The research
Publications
Enhancing the Clinical Competencies of Mental Health Practitioners Who Work With Men: A Parallel, Single-blind, Randomised Waitlist-Controlled Trial of the Men in Mind Intervention. Seidler, Z. E., Wilson, M. J., Benakovic, R., Mackinnon, A., Oliffe, J. L., Ogrodniczuk, J. S., Kealy, D., Owen, J., Pirkis, J., Mihalopoulos, C., Le, L. K.-D., & Rice, S.
(2023). American Psychologist
(2023). American Psychologist
Abstract: Improved engagement of men in psychotherapy is an essential element in improving male health outcomes. This trial examined whether the Men in Mind intervention improved practitioners’ self-rated clinical competencies to engage and respond to male clients in therapy. A parallel, single-blind, waitlist randomized controlled trial was conducted with Australian-based mental health practitioners, currently administering psychotherapy to males, fluent in English and not currently completing their undergraduate degree. Participants were randomly assigned 1:1, through variable sized blocks stratified by gender, to either the intervention (Men in Mind), or waitlist control. Men in Mind was offered as a self-led 6-week, 5-module online program to upskill practitioners to engage and respond to male clients. The primary outcome was self-reported competency in engaging men in psychotherapy, measured by the Engaging Men in Therapy Scale (EMITS) at 6 weeks. All analyses were by intention-to-treat. Between Jan 16 and March 17 2022, 587 participants were randomly assigned to the intervention (n=300), or waitlist control (n=287). In total, 492 (84%) participants completed the primary endpoint assessment at 6 weeks. Men in Mind demonstrated a large effect of improved EMITS scores compared to the control group (d=2.63, 95% CI [2.39, 2.87], p< .001). Men in Mind was effective at increasing mental health practitioners’ self-reported efficacy to work with men, which is potentially a key change mechanism in their ability to improve health outcomes for male clients. A limitation of the trial was the use of a bespoke, self-reported primary outcome, while a strength was the gender-responsive intervention design.
Protocol for a randomized controlled trial of the Men in Mind training for mental health practitioners to enhance their clinical competencies for working with male clients Seidler, Z. E., Wilson, M. J., Toogood, N. W., Oliffe, J. L., Kealy, D., Ogrodniczuk, J. S., Owen, J., Mackinnon, A., Le, L. K.-D., & Mihalopoulos, C.
(2022). BMC Psychology, 10(1), 1–15.
(2022). BMC Psychology, 10(1), 1–15.
Abstract: Background: Although the proportion of men seeking professional mental health care has risen over the past two decades, on average, men continue to attend fewer sessions of psychotherapy and are more likely to drop out of treatment prematurely compared to women. Men account for three‑quarters of suicide deaths; furthermore, over half of the males who die by suicide have engaged with mental health care in the 12 months prior to their death. These findings highlight a need to equip mental health practitioners with skills to improve male clients’ engagement and mental health outcomes. This article reports the protocol for a randomized controlled trial of Men in Mind, a self‑paced online training program purpose‑built to advance the clinical competencies of practitioners who provide psychotherapy to male clients. Methods: A randomized controlled trial with two parallel groups will be conducted. Participating practitioners will be randomly allocated, on a 1:1 basis, to the intervention group (Men in Mind training) or a waitlist control group. The primary outcome, efficacy of the training, will be evaluated by pre‑ to post‑training (T1 to T2) changes in scores on the Engaging Men in Therapy Scale (EMITS) in the intervention group, relative to the control group. Discussion: This trial will provide evidence of the efficacy of Men in Mind training, as an interim step towards adjusting content and delivery of the intervention to maximize the potential for sustaining and scaling. Trial registration: The trial was registered prospectively with the Australian New Zealand Clinical Trials Registry on 3rd December 2021 (ACTRN12621001669886).
Pilot evaluation of the men in mind training program for mental health practitioners. Seidler, Z. E., Wilson, M. J., Toogood, N., Oliffe, J. L., Kealy, D., Ogrodniczuk, J. S., Owen, J., Lee, G., & Rice, S. M.
