Dual Relationships

15 JOURNAL OF PROFESSIONAL COUNSELING: PRACTICE, THEORY, AND RESEARCH, VOL. 41, NO. 2, SUMMER/FALL

R U R A L S U P E R V I S O R S

T his study explored the needs of rural counselor supervisors (LPC-Ss) in Texas.

Fifty participants responded to an online survey consisting of Likert-type items

and free-response questions. Rural supervisors commented on their connect-

edness to their communities and profession, resources, multiple roles, boundaries and

dual relationships, self-care, and personal factors. Supervisors felt disconnected from

their profession and unsupported in supervisory roles but reported low burn-out rates.

They reported perceived areas for additional training and suggestions for counselor

education programs. Other findings paralleled earlier research regarding rural mental

health professionals.

Key words: rural, supervision, counseling, mental health, LPC-S, counselor

education, counselor training

A journey from one end of Texas to the other carries a traveler over some of the most

diverse regions in the United States (US). While Texas hosts several booming metropolises,

many Texans reside in rural agricultural communities (US Census Bureau, 2013), and many of

those communities suffer from a shortage of qualified mental health professionals (Texas

Department of State Health Services [DSHS], 2014). Most of the state’s 18,641 Licensed

Assessing the Needs of Rural Counselor Supervisors in Texas

Karl J. Witt and Christine McNichols The University of Texas at Tyler

Author Note: Karl J. Witt, Assistant Professor of Counseling, Department of Psychology and

Counseling, The University of Texas at Tyler; Christine McNichols, Assistant Professor of Counseling, Department of Psychology and Counseling, The University of Texas at Tyler. This project was funded by a research grant from the Texas Association of Counselor Education and Supervision (TACES). The authors thank the TACES research grant committee for their support.

Correspondence concerning this article should be addressed to Karl J. Witt. Email: [email protected]

Professional Counselors (LPCs) reside in

urban areas (Texas State Board of Examiners

of Professional Counselors [TSBEPC], 2014);

seventeen percent of Texas counties lack LPCs

altogether (DSHS, 2014). Since the TSBEPC

requires supervision by an LPC-Supervisor

(LPC-S) in a counselor’s early career, the

presence of LPC-Ss is important to increasing

services. Breen and Drew (2012) and

Oetinger, Flanagan, and Weaver (2014) both

observed that exposure to rural settings can

help attract new practitioners, yet only nine

percent of LPC-Ss work in rural areas

(TSBEPC, 2014). Researchers have explored

the needs of counselors working in rural

settings, but few have investigated the needs of

rural supervisors. This study sought to answer

the question, “What are the needs and experi-

ences of rural supervisors practicing in

Texas?” Findings from this study will help

stakeholders appreciate rural circumstances

and explore ways to assist and support rural

supervisors in Texas and elsewhere.

Existing literature contains multiple, con-

flicting definitions of the term “rural,” often

based on one of more than 15 US government

definitions (Coburn et al., 2007). The most

common three are from the Census Bureau,

the Office of Management and Budget

(OMB), and the US Department of

Agriculture’s Economic Research Service

(ERS). ERS specifically designed a method, the

rural-urban commuting area (RUCA) codes,

to address other systems’ shortcomings (ERS,

2014). RUCA codes combine population

density, the Census Bureau’s geographic tracts,

OMB’s commuting patterns, the 2010

national census, and the 2006-2010 American

Community Survey to differentiate between

urban and rural. In the RUCA method,

“rural” is defined as any geographic area

where the aforementioned factors result in a

RUCA code of four through ten (Coburn et

al., 2007).

