Gender Aware Therapy: A Synthesis
of Feminist Therapy and Knowledge
About Gender
GLENN E. GOOD, LUCIA A. GILBERT, and MURRAY SCHER
‘The time has come to integrate feminist therapy and knowledge of
gender into principles of counseling for both women anal men, Gender
‘Awware Therapy (GAT) is such a synthesis. GAT encourages coun
selors 10 facilitate the development of women and men through
exploration oftheir unique gender-related experiences, The founda
tions, principles, stages, and applications of GAT are described.
tion in the ways in which psychotherapy is practiced, At
the time feminist therapy evolved, one purpose was to
promote the understanding of women’s experiences within
their societal context and to construct nonsexist theories of
female development. Since feminist therapy intially focused on
the needs of women, and because the root of feminism is femina
(woman), many people have viewed feminist therapy as not
applicable to male clients. While there has been no theory
developed for men that parallels feminist theory, in recent years
research on conceptions of the male gender and its detrimental
‘consequences has been undertaken. (Note tthe reader: The term
sgender acknowledges the broader meaning that has become
associated with biological sex and thus refers to the psychologi-
‘al, social, and cultural features and characteristics frequently
associated with the biological categories of male and female.)
The new knowledge yielded about gender has not yet been
adequately incorporated into therapeutic models and practice.
Hence, the purpose of this article is to integrate the principles
of feminist therapy with recent knowledge of both female and
male gender from theories and research and then to suggest a
new means for conceptualizing therapy, which is called Gender
‘Aware Therapy (GAT). This article examines the roots of GAT
in greater detail and then discusses its principles, The stages of
GAT are described next, followed by specific problems for
which GAT is recommended. Finally, some cautions regarding
this new model of counseling are noted.
yes ‘of feminist therapy has created an evolu:
ROOTS OF GENDER AWARE THERAPY
Sexist notions frequently have been applied to women seeking.
therapy, usually with deleterious consequences for them. Four
general areas of bias identified by a task force of the American
Psychological Association were: 1) fostering traditional sex
roles, 2) bias in expectations and devaluation of women, 3)
sexist use of psychoanalytic concepts, and 4) responding to
women as sex objects, including seduction of female clients
(APA, 1975). Similarly, in early writings on feminist therapy,
the power which counselors, predominantly male at the time,
had over their clients, most of whom were female, was noted
This unquestioned power of men over women paralleled the
social order in which men defined women’s needs and charac-
teristics, and on this basis passed judgments about women’s
‘optimal functioning. In response, writers on feminist therapy
proposed key concepts to correct this situation, Some of these
concepts included recognizing that the personal is political,
encouraging women’s anger, viewing the therapist-client rela-
tionship as egalitarian, advocating female therapists for
women, and challenging sexist aspects of psychodynamic
theories (Gilbert, 1980).
‘The women’s movement madeitapparent that women in our
society had not had the full range of options open to them. With
regard to the mental health profession, both female clients and
helping professionals were cautioned about sexism in the pro-
fession. More specifically, women seeking mental health ser-
vices were encouraged to confront traditional gender roles
(APA, 1975), and practitioners were warned that psy-
chotherapy can no longer tolerate sexism in the diagnosis or
treatment of female clients, or in the training of practitioners
(Marecek & Hare-Mustin, 1987).
Aswas the casewith women prior to the women’s movernent
and the advent of feminist therapy, the current goal of most
therapies is (0 restore troubled men to their traditional gender
role model of mental health (ie., to be strong, assertive, and
independent). Yet recently, concern has been focused on the
detrimental aspects ofthe traditional male gender role socaliza
tion on the psychological development and adjustment of men
(cher, Stevens, Good, & Fichenfield, 1987). Extant beliefs that
'men have few problems because of their more privileged posi
tion in our society have hindered attempts to understand the
male gender role and its effects both on subgroups of men and
‘on individual men (Pleck, 1985).
Fortunately, in our speedily evolving society, conceptions of
‘optimal mental health have also been rapidly changing. The
‘adjustment’ or restoration’ of clients’ mental health—-men’s
‘or women’s—to conform with traditional conceptions of gen-
der is no longer a necessarily desirable outcome (cf. Cook,
1985),
PRINCIPLES OF GENDER AWARE THERAPY
There are many competing and overlapping schools of therapy,
including the various humanistic, cognitive, behavioral, psy
‘chodynamic, and familial therapies. We argue that the follow.
