Inflexibly Enacted Traditional Masculinity Norms (IE-TMNs) and Their Impact on Adolescent and Young Adult Depression: The Hybrid Case Study of "Tommy"

The purpose of this study is to explore and discuss the effects of inflexibly enacted traditional masculinity norms (IE-TMNs) on adolescent and young adult males with depression and how to address such issues in therapy. This study provides a literature review of the subject of IE-TMNs and how such a worldview holds a potentially negative influence and impact on the physical and mental health of boys and young men. Specifically, the study aims to highlight how these beliefs, attributes, and values influence the extent to which these individuals seek help, express emotion, and utilize healthy coping skills when experiencing depressive symptoms and how such behaviors can be addressed in therapy. Treatment considerations are explored through the hybrid case example of "Tommy," a depiction of a depressed college freshman following IE-TMNs while going through a difficult life transition. A fictional case, Tommy serves as a composite character informed by real life psychotherapy cases and clinical examples found in relevant literature. Tommy’s course of treatment depicts potential clinical issues that could come up when working with a depressed male client with strong internalized masculinity norms and how some of these themes can be adequately addressed to create a more flexible masculine identity. Through use of a qualitative, disciplined inquiry approach, I explore therapeutic interventions that could be utilized to meet the unique needs of such a client within the context of historical, contextual, and cultural factors. Tommy’s case material is analyzed qualitatively and quantitatively in accordance with the pragmatic case study research format (Fishman, 2013). The hybrid case of Tommy explores how client-centered therapy, motivational interviewing, harm reduction interventions, and cognitive-behavioral interventions can be integrated to assist adolescent boys and young men with strongly internalized and rigid beliefs about masculinity, while also utilizing Bronfenbrenner’s ecological systems theory to explore the proximal and distal factors in one’s environment that contribute to such a worldview. The hybrid case study of Tommy is designed to serve as a resource for therapists working with clients with IE-TMNs and provides guidance about how to alter unhelpful coping strategies; increase emotional expression and help-seeking behaviors; and explore personal beliefs, goals, and values. This case study concludes with a critical discussion of future directions for research on this topic, as well as the advantages and limitations of the hybrid case study design.