Understanding the needs of rural women with low income: An ecological analysis

The purpose of this study was to determine the treatment needs, perceptions about counseling, multilevel strengths, and potential barriers to services for women who live in rural settings and have limited financial resources. This study was designed to better understand how mental health needs are currently being met by formal mental health services, and what support systems exist so that services can naturally expand on multilevel resources. Principles of the ecological counseling perspective were utilized in the study's conceptualization and methodology.;A qualitative research methodology was employed. The initial research questions were: What are the counseling needs of rural women, particularly those of low income? What are the barriers to treatment for this population? What are the strengths of this community that can be used in treatment? Additional questions emerged throughout data collection and were subsequently incorporated into ongoing collaboration with participants. Individual interviews were conducted with five women in a rural county in Ohio. In addition, interviews with two physicians, two service providers, and one expert review were also conducted to enhance understanding of rural women's lives and need for assistance. Data were organized into ecologically defined levels decreasing in proximity to the individual: sociocultural level, community level, family level, and individual level. Coding was conducted utilizing ecological levels and emergent codes from interviews. The ecological perspective was used to provide a framework for analysis in order to explore the needs of women affected by poverty within the environmental context of their lives. To remain consistent with the ecological perspective and to increase the trustworthiness of the study, data were triangulated with a series of individual interviews, interviews with community members, and expert reviews. Further, the ecological counseling perspective guided the selection of community participants.;Data suggest that a safe and supportive counseling relationship is most helpful in rural women's overall counseling experience. The centrality of interpersonal relationships emerged as a common theme in describing rural women's view of self, family, and counseling services. The self-in-relation perspective was used as a framework for understanding the role of relationship in participant's lives. The theme of connection to others guided data analysis as a way of understanding how women can cultivate a growth-producing environment while maintaining support through their close relationships. This connection emerged as essential to how they viewed their own lives and counseling services. Limitations and implications for future research were discussed.