Educating Rural Psychologists: An Analysis of Professional Training Programs

In rural areas, the lack of psychologists available makes it difficult for patients to receive the care they need. The lack of psychologists available perpetuates the stigma that it is not “normal” to go to a psychologist. Also, working in rural areas is difficult for psychologists because there is a need for special training and instruction and there is not enough funding for training in rural psychology. This study aims to describe the current educational practices of graduate counseling and clinical psychology programs and post graduate internship and fellowship programs in preparing professionals to serve rural populations. Surveys created to assess rural professional training programs were sent to internship/fellowship programs and graduate programs in the United States identified as having a rural focus. Surveys were completed by 33 doctoral programs (21% response rate) and 61 internship/fellowship programs (19% response rate). Then, the responses from both types of programs were compared and contrasted. The three main barriers to educating psychologists to serve rural populations as indicated by the internship/fellowship programs are lack of interest of students working in rural areas, lack of employment opportunities in rural areas, and lack of third party reimbursement for counseling services provided. For the doctoral programs, the top three barriers are lack of qualified supervisors, accreditation requirements not allowing students enough electives to take a course related to rural mental health, and a tie between lack of employment opportunities and distance of university from rural areas. Results were also analyzed for the educational approaches to educating rural psychologists and the steps being taken to address the barriers to educating rural psychologists. The main action taken to overcome barriers by fellowship programs is providing didactic experiences related to providing behavioral health services for rural populations 55% and for graduate programs 53.8% chose integrating content related to providing behavioral health services to rural populations in required courses. Also, recommendations were made for enhancing rural training, improving internship and fellowship experiences, and addressing policy issues for graduate and post graduate programs. Both the graduate programs and fellowship programs agree that students are not as interested in going to rural areas. This could be because lack of funding in rural areas, lack of employment opportunities, and lack of third- party reimbursement for services provided by the graduate student or intern. Rural training should include educating students about rural areas by allowing students to take courses in rural psychology, placing students in rural areas, greater funding for training psychologists in rural areas, possible tele-health training to make working with rural patients easier if the location is distant from university or internship, ways for students to have an internship available after graduate school and a job after the internship, and teaching students ways to reduce the stigma of psychology in rural areas. Integrating psychology into primary care would help rural patients not worry as much about the stigma associated with seeing a psychologist and seeing a psychologist would not require an extra co-pay