I have been asked to write about providing therapy specifically to male youth. Why specifically male youth? Boys, for the most part, think, communicate, and act differently than girls. Many young people are recommended to therapy due to anxiety, depression, mood disorders, and suicidal ideation. However, I have found that boys are more likely to be referred due to behavioral and impulse issues, school underachievement, and also social difficulties (maybe due to overly aggressive behavior or extreme shyness or social avoidance).
It has been documented that the male brain is different than the female brain. Perhaps gender biases or socialization might also impact on the gender differences. Males are, for the most part, less aware of and have great difficulty communicating their feelings. Parents often bring in their boys as they feel their child needs to understand and express their feelings. I explain to parents that repeatedly trying to get their sons to express their feelings can be an exercise in futility for the boy, the therapist, and the parents. Boys are also brought in because they are underachieving in school and are not “motivated”. Many times I have seen boys who have older sisters and the parents are frustrated and don’t understand why their son, unlike their daughter, doesn’t like to read, hates homework, and doesn’t care much about academic performance. Attempts to get a boy to do their homework or read a book may also lead to a great deal of frustration for all. Alternative methods need to be considered. This does not mean these things can’t change but it takes time.
There have been several therapeutic modalities used for children/adolescents. I feel that all children are unique as are their parents. And with boys there are often several different presenting concerns. Therefore, it is important for the therapist to initially observe and understand the child, the family, and the nature of the presenting concerns before deciding what therapeutic approach and interventions to use.
Some things to consider when seeing boys in therapy;
- As with all people it is extremely important to develop a relationship and build trust.
- Help find, reinforce, and further develop the strengths and positive attributes of each youth. Often boys come in with poor self-esteem and it’s important to build on the positive.
- Do not accept the child’s (or parent’s) belief that he is “bad” or “lazy”. No one is inherently bad or lazy.
- Set appropriate limits and apply them consistently.
- Keep the parent involved. Get feedback from them and address parenting concerns.
- Make sure you have the boy’s full attention. Communication doesn’t work when they’re distracted.
- It is important to be creative with male youth. I have had a couple of male youth who could not stand being in an office and would throw major tantrums or crawl under desks. At times I have gone outside and thrown a baseball or shot baskets with a client. I have gone for long walks and discussed issues with male youth until they can cope with being in an office. Supplemental services may be very helpful. Here at JFS there are very effective social skills groups for children on the autism spectrum.
The following case example illustrates some of the issues and principles described above:
C was brought into therapy at the age of 9 by his mother due to defiant and aggressive behavior at school and home, academic “underachievement”, occasionally running out of classes or crawling under tables when seemingly overwhelmed. He was also dealing with his father not being involved in his life since age two. In the first few sessions C. made it clear he was not going to talk about his feelings so we discussed anything else he brought and in good weather we were able to go outside and toss around a football as a way to begin to establish a relationship and some trust.
At the same time, I worked with C’s mother to address parenting strategies. C’s mother and I also collaborated with the school, requested a child study team evaluation and an IEP (Individualized Education Plan as early on it became clear that C had many symptoms of ADHD (Attention Deficit Hyperactivity Disorder). His mother brought him to a child psychiatrist who prescribed him a relatively low dose of ADHD medication. As time went on during sessions we often played games including therapeutic games which helped him begin to address some of his feelings without him feeling threatened. Some days he did not want to discuss issues but he liked drawing or writing things on a board. He also became involved in some extracurricular activities and did well with them.
Eventually, C. became more comfortable with sessions, and when he was in the right mood we were able to discuss what were inappropriate behaviors and more positive alternatives. Mother also learned to focus more on his positive characteristics and behaviors while also setting appropriate limits. C. is now 11. He is doing better academically with the necessary assistance and the lower dose medication. His self-esteem has increased much, while his ability to handle anger and frustrations has improved. Given C.’s early life experiences and other factors C. needed time to trust before he could open up and discuss issues that were important to him including his feelings about himself and those around him. Offering him this time in therapy and allowing him to go at his own pace helped him, over time, feel better about himself and manage his frustrations better. He is now seen approximately once per 3 weeks to reinforce the progresses made and deal with stressors.
JFS is a not for profit, nonsectarian social service agency serving the needs of individuals and families in Somerset, Hunterdon and Warren Counties since 1980. JFS is committed to serving the needs of the entire community and offers a continuum of programs and services. Licensed clinical social workers provide individual, couple and family counseling as well as geriatric assessments, supportive counseling and case management services for home bound elderly. The Family Mentor Program recruits, trains and matches volunteers with vulnerable young families or with elderly persons for friendly, supportive, in-home visits; Families with children with special needs are assisted through social groups, parent groups and through the Family Mentor Program. Career Counseling helps individuals in many aspects of their job search. Ohr Tikvah-Light of Hope Jewish Healing Services offers presentations, support groups, and individual spiritual counseling to address the health, wellness and healing needs of the community. All information is confidential. Many programs are at no cost, on a sliding fee scale or payable through third party insurance. If you are interested in learning more about JFS’ programs, please contact us at (908)725-7799, visit our website: www.JewishFamilySvc.org, like us on Facebook. Jewish Family Service of SHW, Inc. 150-A West High Street, Somerville, NJ 08876.