Rural communities differ from urban

ones in attitudes, beliefs, and values (Breen &

Drew, 2012; Saba, 1991). Relationships often

are more tightly knit, intersect in multiple

ways, and are heavily influenced by family

name and history (Cohn & Hastings, 2013;

Curtin & Hargrove, 2010). There may be a

lack of specialized services and concomitant

multiple roles; a person who works as a judge

may also be a local emergency first responder

(Breen & Drew, 2013; Saba, 1991). Rural

regions are often characterized by aging pop-

ulations facing poverty and a lack of employ-

ment, medical insurance, and resources

(Curtin & Hargrove, 2010). Qualified mental

health providers may be lacking, and mental

health concerns are often first addressed by

law enforcement or primary health care

workers (Robinson et al., 2012). People who

need services may not know how to access

R U R A L S U P E R V I S O R S

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R U R A L S U P E R V I S O R S

17 JOURNAL OF PROFESSIONAL COUNSELING: PRACTICE, THEORY, AND RESEARCH, VOL. 41, NO. 2, SUMMER/FALL 2014

them, and affiliated stigmas may dissuade

exploration. At times, the high visibility of

daily activities in small communities further

deters help-seeking and reduces therapeutic

gains, especially when communities view help-

seeking negatively (Curtin & Hargrove, 2010;

Riding-Malon & Werth, 2014). Individuals

living in rural settings often become their own

advocates, first turning to families and faith

communities before pursuing formal mental

health assistance. For these reasons, rural

mental health providers must work with and

within these systems to be successful. Urban

counselor training programs may take things

like support groups, community centers,

public transportation, and day-treatment

centers for granted, unaware that rural

settings may lack these resources (Helbok, ).

These differences affect the way mental health

practitioners and supervisors carry out their

work.

Though little supervisor-specific rural

counseling research exists, supervisors are also

practitioners. Furthermore, LPC-Ss help

supervisees conceptualize counseling, plan

treatments, and work with rural clients under

the LPC-S’s license. It is therefore important to

examine the rural counseling literature to

better understand the supervisory context.

The complexities of multiple relationships

often arise in rural counseling literature (Breen

& Drew, 2012; Cohn & Hastings, 2013;

Helbok, 2003; Malone, 2010; Oetinger,

Flanagan, & Weaver, 2014; Paulson, 2013).

While rural citizens take abundant dualities

for granted, counselors and supervisors may

experience professional and personal difficul-

ties (Paulson, 2013), leading some to question

training approaches and the rural relevance of

the American Counseling Association’s ethical

code (Gillespie & Redivo, 2012).

Furthermore, mental health resource deficien-

cies and practitioner shortages often force

rural counselors and supervisors to work as

generalists who address and supervise a wide

range of concerns and roles, including those

for which they have little or no training (Breen

& Drew, 2012; Paulson, 2013). Travel to

expand clinical and supervisory competence

through conferences and workshops may also

be cost-prohibitive (Cohn & Hastings, 2013;

Breen & Drew, 2012; Hastings & Cohn,

2013; Helbok, 2003; Malone, 2010; Oetinger,

Flanagan, & Weaver, 2014; Paulson, 2013;

Saba, 1991). Similarly, Cohn and Hastings

(2013) note limited experience and exposure

may impact practitioners’ multicultural com-

petence and may create unique challenges in

supervision (Paulson, 2013).

A lack of personal privacy is another

frequent finding in the literature. Some

authors (e.g., Cohn & Hastings, 2013;

Rollins, 2010) labeled this high visibility as

“being on stage” or “the fishbowl effect.”

Personal public outings may require more

intention and reflection than in an urban

setting. Having a drink in a restaurant, joining

certain interest groups, or socializing with

various people could have negative conse-

quences for counselors, their families, and

clients (Paulson, 2013). For some, feelings of

isolation develop from constantly being

watched by clients and supervisees (Breen &

Drew, 2012; Hastings & Cohn, 2013;

Helbok, 2003; Oetinger, Flanagan, & Weaver,

2014; Paulson, 2013). Reduced social support

can lead to distress and burnout (Hastings &

Cohn, 2013). Counselors might also feel

restricted as advocates since advocacy on con-

tentious topics might harm a counselor’s

practice and personal life, lead to mistrust of

the counselor, and strain community relation-

ships (Bradley, Wreth, Hastings, & Pierce,

2012). Limited financial resources, substan-

dard pay, demanding caseloads, and rural

poverty are other oft-cited challenges for both

counselor and supervisors (Oetinger,

Flanagan, & Weaver, 2014; Hastings &

Cohn, 2013; Paulson, 2013). Such factors

may provide barriers to those practicing in

rural settings or considering rural practice.

Researchers have suggested ways to aid

rural professionals. Some stressed collabora-

tion and continuing education through tele-

health and online training modules for super-

visors (Nelson, Hewell, Roberts, Kersey, &

Avey, 2012; Riding-Malon & Werth, 2014).

