Transcript Psychoanalytic Therapy

Advanced Rural
Generalist
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The term ‘Advanced Rural Generalist’
describes a specialist who has advanced
training in broad areas of social services with
emphasis on ‘the person in the environment’,
client systems, and community systems
theories within a rural culture.
The generalist practitioner
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The generalist practitioner is expected to have the skills
necessary to advocate for the individual client, group, or
community in securing needed resources.
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The advanced generalist practitioner is expected to to advocate
for the community at a macro level by meeting with individual
clients, groups, or community leaders in the development of long
term resources and identifying and removing systemic barriers to
services, in order to meet broader needs of individuals, groups,
or community systems. The generalist rural practitioner is
expected to advocate for the individual client, group, or
community in the securing of needed resources within the
culture of a rural setting.
The advanced rural
generalist practitioner
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The advanced rural generalist practitioner is
expected to advocate for the community at a
macro level by meeting with individual clients,
groups, or community leaders in the
development of long term resources and
identifying and removing systemic barriers, in
order to meet the long term needs of
individuals, groups, or community systems
within the culture of a rural setting.
Rural and Urban
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The concepts of rural and urban may so elusive and changing that
a clear understanding between any two individuals may be difficult
to achieve. To the person raised in a large city, being rural might
mean a place surrounded by cattle, horses, and open fields. To
someone raised in a small city, it might mean a country home
along side a stream or lake with chickens in the yard, rural mail
carriers, and telephone party lines. To the displaced city-dweller
living in what most would consider the country, rural may describe
the backwoods neighbors who are occasionally seen at the
hardware store wearing farm-hand clothing. To the farmer, rural
might mean simply proximity to farmland, regardless of how close
the land is to a large city. Despite these variances most people
agree that there are at least some unique differences in values,
priorities, and general approaches to life between the two groups.
Some of these differences are discussed.
Value differences
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There is an intuitive sense as well as a popular belief
that the values of rural residents may be different as a
group from those of their urban counterparts. In rural
areas, connections between family members, church
members, neighbors, business acquaintances, and
friends are often given a higher priority or value,
reflecting the notion of social capital as a precious
commodity. The rural individual may view the
collection of additional relationships and community
contacts as a desired goal in overcoming feelings of
isolation, and consequently, comes to the position of
holding dear all social contacts.
Community
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There is more participation in civic functions.
There is a stronger sense of how each
person’s welfare may affect the whole,
resulting in greater levels of commitment to
the general welfare of the community. Rural
communities also tend to apply strong social
sanctions to people who don't reciprocate in
helping one another or who do not participate
in the social life of the community. And trust is
often more important than the issues being
discussed.
Rural issues to consider:
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Social capital
is it related to proximity or distance
is it related to religion and church frequency
is it related to personal history or rural
background
do years in rural settings impact more or is it
the early years as rural that has more
influence
Relationship basis
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It may be the dyad influence, that there must be a
relationship to start or base the concept upon.
When, where, how is the rural relationships based. Is it
community vs individual based? The concept of the
hospitality greeter is important to consider. Who starts
the tone of a friendly community? Look at the evolution
between community being family vs. a neighborhood of
unrelated people. How quickly can a neighborhood
adjust to new faces and how does transience impact
the willingness to accept others into the fold.
Transience affects
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What is the impact of school, new teachers,
and transfer students, immigrants who come
and go, look at the ‘seminary’ concept or
military bases? How transience adjusts the
level of commitment to others among rural
populations. Mineral Wells would be a good
place to look. Presence of a university in a
rural setting also would be a good place to
look. How does social capital ‘work’ on
university campuses?
Environment
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Rural vs Urban are general issues to consider.
They are never static. They are dynamic and
pose a complex set of values that changed
from generation to generation. Though some
of these ‘differences’ are difficult to pin down
and can be confused with stereotyping, they
are pervasive enough to consider in assessing
a family in ‘the environment’. I’m sure some
you will recognize, some may be new to you,
and some may seem out of sync with your
own experience of East Texas .
Isolation
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Distance from one another: Isolation The
national model of child abuse provision
includes 24 hour access to trained staff, 24
hour foster care, 24 hour protective in home
care, 24 hour emergency day care, protective
day care, counseling, supervised visitation,
foster group homes, residential treatment, etc.
In a rural area day care is just not cost
effective and it is not offered in most places.
Family is private
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Stay out of my business or I will shoot you.
