Social work in rural areas: a personal and professional challenge

Keywordsconfidentiality, rural, visibility.

Rural AustraliaClose to 30% of Australia’s population of 19 million, live and work in rural or remoteareas (Commonwealth Department of Healthand Ageing 2000; p. 8). While rurality isdefined in many ways, studies confirm thatin a wide range of social, health, educationand economic indicators, rural Australiansface disadvantages when compared tourban Australians (Cheers 1992; Sjostedt

1993; Titulaer et al. 1997). While suchdisadvantages may vary between regions,in general not only is their standard of health lower, they are more oftenhospitalised, death rates and hospitalisationfrom injury is higher, and they have pooreraccess to health services than those livingin metropolitan centres (CommonwealthDepartment of Health and Ageing 2000; p. 8). Education standards are generallylower and access to welfare services isoften limited (Human Rights and EqualOpportunity Commission 1999). Incomesare lower and there is no doubt that ruralAustralians face complex social problemsand social disadvantage (Vinson 1999;Alston 1992; Cheers 1992). IndigenousAustralians, the majority of whom live inrural and remote areas, are among those most significantly disadvantaged(Cheers 1998; Trinidad 2001).

A further set of disadvantages is createdfor some groups through the effects of rural

Australian Social Work/September 2003, Vol. 56, No. 3 209

Social work in rural areas: a personaland professional challengeRosemary Green

Australians live in diverse areas, city and country, coast and hinterland, desert andrainforest, urban and remote areas. While much social work practice is located inlarge population centres, the problem of providing a social work service in rural andremote areas is a challenging one. This article examines some of the issues for ruralsocial workers practicing where networks are small and multilayered, anonymity,privacy and safety for the social worker cannot be guaranteed, and a broad range ofknowledge and skills are demanded. As a profession, it is important to acknowledgethe complexity of delivering an ethical, responsive and appropriate service in ruralareas. For rural social workers, this challenge impacts in both their professional andpersonal roles.

Rosemary Green is currently the Head of School ofBehavioural and Social Sciences and Humanities at theUniversity of Ballarat. Associate Professor RosemaryGreen, School of Behavioural and Social Sciences and Humanities, University of Ballarat, PO Box 663,Ballarat 3353, Australia. Email: [email protected]

restructuring, recession and economicrationalisation (Sjostedt 1993). The adventof the technological age provides somehope in terms of access to information,however, not all rural people have theaccess and skills to capitalise on theprovision of information technology. Whilesome rural communities are thriving andhave successfully adapted to change,many communities have experienced cut-backs in service provision and haveserious social and economic difficulties(Briskman & Lynn 1999, Human Rights and Equal Opportunity Commission 1999).

Recent elections in almost everyAustralian State have shown rural people to be unhappy with the urbo-centricity ofpolicies. Rural politics are now a firm part ofthe national political agenda (Lockie 2000).Rural social workers can be key informantsto these debates and strong advocates for their communities. However, there aresome dilemmas inherent in rural social work practice.

Rural social work practiceOne of the purposes of publishing theBriskman and Lynn (1999) collection ofarticles on rural practice in Australia was todemonstrate the distinctiveness of ruralpractice Briskman (1999: p. 6). While all social work practice must becontextualised, a review of the literatureregarding the nature of rural social workpractice indicates the context impacts onthe nature of professional practice insignificant ways. These include the styles ofpractice, the impact on the professional ofmanaging dual and multiple relationships,confidentiality, privacy and personal safety

and the challenges of providing accessible,ethical and competent practice in a climateof poor funding, geographical distance, andcomplex and multi-layered networks.

The nature of rural communities, and theinstitutions, agencies and organisationsoperating in them, demand a relevant,appropriate form of practice, one whichdiffers from the urban experience and is more than a diluted version of it.Difficulties can arise if workers attempt to apply a model which fails to recognisekey characteristics of rural life. Francis andHenderson (1992: p. 54)

