The Practice of Psychology in Rural Communities: Potential Ethical Dilemmas

Abstract

The practice of psychology in rural areas offers unique challenges for psychologists as they try to provide optimal care, often with a minimum of resources. Psychologists are frequently required to be creative and flexible in order to provide effective services to a wide range of clients. However, these unique challenges often confront psychologists with ethical dilemmas and problems for which their urban-based training has not prepared them. The author examines how certain characteristics of rural communities may lead to specific ethical dilemmas. By being a part of a small community, psychologists will inevitably face multiple relationship dilemmas. Confidentiality is harder to maintain in a small town, particularly with its informal information-sharing network. To provide services to meet community needs, with a limited number of referral options, psychologists typically need to be generalists. This may lead to concerns about scope of practice, training, and experience with diverse populations. Psychologists also face other competency issues, such as a lack of supervision and consultation resources. Other concerns addressed include the psychologist's personal life, and the blurring of professional and personal roles. Suggestions are made for coping with each of these ethical issues, although more quantitative research and discussion are needed on the practice of psychology in rural areas.

Uso del espacio doméstico. Un análisis comparativo de sus escenarios de actividad

“…Se ha reportado que en las zonas rurales la vulnerabilidad es mayor ya que existen grandes disparidades socioeconómicas y acentuadas necesidades de atención a la salud (Helbok, 2003;Hicks, 2002). A pesar de esto, los asentamientos rurales son foco de interés sólo cuando ocurren afectaciones o desastres graves.…”

Vicarious traumatization: The danger of the unknown for transition house workers.

“…Transition house support work is rewarding, yet extremely difficult. While workers have the opportunity to meet women and bear witness to their strength and resiliency, they also are identifies such factors as personal trauma history (Pearlman & Mac Ian, 1995), type of trauma stories heard (Cunningham, 2003;Iliffe and Steed, 2000;Stout and Thomas, 1991), work environment (Pearlman & Saakvitne, 1995;Schauben and Frazier,1995), and issues related to working within a northern context (Coholic and Blackford, 2005;Helbok, 2003).…”

“…As identified in the results section, several support workers shared that they have experienced a disrupted sense of safety in the world. Due to issues of high visibility (Helbok, 2003), support workers have to deal with seeing their clients with their abusive partners in the community. Workers may also face the reality that many community members may know that they work at the transition house.…”

“…Without confidentiality, women may not feel safe to access the shelter or trust the workers. This challenge is amplified in northern and rural communities due to high visibility (Schmidt, 2005;Helbok, 2003). In a study on vicarious traumatization, Coholic and Blackford (1999) found workers experienced more stress when they "maintained confidentiality about perpetrators of abuse who lived in their community and that their personal and leisure activities were frequently curtailed for reasons of safety and privacy" (as cited in Green, 2003, p. 215).…”

Exploring gambling among seniors in rural British Columbia: sociodemographic and mental health correlates

“…Researchers have not come to a consensus regarding a definition of rurality, and a debate continues about whether such a definition should be based on geography or population (Helbock, 2003). It is clear, however, that smaller communities are heterogeneous and that they have unique qualities and challenges that set them apart from large metropolitan areas.…”