(2022). Psychology of Men & Masculinities, 23(2), 257–264
(2022). Psychology of Men & Masculinities, 23(2), 257–264
Abstract: This study aimed to evaluate the acceptability, feasibility, and potential efficacy of an online, 8-hr mental health practitioner training program, Men in Mind. To this end, 196 Australian-based mental health practitioners (72.1% female; Mage = 44.98 years, SDage = 11.75 years) completed a baseline survey and were provided access to Men in Mind. The program demonstrated acceptability, feasibility, and potential efficacy, with significantly improved pre–post scores on the Engaging Men in Therapy Scale (EMITS; p < .001; Δ = 2.04). Among completers, 89.9% (n = 142) demonstrated reliable change on the EMITS. Results of this pilot study indicated Men in Mind may be an important resource for upskilling mental health practitioners in the psychology of men and masculinities.
What gets in the way? Men’s perspectives of barriers to mental health services.Seidler, Z. E., Rice, S. M., Kealy, D., Oliffe, J. L., & Ogrodniczuk, J. S.
(2020)International Journal of Social Psychiatry, 66(2), 105-110.
(2020)International Journal of Social Psychiatry, 66(2), 105-110.
Abstract: This study describes barriers to accessing mental health services among men currently experiencing a mental health concern. Mental health help-seeking survey data from 778 male respondents who self-reported experiencing a mental health concern were analysed. Of these men, 65% (n = 513) wanted treatment and 35% (n = 265) did not want treatment. The most frequently endorsed barriers to mental health treatment were believing that a lot of people feel sad and down (80%; n = 620), not knowing what to look for in a psychotherapist (counselor; 80%; n = 618) and needing to solve one’s own problems (73%; n = 569). Compared with men who wanted help for their mental health concern, those men who did not want help were significantly more likely to be unsure if psychotherapy (counselling) really works or is effective, not tell their physician if they were feeling down or depressed and prefer to solve their own problems. The high endorsement of both structural (e.g., cost) and attitudinal (e.g., beliefs) barriers by respondents suggests that service delivery must adapt to better respond to dominant masculine ideals while also improving men’s ease of access into a transparent treatment process.
Getting Them Through the Door: a Survey of Men’s Facilitators for Seeking Mental Health Treatment.Seidler, Z. E., Rice, S. M., Kealy, D., Oliffe, J. L., & Ogrodniczuk, J. S.
(2020)International Journal of Mental Health and Addiction, 18(5), 1346-1351.
(2020)International Journal of Mental Health and Addiction, 18(5), 1346-1351.
Abstract: Unavailable
Once bitten, twice shy: Dissatisfaction with previous therapy and its implication for future help-seeking among men.
Seidler, Z. E., Rice, S. M., Kealy, D., Oliffe, J. L., & Ogrodniczuk, J. S.
(2020)The International Journal of Psychiatry in Medicine.
Abstract: Men can be reluctant to disclose distress and many men have ambivalence toward seeking help for depression, leading to poor uptake of and engagement in psychotherapy. The present study sought to explore whether a previously dissatisfying therapy experience leads to greater doubts about the effectiveness of treatment, in turn impacting on a man’s willingness to disclose their distress in future. An online survey of 133 Canadian men was conducted to investigate their current depressive symptoms, previous experience of, and belief in, the effectiveness of psychotherapy and likelihood of disclosing distress to their physician. A regression model with mediation was employed to analyse the relationship between these responses. The regression model highlighted a significant negative association between satisfaction with previous therapy and doubt about the effectiveness of therapy (t = −7.299, 99% confidence interval [−.537, −.254], p < .001). There was also a significant indirect effect, such that doubt about the effectiveness of therapy mediated the association between previous satisfaction and willingness to disclose distress to a physician (t = 3.748, 99% confidence interval [.123, .690], p < .001). Providing treatment for depression that men find engaging and satisfying may improve their confidence that psychotherapy can help, make them more likely to reach out for assistance in the future and in turn, benefit their long-term mental health outcomes.
