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APA Guidelines for Men & Boys

APA’s Guidelines for Working with Men & Boys

In August 2018, the American Psychological Association (APA) published a set of guidelines for clinicians working with men and boys in their practice. These guidelines, while written for psychologists, could apply equally to any mental health professional who regularly sees men or boys in their practice.

The overall takeaway from the guidelines is simple. Recognize that there are a set of potentially unique (but in some cases, not all that unique) challenges that men face. But treat and work to understand the specific individual in front of you, and most definitely do not view them as a stereotype (even if some of their behaviors appear on the surface to be stereotypically masculine).

Download the guidelines here.

1. Psychologists strive to recognize that masculinities are constructed based on social, cultural, and contextual norms.

The idea of traditional masculinity doesn’t come primarily from men’s genes. It’s the product of a complex interaction of different factors, including cultural norms, social groups, and parental upbringing. The recommendation from the APA is direct:

Psychologists are encouraged to expand their knowledge about diverse masculinities and to help boys and men, and those who have contact with them, become aware of how masculinity is defined in the context of their life circumstances.

Each man — just like each person — needs to be understood based upon how they were raised with different levels and expectations of masculinity.

2. Psychologists strive to recognize that boys and men integrate multiple aspects to their social identities across the lifespan.

Some of these guidelines could apply pretty much to anyone. Obviously, our identity is made-up of a whole bunch of different characteristics, whether you’re a woman or a man. The APA specifically notes that age, gender, race, sexual orientation, ethnicity, socioeconomic status, immigration status, spirituality, and ability are of special value in understanding a “boy’s basic sense of self and influences his behavior as he grow.”

But in the expression of gender identity, this can be especially sensitive for boys growing up. “Boys with feminine identities or expressions may face especially negative reactions to non-normative gender expressions, including emotional expressions such as passivity or crying, and experience strong pressure to demonstrate and conform to masculine expressions.”

The recommendation?

Psychologists strive to understand the important role of identity formation to the psychological well-being of boys and men and attempt to help them recognize and integrate all aspects of their identities throughout the lifespan. For example, as men’s career identities shift throughout their lives, psychologists could benefit from understanding and applying general knowledge about adult development and aging when working with older adults negotiating role transitions from employed to unemployed (whether by planned retirement or involuntary unemployment).

3. Psychologists understand the impact of power, privilege, and sexism on the development of boys and men and on their relationships with others.

“[I]n the aggregate, males experience a greater degree of social and economic power than girls and women in a patriarchal society.” So it’s not hard to imagine that many men engage, by default and through example, in constant displays of power, privilege, and sexism. This can occur in school, the workplace, and even in romantic relationships.

APA’s recommendation follows from this:

When working with boys and men, psychologists can address issues of privilege and power related to sexism in a developmentally appropriate way to help them obtain the knowledge, attitudes, and skills to be effective allies and potentially live less restrictive lives. Male privilege tends to be invisible to men, yet they can become aware of it through a variety of means, such as education and personal experience.

4. Psychologists strive to develop a comprehensive understanding of the factors that influence the interpersonal relationships of boys and men.

Men’s relationships aren’t always known for their deep emotional connections to others. Instead, it appears that many men either fear or avoid intimacy, and sharing their feelings. As the APA guidelines put it, “[S]some boys are socialized from an early age to avoid intimacy and deep connections with others, potentially leading to serious relational difficulties later in life.”

What should a therapist do to help?

Psychologists strive to promote healthy intimate relationships in boys and men, where healthy relationships are defined and characterized by respect, emotional intimacy and sharing, and mutuality

5. Psychologists strive to encourage positive father involvement and healthy family relationships.

Fatherhood can be a challenge for many men, especially given their relationship with their own father may not have always been the healthiest or most nurturing. Society is still oriented toward mothers as the primary-caregiver, often giving only lip service (and resulting educational workshops and programs) to the father’s role in child rearing.

Fathers must often learn to create positive engagement experiences with their children, as well as reinforcing their warmth and responsiveness behavior. Due to their own emotional upbringing, not all fathers are well-equipped to bring such resources to fatherhood without a little help. Fathers can also find that monitoring their child and knowing where they are at all times, which seems to come more naturally to mothers, can be a challenge.

