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Issues in Serving Rural Populations

Social workers are the backbone of rural mental health delivery systems -- the bachelor's level social worker is the most common rural mental health worker (Geller, Beeson, & Rodenhiser, 1997). Because social work programs are found in rural as well as urban states there is a relatively steady flow of new social workers into rural mental health practice who are well suited to understanding the cultural requirements and nuances of rural communities. Social workers may be one of the few bright spots within the ongoing effort to address the chronic shortage of mental health professionals in rural areas. However, the profession faces ongoing and emerging challenges with respect to rural practice. Rural areas need more master's level clinical social workers. It is not certain that rural areas can successfully compete for these workers, particularly in light of increased specialty certification, which may induce even more clinical social workers to work in more lucrative urban markets. The Bureau of Labor Statistics (2002) forecasts growing demand for social workers, portending that rural areas are likely to experience increased market competition from urban areas. The growing ethnic diversity of many rural areas (particularly Hispanic and Asian) poses a fundamental challenge to the cultural competence of the current supply of social workers practicing in rural areas. Finally, there are efforts to bolster the ability of other non-physician providers, including counselors and marriage and family therapists (e.g. Medicare reimbursement) to provide mental health care in rural and other under-served areas. This would increase the competition faced by social workers who might respond by increasing their own practice requirements to differentiate themselves from these other professions. This could result in a "credentialing race" that might ultimately further constrain, rather than increase, the number of mental health social workers in rural areas.

Professional Counseling Origins of the Profession

The field of professional counseling encompasses a broad array of activities, services, and professional settings. Counseling as a profession is rooted in school guidance counseling and vocational rehabilitation counseling, professions that emerged during the 1950’s partly in response to federal legislation and funding (Remley & Herlihy, 2001). At the same time, professional counselors share much of the same history and practice philosophy with counseling psychology, a branch of psychology that developed during roughly the same time period as professional counseling (Remley & Herlihy, 2001; Goodyear, 2000).


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