Volume 34, No. 6 June 2003

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The rural psychologist
  Maintaining ethics in a rural setting

A Utah psychologist finds that practicing in a rural area poses unique ethical dilemmas.

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Print version: page 66

Psychologist Dan Goodkind, PhD, traded in his suburban life for a rural one after he graduated from University of Tennessee-Knoxville in 1997 and started a practice in Vernal, Utah--170 miles outside of Salt Lake City in the state's arid mountains.

What attracted Goodkind to rural psychology was the National Health Services Corps student loan repayment program and the opportunity to be a generalist. Out in the country, he could treat a variety of clients and build on a broad range of experiences in psychology. And with a three-minute commute to work each morning and easy access to recreation, Goodkind is glad of his decision.

At the Ashley Family Clinic, Goodkind and his colleague Michael Bjornson, PhD, offer psychological services to the underserved Uintah Basin region--three communities totaling 50,000 people. The clinic, a renovated 1890s house on a half-acre filled with lilacs, houses the only two practicing psychologists for miles around.

That has its pros and cons, Goodkind says. While he believes the clinical cases are similar to those he'd see in an urban area, the ethical dilemmas he encounters are more unique to the rural setting. For one, since the area has limited psychological services, neighbors or friends can become his next clients. While Goodkind tries to avoid seeing personal acquaintances professionally, sometimes it cannot be prevented. In those cases, he makes an effort to maintain a respectful distance socially because of his unique role in their life.

"This feels a bit isolating and lonely at times because the number of close friends we have out here is already limited," Goodkind admits.

Adding to the barriers, Goodkind--and his wife, Hilary Sarhatt, a family physician--come in contact with former and current patients around town daily. "We smile, but we do not usually initiate conversation," Goodkind says. Luckily, as he points out, patients seldom seem uncomfortable during the encounters. "I think people living in rural areas are accustomed to running into their doctors around town and in other settings," he notes.

This closer interaction with clients is not necessarily bad, Goodkind says. "Our relationships with patients and with the community are in some ways more genuine because we interact with each other in different settings and view each other in social roles aside from 'doctor' and 'patient,'" he says.

But it's important to know rural practice's limitations, Goodkind notes. "It would be easy to become isolated and ignorant of the best practices and referral resources," he says. "I think it is especially important for psychologists living and practicing in rural areas to become familiar with other psychologists in their state and to participate in continuing education."

For his part, Goodkind is involved in the Utah Psychological Association--which provides him with a network for advice and guidance--and he serves as an adjunct professor at Utah State University to stay up-to-date on psychological research. He is also a board member on the Uintah Basin Tri-County Health Department.

Goodkind is confident that his services fill an important need in the community. For instance, he provides district court judges and local social-service agencies with comprehensive psychological evaluations of juveniles and foster children to help them make informed decisions.

"Local people appreciate having a psychologist around," Goodkind says, "and most see the value of psychotherapy services."

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