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Dealing with the east Texas family can be a throw-back
in time. There is an Appalachia feeling of the family’s
business being sacred and not open to any one. Texas
in particular has a culture that says that the individual
is responsible for him or herself and should not expect,
look for, and actually resist out side help, that it is a
form of weakness to accept help from others. This
makes it doubly difficult for the practitioner to develop
a working relationship with the family, as much
suspicion must be overcome as well as guilt at even
‘needing someone’ to come help them or help them
gain access to needed resources.
Racism/sex roles
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Racism or racial attitude/sex roles: Rural
Areas often track behind urban areas in race
relations. Often the access to diversity is
limited and the level of diversity is more fixed.
People tend to know each other in certain roles
that may remain static throughout their lives.
The postman is the same postman for 30 yrs.
The insurance man is the same man for my
grandfather. People have a place to put people
and change or flexibility is slow and difficult in
coming.
Staffing Issues
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Staffing can be a problem. social services does not
pay well thus most areas are resigned to finding staff
from the community. These workers often carry the
same bias that the community feels such as ‘it is a sign
of weakness to need help’ and thus come to the point
of offering help expecting some resentment from the
client, or even some patronizing affects toward the
client that shows their disrespect for the client for
needed such services.
Funding quirks
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Funding: Rural work faces statistical problems in funding. In
Texas as well as most states there is a ‘capitation’ issue at work in
setting funding. Our 15 county region has continuously grown
each year since 1982. In 1982 it received 5.85 % of the state’s
overall budget for operation of the Child Abuse program. It is
based primarily on child population, though during some of the
80’s it included numbers of reports of child abuse as well. Since
1982 the percentage of the total budget has continued to drop to
3.45% of the state’s budget. Regions in the Valley, Metro Plex, and
Houston have grown appreciably more percentage wise than
here. For instance, Tyler county is the fastest growing county in
Texas, over 100% in the past 10 yrs, but the population is still
such that it cannot impact the total of these large population
centers. Thus as long as funding is based on population, rural
areas will always face a losing battle in terms of allocated dollars.
this includes staff dollars as well as contract dollars.
Law Enforcement Issues
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Law enforcement: Very unsophisticated in
terms of staff (starting salary of the local
sheriff’s office is 17,500 per year. City PD is
more, but not much. hard to attract
professional level officers for that much
money, so who do you get in your application
pool. Often there is little difference between
the enforcer and the violator.
District
Attorney/Court
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District Attorney’s office: relatively low salaries and
the low volume both contribute to a very low level of
sophistication in legal work. very few cases are ever
handled by an attorney in child abuse thus there is
very limited knowledge and skill development in this
area of the law. On the other side, the sophistication
of the defense side is equally limited and that of the
judge is limited as well. It makes for a difficult
setting, where often the CPS staff is light years ahead
of the rest of the court officers in knowledge of legal
procedures an requirements. The CPS workers role
becomes a dual one, worker, quasi attorney,
protector of parents rights, children’s rights and
agency all rolled together.
Local Resources
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Local resources: In an urban community most often there
are several different non-profit agencies that offer social
services to the needy. A referral for counseling is just a
phone call, as is day care, food, rent, clothing, medical
services and transportation is either low cost or free.
(Community health clinics will reimburse with bus tokens)
In a rural area, transportation is a critical problem, but then
even with transportation, the need for social services is so
spread out that there are very few or no social service
providers in a rural county. Many counties have a ‘sharing
post’, goodwill, or similar store but transportation is a
problem. housing is virtually not available for the working
poor, due to the waiting list. up to 18 months in some
areas. Energy assistance is available, though
transportation is often a problem. Phone services are not
always easily available which limits access to services.
Salary and Education
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Salary is usually higher for jobs in rural area.
Education and skills often put employee in a
higher (relatively speaking ) group. They are
more easily assimilated into the professional
community. In court in a rural area a worker
with a few years of experience will be accepted
as an expert vs in an urban area an advanced
degree might be required.
Supervision and Roles
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Less direct supervision, need for more autonomy and
responsibility.
Roles are more fixed, the judge, sheriff, social worker
at the hospital may be the same for the next 20yrs.
Requires the worker to be more generic. Specialization
is a luxury.
Higher community profile. The worker may be the most
educated and the highest paid in a given community.
The rural worker is one of a few than one of many.
Making someone mad at you or getting cross ways with
someone can have much more permanent outcomes.
Values and Ethics in AGP
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Unique values; How does isolation promote
unique values? Consider social isolation vs.
physical isolation? Where might one be more
socially isolated? Physically isolated? Why?
In a rural farming community, what does
isolation mean? In Bowling Alone, the
absence or presence of social contacts and
their strength or weakness is reflected in the
social relationships that exists.