Why it’s time to focus on masculinity in mental health training and clinical practice. Seidler, Z. E., Rice, S. M., Dhillon, H. M., & Herrman, H.
(2019)Australasian Psychiatry, 27(2), 157-159.
(2019)Australasian Psychiatry, 27(2), 157-159.
Abstract: Men present with complex, diverse and often contradictory expressions of masculinity that are relevant to their health status. This article argues for the inclusion of masculinity into mental health curricula in Australia. Masculinity mediates health outcomes by influencing help seeking and engagement with treatment. An online curricula audit of publicly available information from Australian medical programs and their professional bodies reveals increasing awareness of the needs, but limited practical inclusion of masculinity models in training and practice. Described are the elements essential to training and subsequent clinical practice to curb the poor mental health outcomes of Australian men.
Men, masculinities, depression: Implications for mental health services from a Delphi expert consensus study.
Seidler, Z. E., Rice, S. M., Ogrodniczuk, J. S., Oliffe, J. L., Shaw, J. M., & Dhillon, H. M.
(2019)Professional Psychology: Research and Practice, 50(1), 51.
(2019)Professional Psychology: Research and Practice, 50(1), 51.
Abstract: Tailoring psychological treatments to men’s specific needs has long been a concern considering that many men are reluctant to seek or engage with professional help. The present study aimed to seek consensus via an expert panel regarding essential aspects to include in practitioner training programs for those working with men experiencing depression. A 2-round Delphi study was conducted to gain consensus among practitioners, researchers, and educators about the importance of a pool of 30 potential training program components across the following 6 domains: masculinity frameworks; impact of gender on clinical practice; depression in men; assessment and formulation; male-specific adaptations to treatment and; language and communication. The panelists comprised 53 multidisciplinary international experts in the men’s mental health. Panelists were asked to rate each item on a 5-point likert scale from should not be included to essential. Consensus was defined as >80% of respondents scoring within 2 points on the Likert scale. After 2 Delphi rounds, consensus was reached for 22 of 30 items, and a further 2 items approached consensus. All items focused on features of depression among men and the impact of masculinities on clinical practice were endorsed. Items related to suicidality and depression diagnosis received the highest consensus, and the language and communication domain received limited support and was removed. This study provides a set of consensus-based recommendations for practitioner training. The recommendations offer actionable, gender-specific adaptations to psychological treatments for depression in men to be developed and trialed in practitioner training programs.
Men’s mental health services: The case for a masculinities model.
Seidler, Z. E., Rice, S. M., River, J., Oliffe, J. L., & Dhillon, H. M.
(2018)The Journal of Men’s Studies, 26(1), 92-104.
(2018)The Journal of Men’s Studies, 26(1), 92-104.
Abstract: It is well understood that men are reticent in seeking help for mental health concerns. In the wake of government-funded campaigns across many Western nations that have sought to address this, noticeably absent have been the active development, promotion, dissemination, and rigorous evaluation of male-centered treatment styles. We argue that next-generation approaches must actively counteract unhelpful stereotypes, instead promoting diverse and healthy masculinities. The current article makes the case for the development of a masculinities model of mental health care, offering recommendations to advance clinical practice and research toward this goal. We propose that updated help-seeking campaigns and clinician training, gender-sensitive service provision, and comprehensive cost analyses will provide the groundwork for such a model to better target the diversity in men and reduce any reluctance to engage with mental health treatment.
Engaging men in psychological treatment: A scoping review.
Seidler, Z. E., Rice, S. M., Ogrodniczuk, J. S., Oliffe, J. L., & Dhillon, H. M.
(2018)American Journal of Men's Health, 12(6), 1882-1900.
(2018)American Journal of Men's Health, 12(6), 1882-1900.
