Rural environment, how services may be delivered, practice theories, advantages and challenges, improving rural social work, generalist practice approach
This page has three sections:
Background Material that provides the context for the topic
A suggested Practice Approach
A list of Supporting Material / References
Characteristics of rural areas
In 2009 Alston defined “rural” (in Australia) as:
Those areas outside major metropolitan areas that are more commonly in the Outer Regional, Remote and Very remote classifications, where accessibility to services is moderate to remote, where the main industries are agriculture, mining and to a lesser extent tourism, and where people generally relate to the notion of a shared set of values loosely defined as rural.
People living in rural areas can experience the following (Faludi & Neamtu, 2020):
1. Basic material needs
substandard and overcrowded housing, food and nutrition,
inadequate public transport to travel to urban areas
2. Health related needs
general health care problems,
deficit of qualified health personnel,
need for home health care and health education,
higher rates of mental illness and psychological distress linked to adverse social conditions (Bryant et al., 2018)
3. Economic security
poor employment opportunities,
changes in the labour force and in the structure of the population (e.g. increasing rates of older people),
lack of suitable jobs,
problems due to unemployment,
risks of social exclusion for some groups of rural inhabitants.
Mason (2006) suggests this increase in people’s needs is linked to the decline in agricultural-based industries and the impact of globalisation on farmers; continuing drought; the prevalence of violence in rural communities; cuts to rural public service provision; the failure of regional development policy and the impact of economic restructuring; limited educational opportunities; and the impact on rural communities of the introduction of competition policy and tendering. Alston and Kent (2004) attribute this to the neoliberal policy response to globalisation involving regionalisation (centralising services in regional cities), rationalisation (allocating services based on supply and demand principles), centralisation (pulling service administration back to the capital cities) and privatisation (tendering out services previously provided by government).
A number of social services are missing from rural areas: child day-care, services for teenage pregnancy, support and home-based services for senior citizens, assistance to preserve, and where possible, to restore the family unit, meet the needs of adults affected by a disability or a chronic illness or develop the proper social functioning of rural inhabitants (Faludi & Neamtu, 2020).
Service delivery approaches in rural areas
Services in rural and remote areas can be delivered in different ways (Kuyini, 2016, Lecture 1). They can be categorised as centrally based, regionally based, or locally based.
Centrally-based approaches can be centre-based or individual practitioner based.
Centre-based, e.g. on-call centre that operates from a location some distance from its users. It offers services including telephone and/or mail based information, crisis counselling, and/or a referral service. Though these are less personal services, they are a cost effective means of providing a 24-hour information/support link for those in need and are able to deliver services to a large geographical area. However, there are the problems of:
inappropriate and insufficient promotion of such services
little interaction with other agencies
little sense of ownership towards these services by people living in rural and remote areas.
Individual practitioner-based approaches, e.g. itinerant specialists are professional people visiting a location on behalf of a particular organisation. The services are a response to a need from some section of the community and tend to be offered on an 'as needed' basis rather than as an ongoing or regular planned service. Consequently, services are often inconsistent and may be perceived by locals as being external to the community. As this approach only accommodates those with a specialised need and does not offer much to the general community, it can be threatening to those who are non-assertive in dealing with government departments. Consequently, the more confident 'better-skilled’ residents are most likely to access and personally gain from this model of service delivery.
Regionally-based approaches can be centre-based, satellite service centres and individual-practitioner based.
Centre-based The mobile service centre may be specialist, multi-functional or have a community development orientation. As the name suggests, this model of service delivery moves from one community to another with a single team of staff and a single set of resources.
Satellite service centres These centres can be either specialist or multi-functional. They are usually smaller scale versions of their urban-based counterparts because, although they are physically located in small rural or remote towns, these centres are often resourced and managed by a central or regional administrative base.
Individual practitioner-based Community development officers are seen to be highly appropriate to rural and remote areas, especially in those with an underdeveloped sense of community, direction and services. This service delivery approach is region specific, responds to needs, uses a 'generalist' approach and helps to promote social justice.
Locally-based approaches can be centre-based, individual practitioner based or locally based.
