Acknowledging the inevitable: Understanding multiple relationships in rural practice.

Abstract

There are many factors that contribute to increased rates of multiple relationships in rural practice. Although limited availability of mental health practitioners and access difficulties are the most commonly cited factors, characteristics of rural communities and characteristics of psychologists who practice there may also promote the likelihood of these relationships. These characteristics may consequently promote acceptance of multiple relationships. This article addresses some of the unique aspects of rural practice and provides strategies for evaluating, preventing, and managing multiple relationships in rural practice.

Ethical challenges of practicing in rural areas

“…Because of their position and role in the community, psychologists are typically quite visible. The lack of anonymity and the reality of interfacing with clients in social and community settings can be taxing (Campbell & Gordon, 2003). These and other stressors associated with rural practice, including professional isolation and fewer resources for after-hours emergency care, contribute to a stressful work environment.…”

“…Although all bear on rural practice, we focus on multiple relationships (subsuming the standard on conflict of interest), cooperation with other professionals, and informed consent. The topic that gets raised the most in the literature pertaining to ethics and rural practice is multiple relationships (e.g., Barbopoulos & Clark, 2003;Campbell & Gordon, 2003;Harowski et al, 2006), and many components link to other ethical standards (e.g., 6.05 Barter with Clients/Patients).…”

Being fit: The ethics of practice diversification in performance psychology.

“…Although sexual relationships are specifically eschewed, nonsexual multiple role relationships have the potential to be normative in particular settings, such as rural, small, isolated, or closed communities (Andersen et al, 2001;Campbell & Gordon, 2003;Lamb et al, 2004). Many performance settings and circumstances take on qualities of being isolated and self-contained (Hamilton, 1997;Hays, 2002;Moore, 2003;Van Raalte, 1998). "…”

“…Imagining the worst possible scenario and making decisions that take that into account, although sobering, can allow for decision making that recognizes the best interests of all the players-including the consultant (Campbell & Gordon, 2003).…”

Rural acute care nursing in British Columbia and Alberta: An interpretive description of professionalism.

“…Schank and Skovholt (2006) point out that similar conflict occurs among psychologists who practice in small-community areas, and Campbell and Gordon (2003) suggest that multiple relationships with community members, and "role conflict" (p. 430) are inevitable for psychologists practicing in rural settings. Schank and Skovholt (2006) recommend that academic institutions incorporate basic training for students on how to manage "multiplelevel relationships" and "conflicting obligations" in small community practice settings (p.…”