Rural social practice has taken a generalistapproach (Lynn 1990, 1993; Cheers 1998).As specialist services are few, rural social workers work across a range ofmethodologies and interventive strategies.A generalist approach is not only a mode of practice which incorporates differentmodalities, and requires workers to havethe ability to work across different fields of practice, it also includes concepts of interconnectedness, mutuality andreciprocity, interrelatedness andinterdependence. Lynn (1990: p. 17) addsthat not only is a generalist approachappropriate to overcoming the lack ofspecialist services, it is also most culturallycompatible with rural life. Rural socialworkers must have an holistic focus, with avery diverse knowledge base spanningeconomics and politics, rural sociology and geography and knowledge of variousinterventive strategies. It is important toutilise knowledge gained from thecommunity and its members, and to work in ways sensitive to the community.Practitioners need to be flexible, creativeand able to improvise to provide services in

210 Australian Social Work/September 2003, Vol. 56, No. 3

locally relevant ways (Sturmey & Edwards1991; Cheers 1998; Martinez-Brawley2000).

It is also important to acknowledge themyths and stereotypes that exist aboutrurality. There are visions of social care andharmony and rural virtue, which portrayrural life as simple, slower and kindlier than urban life. On the other hand, there is a myth about conservatism, intolerance,suspicion of outsiders, homogeneity,prejudice and racism (Kapferer 1990,Francis & Henderson 1992). While elementsof both aspects exist, to label all ruralcommunities in such a way is as absurd as saying all urban people are cultured,tolerant and educated. Understanding the nature of each community is essentialwhen contemplating living and working as a social worker within that community, as is knowing the myths each communityholds about itself.

Martinez-Brawley (1982) provides uswith basic tenets of effective rural practice.First, she argues the approach must be towork with the community with local people,in a respectful way, acknowledging localvalues, the knowledge base residing in thecommunity and that local people have as much control as is possible overdecision making for their community: theindigenisation of practice. Second, sherefers to conscientisation, or consciousnessraising. By gaining knowledge of systems ofgovernment and public policies, ideologiesthat rule and shape our lives and socialcontrol mechanisms, people can analysecommunity and social expectations andbetter understand the processes that affect their lives. A further step fromconscientisation is politicisation, so thatonce the inequities and inequalities in

the existing power structure have beenidentified, a political process is engaged to address issues both within and externalto rural communities. Such a radicalapproach, using concepts such asdeveloping critical awareness and workingfor social change in anti-oppressive ways,is challenging for all social workers. Forthose living and working in small ruralcommunities, an approach usingconscientisation and politicisation leads to greater visibility and some uniquepersonal and professional challenges.

Belonging to the community inwhich you work

There is a common usage of communitywork strategies by social workers in ruralareas (York et al. 1989; Puckett & Frederico1992). These studies demonstrated that a range of different skills and roleexpectations exist between workers in ruraland urban settings in essentially similarpositions. Puckett and Frederico (1992)found that Australian rural social andwelfare workers adopt a community focus and engage more often in socialplanning, service coordination, communitydevelopment and networking than thoseemployed in non-rural areas.

Jacobson (1980) believes thatcommunity development is the mostappropriate process for rural practice, as it can both work to improve resourcedevelopment and also create fundamentalsocial change, and the worker is seen as acitizen rather than an organiser. This senseof belonging to the community, working withthe community as a citizen goes some way to managing personal-professionalboundaries. Sometimes it is possible to


separate work situations from others.However, there is often overlap and suchseparations are often arbitrary. Rural socialworkers sometimes question whether theybelong to a particular group, for example, atown’s development association, in theirown right as citizens of the community, oras part of their work role. For communitymembers such distinctions are oftenunimportant. However, this blurring of rolescan cause dilemmas about role, the right of sharing information obtained in theworker’s employment, the management of dual and multiple roles and otherconcerns.

There are many positives to working in rural communities, such as lifestyle,autonomy and flexibility. There areopportunities for learning a wide variety ofskills and practice modalities, developingmanagerial and consultancy skills andinitiating innovation (Lonne 1990; Lynn1990; Lonne & Cheers 1999). As Riley(1999: p. 193) notes, her range of skills‘would have taken years to develop in thecity due to lack of exposure’, and shecomments that due to opportunity and thedemand for generalist practice, she wasable to develop advanced skills andexpertise in a much shorter time. However,belonging to the community in which youwork can bring about additional strains.High visibility, dual and multiple roles,boundary ‘overlap’, confidentiality, personalprivacy and safety are major issues thatneed to be addressed for rural socialworkers.