Paulson (2013) recommended peer supervi-

sion for supervisors as an avenue to gain

support. Participants in the Breen and Drew

(2012) study recommended that counselor

education programs stress the importance of

seeking supervision throughout one’s career.

Finally, Paulson (2013) recommended a

formal rural counseling course that would

specifically address issues related to working

in a rural setting.

Despite some of the challenges inherent

in rural work, many counselors and supervi-

sors highlight the positive aspects of working

in this setting. Oetinger, Flanagan, and

Weaver (2014) surveyed 51 rural practition-

ers; 47% reported being very satisfied. They

extolled the inherent diversity of their work,

opportunities to help the underserved, work

and recreation in natural surroundings, and

the slower pace of life. Additional benefits

added by Cohn and Hastings (2013) included

career flexibility, work with generations of the

same family, rural connectedness, school loan

assistance, and a lower cost of living. Paulson

(2013) found that rural supervisors greatly

valued providers’ relationships, collaboration

opportunities, and rural interconnectedness.

Curtin and Hargrove (2010) summed up the

benefits of rural practice this way: “Many of

the potential problems associated with work

in smaller, rural communities may be translat-

ed as opportunities for creative practice” (p.

549).

Much of the research conducted over the

past ten years focuses on the experiences of

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R U R A L S U P E R V I S O R S

rural counselors. As counselors, rural supervi-

sors share many of the same experiences. This

study seeks to extend the supervisor-specific

literature by asking, “What are the needs and

experiences of rural supervisors practicing in

Texas?”

Method

Participants

The study had 50 participants: 29

females (58%), 20 males (40%), and 1 self-

described other (2%). Participants described

themselves as White (n=44, 88%), Hispanic

or Latino/a (n=2, 4%), American Indian or

Alaska Native (n=2, 4%), Black or African

American (n=1, 2%), and Native Hawaiian or

Other Pacific Islander (n=1, 2%). Ages ranged

as follows: 26 to 35 (n=4, 8%), 36 to 45 (n=9,

18%), 46 to 55 (n=13, 26%), 56 to 65 (n=16,

32%), and 66 or older (n=8, 16%). Moss,

Gibson, & Dollarhide (2014) found that

seasoned practitioners perceive counseling

and practice differently than their newer col-

leagues. It follows that there may be differ-

ences between a seasoned counselor who is a

new supervisor and a supervisor with more

years of supervisory experience but less expe-

rience overall. Participants held their practi-

tioners’ licenses from three to 36-plus years

and time in rural settings ranged from less

than one to over 36 years. Experience as an

LPC-S ranged from less than one to over 36

years. The number of years each participant

has been fully licensed as an LPC, the amount

of time working in rural settings, and the

length of time as an LPC-S are reported in

Table 1.

The authors also sought a representative

geographic sample. The Texas Counseling

Association (TCA) divides membership into

five regions comprised of southeastern Texas

(Region I), southern Texas (Region II),

western Texas (Region III), northeastern

Texas (Region IV), and central Texas (Region

V; see Table 2).

