ACA Blog

Steve Bryson
Oct 19, 2009

Counseling in the Big Sky Fishbowl of Montana

I appreciate this opportunity to write about counseling related subjects. I believe I have had valuable experiences over the years which give me a perspective that may be interesting to colleagues across the nation. Some of the issues I look forward to addressing in future blogs include counseling in rural areas, the valuable alternative perspectives of "fresh" versus "seasoned" counselors, trends and fads in counseling over the years, professional collaboration, ethics, and my favorite diagnosis to treat: eating disorders. I will do my best to stay off the soap box, and really look forward to feedback from other professionals.

I have often wondered, for instance, how other counselors in rural areas deal with the "fishbowl effect". As some of you undoubtedly know, in an area with a small population, the boundaries recommended in graduate school ( I attended an urban based grad school) aren't just impractical in a rural area, they are impossible. The person you saw yesterday who discussed her/his most shameful behaviors could be the person who fixes your car or cleans your teeth or serves your food or fixes your toilet the next day. It is impossible to be a blank slate, yet I have found that my involvement in my community must be tempered to truly be available to all walks of life. I feel it is important to be invisible enough to have people feel comfortable with the notion of privacy. So I am careful to assess the potential results of my public exposure. As you may surmise, I at times feel a bit isolated. At other times I feel connected in a way impossible in a big city.

I am curious about how many of you in rural settings have had the experience of seeing a client in your counseling office, then later, in another venue, overhearing their conversation or observing them as they behave in a way not at all resembling their presentation in your office. This is quite valuable as a counselor, as the perspective is much richer. But it makes one wonder how much we miss in traditional counseling interactions. And it creates an important caveat regarding brief counseling: things are usually both much simpler and much more complex than at first glance.

Similarly, it is very unnerving to have your daughter or son bring home as a date someone who is known to you through case consultation. You know more about this individual than most concerned and involved parents would be comfortable knowing about the person who is about to go off with your child. Since your child knows nothing of the information you have regarding this person, you can feel pretty stuck. You are prevented by confidentiality rules from asking direct questions that your professional knowledge says your parent self must address. It can make for an uneasy evening...

I think anyone who plans to be a rural counselor needs to start by reading Gerald Corey's thoughts on the subject in various books and articles. Also a good case consultation group is vital. And of course, being in a rural area, solitude and recreation are literally out your back door.
Steve Bryson is a nurse and counselor in private practice in Whitefish, Montana. He works with adolescents and adults, couples and families and has a special interest in eating disorders

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