Centre-based In larger communities there may be a range of specialist services provided. However, in most rural communities there is a lack of specialist services since the small size of such communities and the cost involved in service provision is prohibitive. As a rule, people requiring specialist services need to go to larger urban centres.
Individual practitioner-based A multi-skilled community (welfare) worker is solely dependent upon the casework, group work, and community practice knowledge and skills of the lone ‘community worker’. Put simply, the worker is both the resource and the model.
Locally-based approaches The literature suggests that natural networks and self-help group enhancement systems are more prevalent in rural communities. Hence when considering service provision and delivery to rural and remote areas the value of the natural helping systems cannot be overlooked.
Practice theories to guide social work in rural areas
Social and other human service workers have a strong focus on addressing social justice issues and ensuring human rights are protected. Being self-reflective practitioners is of fundamental importance. The practice approaches below (from Alston, 2009) should guide the approach of social workers to rural social work.
Structural framework—how limited service infrastructure shapes rural disadvantage and quality of life. A worker’s role is not only to empower people to a greater understanding of their disadvantage (‘conscientisation’) but also to advocate for the resources needed to empower people to make positive changes in their lives.
The human rights approach allows clients and others to see that the human rights of citizens in rural and remote areas are being abused because they do not have the same access to services, health outcomes, education, employment and other opportunities enjoyed by most Australians.
Anti-oppressive practice is highly relevant in the rural situation. It aims to be person-centred, identifies the structural issues associated with individual disadvantage, works for the necessary radical social changes and is based on equality in the helping profession. Oppression is based on unequal power across social categories, e.g. the oppression of women by men.
Feminist approaches aim to create structural change as a result of the oppression of women within male dominated power structures.
Global practice highlights how globalisation, in particular, affects rural communities.
Ecological systems theory emphasises the fit or lack of fit between an individual and her or his environment and seeks to change systems or adapt to them in an appropriate manner to produce better outcomes for rural people/communities.
The ultimate aim of practice is to bring the rural personal into the centre of a usually urbocentric policy domain.
Advantages/assets/opportunities in rural social work
Practitioners in rural and smaller agencies report remaining in their positions longer, having greater autonomy and decision-making authority, and having greater agency support, fairness, and opportunities for professional growth than practitioners in urban and larger agencies. Many report receiving respect from community leaders—they usually live in the community and are known and trusted. Rural workers may engage in using informal networks, and they can sometimes make use of informal resources and relationship skills to create customized resources for clients and families (Brown et al., 2017; Riebschleger et al., 2015).
Problems/challenges in rural social work
In rural areas social workers face a severe scarcity of human and financial resources: poverty, social exclusion, ill health, limited labour market opportunities. Geographical distance from big cities compounds the issues faced by social workers: access and communication issues abound leading to a lack of social services for vulnerable members of communities. The main missing professional social services in rural areas are: residential centres for children, adults with disabilities and older people; services for personal social care; recovery and rehabilitation services; social integration and reintegration services; and home-based social services (Faludi & Neamtu, 2020).
Mason (2006) refers to this as urbocentrism—seeing the city and urban environment as the norm. This is a problem in rural areas, e.g. urban program and service design is often unsuitable for rural areas and may not be relevant. It is likely urban approaches to social work are based on segmented models and rely on the availability of other services existing in the area, services that may not exist in rural areas. Vance (2017) goes further in describing urban society as ‘Gesellschaft’—a society based on indirect social interactions and impersonal institutions. In contrast, rural society (Gemeinschaft’) values direct social interactions and deep personal ties. Rural social work stands at odds with urban social work because of limited resources and the need to rely on the (often informal) resources available in the local community. As Faludi and Neamtu (2020) state: Geographical distance from big cities compounds the issues faced by social workers: access and communication issues abound leading to a lack of social services for vulnerable members of communities.
There is an issue in rural social care with recruiting, retaining and supporting qualified staff. When turnover is high, cases are often passed from one social worker to another, making it difficult for agencies to retain clients, difficult for clients to form a therapeutic alliance, and difficult for clients to access the services they need (Brown et al., 2017). One reason for the high turnover rate may be the lack of professional support for social workers, e.g. lack of supervision, absence of peer support, cost of travel to attend city-based professional development, and inadequate information about the community prior to taking up a position (Mason, (2006).
