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Article 54
Professional Counseling in Rural Settings
Raising Awareness Through Discussion and Self-Study With Implications for Training and Support
For the writing of this article we traveled more than an hour from two different points in rural Maine, one from the western mountains, and the other from the north central section, to a central meeting place. Typical of an early autumn morning, we both saw moose on our drive. One saw a big, old bull moose with a huge rack meandering into the woods, after grazing for a while on the side of the road. The other saw a cow moose and her calf ambling across the road, causing the only other car on the road to stop to allow them to pass. Both of us thoroughly enjoyed the drive on this beautiful fall morning as the sun was rising over the hills and mountains where the leaves were just turning to brilliant colors.
Appreciating the peacefulness and beauty of this day in rural Maine, we were reminded of the reason we love living and working in rural Maine. We were grateful that we were not traveling at dusk when the joys of seeing the moose would instead be apprehension about hitting one of them. We were reminded that such are the rewards and challenges faced in living in rural areas. Rural professional counselors are affected daily by the unique circumstances of rural life and rural practice.
There is much agreement among mental health professionals that living in small towns and rural areas creates unique experiences. “The uniqueness of the rural environment as a context in which to practice has become clear” (Hargrove, 1986, p. 20). It is important for professional counselors to be cognizant of the ways in which the rural context affects their work and their lives.
A review of recent, relevant counseling literature (Bushy & Carty, 1994; Morrissette, 1997, 2000; Pearson & Sutton, 1999; Sutton & Pearson, 2002; Weigel, 2002) revealed that professional counselors who live and work in rural settings face a dichotomy of rewards and challenges. They enjoy close personal and professional relationships. They are known by the community and know many members of the community.Their work is visible and often highly valued. Once known, they are rewarded by a sense of belonging and acceptance. The rural lifestyle offers peace, solitude, beauty, and many opportunities for healthy outdoor recreation. Rural areas are seen as great places to raise families. The rural counselor may enjoy meeting the many and varied needs of rural residents. Often their work is autonomous and satisfying.
The same aspects of rural life and rural practice also present both personal and professional challenges. Close relationships may challenge ethical practice and present difficulties in establishing and maintaining professional boundaries (Erickson, 2001; Herlihy & Corey, 1997). It may be hard to separate friend and relative from client. Visibility compromises confidentiality for the client and privacy for the counselor. Isolation creates challenges as well. Getting to work, to resources, and to professional opportunities and colleagues requires navigating long distances and rural terrain (and perhaps even moose). The rural setting often lacks many resources, calling upon the professional counselor to play multiple roles, serve a wide variety of needs, be readily available when the need arises, and be creative, highly skilled, and flexible (Hovestadt, Fennell, & Canfield, 2002).
Despite recognition that the rural context is unique, affecting the lives and the work of rural professional counselors, the effect of the rural context is not a subject commonly addressed by the counseling profession. Little recognition has been paid to the needs of the professional counselors who practice in rural settings (LaTurno Hines, 2002; Morrissette, 2000; Weigel, 2002).
We have been interviewing rural counselors to learn more about the effect of the rural experience on the lives and work of rural counselors. How is their work affected? How are their lives impacted by their rural work? What questions are raised for them in their work and personal lives? What professional dilemmas do they face? What are their needs for training and support to enhance their practice in the rural setting and to maximize the benefits of rural life and rural practice?
Recommendations from this research have suggested that it is important to focus attention on the effect that the rural context has on the practice of professional counseling. It is suggested that counselors need to be aware of the impact of the rural lifestyle and the rural culture on their lives and their work. It is further suggested that they need both professional training and support that takes into account the unique context of the rural setting. Our research has suggested that those who provide training and support need to spend time working in the rural setting (Breen, 2000). In response to this suggestion, we have engaged in auto ethnographic research, focusing on our lives in the rural culture and our work in the rural community.
Making professional decisions, balancing the issues and incidents with the joys of the rural setting, raises personal and professional questions. Yet, those who work in rural settings become accustomed to the nature of rural life, often taking for granted the idiosyncrasies of rural culture. There is a need to raise awareness of the unique context of the rural setting. One way to do this is to talk about the rural counseling experience. Another is through self-study.
In this article, we present scenarios from our own rural experiences as examples of incidents common in rural counseling. We raise questions about these situations for discussion. Following the scenarios we present a list of questions to guide the self-study of professional counselors who live and practice in rural settings.
The Case of the Awkward Dinner
It’s awkward to find yourself in social settings and yet maintain professional boundaries. You are out for dinner with your family and a father tells you of his son’s progress in counseling, giving specific examples. He looks toward your family as though they know about his son in terms of what he is working on in counseling. You cannot respond to him except with general statements like, “Oh, that’s good.” Your family is not able to respond to him at all because, while they know his son, they do not know what he is working on in counseling. It may touch you personally in three ways: one, that you feel like you are being rude by not talking with him on the level he is presenting; two, that your family is feeling awkward because he is assuming they know what he is talking about yet they have no idea; and three, is that you cannot fill in the missing information for your family.
How do you put your awkward feelings aside and continue with the social interaction? What do you say to your family when they have questions? Can you expect your family to follow your professional standards?