The APA recommends, simply, that, “psychologists strive to promote healthy father involvement and father engagement in treatment with their children and families.” Active, engaged father involvement with their children leads to healthier, more well-adjusted children.

6. Psychologists strive to support educational efforts that are responsive to the needs of boys and men.

While men have traditionally excelled in certain professional fields that require higher education, they continue to fall behind women academically, according to the latest research. Afican American and Latino boys appear to be particularly at risk.

Therefore, the APA recommends that:

Psychologists strive to raise awareness about the special academic, communication, and school-adjustment problems of boys among teachers, educational support staff, school administrators, parents, and policy makers.

7. Psychologists strive to reduce the high rates of problems boys and men face and act out in their lives such as aggression, violence, substance abuse, and suicide.

The guidelines remind us of research that shows that 90 percent of violent crimes in the U.S. are committed by men, but that “the vast majority” of men are not violent. Nevertheless, “many boys and men have been socialized to use aggression and violence as a means to resolve interpersonal conflict.” Most suicides are carried out by men, and the rate of successful completion of suicide is much higher among men.

Aggressive behavior in boys is reinforced or begun due to often-times unreported childhood physical or sexual abuse. Poor supervision at home and school can also lead to increased aggressiveness in some boys, as can living in high-crime neighborhoods, or growing up in a household where violence is commonplace.

Men are also at increased risk of not just being the perpetrators of violence, but are also the victims — especially African American men.

The recommendation?

Psychologists strive to understand the multiple cultural and individual difference factors that lead to aggression and violence in men and boys, including the intersection of exposure to adverse childhood experiences and traditional masculine socialization where applicable.

8. Psychologists strive to help boys and men engage in health-related behaviors.

Men die sooner, on average, than women. Risk-taking is largely to blame, as men appear to enjoy taking more risks. This can manifest in everything from poor eating choices, aggressive driving, and vaping or smoking. Men tend to drink alcohol more, and eat diets higher in fats and red meat — putting them at greater risk for circulatory disease.

The guidelines recommend that:

[Psychologists] build health-promoting behaviors such as resisting social pressure to eschew health concerns, engaging in self-acceptance, fostering a positive identity, engaging in preventative medical services, and developing the habits of healthy diet, sleep, and exercise.

By paying attention to their health, diet, and exercise, psychologists may be in a position to help men lead longer lives.

9. Psychologists strive to build and promote gender-sensitive psychological services.

Far fewer men feel comfortable seeking mental health services for a mental illness or problem with living than women. This can become a problem if a man’s ability to cope with the travails of their life outweigh their resources — internal or otherwise.

Too much traditional therapy techniques can emphasize the need to talk about feelings, acknowledge one’s vulnerability, and emphasizing dependency for help — areas where men often have trouble with. Some therapists and psychologists also can make harmful assumptions about a man’s ability to be expressive, confusing the lack of expression with the lack of actually having emotions.

You should consult the guidelines for the complete recommendation connected to this guideline, as it is more extensive than can be adequately covered here. But a component of the recommendation is:

Psychologists assessing boys and men strive to be aware of traditional masculine gender role characteristics that render underlying psychological states difficult to assess. Psychologists in clinical settings are encouraged to ask boys and men questions about mood and affect and to be willing to probe more extensively when faced with brief responses.

10. Psychologists understand and strive to change institutional, cultural, and systemic problems that affect boys and men through advocacy, prevention, and education.

There are far more men in prison than women, and prison rates of mental illness are at all-time highs. Access to adequate mental health care while in prison, however, remains elusive, and in some prisons, practically non-existent. Since far more African Americans males are imprisoned than other races, this disproportionately negatively impacts that group.

The recommendation?

Psychologists strive to disseminate research findings to legislators and policymakers to inform public health policies and funding for research, prevention, and intervention efforts that can enhance the lives of boys, men, and their families. For example, psychologists strive to support public policy initiatives to ease problems associated with incarceration, such as humane treatment for prisoners, access to drug treatment and other rehabilitation, job training, accessible housing, and alternatives to incarceration.

Read the Guidelines: APA Guidelines for the Psychological Practice with Boys and Men

APA’s Guidelines for Working with Men & Boys