376 JOURNAL OF COUNSELING & DEVELOPMENT ® MARCH/APRIL 1990 ® VOL. 68Gender Aware Therapy
ing principles of GAT warrant incorporation within all these
approaches,
1. Regard Conceptions of Gender as Integral Aspects of
Counseling and Mental Health
It is all too easy for counselors to assume that gender plays no
partin their clients’ lives and in the therapeutic process, despite
vast evidence to the contrary. To date, the resistance has been
strong and the negative consequences in the form of harm to
clients have been unfortunately large (APA Task Force, 1975;
Hare-Mustin, 1983; Marecek & Hare-Mustin, 1987). Jacklin
(1989) recently concluded that: “The times are changing.
‘Change may be occurring too quickly for some, but change is
not occurring quickly enough for many girls and boys [and
women and men] limited by their gender roles to less than full
lives" (p. 132).
Counselors must not only be nonsexist in their work with
lients, but they must alsounderstand clients difficulties within
a gender perspective. Nonsexist counseling and therapy refer
to equal treatments for women and men, Although GAT em-
braces the need for nonsexist treatment, italso incorporates an
understanding of gender effects and sexism in its therapeutic
strategies and goals. A case in point is an adult client with @
6month-old child, who is seeking assistance with his or her
conflict in combining occupational and family roles. Nonsexist
therapy would prescribe thatthe same issues be raised for both
‘a male or female client. Yet the issues involved in combining,
‘work and family often differ remarkably for women and men
due to gender role socialization. These differences must be
considered and discussed for counseling to be effective.
2. Consider Problems Within Their Societal Context
‘The personal and the political cannot be separated for women
‘or men in society. Thus, the availability of quality child care or
anemployer’s policy with regard to paternity or maternity leave
‘would need to be considered in understanding the experience
‘of personal stresses and conflicts. It may also be noted that this,
principle is based on the feminist therapy principle that the
personal is political (Gilbert, 1980; Rawlings & Carter, 1977).
3. Actively Seek to Change Gender Injustices Experienced
‘by Women and Men
Although counseling is primarily a meansof individual change,
not broad social change, an awareness of gender issues and
sexism can shapeand direct the purpose of counseling such that
individual issues can be understood within the context of a
patriarchy that has denied, and to a large degree continues to
deny, wornen and men equal access to social, political, and
‘Of particular relevance here is an extension of Freeman's,
(1975) null environment hypothesis. More specifically, coun-
selors who fail to actively examine gender stereotypes with their
clients may inadvertently support traditional conceptions of
gender. This occurs because such counselors fal to actively
counteract the otherwise pervasive gender biases experienced
by our clients within this society. Thus, in the earlier example
of a dual-career couple, a counselor who neglects to actively
explore both the benefits and liabilities of a woman in a dual-
career relationship who sacrifices her career to assume child
care responsibilities is likely to be abandoning the client to the
pervasive societal pressures urging her to leave her career. The
GAT counselor would encourage the client to also carefully
‘exploreother viable options for which there may beless external
support, such as having her partner take a leave from his
‘employment or some arrangement requiring mutual accom-
rmodation, Likewise, the counselor should not assume that a
rman in a dual-career relationship would not want to consider
being the primary caretaker of children.
4. Emphasize Development of Collaborative Therapeutic
Relationships
Given its foundation in feminist therapy, GAT presumes that
competent counselors are knowledgeable about how gender
constructs affect not only women’s and men’s lives, but also
therapeuticinterventions and models of mental health, Further
‘more, like feminist therapy, GAT seeks to deemphasize the
expert role of the counselor: A collaborative and egalitarian
relationship is sought (Cilbert, 1980). This is done to empower
women and to short-circuit the competitive urgeldrive in men.
The collaborative and egalitariantherapeutic relationship may
also allow clients to experience, recognize, and “own” their
tendency to form “socially acceptable” dependent relationships
with the other sex.
‘The therapeutic process becomes one of helping clients dis
cover the optimal solutions for themselves. This process pro-
vides the possibilty for a freer, less stereotyped relationship.
Clients frequently have not had such an opportunity up until
this point, and the effect of such a relationship may be very
powerful.
5. Respect Clients’ Freedom to Choose
Choice is no less complex and intriguing an issue today than it
was. thousand years ago. GAT values the rights of people to
select views, behaviors, and feelings that are most congruent
for them, despite the gender scripts they may have previously
learned, currently experience, or fear in the future. This free-
ddom to choose involves having awareness of the messages one
hhas experienced, is currently experiencing, or may experience
in the future from others, as well as a sense of what is right for
oneself. GAT recognizes, for example, that both rigid traditional
and nontraditional gender roles can be equally confining. In-
dividuals are urged to choose that which is right for them,
despite dogma: GAT eschews notions of politcal correctness.
