Consequences of mental health issues in men that are left untreated can affect a man’s partner, friends, family, and co-workers. While much research has described the efficacy of psychotherapy with this population, adult male clients may be hesitant to even start treatment. This is due to several reasons including stigma, toxic masculinity, and accessibility. To combat this, the American Psychological Association published Guidelines for Psychological Practice with Boys and Men in 2018. Research from 2005--the year the guidelines were conceived--to 2021 suggests that three therapeutic approaches are among the most effective in establishing or maintaining a therapeutic alliance. The approaches are: (a)-- strengths-based; (b)-- goal/action-oriented; and (c)-- psychoeducation regarding problematic behavior. This dissertation is a systematic review that studied qualitative research to analyze which approach or combination of approaches was most effective for different demographics within the adult male population in the U.S. The research questions are: 1. Among three therapeutic approaches--strengths-based; goal/action-oriented psychoeducation regarding problematic behavior--which is the most effective in establishing and maintaining a strong therapeutic alliance with voluntary adult (18-65) male clients who have been in therapy for at least three sessions? 2. What combination or combinations of the three approaches, if any, are more effective than any individual approach? 3.Which approach or approaches among the three were reported as most effective by clients of specific racial, ethnic, or cultural minority groups?

Library of Congress Subject Headings

Therapeutic alliance; Psychotherapy--United States; Men--United States

Date of Award


School Affiliation

Graduate School of Education and Psychology



Degree Type


Degree Name


Faculty Advisor

Carrie Castañeda-Sound

Included in

Psychology Commons