Building a Practice in Rural Settings: Special Considerations

Abstract

Private practice in rural areas presents special challenges. Rural communities often hold more stigmatizing views about psychotherapy and have fewer economic resources, yet rates of mental health problems are comparable to those in metropolitan areas. Rural practice can be particularly rewarding for clinicians who can build collaborative networks, adjust to visibility, negotiate boundaries, and successfully integrate into the community. This article offers recommendations for mental health counselors on building a practice for branding, marketing, collaborating, and exercising self-care. It also discusses challenges associated with counseling in rural areas and gives suggestions for building a thriving practice.

Interprofessional Collaboration and Telehealth: Useful Strategies for Family Counselors in Rural and Underserved Areas

“…Family counselors can serve as advocates to promote a mutual reliance so that families and providers can earn one another’s trust and they can integrate strategies to identify and eliminate barriers (Murry et al, 2011). To do so effectively, family counselors for rural residents will need training in reflecting on the costs involved in providing medical and mental health care, skilled in collaborating with civic partners, able to recognize and refer illnesses beyond their scope, and have a comfort with utilizing virtual environments (Cohn & Hastings, 2013). Family counselors new to a rural area or in the process of building a trusted relationship with the rural community should engage in self-reflection and seek to understand the uniqueness of rural culture in their location.…”

It takes a village

“…In addition to family and community, the maintenance of other rural values is also of great importance in rural environments (Ford, 2015). Though not true of all small towns throughout the United States, researchers have found certain commonalities among many rural communities that they consider unique and/or important characteristics to life in a rural setting (Cohn & Hastings, 2013;Ford, 2015;Hann-Morrison, 2011;Hines, 2002;Richards & Stambaugh, 2015;Sutton & Pearson, 2002). The most important of those characteristics is an extremely high sense of community pride and reliance on locally available resources (Hann-Morrison, 2011).…”

“…If there is a concern or issue in the community, residents look to each other to solve it. The values of self-reliance and a strong work ethic are important to maintain (Cohn & Hastings, 2013). Church affiliations are also of high importance in most rural communities (Cohn & Hastings, 2013;Edwards & Sullivan, 2014;Ford, 2015).…”

“…Another prominent theme from the literature is the high rate of poverty that generally exists within rural communities (Hines, 2002;Mattingly & Schaefer, 2015;Morrissette, 2000). Not all rural communities fit this profile (Sutton & Pearson, 2002), however, recent U.S. data has indicated significantly higher rates of poverty in rural communities than suburban, and slightly higher rates than in urban communities (Cohn & Hastings, 2013;United States Department of Agriculture, 2017b). Comparison data also shows that the percentage of children living in poverty in rural areas is significantly higher than those in urban areas (United States Department of Agriculture, 2017a).…”

“…Residents in rural environments often need to travel significant distances to receive mental health services (Hann-Morrison, 2011;Hines, 2002). Even if they are able to access transportation, rural residents share a distinct stigma against receiving mental health services (Cohn & Hastings, 2013). There also seems to be a distrust in Human Services in general which could stem from the previously mentioned desire to solve problems internally and not wanting to accept outside help (Hines, 2002).…”