participants chose not to be identified or did not participate in Round 2 where they were asked permission to be identified. I hope the knowledge gained in this study will contribute to further understanding of the need for training for work in the field of rural psychology. This study is close to my heart and as 1 endeavor to promote rural mental health literacy and mental health services in rural areas I will continuously reflect back on its findings. x ABSTRACT Students in graduate level psychology training who intend to work in rural settings must be familiar with and educated in how rural life and identity impacts clients. Currently, there are few doctoral training programs in psychology that offer courses specifically tailored to rural populations despite the fact many psychologists are employed, or work with people, in rural settings. As such, there is a need to understand how to best prepare students in doctoral training in psychology for competent work as psychologists in rural areas. Given the nature of rural culture, rural mental health, urban versus rural characteristics, the current status of rural practice, and the overwhelming lack of education regarding rural issues, the purpose of this study was to ascertain critical factors for training in rural psychology. Through dialogue with 33 current rural psychologists, researchers who have published in the area of rural psychology, and educators in rural psychology (predominantly residing in the United States) via the Delphi method, 129 discrete elements for an effective rural psychology training curriculum were identified. Via the process of the Delphi methodology, 17 factors were noted as critical. Sixty-seven factors were noted as very important. Nineteen more items were reported as very important, but had a variance at or exceeding 1.0, for a total of 86. Ten factors were noted as somewhat important. Sixteen more factors were noted as somewhat important, but reported a variance of 1.0 or greater, for a total of 26. xi Critical components centered around the challenges of being the sole practitioner, coping with limited resources, and understanding of ethical principles including multiple relationships, understanding ones' limits of competence, privacy and confidentiality concerns, boundary setting, and reflecting on psychologist's visibility in rural settings. The need for generalist training rang loud and clear. Results also suggested that students must understand the varying roles one might encounter while working in the rural setting and that communication skills were critical. The importance of collaboration and communication with other professionals and community leaders and gaining exposure to multiple rural settings and hands on training were also cited as critical. Xll CHAPTER 1 INTRODUCTION AND REVIEW OF THE LITERATURE Many researchers of rural psychology and those who practice in rural settings cite the lack of knowledge of rural culture and limited understanding of how living in a rural setting impacts mental health and mental health servi...

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