Helping Professional Athletes

After the Game-Understanding the Experience of Athletes in Transition

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A significant number of professional athletes struggle after retirement from their sport careers, with increased incidence of stress and adjustment difficulties such as identity loss or disruption, problematic substance abuse, relationship dysfunction, depression, withdrawal, and suicide. While some literature points to the usefulness of transition programs for retiring athletes, they have also highlighted athletes’ resistance to engagement in such programs and the existence of stigma or “superstition of bad luck” related to thinking about retirement while still engaged professionally as athletes. Although researchers have frequently examined coping strategies employed by athletes during the career transition process, no study has been conducted on how professionals can support athletes in developing effective coping strategies. The current research will attempt to close this gap. Participants are ex-professional hockey players who played in the National Hockey League (NHL). Through semi-structured in-depth interviews, this research project will attempt to identify key themes in the transition experience with the objective of informing future transition services for this population.

Shifting Work Cultures Towards Inclusion & Empathy

Programs to Help Men Become More Inclusive and Empathic

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Creating cultures of inclusion where men are more welcoming of differences and create a climate of empathy are critical especially in traditionally male dominated workplaces. Heineken Mexico is the largest Heineken company in the world and a company with a compelling stated purpose-To Win Big for a Better Mexico. The Men’s Initiative conducted two efforts with the company. We co-created a dialogue-based program for Heineken Mexico aimed at creating a more inclusive workplace while helping men and women explore the value of differences. The program has ben very successful at raising awareness and changing hearts, has been translated into Spanish and is now being conducted internally in the company.

Tackling Violence Against Women

Advising Tecate on Campaign to Address Domestic Violence

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Violence against women is a major concern for men, women, communities, and families. We believe that this is an issue that men must play a significant part in addressing. As part of our work we have helped advise Tecate, a leading brand in Mexico, in their award-winning efforts to address violence against women by raising awareness among men. We admire their work and are privileged to have had the privilege to serve as advisors to these efforts.

Helping Our Military Personnel in Transition

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The goal of this project was to conduct a broad qualitative investigation of the lived experiences of medically releasing veterans as part of a comprehensive program evaluation of the transition course, Shaping Purpose. An emerging consensus among international experts suggests that the circumstances of the transition “peri-release” period (from 6 months prior to approximately 2 years after release) may play a particularly important role in long-term transition “success” in terms of post-service functioning, community participation, and well-being (Thompson & Lockhart, 2015). There is, however, little research concerning the needs of releasing military personnel during this critical period, or of programs that offer services within the peri-release period of military to civilian transition (MCT) (Shields et al., 2016).  Through interviews with 60 Veterans pre and post program involvement, and interviews with program facilitators and case managers within Veterans Affairs and the Canadian Armed Forces a more nuanced understanding of the context and challenges of transition was sought in order to evaluate and improve service design and delivery and to inform policy development.  Project completion is scheduled for August 2018.

Helping Men in Life Transitions

Living with Prostate Cancer

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Prostate cancer (PC) is the most frequently diagnosed cancer in men. The mean age for diagnosis of PC has decreased by approximately a decade over the past fifteen years. Living with prostate cancer is an experience that is fundamentally male. Like many cancers, the effects of prostate cancer treatment are often debilitating, physically and psychologically, impacting multiple facets of daily life. The many men who are diagnosed and treated for prostate cancer will likely live with altered bodies, an altered sense of self and function, and altered relationships with people who are significant to them. Inherent in the experience of the disease are issues deemed to be very private, and for many men, unspeakable. Categorically they may experience:
1. a loss of control (bladder and for some, bowel incontinence),
2. a sense of feminization (hot flashes and gynecomastia),
3. an altered and/or diminished masculine identity (erectile dysfuntion), and
4. an increased vulnerability (a new awareness of their own mortality).

Multiple studies of men with prostate cancer who had surgery, radiation therapy, hormone ablation or who watchfully waited demonstrate the need for psychological support for men following treatment and for prostate cancer. The support that is required is lacking.

Research in masculinity and health has shown that gender role socialization influences many men not to express health concerns, seek medical help or access psychological services despite their physiological and/or psychological stress. And yet, there are significant benefits to all patients, including men, if they commit to and follow through in getting psychological help. It is recommended that such services be provided for men during and following medical/surgical interventions pertaining to prostate cancer.

Further, while endorsement of “traditional” masculine ideals (e.g., altruism, solving other people’s problems, thinking logically and calmly, and valuing traits such as loyalty, self-reliance, and identifying themselves through their bodies) has many positive aspects, it also presents problematic issues, such as poor self-esteem, reduced interpersonal intimacy, depression, and anxiety. Men are often left in a double bind in which, if they hold to traditional ideals they may resist asking for help and if they ask for help they may expect to be harshly judged or socially ostracized from their friends and acquaintances. Fear of judgment or being ostracized often results in men becoming more aligned with traditional definitions of masculinity, which in turn results in avoiding therapy/treatment.

Research reveals transitional struggles of men with PC who must cope with the rift between idealized masculinity and debilitating treatment side effects such as erectile dysfunction and urinary incontinence. Intertwined with PC and the physical changes that can accompany that disease as well as its treatments are mental health issues – most commonly depression.

In response to the need for psychological support for men living with prostate cancer, David has developed a group therapy program known as Living with Prostate Cancer (LPC) that is part of the Prostate Cancer Supportive Care (PCSC) program at the Vancouver Prostate Centre in Vancouver, British Columbia. The program is being evaluated to determine whether group therapy sessions focused on the experience of living with PC (including incontinence, erectile dysfunction, feminization, and dying/death) are an effective means of reducing depression and anxiety, and improving overall psychological well-being among men with the disease. A secondary objective is to calculate the cost-per-patient of running the group therapy program from the health system and patient perspectives, and to compute cost per unit improvement in depression and anxiety symptoms.