Practicing in a Rural Setting

This post will briefly identify the way a clinician would practice in a rural setting. Identifying key skills and approaches the therapist needs and some problems that may be encountered requiring the therapists use of these particular approaches. 

Firstly, it is important to remember that an occupational therapist remains the same in that their values and beliefs are constant regardless of what setting they are in. Thus the role of the occupational therapist does not differ greatly in a remote setting; the main aim of occupational therapy is constant in that they are working with people to optimize functional occupational performance.

The aspects in a rural setting that may change is the approach that the therapist takes. Thomas & Clark (2007) identify six themes that emerged from a qualitative research study of allied health professionals working in remote locations of Northern Australia. One theme identified is that the clinician should be “organised but flexible”, this has been highlighted as an approach clinicians should take as there are variables that are encountered in rural areas that may not be as common in a more urban setting. This includes the range of places interventions may be carried out, the need to improvise and use limited resources creatively, and the ability to ‘go with the flow’ as community issues may arise in remote areas which the clinician has to be flexible towards in order to “try and work something out just as it unfolds” (Thomas & Clark, 2007, p. 217).

Another highlighted approach is that of “cooperation and mediation”, in remote settings it is stated that “infrequent visits, time limitations and scarce resources necessitated effective communication and cooperation with others” (Thomas & Clark, 2007, p. 118), this is identified as an approach to use with other allied health professionals in the setting as well local services and health workers in the rural location. It is identified that clinicians working in remote settings often have to establish relationships with key people in the communities they visit as direct communication with clients can sometimes not be efficient and therefore having established relationships in their communities will help with this. It is identified that communication is a part of training yet in this practice setting it is important for clinicians to extend the standard realms of communication of client-therapist to include the wider community.  

The third key theme discussed in Thomas & Clark (2007) is “culturally aware and accepting communicators” (p. 219), this theme is specific to the location of the research conducted however the points from this theme are likely transferable into other remote locations in the world. Thomas & Clark (2007) discuss this approach in relation to the Indigenous populations in many remote communities of Northern Australia, in order to have a safe cultural practice it is suggested that clinicians alter their communication with Indigenous people by being sensitive to their style of communication. This includes clinicians reading body language and non-verbal signs, as well as having the ability to wait for responses without filling the silence.

Therapists who use a consultative approach in remote settings are seen to “demonstrate a level of respect and power sharing with clients, which is necessary to empower communities to find solutions to health problems that are sustainable and that reduce dependency on the ‘visiting experts’” (Thomas & Clark, 2007, p. 219).

Thomas, Y., & Clark, M. (2007). The aptitudes of allied health professionals working in remote communities. International Journal of Therapy and Rehabilitation 14, (5), pp. 216-220.