Sixteen licensed psychologists who lived and practiced in rural areas and small communities participated in interviews about ethical dilemmas they faced in daily practice. Dilemmas involving professional boundaries were identified as significant concerns for all of the psychologists. Major themes were the reality of overlapping social relationships, the reality of overlapping business relationships, the effects of overlapping relationships on members of the psychologist's own family, and the dilemmas of working with more than 1 family member as clients or with others who have friendships with individual clients. The psychologists knew the content of ethical codes but often struggled in choosing how to apply those codes in the best interest of clients. Ongoing discussions regarding these choices can contribute to the evolution of practice codes applicable to rural areas and other small communities.
Rural populations as small communities requiring sensitivity to rural culture have received increased attention with professional psychology's commitment to underexamined aspects of multiculturalism including geographic location. This article presents multidisciplinary approaches to service provision and training as natural models in rural and frontier communities and addresses the need for psychologists to move out of a monoculture model of training only in psychology to better serve rural consumers of mental health services. Overviews of rural health curriculum and training models as well as new health delivery options developing in nonmetropolitan areas such as prescriptive authority for psychology are provided. Suggestions are offered for state and territorial psychological associations regarding the needs of rural psychologists.
Ethical dilemmas and boundary challenges are parts of daily life for psychologists who live and practice within small communities. Although rural psychologists are most readily identified as "small-community psychologists," there are a number of other settings that can be considered small communities-colleges, communities of color/ethnicity/culture, lesbian/gay/bisexual/transgender (LGBT), military, faith-based, feminist, criminal justice and corrections, suburban, disability, deaf/hearing impaired, chemical dependency, school districts, sport psychology, graduate training programs, and therapists who see other therapists as clients. Psychologists in these small communities strive to balance a traditional individualist perspective with a need to participate in and contribute to the overall wellness of the community in which they live and work. The 3 invited commentaries provide additional depth through their perspectives on rural, LGBT, and Latina/o community practice. Their insights model thoughtful and contemporary practice that challenges, enriches, and educates the larger field of ethical psychological practice.
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