258 Psychology of Women and Gender
responsibility takes precedence over self-sufficiency (Hare-
Mustin & Marecek, 1986).
Feminist critiques have been accompanied by a variety of
efforts to change clinical training and practice. In 1977, the
Division of Counseling Psychology undertook a 2-year pro-
gram of conferences and special issues of The Counseling
Psychologist designed to provide information and skills
about women and girls and to counter sex bias in therapy and
counseling. Around the same time, the APA constituted a
Task Force on Sex Bias and Sex Role Stereotyping, which
produced and promulgated guidelines for nonsexist therapy
(American Psychological Association, 1978). In 1979, the
APA and the National Institutes of Mental Health convened
an interdisciplinary conference of mental health specialists to
identify priorities for clinical research on women. Women
and Psychotherapy,the volume resulting from that confer-
ence, served as a core text in the area of women and psy-
chotherapy for many years (Brodsky & Hare-Mustin, 1980).
Feminists “broke the silence” surrounding sexual contact in
psychotherapy (Hare-Mustin, 1974). They argued that be-
cause of the inevitable power differences in therapy relation-
ships, sexual involvement between therapist and client could
not be consensual. As a result of pressure by feminist groups,
the APA eventually altered its ethical code to include an ex-
plicit injunction against sexual contact between therapist and
client.
Feminist Approaches to Therapy
The term feminist therapycame into use in the early 1970s.
The first feminist therapists deliberately positioned them-
selves outside the system in freestanding therapy collectives.
One therapist has described the early days of feminist ther-
apy as “raggedy, boisterous, know-it-all, risky, and heady”
(Adelman, 1995). In those times, some volunteered their ser-
vices without pay. Others raised funds to be able to offer
therapy without charge or on a sliding-fee scale. Now, femi-
nist therapy has for the most part moved beyond its separatist,
grassroots beginnings and its underground aspect. Therapists
who identify themselves as feminist therapists or who spe-
cialize in women’s issues work in a variety of settings, in-
cluding universities, public and private hospitals and clinics,
private agencies, and independent practice.
Although there are a number of frameworks for fem-
inist therapy, certain concepts unite feminist approaches to
therapy. First and foremost is an ethical commitment to pro-
moting equality and social justice. Other key concepts are at-
tention to the social context, particularly to inequities in the
distribution of power and resources; respect for diversity and
cultural difference; valuing ways of being and social roles
associated with women; and a commitment to collaboration
and power sharing in therapy relationships.Women in ContextFeminists bring to clinical practice a focus on the gender
system—the institutions, social practices, language, and nor-
mative beliefs that constitute maleness and femaleness as we
know them and that create and normalize power inequities.
The first feminist therapists incorporated consciousness rais-
ing as part of therapy with women. Consciousness raising
helped women see how “the personal is political,” that is,
how private troubles were connected to social roles and ex-
pectations and women’s subordinate status (Brodsky, 1977;
Lerman, 1976). Feminist therapists and researchers view
gender as a central feature of social life and personal iden-
tity; thus, they seek to understand clients’ difficulties and
strengths in relation to the gender system (L. S. Brown, 1994;
Lerner, 1988). This angle of vision goes beyond cataloguing
symptoms and syndromes. It sometimes dislodges conven-
tional meanings of behavior and may even overturn custom-
ary judgments about what is healthy or unhealthy.
The influence of the sociocultural context on women’s
psychological well-being can be seen with special clarity in
the case of eating problems. In the United States, more than
90% of those with clinical eating disorders are women.
Women’s eating problems are neither timeless nor univer-
sal; they are specific to contemporary Western societies (es-
pecially North America). One line of feminist work has
identified a prevailing “culture of thinness,” that is, the
glamorization of ultrathin female bodies in the mass media.
The culture of thinness promotes an intense preoccupation
with body shape and size, feelings of shame and chronic dis-
satisfaction with one’s body, and rigorous dieting in order to
achieve an ideal body (Rodin, Silverstein, & Striegel-Moore,
1984). Other feminist work has drawn attention to motifs and
themes associated with women’s body size, virtuous self-
restraint, and self-denial (Bloom, Gitter, Gutwill, Koegel, &
Zaphiropoulos, 1994). Another line of work has tied
women’s eating problems to social processes of objectifica-
tion, which set a woman’s body parts and sexuality apart
from her personhood (Frederickson & Roberts, 1997). Sexu-
alized scrutiny, sexual evaluation, and sexual objectification
are continually present in women’s lives, both in actual inter-
personal encounters and in media images (Kaschak, 1992).
Not surprisingly, many women and girls come to adopt atti-
tudes of self-scrutiny and self-evaluation, resulting in shame,
anxiety, and distortions in body image. Eating problems may
also arise as a means to relieve severe emotional strain—for
example, adolescent struggles over coming out as a lesbian or