Dual and multiple roles

Dual and multiple roles must frequently beadopted and managed within professional

and personal contexts by rural socialworkers (Miller 1998; Wilson-Barrett &Dollard 2000).

When working from a communitydevelopment perspective, social workersmay be on committees with clients, meetpeople ‘wearing different hats’ and haveaccess to a range of knowledge andinformation to which they would nototherwise be privy. For many urbanworkers, friendships or associations with clients, ex-clients, extended families of clients, members of boards ofmanagement, etc. would be consideredunethical, but in the country it is impossibleto join a sporting club, a creative artsgroup, or a school council without somecompromise to this position. Martinez-Brawley (2000) comments that in many rural areas it would be impossible not toknow a client, or know of a client incircumstances other than the professionalwork. She goes on to argue that this mayadd to the effectiveness of practice andthat codes of ethics for social workers must address this aspect of rural practice.Dual roles, multiple roles and relationshipscan create a humanising effect that isbeneficial to both the worker and theirclients, leading to better practice (Cheers 1998).

The National Association of SocialWorkers in America have recently amendedtheir Code of Ethics (Martinez-Brawley2000: p. 254) to provide for greatersensitivity to complex situations arising from rural practice. They recognise that in rural practice some relationships aremore easily avoidable than others, or arepotentially more harmful than others, andrecommend rural social workers discussboundary issues clearly with clients, utilise


supervision effectively and address thesematters within cultural and ethicalexpectations.

Further research into the nature of dual and multiple relationships in ruralpractice would be a worthwhile study, where assumptions about the ‘problems’ or‘benefits’ of dual and multiple relationshipsand role blurring could be analysed.

Lack of anonymity

Lack of anonymity for the rural socialworker, their family and their clients is animportant factor to acknowledge in ruralsocial work practice. Edwards (1993)argues for a low profile approach whensetting up new services in an Australiansmall town, initially working on creatingprofessional credibility rather thandeveloping a high profile. However, sheacknowledges that the worker soonbecomes highly visible in the communityboth within the networks of otherprofessionals and power lobbies, and with clients. She tells of how she wasshopping with her husband and youngchildren and three different clientsapproached to tell her of significant issuesin their lives. In urban practice, this set ofcircumstances would be unlikely; in ruralcommunities it is a fact of life forprofessionals.

One has to develop appropriate ways todeal with this. It is inappropriate in myopinion to indicate, by whatever means,that you are not at work and therefore notresponsive. On the other hand it is alsoinappropriate to conduct confidentialdiscussions on the footpath just becausesomeone runs into you. Another issue thatcan cause discomfort is that it may not be

possible to sustain the image of a fully selfrealised being with the perfect family in the face of that screaming child in thesupermarket, particularly when the offenderhappens to be your child who is throwing amajor tantrum in front of your clients.Edwards (1993: p. 12)

There are various ways professionals candeal with this situation, but as Edwards(1993) indicates, professional practiceissues can emerge even on Saturdays, andappropriate strategies must be used tomanage them. While being clear about yourprofessional role and the expectations ofthe relationship with clients is vital, socialworkers need to consider for themselveshow best to manage these issues in theirown community. A sense of balance and ofbeing a citizen as well as a social worker(Jacobsen 1980), of seeing oneself as anactive part of the community, may assist indealing with these events.

Disturbing issues can occur when arural social worker works to reduceoppression, discrimination anddisadvantage in rural communities, usingradical practice or Martinez-Brawley’s(1982) approach. Working for social justiceand challenging oppression in rural areascan be more complex and dangerous than in urban environments because of the high visibility of workers. People whoare most discriminated against may find it very difficult to demand their rights, ortake social action for fear of furtherdiscrimination. The social workers who work with these client groups may also befearful of consequences for themselves and their families (Pugh 2001). As part oftheir role, they may have to challengedominant ideologies, remove children from families, help women escape family


abuse and challenge racist and oppressivepractices. This may eventuate inunwelcome attention to themselves andtheir families, such as threats, violence or harassment in the community or at work. There can be enormous tension inundertaking such a role (Lynn 1999; Pugh 2001), and if powerful ideologies are challenged, a worker’s future jobprospects can be damaged. Reprisalsagainst the social worker and their familymembers can and do occur. Challengingthe dominant view and supporting thepoliticisation process for marginalisedgroups when supervision and support fromagencies may be minimal can make itdifficult for workers to remain positive andoptimistic (Briskman 1995; Lynn 1999).

