This article reviews how psychologists working in rural communities often have to be at the cutting edge of practice because of the issues inherent in rural life. Problems faced by rural residents, such as poverty, unemployment, lack of transportation, lack of education, substance abuse, lack of health and mental health providers, and lack of insurance, complicate living day-to-day and receiving physical and mental health care. In addition to reviewing these topics, we highlight 3 areas of emphasis in psychology in which rural psychologists are on the cutting edge: integrated care, use of technology, and prescription privileges. Implications for professional practice include considering adopting the changes in the field such as pursuing training in telehealth technology, investigating advocacy, the benefits of possible collaboration with rural training programs and researchers, and prescription privileges.

Mental health professionals practicing in rural areas face ethical dilemmas different from those experienced by their urban counterparts and may find that the existing ethics literature and American Psychological Association (APA, 2002) ethics code not particularly helpful. We highlight parts of five standards from the APA ethics code to illustrate the dilemmas rural practitioners frequently confront and offer suggestions for how to handle them. We discuss competence, human relations, and confidentiality as specific areas and then examine assessment and therapy as broader situations in which dilemmas may occur. We use case examples to highlight complications that may arise in rural areas.

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Mental health practitioners, especially in rural areas, can benefit at least as much as religious leaders from bridging the gap between the two fields as both types of professionals focus on developing collaboration to improve mental health. A significant body of literature supports this claim; however, there is a lack of such data from the rural religious leader's perspective. Therefore, the researchers conducted interviews with clergy in the region to explore their needs and preferences regarding collaboration with mental health professionals. Interviews were audio recorded, transcribed, coded, and analyzed for themes, using grounded theory methodology. The main themes were that clergy: (a) demonstrated awareness of mental health needs, (b) expressed a desire to collaborate, (c) mentioned existing relationships with mental health professionals, (d) delineated professional responsibility to initiate collaboration with mental health professionals, and (e) discussed perceived mutual distrust between the two fields.

The aim of this literature review is to summarize the relationship between breast cancer survival and posttraumatic growth (PTG). Because of the many inconsistencies found in the literature related to variables that foster PTG in breast cancer survivors, the relationship needed to be clarified. Breast cancer is often viewed as a traumatic experience, and although 1 might expect only negative effects, studies show that breast cancer survivors often experience PTG, which can manifest in many forms and is influenced by a variety of factors. One such variable, social support, is malleable and differs widely in scope and measure. To better understand the effectiveness of types of support, the social, psychological, and spiritual encouragement that breast cancer survivors may be provided have been highlighted in this manuscript. Geographical location (i.e., rural vs. nonrural) has not yet been considered when researching PTG. It is plausible that levels of PTG in breast cancer survivors living in rural areas differ significantly from those living in nonrural areas because they may have fewer resources and a reduced likelihood of available peer support groups. Implications and suggestions for further research of PTG, breast cancer, and types of support are discussed.