Being highly visible in both work and private life, issues of privacy and confidentiality, tension between being accepted and engaging in social action on behalf of the powerless, needing to be accepted by the community before value as a professional is appreciated. At times social workers may need to relate to the same person on several levels, something that country people accept as part of rural living. Other challenges include being on-call 24/7 e.g. being approached at the football about a domestic violence issue, managing gossip and inuendo in a rural setting e.g. entering a building in public, overcoming the pressure to conform that is placed on many rural people (Mason, 2006).
Rural social work holds challenges for workers: professional and geographic isolation, inadequate access to formal community resources, the need to deal with dual relationships, multiple job roles, and a lack of personal anonymity (Riebschleger et al., 2015).
Alston (2009) suggests that the four’-isations’ have impacted rural areas adversely. New efficiencies have led to centralisation into capital cities and larger centres of administration of many services and the regionalisation (shifting into regional centres) of many specialist services. Privatisation of services has also resulted in the retreat of governments from the front-line of service provision and the introduction of private providers in the area of welfare and health service delivery. In rural areas, there can be multiple providers in some areas, and none in others. Because it is difficult to make a profit, many areas have lost services all together. Marketisation—the adoption of user pays principles to health and welfare services—is a more prominent factor of service delivery; services become inaccessible to people who are unable to pay.
Improving rural social work
Bryant et al. (2018) suggest that telehealth offers an opportunity for social workers to reduce the isolation of rural residents, enabling them to access specialist resources often only available to non-rural residents. However, the authors point out that technology cannot simply be inserted into complex social systems and rural communities with an expectation that if it is installed, it will be utilized. This is because health care, especially mental health care, occurs within complex intersections between place, health, and social processes embedded in history and cultural contexts. Local participation in the development, design, mode, timing, introduction, and delivery style is important. A discussion of telehealth and its use in social work can be found at https://www.thesocialworkgraduate.com/post/telepractice
Vance (2017) suggests the first step in improving rural social work is to stop thinking of rural social work as being defined by a deficit of services. Rather, consider the capacities of the community. This involves the social worker listening more than talking, especially when just arriving in a rural area. It is important to determine what the community’s values and desires are, something that comes once relationships with a wide variety of individuals and service providers are established. Ultimately it will probably emerge that rural communities do not lack capacity to solve problems but lack the concrete resources to fully deliver on the capacity they have. The social worker’s role may be to seek out and recognize existing services and connections, formal or informal, and collaborate on ways to both connect clients with them and to strengthen the services themselves through new resources or programs. (The difficulty for the worker trained in an urban, mainstream model is being able to seek out and identify those resources in a community. They may be hidden or informal. Once discovered, knowing when and how to bring these resources to bear appropriately would be the next step.) Vance points out that restoring the Gemeinschaft of clients (i.e. supportive social interactions and personal ties) is concerned, above all, with the empowerment of communities and individuals on their own terms. It is the role of the social worker to illuminate pathways to the resources and to assist as a member of the community.
Rural social work in practice
Lonne and Darracott (2006) summarise rural social work practice as follows:
Rural social work is a contextually based practice field with the macro and micro levels intricately linked. Best practice requires an understanding of the social, structural, geographic, community, personal, professional, practice field and practice wisdom domains and how they impact on the interface between a particular community and a particular practitioner. It is this contextualisation of practice that is required in each and every community that differs rural social work from urban practice. Developing best practice in rural social work requires an ongoing commitment to developing practice wisdom through integrative thinking and reflective processes, as well as training and professional development opportunities. In rural practice contexts, regular, quality supervision from an experienced colleague is critical and assists practitioners to manage the complexities of living and working in the same community and managing the resulting multiple relationships with integrity. While beginning practitioners typically align more readily with the structural domain, the journey towards a central location within the practice wisdom domain is required to achieve best practice in the diverse and complex practice and living contexts found in rural and remote communities.
