On the Frontier: Exploring Rural Psychologist Practice in Integrated Behavioral Health Care

Abstract

Research on psychologists in integrated behavioral health care (IBHC) remains sparse (McDaniel et al., 2014) and appears non-existent for rurally located psychologists. A study of doctoral-level licensed psychologists practicing in rurally located IBHC settings was conducted. The study had three main objectives: to understand the nature of the work of rural psychologists in IBHC, to explore what impacts the rural and IBHC setting have on psychologists, and to identify the characteristics that psychologists perceive as important for working effectively in rurally located IBHC settings. Eight participants completed in-person semi-structured interviews. A qualitative methodological approach using Consensual Qualitative Research (CQR) (Hill et al., 2005) focused on accumulating information-rich data that may be relevant (Packer, 2010) to the practice of rurally located IBHC psychologists. The examination resulted in seven domains, including nine general categories, 14 typical categories, and six variant categories. Major findings correspond with established descriptions of integrated care (McDaniel et al., 2014; American Psychological Association [APA], 2008) and include collaboration as integral and close physical proximity to other medical team members as important. Related to the rural setting, results provide a point of integration for understanding the experiences of being both rurally located and an IBHC psychologist. Findings correspond with the experiences of rural psychologists reported in the literature (Cordes, 1989; Hogan, 2003; DeLoen, 1989). Finally, results provide a point of illumination for better understanding characteristics seen as important to working effectively in rurally located IBHC. Providing an intimate portrait of rural IBHC practice, findings combine notions of rural practice and integrated health care, while extending views on rurally located IBHC practice. The results hold practical implications for psychologists in rurally located IBHC settings. Of particular interest are the unique roles a psychologist has in these settings, the ethical issues that emerge within integrated care, and the characteristics deemed important for being successful in these settings. Limitations and future considerations are discussed.