For instance, people may choose to generally follow a gender
role yet realize that aspects of that role are not for them. An
ardent feminist may choose to have a beautiful marriage cer-
‘emony, a man who prides himself on his physical strength may
find carrying a purse convenient, a man who loves cooking and
caring for the house may also enjoy watching football with the
boys, and a soft-spoken woman may be enraged about sexism.
in the workplace. In summary, GAT supports the notion that
particular behaviors, preferences, and attributes need not be
‘categorized as falling into the domain of traditional or nontradi-
tional, male or female, gender roles. Rather, what GAT advo-
cates is simply choice, despite gender conceptions or political
correctness.
STAGES OF GENDER AWARE THERAPY
GAT principles are germane to all therapies and warrant incor-
poration into counselors’ approaches to the therapeutic situa-
tion, They represent a basic approach to and principles about
counseling. Most approaches to therapy share similar stages in
terms of how therapy isto be conducted. GAT focuses on the
contribution of social forms, customs, and structures to indi
JOURNAL OF COUNSELING & DEVELOPMENT ® MARCH/APRIL 1990 ¢ VOL. 68, amGood. Gilbert, and Scher
viduals’ development as a woman or man throughout these
stages of counseling,
While brief therapy methods are frequently employed, an
exploration in some depth of clients’ difficulties is a valuable
‘component of GAT when circumstances allow. The contribu-
tion of gender fo the development of personality and behavior
{s generally quite significant and begins so early that a deep
exploration may be required in order to understand, and ifone
s0 chooses, to change, its effects
Problem Conceptualization
Inthe initial assessment phase of counseling, the conceptualiza-
tion phase—an understanding of the client's perception of the
problem—is obtained. Counselors using GAT seek to under
stand which aspects of gender socialization may have played a
part in their clients’ concerns. In the case of sexual molestation
‘where the victim is a male, for example, it is important for the
client to know that extant views of maleness stress being in
controland hence often keep the boy from telling because of his
shame at having allowed himself to be overpowered. Conver-
sely, the shame typically causing a female vietim not to reveal
sexual molestation may in part come from the stereotypic view
of womens seductresses and hence blameworthy for whatever
happened.
‘Therapeutic Interventions
During the course of counseling clients may be introduced to
‘emerging views of gender and socialization, as well as to how
their own development has been affected. The range of inter
1s employed in GAT encompass all of those of counsel
ing, including direct discussion, support, clarification, inter-
pretation, confrontation, information offering, guided fantasy,
experimentation, modeling, self-disclosure, bibliotherapy, and
support groups. In the examples of sexual molestation dis-
‘cussed previously, GAT counselors would work with the client
to facilitate the client’s understanding of how he or she may
have internalized stereotypic views of maleness and femaleness
and then help him or her to realize that asa child one could not
possibly be responsible either for causing the act or for prevent-
ing it
In addition to gaining new knowledge and perspectives,
clients will generally benefit from the opportunity to apply and.
rehearse new skills and behaviors in the session so that they
‘may use them effectively in life. The application of these newly
acquired skills necessitates determination on the part of the
lent and support from the counselor. During this stage GAT
recognizes that these changes may have a profound impact on
clients and the people in their lives. Hence, clients are en:
couraged to explore the implications of changes that they are
considering, to anticipate potential difficulties, and to develop
the skills necessary to successfully implement the changes that
they desire. For example, a woman who gave up her artistic
career goals after marriage may become depressed and enter
therapy. Through counseling, she may begin to recognize her
wants and then take actions to meet her needs, However, the
people in her life have not necessarily also been simultaneously
‘changing in counseling. Hence, they may unconsciously at.
tempt to maintain the homeostasis by stifling or punishing her
efforts. Likewise, aman who has been restricting his awareness
and expression of affect may decide in the course of counseling,
that he desires to start sharing more of his feelings. However,
the people in his life may be quite uncomfortable with such
Uunusual male behaviors as his stating that he sometimes feels
frightened, unsure, or vulnerable. The counselor employing
GAT would assist the client in anticipating the likely reactions
she or he may receive to the changes that are considered. The
GAT counselor likewise would both support and assist the
lent in developing effective methods to cope with the barriers
toand consequences of desired goals
‘Termination
The gender aware therapist recognizes the liabilities associated
with traditional conceptions of gender and assists the client in
learning from the opportunities that termination offers. For
example, a male client during the course of therapy may learn
toallow both the experiences of deeply caring for someone and
feeling deeply cared for. Through the process of termination,
hhe may learn to acknowledge feelings of sadness, vulnerability,
and the pain of good-byes. Conversely, a female client who has
been developinga sense of personal self-efficacy during therapy
may find termination an opportunity to further increase her
sense of self-reliance and self-dicection
PROBLEMS FOR WHICH GAT
IS RECOMMENDED.