Procedure

The public roster of Texas LPC-Ss

(n=3,911) was obtained from the TSBEPC

website in June 2014. Eliminating unlisted

(n=133) and out-of-state (n=95) addresses left

3,685 LPC-Ss. Using the May 2014 RUCA-

zip code correlations co-developed by ERS

and ORHP, each address was classified as

rural or urban. Addresses with codes one

through three were considered urban; codes

four through ten denoted rural areas. Zip

codes with multiple RUCA codes and seven

addresses created after the 2010 census were

categorized by matching census tracts from

the Federal Financial Examination Council

Geocoding System and Google Maps with

uncorrelated RUCA data. The resulting rural

LPC-Ss (n=344) were all mailed postcards

R U R A L S U P E R V I S O R S

19 JOURNAL OF PROFESSIONAL COUNSELING: PRACTICE, THEORY, AND RESEARCH, VOL. 41, NO. 2, SUMMER/FALL 2014

Table 1 Experience-related Characteristics of Participants

Years Full LPC Rural LPC LPC-S

f f f

<1 0 1 4

1 0 1 2

2 0 0 7

3 1 3 5

4 2 1 6

5 4 3 2

6-10 7 14 10

11-15 10 9 4

16-20 7 5 3

21-25 8 5 5

26-30 4 3 1

31-35 6 3 0

36+ 1 2 1

Total 50 50 50

Table 2 Responses by TCA Region

Region Rural LPC-S Universe Study Participants Representation by Region

N % n % %

Region I 49 14.2 3 6 6.1

Region II 48 14.0 6 12 12.5

Region III 35 10.2 6 12 17.1

Region IV 153 44.5 30 60 19.6

Region V 59 17.2 5 10 8.5

Total 344 100.1 50 100 14.5

Note. Percentages may not add to 100% due to rounding.

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R U R A L S U P E R V I S O R S

inviting participation in an anonymous elec-

tronic survey with a second invitation four

weeks later. Fifty-three individuals agreed to

participate; fifty actually completed the study.

Instruments

The authors created a survey derived

from existing rural mental health literature,

interactions with rural supervisors, and obser-

vations of supervisory processes. Qualtrics

web-based survey software was used to collect

demographic data and responses to 26 stand-

alone Likert-type items (see Table 3) and five

free-response questions. The five free-response

questions were: (a) What areas of training do

counselor education programs need to include

or improve, (b) Counselors often wear

multiple hats in their professional settings.

What roles do you play in your setting, (c)

How do you engage in self-care as a rural

supervisor, (d) What are the benefits of

working as a supervisor in a rural setting, and

(e) What other issues do you feel rural super-

visors face?

Data Analysis

Different analytic approaches were used

for the two types of data collected. For stand-

alone Likert-type items, median, mode, and

frequency are the only meaningful descriptive

statistics (Boone & Boone, 2012). The

endorsement frequency for specific responses,

the mode, and the median for each item are

reported in Table 3. The researchers also inde-

pendently conducted a conventional content

analysis for each of the free-response

questions, as described by Hsieh and Shannon

(2005). For each question, responses were

read repeatedly to discern initial common

thoughts and ideas. A color coding system

was created to categorize similar data. Each

color code was given a descriptive label high-

lighting the pattern for that text. Researchers

then discussed and reconciled patterns and

labels. Resulting patterns were reported.

Results

Quantitative Results

Participants responded to Likert-type

items about their connectedness to and collab-

oration with others, professional develop-

ment, professional roles, dual relationships,

technology, resources, and particular aspects

of rural culture. Rural supervisors frequently

or very frequently worked as generalists and

fulfilled multiple roles in their settings. Despite

distances, they did not use technology for

distance supervision. They considered the

financial resources for mental health to be

inadequate and frequently or very frequently

engaged in professional development activi-

ties. LPC-Ss also felt connected to others in

their communities but disengaged from other

counseling professionals. The Likert-type

items and responses are reported in Table 3.

R U R A L S U P E R V I S O R S

21 JOURNAL OF PROFESSIONAL COUNSELING: PRACTICE, THEORY, AND RESEARCH, VOL. 41, NO. 2, SUMMER/FALL 2014

Table 3 Likert-type Questions and Responses

Scale Responses (Frequency) Question 1 2 3 4 5

f f f f f Mdn Mode

How connected do you feel to other mental 8 13 16 7 6 3 3 health professionals in your geographic area? (1 – Very Disconnected, 5 – Very Connected)

How connected do you feel to others in your geographic community? 4 8 13 18 7 3.5 4 (1 – Very Disconnected, 5 – Very Connected)

How supported do you feel in your role as an LPC-Supervisor? 7 21 17 4 1 2 2 (1 – Very Unsupported, 5 – Very Supported)

How adequate are the financial resources for mental health 19 19 9 2 1 2 1.2 agencies in your geographic area? (1 – Very Inadequate, 5 – Very Adequate)

How adequate are the counseling facilities in your place of practice? 3 10 12 13 12 3.5 4 (1 – Very Inadequate, 5 – Very Adequate)

Finding a qualified licensed mental health professional to act as 1 5 15 22 7 4 4 agency staff or a referral is (1 – Not At All Challenging, 5 – Very Challenging)

