Counseling Families and Children in Rural Poverty

Introduction

Rural areas have specific resource concerns, health problems, and variations in demographic, cultural, and economic issues that influence mental health (Smalley et al., 2010). It is important to note that two relatively consistent characteristics across rural populations are poverty and payment for services (Smalley et al., 2010). Unfortunately, approximately eight million people living in rural areas meet the poverty threshold, with nearly 20% of children in poverty living in rural areas (U.S. Department of Agriculture, Economic Research Services (ERS; 2014). Additionally, students in rural communities experience relatively higher rates of mental health issues compared to their counterparts in other communities (Lenardson, Ziller, Lambert, Race, & Yousefian, 2010). Approximately 20% of the entire United States population—55 million people—live in rural areas and are significantly impacted by the lack of availability and acceptability of mental health services (Health Resources and Services Administration, 2005; Jameson & Blank, 2007). When referring to mental health concerns: depression, substance abuse, and domestic violence occur at the same rates in rural areas in comparison to urban areas (Cellucci & Vik, 2001; Smalley et al., 2010), and some issues, such as suicide, occur at higher rates in rural areas (Singh & Siahpush, 2002).

It is imperative that counselors and educators have an understanding of what concerns are most prevalent and how to address these mental health issues for those living in rural poverty. Unfortunately, according to East, Powers, Hyatt, Wright, and May (2016), the counseling literature suggests that people living in poverty are two times more likely to manifest psychological stress than those living in the upper and middle classes (Foss et al., 2011). Therefore, the consequences of this psychological stress may exacerbate the symptoms of mental health problems for adults and children in poverty. Ultimately, the implications of neglecting these detrimental mental health concerns can lead to a decreased quality of life for those with limited access to health care, such as individuals living in rural poverty America. This chapter examines state-specific theories and models, such as the social cognitive theory (SCT), positive psychology (PP), and the CARE and I-CARE models, as well as outlining and highlighting the key aspects of each model and theory. The information provided in this chapter will connect each theory back to how it could be a viable tool when counselors, counselors-in-training, and all human service professionals are assisting individuals in rural poverty with mental health concerns.

The fundamental core counseling skills which have been utilized in the counseling discipline will be discussed throughout this chapter with an overall emphasis on how to employ these skills when working with families and children in rural poverty. Additionally, the significance of a multidisciplinary approach will be discussed in detail. When counselors and counselors-in-training are working with clients of marginalized populations, it is imperative to recognize that positive changes can exist when all stakeholders are involved. According to Herman, Reinke, Thompson, and Hawley (2016), the multidisciplinary approach from scholars and community change agents is essential and critical to the societal, institutional, and organizational context of preventive interventions. The scholars posit that to improve general population health outcomes, it is essential to not only initiate effective interventions but also create effective and successful organizational contexts that support the use of these interventions as intended (Herman et al., 2016). Within a macro-level counseling lens, systematic change will need to occur for families and children in rural poverty to receive adequate services regarding mental health.