Exploring the experiences of counselors responding to crisis in rural communities.

Abstract

Responding to clients/students who are threatening harm to self or others is often perceived as a demanding and challenging job for any clinician, especially for those working with limited resources in rural communities. This research explored the experiences of clinical mental health and school counselors who respond to those types of crises within four different states in communities of 9,000 or fewer residents. Using face-to-face and synchronous online interviews, five themes were identified through phenomenological analysis, including collaboration, training, staffing, distance, and time. Though each clinician identified ample opportunities for crisis response improvement within their communities, there was a sense of pride working in small communities where the residents are familiar with one another and offer individualized support not often found in larger cities. Overall, what emerged from this study is the importance of highlighting clinicians' needs in smaller communities as their stories and experiences are often lost to the trauma and crises happening in metropolises. Public Health Significance StatementThrough this study, a voice was given to counselors in rural communities regarding their experiences in crisis response. We wanted to highlight the shortcomings of rural crisis response and increase awareness within the healthcare system about these small communities' plight. Five themes that were discovered include collaboration, training, staffing, distance, and time, which demonstrated that smaller communities tend to benefit when collaboration and communication occur.

Understanding the Experiences of Rural School Counselors Implementing Trauma-Informed Practices

“…Despite over two decades' worth of ACEs research, there remains a relative lack of focus on ACEs in rural settings. This dearth is important as rural settings come with unique characteristics and challenges not only to the presentation and intensity of ACEs but also distinct considerations for rural schools and school counselors (Crumb et al, 2021;Frankland, 2021;Fruetel et al, 2022;Keesler et al, 2021;Nichols et al, Theory & Practice in Rural Education, (13)2 | 78 2018; Talbot et al, 2016, Weiss et al, 2023. These considerations will be discussed below.…”

“…Additionally, Johnson et al (2022) identified inequitable access to schooling, food, housing, and resources as major ACEs children in rural communities encounter. These factors combined with higher pregnancy-related fatalities, elevated suicidality rates, and the spread of the opioid epidemic, situate children in rural settings in spaces that place them at a higher risk for traumatic experiences (Crumb et al, 2021;Frankland, 2021;Fruetel et al, 2022;NACRHHS, 2018).…”

“…Limited resources often result in rural school counselors playing numerous roles within a school, even multiple schools, and engaging in non-counselor-related activities (Crumb et al, 2021;Lane et al, 2020;Savitz-Romer, 2021). Indeed, due to the overall scarcity of mental health resources in rural communities and widespread school counselor shortages in rural spaces (Fruetel et al, 2022;Lane et al, 2020;Weiss et al, 2023), rural school counselors are often the sole deliverers of mental health-related services to students (Crumb et al, 2021). Grimes (2020) found that rural school counselors often experience ethical dilemmas related to the scope of their professional role and providing long-term mental health services in the school setting due to resource paucity in rural spaces.…”

“…Geographic isolation, combined with restricted in-school resources, has often led school professionalsincluding school counselorsto collaborate with members of the community to adequately meet the needs of students (Crumb et al, 2021;Fruetel et al, 2022;Grimes et al, 2013;Nichols et al, 2018;Wimberly & Brickman, 2018). Here the oftdiscussed "close-knit" strength of a rural community frequently comes into play, with partnerships between school professionals, community mental health resources, faithbased communities, and other forms of social service coming together to meet the holistic needs of studentsparticularly when addressing the multiple needs resulting from exposure to trauma (Crumb et al, 2021;Fruetel et al, 2022;Grimes et al, 2013;Lasatar, et al, 2022;Nichols et al, 2018;Wimberly & Brickman, 2018).…”

“…Additionally, work conditions, experiences of little administrative support, high caseloads, lack of community mental health resources or referrals, and elevated burnout compromise rural school counselor effectiveness at implementing TIP consistently (Grybush, 2020;Wimberly & Brickman, 2018). Lastly, there is a disconnect between the evidence-based frameworks created to address trauma in schools and rural community cultures (Weiss et al, 2023), as well as ongoing stigmatization of mental health help in rural communities that make the fluid implementation of TIP more cumbersome for rural school counselors (Fruetel et al, 2022;Herrenkohl et. al, 2019;Keesler et al, 2021;Nichols et al, 2018;Talbot et al, 2016).…”