Academic journal article Culture, Society and Masculinities

The Integrity Model: An Existential Approach in Working with Men, Culture, and Identity

Academic journal article Culture, Society and Masculinities

The Integrity Model: An Existential Approach in Working with Men, Culture, and Identity

Article excerpt

Many cultures impinge on men's physical and psychological environments, including the political, economic and sociological forces that impact on personal and familial cultures. The capital city in which we practice is known for its cultural mosaic. As one walks down city streets, one may see yarmulkes, turbans, hijabs, niqabs, caftans, or the triple robes of Buddhist monks. Embassies abound with dignitaries and support staff, and a major thoroughfare waves the Rainbow Flag for several blocks. There are immigrants, refugees, tourists, panhandlers, ladies and gentlemen of the night, and a full spectrum of individuals from differing socioeconomic backgrounds. Although political protests arise from time to time, these are basically polite times with few skirmishes.

As clinicians with backgrounds in tertiary care, community practice and academic settings, we work with men from all walks of life within this cultural mosaic. This article examines ways in which men in Integrity-based therapeutic work explore their unique cultures, identities and masculinities within the multiple layers of their environmental contexts. Framed around the case vignette of Akio, a Shinto priest facing a severe crisis, we will offer a theoretical and clinical exploration of the Integrity model-an existential, values-based psychotherapeutic approach-in working with men around issues of culture and identity.


In this increasingly global society, therapists and male clients from different cultures face the challenge of working together. Nolte (2007) suggests that in this "meeting of cultures" (p. 378), therapists must strive to develop a more nuanced understanding of their own culture and of similarities and differences with other cultures. Liu (2005) invites clinicians to integrate masculinity issues with a greater understanding of the cultural factors that impact on male clients in order to work with men in "a culturally congruent manner and to develop appropriate interventions" (p. 694).

A number of authors have focused on the development of what Sue et al. (1982) termed Multicultural Counseling Competencies. Chao's (2012) study of 460 counsellors revealed a significant interaction between (a) racial/ethnic identity and multicultural counselling, and (b) gender-role and multicultural training on multicultural knowledge rather than on multicultural awareness. In a process-outcome study of cross-cultural clinical practice, Tsang, Bogo and Lee (2011) found that "whereas the literature on multicultural counseling competence tends to focus on awareness, knowledge and skills, the cases analyzed in this report showed that emotional attunement between the client and practitioner was critical to therapeutic success" (p. 85). Their findings emphasize the importance of "understanding internalized culture in the therapeutic process (Ho, 1995) rather than a cultural literacy approach which assumes that members of any ethnic group would share common cultural knowledge, values, beliefs, and practice" (p. 86).

There is a dearth of published articles examining therapeutic interventions with men around cultural issues. Several authors (e.g. Gondolf & Williams, 2001; Harper, Terry & Twiggs, 2009) suggest that counsellors working with African-American men and boys should focus on a culturally-focused and sensitive approach examining the interplay of race with gender and other demographic variables. Connor, Ling, Tuttle, and Brown-Tezera (1999) report that a peer educational intervention with a homeless population comprised primarily of African-American men was successful in enhancing empowerment, self-esteem, dignity and hope. Participants "moved from the position of being marginalized to becoming the central figures in this work. Although broken and wounded, they brought health and healing to others" (p. 372). Parkar, Fernandes and Weiss's (2003) ethnographic study of mental health and gender in a Mumbai slum suggest that in this overlooked population, traditional psychiatric perspectives may not be sufficient to remedy the plethora of socio-cultural issues which impede mental health. …

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