In a previous post, I wrote about the need for rural counselors to be generalists. I also noted you need to be ready to treat trauma as trauma is, unfortunately, nearly everywhere. There are high incidences of trauma in places where there are elevated levels of domestic violence, and a high percentage of gun-owner households.
In rural areas, especially in small towns, there are also high incidences of substance use disorders, which means the rural counselor needs to be prepared to treat those, including the accompanying mental health conditions substance use disorders so often present with. A rural counselor needs to be competent in dual diagnosis treatment.
Most of us have heard stories of small towns ravaged by drug and alcohol abuse, especially with the increased use of methamphetamines and more recently, what is currently being deemed the opioid epidemic and a resurgence of heroin use. A superficial Google search on this topic reveals an endless selection of articles detailing the downfall of small town America precipitated by so much drug use and abuse. Wyoming is no stranger to this scenario.
To make matters worse, there are often limited treatment options, especially here, with the state's low population density, and its ongoing service provider shortage. Wait times to get into rehab are long – often 6-8 weeks at a minimum – and detox facilities are limited. Many clients opt to go it alone, a potentially life threatening prospect depending on the circumstances.
Another difficult facet to this situation, is that much of the substance use disorder treatment here is court-ordered, which most often means those individuals have not made a true commitment to recovery and ongoing sobriety. Treating them often feels non-productive, and burnout levels among those who do provide this treatment, is high.
One must truly have a passion for the work in order to be successful.
Stormy Filson is an independently licensed counselor living and working in Wyoming, with special interests in treating trauma, community building, and empowering women. She is also passionate about writing, photography and film.