DIGEST - Volume 11, Issue 1

13 TPC Digest | TPC Digest Literature searches revealed references to rural women as “unnoticed” and “overlooked,” which may illuminate why rural women have less access to appropriate mental health services. Rural women do experience mental health needs unique to the context of their environment, such as food insecurity, intimate partner violence, poverty, and inadequate maternal care, all exacerbated by the barriers of accessibility, availability, and acceptability of mental health services in rural areas. Rural women are now diverse in race, ethnicity, age, socioeconomic status, and sexual orientation. The intersectionality of diversity within the rural context further compromises efforts of rural LPCs to provide care that is culturally responsive and efficacious. A feminist theoretical approach was utilized in this study to respond to the limited research, promote recognition of the intersectionality of identity, and give voice to the minimization of rural women’s mental health needs. In the present phenomenological study, 12 LPCs were interviewed about their experiences of working with rural women. The themes in the data reflected LPCs’ subjective experiences of their work with rural women and the acknowledgement of the context of multiple perspectives. Some of the themes were bootstraps , trailblazer , and protective factors , all of which described attributes LPCs observed in their clients. Perceived challenges for rural women included isolation, poverty, grief, role overload, and generational trauma. Contextual themes described LPCs’ personal connections to rural areas, barriers to mental health services for rural women, and their preparation and response to working with rural women clients. LPCs found that rural women experienced stigma for seeking services and often traveled long distances to preserve their anonymity. Although all LPCs expressed a family connection to rural heritage, none had received academic training specific to working with rural women. T he present study provides support for rural-based counseling preparation and further exploration of integrated care with rural medical services. Most significantly, participants’ experiences reflected the invisibility of rural women, indicating the need for LPCs to amplify their voices, listen to their stories, and validate their unique experiences. Future research is warranted to continue addressing this gap and include rural women who represent a blend of races, ethnicities, gender identities, and geographical locations. Lisbeth A. Leagjeld, PhD, NCC, LCPC, LPC-MH, is a program liaison and faculty member at South Dakota State University – Rapid City. Phillip L. Waalkes, PhD, NCC, ACS, is an assistant professor and doctoral program coordinator at the University of Missouri – St. Louis. Maribeth F. Jorgensen, PhD, NCC, LPC, LMHC, LIMHP, is an assistant professor at Central Washington University. Correspondence may be addressed to Lisbeth A. Leagjeld, 4300 Cheyenne Blvd., Rapid City, SD 57709, Lisbeth .leagjeld@sdstate.edu.