Why I Became a Therapist at Midlife

By Rob Krupicka, MSW | River Grove Therapy

A Wall Street Journal piece published in March 2026, written by Pamela Paul and

republished by the Spritzler Report under the title What Will Happen When All the

Male Therapists Are Gone? asks a question worth sitting with. The article examines

how psychology has shifted from an 80/20 male-to-female ratio in the 1960s to the near-

complete reversal we see today, and what that means for the millions of boys and men

who need mental health support. Men now account for only 18% of social workers and

20% of psychologists in the United States, down from 38% and 68% respectively in 1968.

The piece draws on researchers, clinicians, and data to make the case that this shift is

arriving at precisely the wrong moment. I read it and felt something between recognition

and urgency. This essay is my attempt to explain why I made the choice to enter this field

at midlife, and why I think more men should consider doing the same.

From Policy to Practice

I did not arrive at therapy through a traditional path. I spent years working in business

as well public policy with a particular interest in mental health. I reviewed systems, gaps,

and data. And the data, frankly, is alarming. Suicide rates among men ages 25 to 34 are

on the rise, and roughly 15 percent of U.S. men aged 21 to 25 reported experiencing a

major depressive episode in 2024. I watched those numbers climb for years from behind

a policy desk. At some point, I realized I did not want to work on the systems anymore. I

wanted to be in the room.

That shift from shaping policy to sitting with people was not a small one. It required

going back to school, being among the oldest people in most of my classes, and

rethinking what expertise and contribution looked like at this stage of life. But the

statistics I had spent years analyzing had stopped feeling abstract. They felt personal.

Men were struggling, quietly and often invisibly, and the field designed to help them was

becoming less and less equipped to speak their language.

What I am finding in practice confirmed what the data suggested. As I wrote in a recent

post on therapy for men: many of the men I work with do not arrive saying they need

help. They arrive saying they are frustrated. Irritable. Tired in a way that sleep does not

fix. That exhaustion is often the first honest thing they have said out loud in a long time.

Underneath it, the questions are usually deeper: Who am I if I am not producing? What

do I want from my relationships? Why does everything feel harder than it should?

Gender as a Clinical Variable

Here is something graduate school does not always say out loud: for some clients, the

gender of their therapist matters. Not because a skilled clinician of any gender cannot do

excellent work, but because for certain men, walking into a room and seeing another

man sitting across from them changes something before a single word is spoken.

I have watched this happen. Adult men who have struggled to articulate vulnerability

with anyone suddenly find themselves talking, really talking. Adolescent boys who have

learned to perform competence and indifference around adults let that performance

soften. The WSJ piece captures this directly. According to one of the few studies on the

subject, 40% of men have a gender preference in therapists. The most common reasons

for preferring a male therapist were feeling more comfortable (46%) and feeling better

understood (26%). Men also reported feeling more empathy from and less judged by

male therapists.

"A male clinician can reduce the fear of being judged or exposed and lower the

threshold for disclosure. Simply seeing an emotionally fluent adult man can itself be a

therapeutic intervention." -- Michael Zakalik, Clinical Psychologist

This is not about male therapists being better. It is about the value of options and about

meeting people where they are.

Therapy Needs More Male Voices

I was often the only man in my MSW classes. That experience taught me a great deal, but

it also revealed a real tension. Many of the frameworks we were taught were built from,

and speak most naturally to, a particular emotional vocabulary. The emphasis on naming

feelings, processing relationally, sitting in emotional ambiguity: these are valuable skills,

but they can feel foreign or even alienating to men who have been socialized very

differently.

As researcher Mark Kiselica has observed, the helping professions tend to approach men

and boys with a deficit perspective, focused on how they are flawed rather than how they

are different. That distinction is everything. Nobody wants to go to therapy to be told

their identity, directly or indirectly, is the problem. Therapy that begins from a deficit

frame, however unintentionally, can feel like confirmation of what a man already fears:

that something is wrong with him.

The WSJ piece also surfaces something that matches my own experience in graduate

training. One recently trained social worker noted he was very unimpressed with how

unseriously men's mental health was taken in classes, adding that men's concerns were

generally ignored relative to other demographic groups. Grad school talks about

intersectionality, but that often includes everything other than maleness. That is a

problem not just for future male therapists, but for the male clients they will eventually

serve.