The predominant theme around rural social work is one of ‘generalist practice’—the practice that calls on all methods of intervention. Rural social workers should be good generalists; specialisation is alien to rural culture where people are more accepting of informal helping networks. Generalist social work requires skill working with individuals, groups and communities, developing policy, planning, and undertaking research, management and community consultation, all as part of one job. Rural social workers, therefore, need a broad range of skills and the capacity to work independently, as there are few, if any, specialist agencies to refer on to. Rural social work is based on ‘community-oriented practice’ (Brown et al., 2017; Faludi & Neamtu, 2020; Mason, 2006).
Kuyini (2016, Lecture 9) suggests generalist practice can be organized into three main functional areas (but, in the field, these roles overlap):
Consultancy: consulting with client systems to resolve problems;
The micro level (Enabler role) is about work with individuals families and small groups
The middle level (Facilitator role) is work with formal groups, organisations or bureaucratic structures to improve functioning of these multi-person systems, e.g. organisation development work, which requires collaborative work to improve planning, patterns of communication with other organisations, decision-making and administrative structures
Macro level (Planner role) is about working with communities or societal structures to assess unmet needs, help to set goals, develop policies and initiate programs.
Resource management: Managing the resources of client systems and the social environment. Here tasks include utilizing and coordinating service delivery system and linking consumer systems with formal and informal resources.
Education and information: providing instruction or helping to learn.
Riebschleger et al. (2015) suggest a generalist approach is essential because workers will have to practise in isolation at times, targeting micro-, mezzo- and macro-interventions. They achieve this by using all of the resources, relationships, and knowledge of the community to provide services. Workers need to be proficient in running small groups without backup or assistance. Ecological systems theory and working with families in the rural environment is central to rural social work. The authors suggest workers may need to address the following areas:
Poverty: Because of, for example, lack of employment opportunities, little or no public transport, and low educational achievement poverty persists in rural areas, presenting a barrier to case plan development and completion. Advocacy around addressing poverty and providing adequate services may be necessary.
Lack of resources: Informal community resources may need to replace formal resources.
Trauma-informed services: The social worker may be the only professional trained in trauma-informed practice and will need to provide these services or refer and monitor trauma treatment to meet the needs of clients.
Cultural competency: Different cultures will be common in rural areas; adopting a humble, self-reflective stance will be necessary.
Personal safety: Because rural social workers are geographically isolated and practice in small groups or as itinerant workers from metro agencies, they need to exercise caution and practise safety measures.
Ensuring personal support: Seeking support via supervision and collegial relationships is an important part of rural social work.
Managing dual relationships: Dual relationships are an inherent part of rural social work. Rural social workers must retain a delicate balance between community involvement and professionalism.
Confidentiality: Confidentiality is essential but can be difficult to maintain in a rural area. It is important to discuss with families how to handle chance encounters, e.g. at the grocery store, sporting event, social event or school.
Boundaries: Clear boundaries are important but can be difficult to establish, e.g. around availability.
Maintaining reciprocal relationships: Rural communities are based on reciprocal relationships. The worker can enhance relationships using evidence-based practice skills—through advocacy, presentations and informing people. Maintaining good relationships with others at all levels of society will lead to higher social capital overall.
Workers in rural areas use a continuum of practice options from specialist individual counselling/service provision through to macro-level policy development and social planning. Casework (counselling or consultation with or without case management by a team) is at one end. Group work follows—a form of delivery that allows people in similar circumstances to be supported in a group environment, both therapeutic and self-help groups. Community work is next—working to improve the circumstances and resources of communities through planning, researching, networking with locals, governments and private sectors, and generally operating in the best interests of the community (Alston, 2009).
The following strategies can guide social workers involved in rural work (Alston, 2009):
Use skills drawn from across the continuum
Be strategic in using these skills
Work to build community capacity and leadership
Work across boundaries within and beyond community
Work with, and support, other human service providers
Advocate for communities and rural people
Advise on rural disadvantage and policy
Fill the space between community and external bodies
Work strategically at the intersection of market and government
Enable a voice for rural people
Collaborating with other disciplines to provide service to client groups and meet agency objectives is vital for safe work in rural communities. In rural and remote settings, patient safety and staff shortages mean that social workers, police, corrections officers, social welfare workers and health practitioners must be able to work collaboratively across their professional boundaries. Multi-professional networks ensure consistent, continuous and reliable service delivery. Networks—both formal and informal—are essential in rural practice as practitioners face situations that may require expertise beyond their level of skill or experience (Beddoe & Burley, 2012).