The Case of the Unknowing Tutor
Your friend is a tutor at the local private boarding school. Some of these students come to your office for counseling. Because of confidentiality, you never talk with your friend about who you are seeing for counseling. However, she, at times, may talk about the students she is tutoring. One evening, while at dinner, your friend mentions that she is concerned about one of her students because he left the school unexpectedly to go home. You have been working with this student in counseling, and it is news to you that he left the school suddenly. However, you cannot acknowledge that you know the student, nor can you ask your friend questions.
Are you worried about the student? If so, do you put your concerns for this student aside and continue with the social interaction? How do you do this? Do you feel like you have to be an actor, quickly covering up your natural reaction?
The Case of the Emergency Response Person
A local emergency response person approaches you in a social setting to talk about one of your clients. You explain that you cannot talk about the client, especially in that setting. You go to his office the next week to talk with him about emergency response issues and client confidentiality. He is not there, so you leave a message for him to call you. He does not call you and again approaches you in a social setting to discuss your client.
How might you talk with the emergency response person while maintaining respect for both the client and the emergency response person? How do you put aside your frustration with being challenged with this in a social setting? Do you struggle with trying to follow the ethical standards of the profession?
The Case of the Unknowing Neighbor
A client makes reference to someone in your neighborhood during one of her sessions. Her relationship with the neighbor is one of the issues she is working on in that session. Consequently, you hear things about the neighborhood person that you might not otherwise know.
How do you remain focused on the client and put aside your natural reaction to new information you have about your neighbor? Does this information affect your relationship with your neighbor?
The Case of Muddy Mitts
Cients sometimes visit neighbors on your street. They see you outside gardening when they come by. You are dressed in shorts with muddy hands and face. Your appearance is not professional.
Do you always need to look professional? What are they thinking of you? Can you relax and enjoy your own yard? How does it feel to be so visible?
The Case of the Pastor
The pastor of your church sometimes mentions you from the pulpit during her sermons. She refers to you when she is speaking about local or national mental health issues or news stories. The pastor talks about counseling at times during her sermons. There is a rumor in the church and community that you are her counselor. You are not.
How do you feel about being referred to during sermons at church? Do you need to dispel this rumor? If so, how? Do you talk to the pastor about this rumor?
These scenarios raise a few of the many issues from our experiences. We suggest that rural counselors engage in self-study to better understand their own experiences as rural counselors and to realize their needs for training and support focused on the rural setting. We encourage rural counselors to listen to their internal dialogue and pay attention to their feelings, thoughts, and emotions. We offer the following questions for rural counselors to contemplate:
In what ways does the rural setting help your counseling practice?
In what ways does it challenge your practice?
How does it change your work?
How does it change your concept of the role of a counselor?
How does your rural professional role challenge your personal life?
What can you draw upon from your training that focuses on rural counseling?
What kind of training do you need to look for that focuses on rural counseling?
What kind of support do you have that focuses on rural counseling?
What kind of support do you need to look for that focuses on rural counseling?
Conclusion
It seems that rural counselors are so accustomed to their rural settings that they may not always see the ways in which the rural culture affects their lives and their work. There is a need to raise awareness of the culture of rural counseling. To focus attention on the effects of the rural context on the lives and work of professional counselors, we are researching rural counseling. We are finding the need for rural training and support provided by those who have experienced the rural setting. Taking a recommendation from our findings, we are engaging in auto ethnographic research of our experiences working in the rural setting. In this article, we have presented scenarios from our experience in an effort to encourage rural counselors to engage in self-study. We hope those who participate in self-study will become more aware of the impact of the rural setting on their lives and practice as well as their training and support needs.
References
Breen, D. (2000). Rural counselors, you are community leaders: Tell your stories. Paper presented at the meeting of the Maine School Counselor Association, Rockport, ME.
Bushy, A., & Carty, L. (1994). Rural practice? Considerations for counselors with clients who live there. Guidance and Counseling. 9(5), 16-25.
Erickson, S. H. (2001). Multiple relationships in rural counseling. The Family Journal: Counseling and Therapy for Couples and Families, 9(3), 302-304.
Hargrove, D. S. (1986). Ethical issues in rural mental health practice. Professional Psychology: Research and Practice, 17(1), 20-23.
Herlihy, B., & Corey, G. (1997). Boundary issues in counseling: Multiple roles and responsibilities. Alexandria, VA: American Counseling Association.
Hovestadt, A. J., Fennell, D. L., & Canfield, B. S. (2002). Characteristics of effective providers of marital and family therapy in rural mental health settings. Journal of Marital and Family Therapy, 28(2), 225-231.
LaTurno Hines, P. (2002). Transforming the rural school counselor. Theory Into Practice, 41(3). Columbus: College of Education, Ohio State University.
Morrissette, P. J. (1997). The rural school counselor: A review and synthesis of the literature. Guidance and Counseling,15(1), 19-23.
Morrissette, P. J. (2000). The experiences of the rural school counselor. Professional School Counseling, 3(3), 197-207.
Pearson, R. E., & Sutton, J. M., Jr. (1999). Rural and small town school counselors. Journal of Research in Rural Education, 15(2), 90-100.
Sutton, J. M., Jr., & Pearson, R. E. (2002). The practice of school counseling in rural and small town schools. Professional School Counseling, 5(4), 266-276.
Weigel, D. J. (2002). Differences in counseling practices across rural and urban environments: An empirical investigation. Dissertation Abstracts International, 62 (10-B), 4460.