Fluent Essays

The dilemma of dual relationships, particularly in rural communities, can present significant ethical challenges. Review the articles by Gonyea, Wright, and Earl-Kulkosky (2014) and by Witt and McNichols (2014) in the studies for this unit. In your initial post, discuss some of the methods used to manage potential dual relationships from the perspective of a provider and from the perspective of a supervisor. Describe at least one similarity and one difference in the ways a provider and a supervisor address dual relationship situations. 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 JOURNAL OF PROFESSIONAL COUNSELING: PRACTICE, THEORY, AND RESEARCH, VOL. 41, NO. 2, SUMMER/FALL 2014 16 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 JOURNAL OF PROFESSIONAL COUNSELING: PRACTICE, THEORY, AND RESEARCH, VOL. 41, NO. 2, SUMMER/FALL 2014 18 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. JOURNAL OF PROFESSIONAL COUNSELING: PRACTICE, THEORY, AND RESEARCH, VOL. 41, NO. 2, SUMMER/FALL 2014 20 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 JOURNAL OF PROFESSIONAL COUNSELING: PRACTICE, THEORY, AND RESEARCH, VOL. 41, NO. 2, SUMMER/FALL 2014 22 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 R U R A L S U P E R V I S O R S 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 JOURNAL OF PROFESSIONAL COUNSELING: PRACTICE, THEORY, AND RESEARCH, VOL. 41, NO. 2, SUMMER/FALL 2014 24 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 … Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. NAVIGATING DUAL RELATIONSHIPS IN RURAL COMMUNITIES Gonyea, Jennifer L J;Wright, David W;Earl-Kulkosky, Terri Journal of Marital and Family Therapy; Jan 2014; 40, 1; ProQuest Central pg. 125 Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. Reproduced with permission of the copyright owner. Further reproduction prohibited without permission.