Improving service response for men Dr Jeff Young Director , The Bouverie Centre Bouverie.org.au

1. Improving service response for men • Dr Jeff Young • Director, The Bouverie Centre • Bouverie.org.au

2. Outline • Not an expert on men's issues or service delivery to men • I speak: • as a family therapist who has to work with men as part of families and • from two major projects that required me to think about men’s sensibilities. • Supporting drought counsellors across Victoria (2006-2009) • Combine counselling with community development/outreach • Single Session Therapy • No Bullshit Therapy • Creating family sensitive POPS for The Australian Defence Force (2011; 20112) • Ciricular questions – conducting virtual family therapy with individuals

3. The need to respond effectively to men – is a powerful argument • Suicide leading cause of death in rural men (Wainer & Chesters, 2000). Australian rural males suicide at a greater rate than their international counterparts (Sartore et al 2005) and at a higher rate than urban males (Caldwell 2004). • Indigenous men average life expectancy is lower than the age of superannuation access

4. Support for State-funded Drought Counsellors • $588KDecember 2006 - September 2008 • Support 35 drought counsellors +7 telephone counsellors • 5 Regions: Hume, Grampians, Loddon-Mallee, Gippsland, Barwon South-West • Start with 2 day forum to engage 42 drought counsellors • End with 2 day best practice forum 72 delegates attended • 15 No Bullshit Therapy Workshops - 323 rural workers, SST training • Qualitative Action Research (CIG / PAR) – 74 x 2hrs recorded, summarised – thematic analysis • A range of pre and post questionnaires

5. local community local community local community local community local community Grampians Barwon SW Hume CIG CIG CIG Bouverie Debrief Gippsland Loddon Mallee CIG CIG Co-operative Inquiry Groups (CIGs) Jeff Young: Bouverie

6. Combine Counselling & Community Development • Combining practical support with emotional support • Discretionary funds and practical supports • Whatever it takes (WIT) with minimal red tape (Accessible services) • Flexible work conditions – not just office based 9-5 • Co-ordinated funding to address ‘stop-start funding’ • New skills required for counsellors • Moving outside comfort zone – work at sale yards, businesses etc • Providing practical help & information as part of engagement • Assertive outreach – cold calling (Farmgate) / warm calling / third party referral • Moving from ‘chat to counselling’ • Funnelling: Start broad and move toward specifics • Redflagging: Moving in and out of emotional issues • Informed counsellors – the ‘Bowerbird Effect’ for outsiders (close outsiders)

7. Accessible & relevant models of counselling • Single Session Therapy • Making the most of the first (& every) encounter • No Bullshit Therapy • Strategies for engaging ‘Therapy Haters’ Culturally sensitive metaphors & community development strategies • Coach the coach (engaging sporting clubs) • Tool boxes (self help/counselling as a practical tool) • Pit stop (for physical health check ups) • Ute Therapy • Cuppa Tea Therapy

8. 42 771 (2004-5) 40 822 (2003-4) 31 613 (2002-3) Community Health Counselling state-wide contact data Total Contacts

9. Who influence Men to go to therapy? • Sample: 73 men • 96% were influenced by others • GPs and Intimate partners especially • 37% would not have sought help w/o this influence • But once in therapy, treatment helpfulness (judged by the first session) was the significant predictor of future help seeking for emotional / suicidal thoughts irrespective of pathway to care.Source: Jason Cusack et al (2004)

10. A comprehensive resource pack

11. NBT has 4 basic clinical guidelines • Striving toward mutual honesty and directness in working relationships • Marrying honesty and directness with warmth and care 3. Being upfront about constraints 4. Avoiding jargon

12. NBT Rhetorical Collaborative Business Social NBT Social Business Collaborative Engagement Therapy Haters Address hot spots to engage Therapy Lovers Engage to address hot spots Jeff Young: Bouverie

13. Good News! The Birchip Cropping Group Very innovative farming group in the Mallee 60 random farming families interviewed Report states rural people are anti counselling 13% of those interviewed had counselling; mostly in the past and all found it positive 66% “I don’t want it but it should be there for those who do” Only 21% “Believe it is simply of no help” Rickards (2007)

14. In depth interviews • Only one completed (with depressed shearer Bob & Jean)Main findings • Word of mouth • Come to us was important • A friendly stranger – made us comfortable, made a connection • Not comfortable attending community events • Thought counselling was bullshit until I had it • “We realized it wasn’t our fault – which really helped” • Only needed one session • “Can’t hurt you, but it could help you” No Bull: July 07 page 6 Jeff Young: Bouverie

15. Australian Defence Force Family Sensitive Post Operation Psychological Screening (POPS) The use of circular questions to help members explore the family relations Organisational supports and a cultural change process to support innovation.

16. Working with men (generalisations) • You cannot deny men their favoured means of emoting and then give them a hard time for not expressing emotions (Merz, 2000) • Malestream culture…the realm of the emotional is both dangerous and yet sacred, not to be touched except in special circumstances. • Need to provide control and to use emotions sparingly • Name but don’t push for emotional expression • Can be direct about emotions if not directly emotional (Furlong 2001) • Be upfront about what to expect with feelings • Talk more about thinking than feelings • Increase emotional vocabulary • Educate how to recognise and name feelings in others and in self

17. Bouverie.org.au