Social Work Practice with Men at Risk?
Rich Furman,
MSW, PhD
Director and
Associate Professor
Social Work
University of
Washington, Tacoma
Abstract: The purpose of
this article is not to assert that men are at more risk than women, but to call
attention to the notion that many men are indeed at risk, and that the
profession of social work may not be sufficiently attending to the men who are
at risk of various biopsychosocial maladies
Key words: Men,
Practice with Men, Masculinities
Social Work Practice with Men at Risk?
Introduction
Social work practice
with men at risk? A curious title of an article, given that men, as a segment
of the population, have more power, money, and social status than women. Yet, in spite of their power and privilege,
many men are at risk. Men, at the hands of other men, are more likely to be the
victims of violence (Clatterbaugh, 1990), and have
lower life expectancies (Center for Disease Control,
2004) than women. Poor older men,
returning male veterans, homeless men, and men from various diverse communities
face challenges of access that are associated with social isolation,
discrimination and significant risk.
The purpose of this article is not to assert that men are at more risk than women, but to call attention to the notion that many men are indeed at risk, and that the profession of social work may not be sufficiently attending to the men who are at risk of various biopsychosocial maladies such as schizophrenia, depression and anxiety, to mention only a few. In this brief article, we will explore the ethical and practical reasons why the profession should devote more attention to the needs of men. We shall highlight the major categories of risk, the current scope of practice with men at risk, and implications for the profession. Our overall aim is to draw attention to the need for the profession to develop culturally responsive practices based upon an understanding of men and masculinities.
The Need to Practice
for Men at Risk
The profession of social work has a long and storied history of creating and
providing services to meet the needs of diverse communities (Weaver, 1999).
Culturally sensitive or competent practices have been developed to make social
work practice congruent with important cultural variables and historical and
social contextual factors in order to provide relevant services to women,
Latinos, African Americans, Asian Americans and other groups. Yet, few social
work scholars have explored the notion of a culturally competent practice for
men (Furman, 2010; Kosberg, 2002). There are several
key reasons for this. First, it has been widely assumed that theories of
development and change have largely been developed for practice with middle
class white men. However, these theories may merely “split the difference;”they
are equally deficient in exploring the needs of women as they are with
explanations of masculinity and male identity development (Bannon
& Correia, 2006). In other words, while clearly
more research has been conducted on men and on the male body, this research has largely ignored gender specific
aspects of masculinities and how gender is implicated in this research. Second,
the help seeking and receiving behaviors of men and women differ greatly (Addis
& Mahalik, 2003).
When understanding the meaning and nature of seeking help, it is normal
and natural to contextualize this understanding within the context of how each
of us feel and behave. Since the vast majority of practicing social workers are
women, it would be useful for them to learn what it means to receive help
through the eyes of men. For instance, according to the hegemonic masculine
ideal, or the dominate form of masculinity to which men are acculturate to
strive to achieve (Connell & Messerchmidt, 2005);
receiving help is viewed as a sign of weakness.
Male social workers have an intuitive understanding of this cultural
norm that women may struggle to connect with on a personal level. Third, what
works with women in the helping relationship may not work with men. Men tend to
be instrumental or behavior in their approach change, and downplay the role of
emotions in the change process (Furman, 2010). Social workers who focus
extensively on affect and emotions, especially in the early phases of
treatment, may perceive men who refuse to talk about their feeling and want to
“do something” as being resistant, when in fact they are behaving according to
traditional masculine roles. To ask them to do otherwise, without help and
training, may feel unnatural. Four, a number of scholars and practitioners,
particularly in the world of international development and non-governmental
organizations, contend that human service professionals must attend to the
needs of men if they seek to help women (Bannon &
Correia, 2006).
By not viewing the needs of poor, oppressed and at risk men, those
professionals that do not work with the whole family, including men, run the
risk of engaging in interventions that do not change the whole system, thereby
minimizing the potential for lasting and meaningful change. The goal of gender
equity is best served by including men as allies and partners in the process.
Lastly, many men indeed are vulnerable, hurting, suffering and at risk.
Ethically, social work is called upon to provide services to society’s
vulnerable citizens, many of whom are men.
If social workers are to continue to work with men, as we always have,
we are ethically charged to practice effectively and from a culturally
competent perspective. From an ethics of care approach, which sees society as
an interdependent network, the wellbeing of one person risk jeopardizes our
work with other populations. In other words, since men clearly have
relationships with members of their community, they affect the wellbeing of
others; by not attending to the needs of men at risk, we not only fail to serve
this population, but we also miss the opportunity to further support the
populations that we do, in fact, serve.
