Does Feminization of Mental Health Care Impact Custody Orders?

This article is about the “feminization” of psychology and social work (New York Times, 5/22/11).

It seems that the rise of managed care plus the tendency among psychiatrists (doubtless encouraged by health insurance companies) to replace talk therapy with drug therapy reduced earnings for mental health practitioners.  That tended to drive men out of the profession and women to dominate, which they now do.

Men earn only one in five of all master”s degrees awarded in psychology, down from half in the 1970s. They account for less than 10 percent of social workers under the age of 34, according to a recent survey. And their numbers have dwindled among professional counselors — to 10 percent of the American Counseling Association”s membership today from 30 percent in 1982 — and appear to be declining among marriage and family therapists.

And that turns out to have a profound effect on men who seek the services of mental health professionals.  Whether rightly or wrongly, men tend to seek male therapists.  So the near-absence of men in the profession effectively denies services to half the population.

The result, many therapists argue, is that the profession is at risk of losing its appeal for a large group of sufferers — most of them men — who would like to receive therapy but prefer to start with a male therapist.

“There”s a way in which a guy grows up that he knows some things that women don”t know, and vice versa,’ said David Moultrup, a psychotherapist in Belmont, Mass. “But that male viewpoint has been so devalued in the course of empowering little girls for the past 40 or 50 years that it is now all but lost in talk therapy. Society needs to have the choice, and the choice is being taken away.’

Of course, many men go to female therapists and many doubtless get help from them.  After all, as the article points out, a good therapist is a good therapist; a bad one is a bad one.  And the two aren’t sex-specific.

Still, it seems that a man tends to be more comfortable talking about intimate details of his life and psyche to another man, and that creates a problem when there aren’t many males in the profession. 

In just the past few years, psychologists have identified a number of issues that are, in effect, male versions of the gender-identity issues that so many mothers face in the work force: the self-doubt of being a stay-at-home father, the tension between being a provider and being a father, even male post-partum depression.

“In the same way that there is something very personal about being a mother, something very important to female identity, the experience of fathering is also very powerful,’ said Aaron Rochlen, a psychologist at the University of Texas, Austin. “And some men, I think, prefer to talk about that — the joy of being a father, the stress, how it”s impacting them — with a therapist who”s had the same experience,’ from the same point of view.

There’s a small upside to this.  If a man wants a good job, he knows where to find it.  Graduates schools and clinical programs are begging men to apply.

“I remember when I started training, I looked around and realized that for the first time in my life, I was an endangered minority,’ said Ryan McKelley, a psychologist at the University of Wisconsin, La Crosse. “Now I tell my male students, if you”re interested in clinical care, you can write your own ticket. You”ll be hired immediately.’

I have a couple of thoughts on this that the article didn’t mention.  The first is that, with the dramatic rise in fatherless families over the past 40 years, and the virtual monopoly women enjoy of teaching, it’s possible for a child to reach college age and never have any meaningful dealings with an adult male.  That’s not a revelation of course; it’s been commented on numerous times.

But one of the places a person might go to deal with the problems of having no contact with adult males is to a therapist.  Now we know that that’s not an option either.

The second is more important.  Anyone who follows family court practices very closely knows about the immense impact mental health professionals have on custody decisions.  Family judges rely on them to an enormous degree to recommend not only custody but the amount of time a non-custodial parent will have with his child and under what circumstances.

The fact that 90% of these professionals are women can’t help but have an overall impact on custody outcomes in family courts.  Of course we’d like to believe that their professionalism would prevent any sort of bias or prejudice in favor of mothers and against fathers, but experience teaches that that’s a “frail reed.”

Many, perhaps most – mental health professionals strive to do their jobs scrupulously.  But the news has plenty of examples of those who don’t and anecdotal evidence of fathers supports the notion that part of the tilt of family courts toward maternal custody comes from the counsellors they rely on.  And in any event, who would be surprised to find a female social worker who’s also a mother who’s been involved in a custody battle with her ex-husband erring on the side of maternal custody.

That’s even more likely because of the hesitancy men have with female therapists.  If a dad’s not comfortable with a female mental health professional, how likely is it that he’ll come across well on her evaluation of him?

It’s yet another wrong that a presumption of equally shared parenting could help to right.  If a judge has to order equally shared parenting absent a strong showing that one parent shouldn’t care for the child half of the time, it would be harder for mental health professionals to skew the results by unflattering evaluations.

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