The following is but a brief summary of some problems that
have been identified as associated with gender socialization. As
such, these problems would be especially appropriate for treat-
ment with GAT. It is important to note, however, that all
problems ringing people to therapy are anchored in some way
their view of the world, which is in part determined by the
dimensions oftheir gender roles and how these roles have been
inculeated in their particular case.
For Women
GATis especially salient forthe career development of women.
Numerous obstacles typically prevent women from equal ac-
‘ess to higher payingcareers. One particularly problematic filter
for women is the lack of sufficient support for persistence in
mathematics, science, and computer courses that are prereq-
Listes for entrance into many of the best career opportunities
in society (Betz & Fitzgerald, 1987). Another barrier for women
seeking to enter higher education, business, and industrial
settings is the lack of adequate mentors and role models,
(Douvan, 1976). Women also frequently face extreme conflicts
between establishing career priorities and attending to family
responsibilities, as well as encountering unrealistic societal and
personal expectations for being superwomen (Betz & Fitz
serald, 1987)
‘Another area that has earned increased attention recently is
eating disorders and body image disturbances. Women are
urged to conform to unrealistically thin weight expectations,
which precipitate unhealthy attempts to contzol weight, Fur
thermore, the more women adhere to socio-cultural mores
about thinness and attractiveness, the more likely they are to
engage in disordered eating to achieve these untealistic expec-
tations (Mintz & Betz, 1988). Hence, GAT would present a
highly effective approach to the treatment of these concerns,
Moreover, we live in a society that sexually oppresses
women. The statistics for women who survive incest, sexual
abuse, sexual harassment, and rape are staggering, and.
‘women’s experiences horrendous (cf, Brownmiller, 1977; Cour-
tois, 1988). In addition to a great deal of therapeutic skill, the
effective GAT counselor possesses and conveys a deep, em:
318 JOURNAL OF COUNSELING & DEVELOPMENT MARCH/APRIL 1990 @ VOL. 68.pathic understanding of the survivor's experience and facil
states appropriate attribution of causality.
For Men
Men ascribing tothe traditional views of maleness are generally
roluctant to ask for help of any kind, even to the point of not
asking for directions when lost. Adherence to this traditional
role has been found to be associated with men’s reluctance to
seek assistance for psychosocial concerns (Good, Dell, Mintz,
1989; Robertson é& Fitzgerald, 1989; Werrbach, 1989). Men are
prohibited from “giving voice” to that which is perceived as
“unmasculine,” such as feats, vulnerabilities, and insecurities.
‘Thus, for many men, normal lfe reactions are denied expres-
sion and perhaps eventually even blocked from self-awareness.
Hence, at the very thought of seeking counseling, conceptions
of gender may have a notable impact.
‘The traditional male gender role has also been linked to a
variety of problems (Harrison, 1978). These problems are hy-
pothesized to include a prohibition against experiencing de-
pression (Warren, 1983). Yet adherence to aspects of the male
sgenderrole have been found to be associated with an increased
Likelihood of depression (Good & Mintz, in press). Sexual
dysfunction is another problem often related to traditional
conceptions of maleness, whereby a mistaken emphasis on
control and performance interfere with normal functioning,
(Fracher & Kimmel, 1987; Zilbergeld, 1978). Additionally, sub-
stance abuse is another area likely to contain a significant
‘gendercomponent, as men seek to cope with restricted feelings,
lunacceptable thoughts, and prokibited behaviors through the
use of alcohol and/or drugs (Diamond, 1987). Increasing atten-
tion is also being focused on the detrimental side of extreme
independence. Traditional conceptions of the male gender pro-
mote interpersonal isolation, as emotional intimacy is asso-
ciated with vulnerability. Hence, interpersonal intimacy (re-
lationship) and intrapersonal intimacy (self-awareness) become
confused with loss of invulnerability, autonomy, and instru-
mentality, Clearly, men have much to learn about the ethics of
care and the notions of interdependence (cf. Belenky, Clinchy,
Goldberger, & Tarule, 1986; Gilligan, 1982)
For Couples and Families,
Gender also needs to be examined for its impact on relation-
ships, marriages, and families. As noted by Carter (1989), “For
ustoignore the relevance of gender at every level ofthe system,
or to ignore the enormous differences in male and female value
systems, or to ignore the ways in which gender organizes our
functioning as therapists is to truly blind ourselves” (p. 60)
‘Communication patterns, marital dissatisfaction, domestic vio-
lence, financial concerns, childzearing, substance abuse, and
sexual dysfunction are all concerns that are likely to have roots
jn gender scripting. For example, a couple involved in repeated.
