do come to therapy. - Suggestions regarding adjustments to psychotherapeutic processes for conducting effective psychotherapy with men. - Development and assessment of instruments to assess endorsement of various male norms and of aspects of men's gender role conflict and stress. Reviewing the earliest writings, some of these pioneering therapists' initial clinical observations remain highly relevant today.

To accept a pilot? Addressing men's ambivalence and altering their expectancies about therapy.

When considering the challenges therapists encounter with their male clients, perhaps the most daunting tasks occur at the very beginning. Getting boys and men to avail themselves of psychological services is the first challenge. But when men do present, the second challenge is to get them to trust therapists sufficiently enough to share their issues and to form an effective working alliance. This article describes these gender-related challenges from male clients' point of view, and then elaborates upon effective techniques to help them engage in and benefit from psychotherapy. We suggest that good therapists for men, like good ship pilots, are informed and prepared. They learn the major cognitive and emotional issues they are likely to encounter with their male clients, and develop a variety of ways to help their male clients navigate the tricky psychological issues of their lives.

Masculine role variables and outcomes among men with spinal cord injury.

PURPOSE: Few studies have considered the impact of masculine role variables on outcome and adjustment to SCI among men. The present study examined the relations among SCI, views of masculinity, psychological adjustment, and rehabilitation outcomes among men with SCI. METHOD: The sample included 20 men with SCI receiving inpatient rehabilitation, with a mean age of 45 years. Data included demographic variables as well as Conformity to Masculine Norms Inventory (CMNI), Gender Role Conflict Scale (GRCS), Functional Independence Measure (FIM), and Satisfaction with Life Scale ratings, and change in marital status. RESULTS: The findings revealed that satisfaction with life was positively related to scores on the CMNI Violence scale, FIM change from admission to discharge was positively related to the CMNI Emotional Control scale and negatively related to the CMNI Dominance scale. Change in marital status was inversely related to the CMNI Emotional Control and Primacy of Work scales and the GRCS Restricted Emotionality and Power, Success, and Competition scales. CONCLUSIONS: The findings show that certain aspects of the traditional masculine role (i.e., ability to modulate strong emotions) may be adaptive in the rehabilitation process, whereas other aspects (i.e., a dominant interpersonal style) may present a barrier to effective rehabilitation.

Masculine role adherence and outcomes among men with traumatic brain injury.

PRIMARY OBJECTIVE: Traumatic brain injury (TBI) is a significant health problem disproportionately affecting men and is often associated with changes in masculine role functioning in life domains such as vocational functioning, sexual and inter-personal functioning and personal independence. These changes could have serious implications for men's adjustment following injury. The aim of this study was to examine the relations among traditional masculine role adherence, psychosocial adjustment and rehabilitation outcomes in men with TBI. RESEARCH DESIGN: A correlational design was chosen to examine the relations among variables. Spearman correlations and Wilcoxon Rank Sum tests were used to examine relationships between masculine role variables and outcome variables. METHODS AND PROCEDURES: The study included 33 men with TBI who had been discharged from inpatient rehabilitation within 5 years. Participants completed surveys on traditional masculine gender role adherence and gender role conflict and additional data, including measures of functional outcome, life satisfaction, psychosocial outcomes and earnings, were obtained through the TBI Model System longitudinal data collection system. MAIN OUTCOMES AND RESULTS: The results revealed significant associations between masculine role adherence and satisfaction with life, follow-up earnings and FIM change from admission to discharge. CONCLUSIONS: In the current study, particular masculine role variables corresponded to different functional and psychological outcomes. Understanding these differences provides new directions for treatment and offers important information about aspects of traditional masculine roles that may enhance or hinder adjustment to injury.

Men and therapy: critical concepts, theoretical frameworks, and research recommendations.

Scholars are increasingly recognizing the existence of multiple evolving conceptions of masculinity and the need for psychologists to better attend to masculinity-related constructs and their implications for men's lives. This article seeks to respond to this need by (a) reviewing research linking masculinity-related constructs to clinically relevant issues, (b) providing suggestions for building effective therapeutic relationships with male clients, (c) describing the role that culture and racism may play in male clients' lives, and (d) offering recommendations for future research.