Furthermore, if men represent nearly 50% of the US population, failure
to provide adequate and appropriate services to men at risk would appear to be
a significant failure on the part of social workers.
Who are Men at Risk
Again,
the purpose of this article is not to argue that men are at more risk than
women, but to explore how many men are indeed at risk. As a population, given
our historical legacy of patriarchy and sexism, many of our social institutions
remain deeply biased against women. Women continue to make less money than men
(DeNevas-Walt, 2005), are blocked from many social
roles (Andersen, 2007), and are disproportionately the victims of severe
domestic violence. Ending violence against women must remain an important focus
of our profession.
Still, many men are at risk and are in
pain. It is beyond the scope of a brief article such as this to explore all the
areas in which men have risk, yet a few include: substance abusing men; men in
prison, men in war and veterans; unemployed men; poor men;
men from historically oppressed communities, gay, bisexual and
transgendered men who are the recipients of reactive violence and
discrimination; and men who are undertrained and unprepared for the social
upheavals of the 21st century. The current economic crisis and
greatly depends on the wellbeing of others (Tong, 1998); thus, neglecting the
needs of men at the wars in Iraq and Afghanistan place two groups of men at
special risk, unemployed men as well as military personnel and veterans.
Statistics show that men have been
disproportionally impacted by the economic downturn. Since the beginning of the
recession, over 800, 000 men have become unemployed, and have accounted for 78%
of the job loss (Wall, 2009). While the national incidence of unemployment
hovers at a near fifty-year high of 10%, for some segments of men, the
statistics are far grimmer; nearly 16% of African American men are currently
unemployed. For men, prolonged unemployment has extremely serious mental and
physical health impacts. Masculine scripts and traditional means of forming
identity have largely hinged on the importance of work and the ability to be a
provider. Large segments of unemployed men are finding prolonged unemployment
deleterious to their mental and physical health. Without as many ways of
defining themselves positively outside of the economic sphere, many men are
experiencing a sense of worthlessness that places them at risk of substance
abuse and other dangerous behaviors (Meltzer at al,
2009).
The wars in Iraq and Afghanistan have had
profound effects on American service personnel, the majority of whom are men.
All wars have risk factors that are similar and unique at the same time.
Longitudinal studies have shown that all wars predispose men to mental health
and health problems (National Center for Posttraumatic Stress Disorder, 2006).
Several factors associated with the current wars exacerbate soldiers' risk
factors. First, many soldiers are deployed multiple times, often over the
course of several years. These multiple and elongated deployments have been
shown to increase various types of mental health disorders, including
depression and PTSD (Foa, Keane, & Friedman, 2000;
King et al, 1999), and places veterans at greater risk of suicide.
Additionally, the nature of fighting a war against guerrilla insurgents is far
different from what we know as conventional warfare. The hypervigilance
associated with this mode of combat greatly increases stress reactions,
including PTSD. Further, this particular type of combat places men at greater
risk of serious health concerns, such as Traumatic Brain Injuries (TBIs).
The Scope of Practice
with Men at Risk
Programs that do not take into account the specific needs of men as a cultural
group and the insights from gender and masculinities studies will likely not be
as effective as programs that take into account the nature and needs of
men. Likewise, gender-neutral services
attempting to meet the needs of both men and women may not fully meet the needs
of either. In this sense, using gender as a lens and variable to guide
practice, is perhaps as important a consideration as is ethnicity or race. As
we have explored above, the problems that men face are varied and diverse.
However, the number and types of programs that integrate key concepts from
gender studies, or in this case from masculinity studies, as variables in
designing services are fairly limited. The majority of programs designed for
men fall within the domain of several areas: violence prevention and
amelioration; fathering; and sexual health. Innovative programs within each of
these areas have helped those whom they serve immeasurably and must be
continued. This is particularly true of violence prevention and treatment
programs, as the violence of men against women remains one of the most
significant social problems that we face. Yet, the paucity of programs
specifically designed for men in other areas is lamentable.
Conclusion
It is my hope that
social workers will begin to more fully explore the implications of key gender
studies concepts and theories and their utility for practice with men and woman
alike (Furman, 2010). In terms of providing services to men, too few social workers
are educated to understand the implications for gender and masculinities on the
provision of micro, mezzo, and macro social work. To help men become more fully
involved in prevention, treatment, and social change programs, social workers
must begin to understand the nuances of how diverse groups of men view the
process of change, the helping relationship, and other key factors that lead to
treatment success. It is time that social workers more fully and deeply apply
and integrate insights from culturally competent practices to their work with
men, and men at risk in particular.
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