Mark Meier knows there's only one thing tougher than getting a man into therapy — and that's keeping him in therapy. Meier, of Minneapolis, is a licensed clinical social worker and co-founder of Face It Foundation (faceitfoundation.org), whose mission is to help men understand and recover from depression. Face It, founded in 2009, offers individual and group support, community events and training for mental health professionals. In 2019, the nonprofit launched an unusual program pairing traditional therapy with peer support to see if that combination improved outcomes for men. Early results look promising. Meier talks about the program and what men need most to get and stay mentally healthy.
Q: You've said that men will go to therapy but they tend to only stay with it for a session or two. Why?
A: The literature is clear that men stop going to psychotherapy after one or two visits. For a number of reasons, it hasn't served them well. Sitting down for 50 minutes of talking is counterintuitive for most men. These guys never got Emotion 101. Guys need the cover of the group.
Q: So you provided that cover while still requiring that they see a therapist. And they were good with that?
A: These are all men who have already participated in Face It support groups. Many have been coming to us for years and have built friendships. But we're not a therapy organization. I wanted them to also go to therapy and have it be more effective. We kind of promised these guys that we could help them in a new way. I sent out an e-mail about this new program and it was like I was selling tickets to the seventh game of the World Series.
Q: In other words, they're hungry for professional help, but in a way they can best receive it.
A: The men who come in this door are starved to get better. They're experiencing depression, anxiety, a lot of hospitalizations and suicide attempts. They're 40, 50, 60 years old, finally revealing secrets they've carried their whole lives, including sexual and physical abuse. They've been medicating with alcohol, drugs, gambling. Many no longer have relationships with their partners or kids. They're alone.
Q: How many men participated in the initiative in 2019?
A: We had three groups of nine men each. Each group met for about eight weeks, seeing the therapist individually five times. Then they came back to Face It for four peer-led sessions where they could discuss and reinforce the skills they were learning in the professional therapy sessions with a clinical psychologist.
Q: What did they say helped most in those therapy sessions?
A: The guys loved the psychologist because he's direct. Some attended sessions with their wives. The psychologist shared real-life stories and did skills-based therapy with these guys, such as guided imagery, breathing techniques, [the eye movement approach] EMDR, not just talk therapy.
Q: What did you and Face It co-founder Bill Dehkes hear in your group sessions while the men were also seeing the psychologist?
A: Sometimes it was funny. When we'd gather in our friendly group environment, they'd say, "What just happened?" Or, "I don't understand how that tapping works." But they also said they had started sitting at work listening to his guided meditations and they'd feel less anxious. Their confidence was going up. We started seeing optimism in them.
Q: What were some measurable outcomes?
A: Ninety-eight percent of the men completed all five therapy sessions. Fifty-one percent strongly agreed and 39% agreed that having a peer support group to attend was an important component in helping them complete the five therapy sessions. And, most important, they showed significant improvement on the depression and anxiety rating scales they were provided in therapy. Twenty five of the 27 men said they strongly agreed or agreed that their depression improved because of the combination of peer support and five therapy sessions. A few of the men are still seeing the psychologist.
Q: Is this a pricey proposition?
A: It was actually very cost-effective. We negotiated a substantially reduced hourly rate with the psychologist to maximize the number of therapy sessions the men could attend. And I facilitated all 15 peer support groups. Based on market rates, we accomplished our goal at half the cost and achieved better outcomes because of our coordinated efforts.
Q: Where did funding come from?
A: The O'Gara Family Foundation has been instrumental in helping Face It grow and in supporting this project. Richard and Deborah O'Gara connected us to the Katherine B. Andersen Fund of the St. Paul Foundation, which has also helped to fund this project. Thanks to individual and family foundation funding, we can serve more than 200 men, ranging in age from 32 to 70, and we don't charge them a nickel.
Q: This is tough work. Why do you do it?
A: Bill [Dehkes] and I started it because of our own desire to help ourselves. In turn, we've helped a lot of people.
Q: Will you offer this combination program again?
A: If we can get funding, we'll do more. It's a no-brainer. I'd do five cohorts if we could get the dollars. It works.