How often do you contact or collaborate with the nearest 22 11 8 5 4 2 1 university counseling program? (1 – Very Rarely, 5 – Very Frequently)

How often do you participate with local or regional professional 17 12 12 4 5 2 1 counseling organizations? (1 – Very Rarely, 5 – Very Frequently)

How frequently do you engage in professional development activities? 1 4 9 23 13 4 4 (1 – Very Rarely, 5 – Very Frequently)

How would you rate your access to professional development activities? 4 12 11 11 12 3 2.5 (1 – Very Poor, 5 – Very Good)

How often do you have access to varied multicultural experiences? 3 12 13 13 9 3 3.4 (1 – Very Rarely, 5 – Very Frequently)

How often do you fulfill multiple roles within your agency? 8 0 7 14 21 4 5 (1 – Very Rarely, 5 – Very Frequently)

How often do you fulfill multiple professional roles within your community? 8 7 8 11 16 4 5 (1 – Very Rarely, 5 – Very Frequently)

Table 3 continued on next page

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R U R A L S U P E R V I S O R S

How often do you deal with situations involving dual relationships or 7 13 8 14 8 3 4 boundary management between you and your clients? (1 – Very Rarely, 5 – Very Frequently)

How often do you deal with situations involving dual relationships or 13 16 8 11 2 2 2 boundary management between you and your supervisees? (1 – Very Rarely, 5 – Very Frequently)

How often do you discuss client dual relationships or boundary 3 3 10 19 15 4 4 management with your supervisees? (1 – Very Rarely, 5 – Very Frequently)

How often do you feel you must work as a generalist/jack-of-all-trades 2 2 3 22 21 4 4 to meet the needs of your clients and supervisees? (1 – Very Rarely, 5 – Very Frequently)

How often do you take a stance and support unpopular views on 9 9 13 13 6 3 3.4 controversial issues in your community? (1 – Very Rarely, 5 – Very Frequently)

How often do you supervise counselors-in-training (pre-master’s 16 13 7 7 7 2 1 practicum and internship students) at your agency? (1 – Very Rarely, 5 – Very Frequently)

How often are you approached by a prospective LPC-Intern 11 13 12 13 1 3 2.4 to act as an LPC-Supervisor? (1 – Very Rarely, 5 – Very Frequently)

How well do your supervisees understand rural culture? 2 6 21 15 6 3 3 (1 – Not Well, 5 – Very Well)

How well do counselor training programs prepare students and 7 19 20 3 1 2 3 supervisees to work with rural populations? (1 – Not Well, 5 – Very Well)

How often do you use technology to conduct distance supervision? 30 12 6 1 1 1 1 (1 – Very Rarely, 5 – Very Frequently)

In your experience, how effective is distance supervision? 8 17 18 4 3 2.5 3 (1 – Very Ineffective, 5 – Very Effective)

How frequently do you work to maintain your personal privacy 7 5 11 18 9 4 4 in your community? (1 – Very Rarely, 5 – Very Frequently)

How frequently do you experience symptoms of counselor burnout? 11 14 17 4 4 2.5 3 (1 – Very Rarely, 5 – Very Frequently)

Table 3 continued from previous page

Scale Responses (Frequency) Question 1 2 3 4 5

f f f f f Mdn Mode

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23 JOURNAL OF PROFESSIONAL COUNSELING: PRACTICE, THEORY, AND RESEARCH, VOL. 41, NO. 2, SUMMER/FALL 2014

Qualitative Results

Free-response questions solicited sugges-

tions for counselor education programs, roles

played, self-care regimens, and benefits and

issues of rural supervision. For the first

question, participants recommended that

counselor education programs improve

training in business management; diagnostic

skills and substance abuse counseling, espe-

cially dual diagnosis and treatment; bound-

aries and dual relationships; and couple and

family work. Business acumen and “middle

management techniques” were consistently

stressed. Participants noted that supervisees

needed better training about boundaries and

dual relationships. One respondent wrote,

“many of my practicum students come to me

from a larger city and have no idea whatsoev-

er how difficult it is in a small town to

maintain boundaries”, and another added,

“[Supervisees need to know] how to navigate

dual relationships in a small rural community

including how to deal with invitations to

social events, church, and community activi-

ties.” Finally, a participant observed, “family

counseling is needed to a greater extent in

rural settings and most counseling graduates

have had only one course in family therapy

and/or diversity.”