In rural social work practice anindividual can really make a difference, may be a strong role model for others andmay ‘break the silence’ about importantissues which the community must address.As social workers, with strategies of empowerment and communitydevelopment, social workers are in verypowerful positions to create lasting change.However, there are times when workingwithin a social action, anti-oppressivepractice model may be risky, evendangerous, for the individual involved and their families, and more so for those inrural areas where lack of anonymity exists.

Confidentiality and privacy

Lack of anonymity also impacts on the wayservices must be delivered. In a study byMacklin (1995) clients reported concernsrelated to privacy and confidentialityassociated with particular professionalservices. Many chose to go to other towns

for services to avoid the ‘gossip andinnuendo’ they feared would result if theywere seen to approach a local worker.Many also were worried that administrativestaff, or others working at the agency would have access to personal records and could not necessarily be trusted. Intheir study of privacy and sexual healthissues for young rural people, Warr andHillier (1997) emphasised the need forservices to be sensitively offered in ways that would ensure privacy andconfidentiality. Care must be taken toprovide a service that is, and is seen to be, scrupulous in the management ofpersonal and private information.

For the social worker, ethical dilemmascan arise with the management ofinformation gained indirectly as a result ofliving and working in the same community.Often information is obtained about aclient’s circumstances in informal settings,out of work hours and is sometimes soughtor given by friends or family of the client. Itis critical to develop strategies to deal withthese situations and to consider the validityof receiving and using this information(Green & Mason 2002).

Social workers are often expected toshare sensitive material with other workersor the community. Often social workers areprivy to information the community feels ithas a right to know, but cannot share due toprofessional ethics. An example might be asocial worker working with a child sexualoffender who has been released fromprison and relocated to the community. Ifthis person re-offends, the offences couldinvolve the social worker’s own familymembers or their friends and the issuebecomes intensely personal. There aretensions about community ‘need or right to


know’ and professional confidentiality whichcan have a major impact on the individualsocial worker and their practice. If anoffence occurs, friends may believe theyshould have been warned in some way and members of the community retaliate for what they may see as practices whichprotect the perpetrator and not thecommunity. For many social workers thistension is constant. A possible strategywhich protects the client’s confidentiality but also goes some way to addressingcommunity concerns is to be proactive with formulating community basededucational strategies that prepare and alert rural communities to potentialdangers.

Personal safety issues

Staying safe as a worker and protectingyour family’s safety may be a concern as anonymity in rural areas cannot beensured and social workers often work incontentious fields such as child protection,family violence, the criminal justice system,and child and family welfare. Wilson-Barrettand Dollard (2000) discuss some of thecomplications of having professionalknowledge about perpetrators of violence,and the need to protect vulnerablemembers of the worker’s family such aschildren. Similar examples are given byMacklin (1995) where social workersacknowledged a fear of reportingsuspected child abuse due to the possibleretaliation by violent perpetrators. Horejesiand Garthwait (1994) identified that a high percentage of American rural childprotection workers had experienced threatsand violence. Ninety-seven per cent of thesurveyed child protection workers had

encountered screaming or cursing by aclient and 10 per cent had been pushed,shoved or hit by clients. One in eightreported being very fearful. In ruralcommunities in Australia, figures may besimilar, but few studies have examined this matter.

Sexual assault workers often work inrural locations where they know rapes have taken place, frequent the same socialfacilities and live in the same communitieswith both survivors and perpetrators. Thismust have an impact and hypervigilanceand feelings of compromised personal and family safety may be an outcome.Coholic and Blackford (1999) in their studyof vicarious trauma, found that there wasadditional stress for rural social workerswho had to maintain confidentiality aboutperpetrators of abuse who lived in theircommunity and that their personal andleisure activities were frequently curtailedfor reasons of safety and privacy. Ruralsocial workers must have agency support,adequate supervision and proper training toensure they can practice competently,professionally and securely in rural andremote locations.

Adaptation to rural practicePeople who begin their practice in ruralareas come from a range of backgrounds,including some with experience of living inrural communities. While there are somenotable regional Universities teaching rural aspects of social work, most socialwork courses are urban in nature, thoughsome provide ‘rural electives’. While new graduates take up rural practiceopportunities, not all newcomers to rural


practice are new graduates. Many haveadvanced skills and experience andrelocate to rural practice for a variety ofreasons including lifestyle and workopportunities.

