The professional literature related to social justice has increased, but there has been little discussion of the practical issues and implications associated with social advocacy. However, adding new roles will result in new considerations for counseling psychologists. The need to be attuned to how the practical aspects of advocacy intersect with the context of psychological work may be especially present in rural areas where practitioners may be more involved in the community and thus their actions highly visible. Because the data indicate that rural communities may have few resources, a limited number of mental health professionals, and higher rates of mental illness, psychologists practicing in these areas may feel compelled to engage in advocacy. Yet there is little practical guidance for these psychologists. Therefore, the authors present considerations for social justice advocacy in rural areas, using the American Counseling Association advocacy competencies as an organizing framework.

Current and developing models of integrated behavioral health service delivery have proven successful for the general population; however, these approaches may not sufficiently address the unique needs of individuals living in rural and remote areas. For all communities to benefit from the opportunities that the current trend toward integration has provided, it is imperative that cultural and contextual factors be considered determining features in care delivery. Rural integrated primary care practice requires specific training, expertise, and adjustments to service delivery and intervention to best meet the needs of rural and underserved communities. In this commentary, the authors present trends in integrated behavioral health service delivery in rural integrated primary care settings. Flexible and creative strategies are proposed to promote increased access to integrated behavioral health services, while simultaneously addressing patient care needs that arise as a result of the barriers to treatment that are prevalent in rural communities. (PsycINFO Database Record

Practitioners who wish to advocate for clients or respond to larger social justice issues have little practical guidance. Depending on contextual factors, there may be numerous issues to consider before deciding whether to become involved in social justice advocacy. The challenges associated with practicing in a small community amplify the need to carefully consider whether or how to act as an advocate. In this study, eight rural mental health professionals were interviewed about the benefits and challenges of rural practice, experience with social justice advocacy, and perspectives on participating in advocacy about contentious social justice issues. The results highlight how the context of rural community practice affects decisions regarding advocating for clients or responding to larger social justice issues.

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