When asked about roles and self-care,

LPC-Ss reported working as managers,

community crisis intervention contacts, legal

consultants to colleagues, teachers or trainers,

committee members and project coordina-

tors, and janitors and babysitters beyond their

counseling and supervisory commitments.

Participants engaged in self-care through

healthy eating and exercise, being in nature,

traveling, spending time with others, practic-

ing spirituality, engaging in personal and pro-

fessional development, and using time man-

agement techniques. Some respondents

reported that time constraints inhibited their

self-care. Others “recognize[d] the need to

recharge my batteries” and “knowing what

gets me reconnected with things that matter.”

Perceived benefits of rural settings consisted

of no competition with other providers, the

atmosphere (e.g., being close to natural

beauty, no traffic, slower pace), connection to

community, the rewards of conducting super-

vision, and being able to meet the

community’s needs. Many respondents

commented on how fulfilling supervision in a

rural area can be. One respondent wrote,

The interns are passionate and eager to

serve in their communities. Since there

are not many interns, the needs for

supervisors is lessened which allow me to

invest in the interns more than if I had a

full case of interns. I’m able to help train

them for the needs of our area and refer

to interns and licensees with confidence

in their skills, abilities, and desire to help

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R U R A L S U P E R V I S O R S

others. The interns become lifelong

friends and colleagues since we need to

help each other in rural communities. We

form our own support systems for counselors.

The open question about what issues

rural supervisors face resulted in five patterns:

a lack of resources for referrals such as super-

visors, doctors, and other helping agencies; a

lack of funding and reimbursement; a lack of

access to continuing education; difficulty

managing dual relationships and boundaries;

and a lack of professional support. When

talking about the lack of resources in a rural

community, one participant described the

issue this way: “how to cope with the strain of

feeling that you have to take everyone because

there are no options for referrals.” Another

respondent stated, “I often feel obligated to

take on an intern because there are so few

options available to them.” Issues related to

boundaries were also repeated with one par-

ticipant stating,

I often face challenges maintaining

boundaries. My children also attend

school and befriend my clients (as there is

only one school system) which creates a

unique issue. If I were to need clinical

help for myself, it would be difficult to

find someone I do not already have a

relationship with professionally.

Finally, a lack of access to continuing

education was a common pattern. Many

discussed issues relating to having to travel a

great distance to receive continuing education.

One respondent stated it this way:

It’s difficult to access continuing

education that is not offered online. We

often must travel six hours for live

trainings. This requires significant time

away from our practice as well as costly

travel. We are not able to meet other

supervisors and counselors in our rural

areas when trainings are halfway across

the state of Texas.

Discussion

This study sought to explore and describe

the needs of rural supervisors. Results

confirmed and enhanced existing literature

about rural practice. Paralleling Paulson’s

(2013) research with counseling supervisors,

rural LPC-Ss generally felt connected to their

communities but disconnected from other

mental health practitioners. This might be due

to the distance and time required to connect

with professional counterparts, as it is with

counselors (Breen & Drew, 2012; Hastings &

Cohn, 2013). This lack of connection stems

from competition for a limited paying client

base (Cohn & Hastings, 2013); findings from

this study suggest similar fears from supervi-

sors. Respondents in the current study

described low levels of participation in profes-

sional counseling organizations and collabo-

ration with university training programs,

which might also contribute to disconnected-

25 JOURNAL OF PROFESSIONAL COUNSELING: PRACTICE, THEORY, AND RESEARCH, VOL. 41, NO. 2, SUMMER/FALL 2014

R U R A L S U P E R V I S O R S

ness and isolation. As with their non-supervi-

sory colleagues, rising conference and mem-

bership costs and a lack of pertinence to rural

settings could also be prohibitive factors

(Breen & Drew, 2012). Supervisors might be

unaware of nearby training programs or uni-

versities’ roles as resources. Though respon-

dents engaged in professional development

activities, qualitative data conveyed fewer face-

to-face opportunities for rural supervisors.

