Author: Gary Jackson

Treatment Issues for Men Addressing the Specific Behavioral Health Needs of Men NCBI Bookshelf

These drugs also have a high potential for abuse; this may or may not be due to addictive properties. Drugs that are considered “gateway drugs” (that is, substances that are often precursors to abuse of other, possibly more dangerous drugs) or deemed a public health risk may also be listed under Schedule I. In 2006, 95.4 percent were male, whereas just 2.9 percent were female and 1.8 percent were of unknown gender (DOJ 2008). Among incarcerated sex offenders in 1994, 99.6 percent of an estimated 33,800 convicted rapists were male, as were 98.8 percent of the 54,300 people convicted of sexual assault (Greenfeld 1997). Men who participate in mutual-help groups can be encouraged to engage in service activities related to those groups, and others can seek service opportunities in their communities or religious institutions, or with national or international groups.

Relapse can be a particularly high risk time for domestic violence, although it is unclear which event (relapse or domestic violence) precipitates the other. In the midst of a relapse crisis, it can be easy for the counselor to decide to deal with the violence at a later date. It also invites the client to sweep the event under the rug and not address it at a later date. Not addressing the violence may also signal to other family members that the violent behavior should not be brought into the open and discussed. Additional material on addressing domestic violence in counseling is offered later in this section.

Drug Abuse by Sex or Gender

Although this is a common occurrence, substance abuse treatment counselors may have received very little training in how to address client transference feelings, particularly sexual feelings. The following clinical scenario offers some options for addressing sexualized transference. Although male clients may have some common attitudes and behaviors based on gender role socialization, their personal definitions of masculinity and attitudes toward behavioral health services and interventions (e.g., therapy and assessment) will vary. Because men are generally ambivalent about seeking help for behavioral health problems, it is useful for clinicians to understand the circumstances that prompted a given man’s help-seeking behavior.

For others still, difficulty with emotions may be a personality trait that has been with the individual since early childhood.
In fairness, the Black community has been the casualty of the medical industry, dating back to the Tuskegee experiment where many African American men were misled into being injected with syphilis when they thought they were receiving free health care.
Specifically, these groups differ with respect to access to substances, risk for problematic substance use, and access to substances; the nature of these differences and their implications for treatment are not yet well-characterized.
Similarly, when men have systematically abused or neglected children for a long period of time, clinicians may need to help them negotiate difficult decisions about petitions for extended placement of children, voluntary termination of parental rights, and/or adoption by others interested in functioning as parents.

Transference and countertransference are not inherently good or bad, but both can potentially disrupt the therapeutic process if not recognized and monitored. Some men find it easier to look at their problems through a concrete visual representation (Halpern 1997). Timelines (Suddaby and Landau 1998), node-link maps (Czuchry and Dansereau 2003; National Institute on Drug Abuse 1996), and genograms (DeMaria et al. 1999; McGoldrick et al. 2008), among others, can be useful in treatment (Dees and Dansereau 2000). Eco-maps, similar to genograms, are graphic portrayals of personal and family social relationships (Rempel et al. 2007).