There is some evidence that indicatesrelocating to rural practice may be initiallydisempowering despite a high level oftraining or experience, as workers mustadapt to a new culture and establish theiridentity within a community (Sturmey &Edwards 1991). Even those moving fromone community to another will finddifferences and have to take time to adaptto new circumstances and expectations. As it involves living in the community aswell as working there, new social as well as work connections must be forged.Additional stresses are created as socialworkers are confronted not only byprofessional challenges such asmaintaining confidentiality and clientprivacy, but also their own adaptation todual and multiple roles, blurred roles andlack of anonymity. Lonne (1990) examinesthe phases that a social worker, relocatingto rural practice, progresses through asthey make the personal and emotionaladjustment necessary. He argues that thisprocess commonly takes 12–18 months and includes disorientation, honeymoon,grief and loss, withdrawal, depression,reorganisation and adjustment phases.Adequate agency support, includingpreparation prior to commencement andeffective supervision, need to be providedduring this time.

Many rural social workers do notachieve successful integration into theirchosen communities and are dissatisfiedwith work arrangements. Lonne and Cheers(1999) found that many rural social workers

left their employment much earlier than theyhad planned and Puckett and Frederico(1992) also found that rural social workersseemed overall more concerned with theiremployment than their urban counterparts.Dollard et al.’s (1999) study of burnout andjob satisfaction in rural and metropolitansocial workers indicated that for ruralworkers, role ambiguity and unfair selectionprocesses were important predictors ofstrain for rural workers. In thesecircumstances access to high level,supportive supervision may assist inretention and reduction of stress in ruralsocial workers.

Supervision and debriefing

Rural social work is complex. For manysocial workers this is challenging andimmensely satisfying, as local needs maybe addressed in innovative and creativeways, and they can see the lasting effect oftheir work with individuals, families and inthe community. Professional boundaries inorganisations are often blurred and rolesare flexible which provides a range ofprofessional opportunities and challenges.(Cheers 1998; Brand & Kesting 1999). For some rural social workers, this lack ofrole clarity becomes a constant source ofstress (Dollard et al. 1999).

Access to relevant and supportivesupervision for rural professionals isimperative given the range of potentialdilemmas discussed in this paper. Socialworkers in rural areas need to developadvanced skills, be creative and adaptive,and be able to effectively negotiate a rangeof personal, professional and practicedemands. Support and professionalsupervision enhances the chances of the


social worker integrating effectively into the community and maintaining a credibleand professional service. However, thedensity of networks in rural areas can affectthe ability to confidently and confidentiallydebrief or utilise supervision.

Within the agency, the supervisor, aswell as the social workers themselves, mayhave relationships with members of thecommunity that can compromise a trustingand open supervisory relationship. Perhapsthe supervisor may be friends with the client or their extended family, or part of the same or associated networks. Thesupervisor may be married to the director of an agency, which the social worker maywant to criticise. Maintaining confidentialitycan be very complex. Social workers andtheir supervisors frequently will have otherassociations that impact on the ability todiscuss sensitive and private materialconfidently. These networks must be takeninto account as they do impact on thecapacity to find and access supervisionand debriefing. It is necessary to honestlydiscuss these situations, and in somecircumstances seek supervision outside the agency, or even the region.

ConclusionFor social workers choosing to work in ruralareas, the work has many positive benefits.Living and working in the community allowsworkers to be citizens as well as workers,provide vital services, contribute tocommunity change and well-being andreally ‘make a difference’. However, ruralpractice contains some professionalchallenges that must be acknowledged.Rural social work that confronts oppression,

works with marginalised people and takes a developmental and generalist approachrequires a range of skills and the ability to analyse complex social, economic,structural and cultural factors. The effects of working in rural areas impact not only on the professional aspects of work, but on the person as well. The management of these personal and practice issues need to be addressed comprehensively by education, supervision and agencypractices. For those in rural areas, theeffect of their work is both dramatic andpersonal, and strategies for dealing with the consequences of this practice must be developed and shared.

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Article accepted for publication 16 December 2002


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Social work in rural areas: a personal and professional challenge