The information presented above suggests the following are key components to practising rural social work. Being mindful that rural social work can vary from one rural community to another, rural social workers should
Adopt a generalist approach to social work: work with individuals, groups and the community as a whole across a range of practice areas as a consultant (enabler, facilitator and planner), as a resource manager, and as an educator.
Be skilled in casework (e.g. counselling and case management), group work (therapeutic, educational and self-help), and community development.
Be aware of the needs of people in rural areas: material, health and economic needs (often a result of the globalisation trend causing centralisation, regionalisation, privatisation and marketisation).
Have an understanding of practice theories relevant to rural social work practice, e.g. structural, human rights, anti-oppressive, feminist, global, and ecological.
Be skilled in developing relationships with a broad range of people, both influential and otherwise.
Collaborate with other service providers for the benefit of individuals and the community
Be able to mobilise formal and informal resources available in the community to address community needs.
Manage dual relationships successfully
A number of topics elsewhere on this website offer a suggested practice approach in areas pertinent to the generalist approach to social work. They include:
An ‘everyday’ (generalist) approach - https://www.thesocialworkgraduate.com/post/generalist-social-work
Community development - https://www.thesocialworkgraduate.com/post/community-development
There are many other topics relevant to social work on the socialworkgraduate.com website that may assist workers in rural areas as they engage with people from a range of backgrounds who have a variety of problems: https://www.thesocialworkgraduate.com/post/contents
Supporting Material / References
(available on request)
Alston, M. (2009). Innovative human services practice: Australia’s changing landscape. South Yarra, Victoria: Palgrave Macmillan.
Alston, M. & Kent, J. (2004). Coping with a Crisis: Human Services in Times of Drought. Rural Society, 14(3), 214-227.
Beddoe, L. & Burley, M. (2012). Collaborating within and across interprofessional teams. In J. Maidment & U. Bay (Eds.), Social work in rural Australia: Enabling practice (pp. 40-57). Sydney Australia: Allen & Unwin.
Brown, A. R., Walters, J., Jones, A., & Akinsola, O. (2017). Rural social work: Recruitment, job satisfaction, burnout, and turnover. Contemporary Rural Social Work Journal, 9(1), article 12. https://digitalcommons.murraystate.edu/crsw/vol9/iss1/12
Bryant, L., Garnham, B., Tedmanson, D., & Diamandi, S. (2018). Tele-social work and mental health in rural and remote communities in Australia. International Social Work, 61(1), 1-13. https://doi.org/10.1177/0020872815606794
Faludi, C., & Neamtu, N. (2020). Social work in Romanian rural communities: An inside perspective from a qualitative study. Transylvanian Review of Administrative Sciences, 61(E/2020), 25-45. doi: 10.24193/tras.61E.2
Kuyini, A. B. (2016). HSSW303 Rural Social Work [Lecture notes]. School of Health, University of New England.
Lonne, B., & Darracott, R. (2006). Rural and remote communities. In W. H. Chui & J. Wilson (Eds), Social work and human services best practice (pp. 172-191). Annandale, N.S.W.: Federation Press.
Mason, R. (2006). Providing social care services in rural Australia: A review. Rural Social Work and Community Practice, 11(December), 40-51.
Riebschleger, J., Norris, D., Pierce, B., Pond, D. L., & Cummings, C. (2015). Preparing social work students for rural child welfare practice: Emerging curriculum competencies. Journal of Social Work Education, 51(sup2), S209-S224. http://dx.doi.org/10.1080/10437797.2015.1072422
Vance, C. (2017). Toward a radical model of social work in rural communities. Journal of Progressive Human Services, 28(1), 2-5. http://dx.doi.org/10.1080/10428232.2017.1249245