Group therapy not always best choice for men

For depressed men seeking support for severe grief, group therapy may not be the best choice, new research suggests. A study of men and women in group therapy found that men did not benefit as much as women.

“Men and women respond differently to the group therapy format,” Dr. Anthony S. Joyce of the University of Alberta in Edmonton told AMN Health.

Men’s treatment preferences seem to differ from women’s, according to Joyce.

Depression

Depression is the most common psychological problem in the US. Minor Depression can be attributed to normal depressed feelings that arise because of a specific life situation, a side effect of medication, hormonal changes or physical illness, and does not usually require treatment. Major Depression (depressive illness) is a serious condition that result in extreme fatigue, sleep problems and eventually an inability to function. The exact cause is unknown, but it is thought to be a malfunction of brain neurotransmitters, which are chemicals that modulate moods. Major Depression is usually treated with a combination of psychotherapy and antidepressants which moderate or correct chemical imbalances in the brain. The group of antidepressants most frequently prescribed is the selective serotonin reuptake inhibitors (SSRIs) which regulate the neurotransmitter serotonin. Examples: Amitriptyline HCL WELLBUTRIN Wellbutrin SR Fluoxetine Celexa Lexapro Paxil Prozac Remeron Zoloft Effexor XR

For instance, men may prefer working with a more “distant” therapist in a problem-solving approach, according to Joyce. That could put them at a disadvantage in group therapy, “where close relationships and intimate disclosure are more common,” Joyce said.

“This statement needs to be qualified, however,” Joyce said. He noted that the study looked at gender differences in a short-term group. In longer-term groups, the differences between men and women may disappear, he said.

“Also, most of the groups studied had very few men - no more than 3 out of 8 to 10,” Joyce said. “So the effect reported was possibly less due to gender than to the particular composition of the group,” Joyce said. In groups with only a few men, the women’s preferred way of working may have been the dominant orientation of the group, he said.

Despite the caveats about the study, this is not the first time that Joyce and his colleagues have uncovered gender differences in therapy. In a previous study, the researchers compared men and women in individual, not group, therapy.

“We found that men and women did the best in the form of treatment that presumably matched their preferences for treatment,” he said. For women, that tended to be a supportive approach, while men were more likely to prefer an interpretive approach to therapy.

In the current study, Joyce and his colleagues evaluated the effectiveness of group therapy in people with major depression who also had a condition called complicated grief. People with complicated grief experience grief symptoms that are more extreme and long lasting than usual.

The 47 participants in the study were enrolled in group therapy that met for 90 minutes once a week for 12 weeks.

Some of the groups were supportive in nature, meaning that they were aimed at helping group members adapt to their life situations. Other groups used interpretive therapy aimed at enhancing patients’ insights about their problems.

Overall, depression, anxiety and other symptoms improved more in women than in men, Joyce and his colleagues report in the summer issue of the journal Psychotherapy Research. In fact, men experienced virtually no change at all in several symptoms.

The study also showed that men were not as committed to their group therapy as women. In addition, women felt that men were less compatible than the women in the group. This may have “partially mediated” the gender difference in response to group therapy, Joyce’s team believes.

SOURCE: Psychotherapy Research, Summer 2004.

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