Confirming Paulson’s (2013) results, par-

ticipants felt unsupported as counselor super-

visors. As they strived to balance multiple

roles, many unrelated to their expertise, role

confusion and invalidation sometimes

resulted. Though facilities were adequate,

respondents decried the lack of local qualified

professionals and financial resources for

mental health. Unique to this study, despite

these obstacles, supervisors reported low

burnout rates. This may be due to respon-

dents’ age and experience combined with

active, quality self-care.

Another finding concerned dual relation-

ships and boundaries within rural communi-

ties. Participants noted that while they often

fulfilled various community roles, only some

had to deal with dual relationships or

boundary management with clients similar to

Paulson’s (2013) findings. This study also

inquired about dual relationships and

boundary management with supervisees.

Incidents were fewer with supervisees than

with clients, and frequent conversations about

these issues may have decreased the likelihood

of problematic occurrences. These results

might also indicate that seasoned rural coun-

selors adeptly handle this rural norm.

Supervisors also discussed counselor

preparation and distance supervision. They

felt universities did not adequately prepare

students for rural work. They also very rarely

used distance technology and preferred face-

to-face interactions. Many also highly valued

helping supervisees grow and developing

lasting collegial relationships with them.

Implications

Several implications can be drawn from

this study. One prevalent need is for rural

counselor supervisors to feel supported and

connected to colleagues. Professional mem-

berships and continuing education may help.

Counseling organizations might continue to

closely monitor membership costs and

services’ relevance. While online continuing

education is valuable, contact is crucial to

reducing isolation. Regional organizations

and universities might host local conferences

or workshops, especially on issues such as

boundary management, finding resources,

and self-care. Increased rural training place-

ments for student counselors may provide

fresh perspectives, aid with caseloads, and

prepare future rural counselors.

R U R A L S U P E R V I S O R S

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Counselor educators should consider a

focus on uniquely rural issues. Navigating,

rather than avoiding, realistic dual relation-

ships; rurally-oriented multicultural training;

and working within systems as an outsider

might be beneficial. Practical lessons on

locating resources, making referrals, using

non-mental health professionals, and

managing businesses may also be constructive.

Programs might also infuse self-care and rural

exposure into the curriculum.

Advocacy efforts might be made on

behalf of rural practitioners. Minimal

resources make it hard to meet community

needs. Based on participant responses, advo-

cating for proper payment and reimbursement

for LPCs and LPC-Interns from insurers and

Medicaid could have positive wide-ranging

effects.

Limitations

The study had some inherent limitations.

While each TCA region was represented, there

were more participants from Region IV

(northeast Texas) than the other four regions

combined. Findings may be heavily colored by

the experiences of rural counselor supervisors

working within that region. There may also be

differences between those who responded to

the survey and those that did not. The design

relied on potential participants to manually

enter a survey link web address from a mailed

postcard. The extra steps and reliance on

practitioners’ technological prowess may have

decreased the number of participants or dif-

ferentiated respondents from the larger popu-

lation. Although results of this study may be

generalized to other rural contexts, conditions

in Texas may differ significantly from other

rural areas. Therefore, caution is warranted

when applying these findings.

Future Directions

This study examined the needs of LPC-Ss

working in rural Texas. The findings support

prior literature and open the way for new

areas of research. Investigating relationships

between the age and experience of rural

counselor supervisors and their ability to deal

with complicated issues pertaining to dual

relationships and boundaries might be one

avenue. Another research area might explore

how rural counselor supervisors develop

methods of self-care despite dealing with high

levels of professional isolation. Looking more

closely at how and why rural counselor super-

visors feel isolated, especially when competi-

tion for resources and paying clients exists,

may also give practitioners valuable informa-

tion about how to best help those working in

rural settings. Finally, this study only explored

rural supervisors in Texas. Subsequent studies

from other rural areas or with national

samples can further enhance the literature.

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Conclusion

There is no doubt that the need for

mental health services in rural areas is rising

(Robinson et al., 2012; DSHS, 2014). Those

who currently work in rural settings have a

diverse set of needs; however, the solutions

may be tangible and feasible as professional

organizations, counselor education programs,

and LPC-Ss, both in Texas and beyond, work

together to meet the needs of rural supervisors

and strengthen rural mental health services.

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