Counseling Ethics in a Rural Community

Living in a rural area, I’ve learned that everyone is related, and news gets around fast. As a counselor in a rural area, I’ve had to put my own counseling ethics into practice on a daily basis to protect my clients’ confidentiality and maintain a healthy therapeutic relationship.

In my little small town, I can’t leave the house without running into someone I know. When I first moved here, I was viewed as a “come here,” an outsider. Over the past few years, I’ve formed many relationships, but I’m also still very mindful of my position as a counselor and maintaining my counseling ethics.

In addition to my full-time counseling position, I work as a part-time crisis counselor in my community. I’ve knocked on doors and been greeted by families that I go to church with.  After a particularly interesting day, I went to the gym and was in the ladies’ locker room with the school counselor, social worker, and juvenile probation officer. We all just shared a look and a nod of acknowledgement. In a public place, we couldn’t ask any questions or comment on the situation that was unfolding at work. It’s just the nature of the occupation.

Because I never know when I’m going to run into my clients, I practice my own personal counseling ethics every day. 

Counseling Ethics in a Rural Community

Here’s the basics:

• Know the actual ethics code.
• Know your community.
• Explain the limits of confidentiality to your clients.
• Let them know what to expect when they see you.
• Know who you can talk to about your client’s treatment.
• Realize that others may not be limited by confidentiality.
• Address any concerns.

Ethical Code

The American Counseling Association publishes an ethical code for their members. Even if you aren’t an ACA member, it’s a good ethical code to be familiar with if in the mental health profession.

Know Your Community

When I first moved to the country, several people made the statement that “it must be so easy to work in the country.” Haha. After two years of working in the country, I’ve realized that the country has all the same issues that the city has, but a huge lack of resources to help with those problems, especially mental health resources.There’s no bus system, and the nearest counseling center is 45 minutes away.

Limits of Confidentiality

During my first session, I let my clients know that what they say in my room stays in my room with two exceptions:

1. If they say they are going to harm themselves or someone else.
2. If they tell me that someone else is hurting them or someone else.

That’s a deal breaker. I cannot ignore any reports of self-harm or abuse to others.

Because I work with children, I also have to make it clear with some of my 7-13 year old clients about talking to me outside of my office. Many times, I’ve had clients try to tell me something really important in the hallway or classroom and become upset when others hear the conversation. My office is a safe place; the rest of the school is not.

If your clients see you in the community

I’ve always told my clients that they are welcome to come say “hello” to me if they see me in public, but I won’t approach them. I always communicated this clearly to my middle school clients and their families.

Confidentiality with others

For all of my clients, I have a release of information for my school district, so I can coordinate services with their teachers and attend all meetings. Even though I have the release to talk with teachers and administration, I’m very selective in what I share and guard my client’s confidentiality as much as possible. Sometimes, the teachers are related to the students that I’m working with, so there’s multiple variables to take into account.

The school that I partner with will ask me about general treatment techniques, thoughts about behavior interventions within the classroom, or group session topics; but has never asked me to disclose conversations from individual or group sessions.

Address any concerns.

Because I live in a small town, rumors fly all the time, and I have clients accuse me of “ratting” them out. It definitely puts a strain on the therapeutic relationship. If I’ve had a conversation with anyone about a particular client, I’m very honest with my clients about what I shared and when. Sometimes, they don’t believe you, but you continue to maintain that relationship and hold to your ethical code. Eventually, the relationship would be restored.

Do you work as a counselor in a rural community and have other ethical questions? Leave them in the comments.