domestic violence is highly likely to have gender issues as
central to their difficulties (Long, 1987; Scher & Stevens, 1987;
Walker, 1979), While couple, marital, and family problems are
‘complex, an awareness of gender socialization by the therapist
and the use of GAT principles are likely to contribute to the
effectiveness of treatment.
CAUTIONS:
GAT is a potentially powerful approach to the amelioration of
psychological difficulties. This manner of viewing clients and
their gender in their societal contexts is likely to change how
Gencier Aware Therapy
they progress in dealing with their lives. However, counselors
must also use care due to the social, politcal, as well as per-
sonal, implications of this approach. Changing rights, roles,
and privileges are political acts, and the repercussions for
individuals and society are significant (Scher, 1984). In short,
GAT is not a philosophical position to be taken lightly.
Due to the nascent nature of gender theory and research,
coupled with recognition ofthe salience of gender issues in the
lives of clients, counselors must often work beyond the current
bounds of empirically validated knowledge of gender. This isa
necessary but not ideal state of affairs, At this time the challenge
for counselors is to integrate gender theories, case reports, and
‘empirical research and then to apply this knowledge of gender
to the idiosyncratic needs of their individual clients. Thus,
‘counselors Seeking to address the gender issues of their clients
face significant challenges in their eforts to develop and faci-
itate healing interventions. The possibility of change in such a
core concept as one’s gender role is often surprising and dis-
orienting: most people are raised believing that gender qualities
are “givens” rather than characteristics that are learned. Even
when interventions are wisely chosen, many clients are in-
plicitly or explicitly resistant to changing elements of their
conceptions about gender.
Clearly, its not desirable to indiscriminately force clients in
nontraditional direction. Counselors need to be cognizant of
their values and careful not to devalue clients with differing.
views, Furthermore, GAT should also not be applied indis-
criminately across different ethnic groups. More research, writ-
ing, and dialogue are necessary to investigate the application
of GAT across different ethnic, socioeconomic, and life stage
‘groups.
CONCLUSION
Itis time to end the era of sexism and obliviousness to gender
by the mental health profession. GAT advocates that counselors
need to possess the knowledge, attitudes, and skills necessary
toassist women and men in leading lives free from oppressive
societal and personal stereotypes of gender. To help accomplish
this, GAT proposes guiding principles, which include 1) regard-
ing conceptions of gender as integral o counseling, 2)consider-
ing problems within their societal context, 3) actively seeking to
change gender injustices, 4) emphasizing development of a
collaborative therapeutic relationship, and 5) respecting clients’
freedom to choose. As our society continues to change rapidly
and increase in compleaity, the ability tobe situationally flexible
appears desirable. GAT encourages clients to gain an under
standling of societal conceptions of gender and how they limit
the feelings, thoughts, and behaviors of men and women, An
important goal of GAT isto help clients learn to actin new ways
that will allow them to develop healthier and more fulfilling
lives
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Glenn E. Good is « visiting asistent professor in the Departments of
Counseling und Higher Eduction, School 0 Education, atthe Uniersity of
Southern California, Los Angels. Lucia A. Gilbert is 2 profesor in the
Deparment of Educitional Psychology tthe University of Ts at Astin
Murray Scher is a psychologist 1 independent practice in Groowe,
Tennesse. The authors. thnk Jef Beane, Heath Caldwell, and Indra
Rochi-Singh fo ther feedback on cal drats of sate. Correspondence
‘garding this arte shoul be sent 10 Glenn E- Good, Dep. of Counseling,
‘Shoal of Education, Unizersty of Southern Cari, Lae Angeles, CA
0088-0031,
380 JOURNAL OF COUNSELING & DEVELOPMENT @ MARCH/APRIL 1990 @ VOL. 68