In my work with men who have ADHD, I see this acutely. By the time many reach my

office, the labels have long since become internal. The outside critic, lazy, inconsistent,

not living up to his potential, has moved in and taken up residence. That accumulated

shame is often heavier than the ADHD itself. What shifts things is not a new

organizational system. It is the moment a man understands that his brain is not broken:

it is different. That reframe, from deficit to difference, is where real work becomes

possible.

Beyond ADHD, I have found that therapy with men works best when it honors how men

actually communicate and process. Men often respond well to a degree of self-disclosure

from their therapist. Not oversharing, but the kind of grounded honesty that says I have

been in territory like this too. It lowers the stakes. It normalizes. Men also tend to

respond well to being challenged directly and without judgment. And perhaps most

powerfully, men want to know that what they are feeling is not crazy. Validation, the

simple act of saying of course you feel that way given what you are carrying, can be one

of the most disarming and healing things a therapist offers. When that comes from

another man who is not flinching at what is on the table, it tends to land differently.

Purpose Is the Thread

One thing I have written about before is the centrality of meaning in nearly all the work I

do. Whether the presenting issue is depression, anxiety, ADHD, or a life transition,

meaning is almost always part of the picture. People expect purpose to arrive as a

revelation. More often, it is built through small commitments repeated over time: being

present when you could withdraw, showing up when it would be easier not to, finding

ways to make the people around you feel seen.

For men navigating midlife, retirement, career transitions, or the quiet erosion of

identity that can follow years of equating worth with productivity, this is often the core

question: who am I when I am not performing? Therapy creates space to sit with that

question seriously, not to pathologize it, but to honor what it is pointing toward. As I

wrote in an earlier post on meaning and distraction: purpose is not something found by

turning inward alone. It emerges through connection and contribution. It is cultivated

through presence, relationship, and the courage to be fully human.

The Real Barriers and Why They Are Worth Pushing Through

I want to be honest about the harder parts of this choice. The pay in this field,

particularly in community and clinical settings, is genuinely difficult. The professional

culture does not always feel built with men in mind. There is a real irony in the fact that a

profession devoted to helping people navigate belonging can itself feel like an

unwelcoming space for men considering it as a career.

And yet. I keep coming back to what is possible here, both for clients and for the men

who might consider this work. In a world where many men quietly struggle with

questions of purpose and meaning, choosing a vocation centered entirely on helping

others navigate the same terrain is not a small thing. For me, this work has been exactly

that kind of answer.

I also think technology has a meaningful role to play, both in attracting men to therapy

as patients and as practitioners. The integration of digital tools, teletherapy, and AI-

assisted support has the potential to expand a therapist's reach considerably, making

practice more economically sustainable and care more accessible to men who are

reluctant to commit to traditional weekly appointments. More men than ever are open to

seeking help: 17.3% sought some form of counseling in 2024, up from 8.7% in 2002.

Technology could be part of what meets that demand at scale.

A Case for the Midlife Career Switch

Graduate programs and licensure systems are not particularly designed for people in

their 40s and 50s who are changing careers. They probably should be. Still, there are

flexible online options out there. You can do this. The life experience, professional

history, and hard-won self-awareness that someone brings to clinical training at midlife

is genuinely valuable, and in some ways particularly well-suited to working with adult

male clients who are navigating their own questions about identity, meaning, and what

the second half of life is supposed to look like.

The lack of male representation in mental health professions could not come at a worse

time. But it also could not come at a more interesting moment, when more men than

ever are willing to ask for help, when technology is reshaping how care is delivered, and

when the conversation about what it means to be a man in the world is genuinely open in

ways it has not been before.

If you are a man at midlife wondering what comes next, whether there is work that

would feel meaningful and that uses everything you have learned rather than asking you

to start over, I would invite you to consider this. The room needs more of us in it. And for

the men we might serve, it matters that we show up.

Further Reading

The ideas in this essay were sparked in part by a Wall Street Journal piece written by

Pamela Paul, published March 12, 2026, titled What Will Happen When All the Male

Therapists Are Gone? The article covers the dramatic shift in gender representation

across mental health professions, the growing demand for male therapists among male

clients, how training programs may be inadvertently discouraging men from entering the

field, and what researchers say about the relationship between therapist gender and

treatment outcomes. It is available in full via the Spritzler Report:

What Will Happen When All the Male Therapists Are Gone? (Spritzler Report)

Rob Krupicka, MSW is a therapist & supervisee in Social Work at River Grove Therapy in Alexandria, Virginia, where he works withadults, adolescents, and children.

River Grove Therapy is located at 107 Oronoco Street, Alexandria, VA

22314. For inquiries, visit www.rivergrovetherapy.com.