Abstract: Tailoring psychological treatments to men’s specific needs has been a topic of concern for decades given evidence that many men are reticent to seek professional health care. However, existing literature providing clinical recommendations for engaging men in psychological treatments is diffuse. The aim of this scoping review was to provide a comprehensive summary of recommendations for how to engage men in psychological treatment. Four electronic databases (MEDLINE, PubMed, CINAHL, PsycINFO) were searched for articles published between 2000 and 2017. Titles and abstracts were reviewed; data extracted and synthesized thematically. Of 3,627 citations identified, 46 met the inclusion criteria. Thirty articles (65%) were reviews or commentaries; 23 (50%) provided broad recommendations for working with all men. Findings indicate providing male-appropriate psychological treatment requires clinicians to consider the impact of masculine socialization on their client and themselves, and how gender norms may impact clinical engagement and outcomes. Existing literature also emphasized specific process micro-skills (e.g., self-disclosure, normalizing), language adaption (e.g., male-oriented metaphors) and treatment styles most engaging for men (e.g., collaborative, transparent, action-oriented, goal-focused). Presented are clinical recommendations for how to engage men in psychological treatments including paying attention to tapping the strengths of multiple masculinities coexisting within and across men. Our review suggests more empirically informed tailored interventions are needed, along with formal program evaluations to advance the evidence base.
Men in and out of treatment for depression: strategies for improved engagement. Seidler, Z. E., Rice, S. M., Oliffe, J. L., Fogarty, A. S., & Dhillon, H. M.
(2018)Australian Psychologist, 53(5), 405-415.
(2018)Australian Psychologist, 53(5), 405-415.
Abstract: While the prevalence of major depressive disorder continues to rise, many men are reticent to seek and sustain psychotherapy. The current study explored Australian men's experiences with treatment for depression with a view to guiding recommendations for improving treatment engagement. Twenty men (23–64 years) who had received psychotherapy for depressive symptoms in the past 3 years took part in individual, semi‐structured interviews. Interviews were transcribed verbatim and coded in line with interpretive descriptive methodologies. Findings suggested men's preference for a transparent orientation to treatment, including the provision of a clear structure for therapy. Men's preferred structure included focusing on individualised goals and expected progress, establishment of trust, and a sharing of decisional control. Providing an action‐oriented functional treatment with targeted skills attainment was recommended as most engaging. The focus on “doing” in treatment, as distinct from pure talk therapy, engendered feelings of strength and empowerment in the men, bridging self‐management of symptoms and wellness. Most participants, however, did not receive a treatment style that properly engaged them, and articulated clear recommendations for changes needed. Findings highlight the potential for development and dissemination of gender sensitive, strength‐based clinical training and treatment options for better engaging men in psychotherapy for depression.
The role of masculinity in men's help-seeking for depression: A systematic review.
Seidler, Z. E., Dawes, A. J., Rice, S. M., Oliffe, J. L., & Dhillon, H. M.
(2016)Clinical psychology review, 49, 106-118.
(2016)Clinical psychology review, 49, 106-118.
Abstract: Conformity to traditional masculine gender norms may deter men's help-seeking and/or impact the services men engage. Despite proliferating research, current evidence has not been evaluated systematically. This review summarises findings related to the role of masculinity on men's help-seeking for depression. Six electronic databases were searched using terms related to masculinity, depression and help-seeking. Titles and abstracts were reviewed and data systematically extracted and examined for methodological quality. Of 1927 citations identified, 37 met inclusion criteria. Seventeen (46%) studies reported qualitative research; eighteen (49%) employed quantitative methods, and two (5%) mixed methods. Findings suggest conformity to traditional masculine norms has a threefold effect on men experiencing depression, impacting: i) their symptoms and expression of symptoms; ii) their attitudes to, intention, and, actual help-seeking behaviour; and, iii) their symptom management. Results demonstrate the problematic impact of conformity to traditional masculine norms on the way men experience and seek help for depression. Tailoring and targeting clinical interventions may increase men's service uptake and the efficacy of treatments. Future research examining factors associated with men's access to, and engagement with depression care will be critical to increasing help-seeking, treatment uptake, and effectual self-management among men experiencing depression.
