From our community to yours: Rural best perspectives on psychology practice, training, and advocacy.

Abstract

Rural populations as small communities requiring sensitivity to rural culture have received increased attention with professional psychology's commitment to underexamined aspects of multiculturalism including geographic location. This article presents multidisciplinary approaches to service provision and training as natural models in rural and frontier communities and addresses the need for psychologists to move out of a monoculture model of training only in psychology to better serve rural consumers of mental health services. Overviews of rural health curriculum and training models as well as new health delivery options developing in nonmetropolitan areas such as prescriptive authority for psychology are provided. Suggestions are offered for state and territorial psychological associations regarding the needs of rural psychologists.

Ethical challenges of practicing in rural areas

“…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).…”

“…Psychologists in rural areas regularly confront special ethical challenges resulting from the sociocultural context in which they practice (Barbopoulos & Clark, 2003;Harowski, Turner, LeVine, Schank, & Leichter, 2006). Part of the difficulty for rural psychologists is that much of the ethics literature and even the American Psychological Association's (APA, 2002) ethics code appears to be urban-based, leading to unexamined assumptions about the distinction between appropriate and inappropriate behaviors (Helbok, 2003;Roberts, Battaglia, & Epstein, 1999).…”

Rural schools' mental health needs: Educators' perceptions of mental health needs and services in rural schools.

“…As refugees and immi grants enter the rural community land scape, their needs introduce further complexity, such as culture differences and language barriers. (Harowski et al, 2006). Schools staff report being more concerned about mental health services than they are about physical health services; yet regardless of geo graphical location, more public health services related to physical health are available for students than are mental health services (Weist et al, 2000).…”

Cognitive training in the rural elderly: A randomized trial to evaluate the efficacy and accessibility of a new approach.

“…Rural northern can more elaborately be described as isolated (no year-round road) or remote (over 350 km) from the nearest year-round road (Public Health Agency of Canada, 2009). Whilst there is no standard way to define rural, there seems to be a common understanding among rural-dwellers of what it means to "live rural": low population, long distance to large metropolitan areas, and unmet healthcare needs (Harowski, Turner, Levine, Schank, & Leichter, 2006). While these characteristics appear restrictive, it is important to recognize that rural areas also possess inherent strengths that make them uniquely able to address community needs.…”

“…Hinton, Franz, and Friend (2004) point out that the long-standing shortage of services has shifted the provision of aging care to primary care physicians. It is estimated that 60% of psychological care is delivered by primary care physicians (Geller, 1999;Harowski et al, 2006).…”