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Kentucky substance abuse counselors identified lack of funding, transportation, bureaucracy, and lack of interagency cooperation as the four key barriers to successful client outcomes in rural and urban communities.
Substance abuse counselors shared their perceptions that:
Counselor-Identified Barriers to Effective Substance Abuse Treatment, Major Themes and Subthemes
Lack of Funding
Difficulty meeting needs of non-English speaking clients
Lack of technological resources - i.e., computers
Heavy caseloads and understaffing
Fewer treatment options for rural clients
Lack of educational resources for clients
Limited continuing education opportunities for counselors
Lack of good facilities (e.g., building resources)
Transportation and Accessibility
Challenges getting to treatment facilities, especially in rural areas
Client distance from treatment centers
Reliance on friends/family for transportation
Lack of case management
Delays getting clients into treatment in rural areas
Lack of Interagency Cooperation
No continuum of care
Lack of detoxification facilities
Lack of mental health services
Clients must improvise to access treatment services ^
Challenges meeting housing needs of clients
Need for dental and medical services
^ Both rural and urban counselors recognize that there are fewer treatment options, as well as challenges and delays getting clients into treatment in rural communities
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This research suggests that substance abuse treatment programs work best when they’re tailored to unique community needs. Especially among rural clients, unique cultural characteristics must be addressed, such as family histories of abuse and community encouragement of substance use.
The ability of substance abuse counselors to provide more diverse services, along with increased interagency collaboration, could improve client outcomes in Kentucky.
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More About the Research
Substance abuse is a major public health concern in rural and urban communities. Lack of funding, concentrated poverty, and the increased availability and use of drugs, formerly challenges faced primarily by urban communities, now exist in rural communities as well.
This study builds upon extensive research into the barriers to substance abuse treatment in both rural and urban communities. It compares rural and urban substance abuse counselors’ perceptions of barriers to providing effective substance abuse treatment services.
The study examines this complex issue from the unique perspective of counselors who are both aware of the organizational challenges of delivering services and intimately connected with clients. It simultaneously compares perspectives of rural and urban counselors who work within a single state at state-funded treatment sites. This research provides a more direct comparison between the challenges of providing substance abuse treatment in rural and urban communities than previous research.
Findings from this study could inform targeted efforts to improve the accessibility and effectiveness of substance abuse treatment in both rural and urban communities.
Pullen, A., & Oser, C. (2014). Barriers to Substance Abuse Treatment in Rural and Urban Communities: A Counselor Perspective. Subst Use Misuse, 49 (7), 891-901.