Small Town Living: Unique Ethical Challenges of Rural Pediatric Integrated Primary Care

Objective: The objective of this paper is to address ethical and training considerations with behavioral health (BH) services practicing within rural, integrated primary care (IPC) sites through the conceptual framework of an ethical acculturation model. Method: Relevant articles are presented along with a description of how the acculturation model can be implemented to address ethical dilemmas. Results: Recommendations are provided regarding practice considerations when using the acculturation model and the utility of the model for both established BH practitioners and trainees. Conclusions: Psychologists integrated into rural IPC teams may be able to enhance their ethical practice and improve outcomes for patients and families through the use of the acculturation model. Psychologists serving as supervisors can utilize the acculturation model to provide valuable experiences to trainees in addressing ethical dilemmas when competing ethical principles are present. Implications for Impact Statement By addressing ethical dilemmas through an acculturation model, psychologists may prevent themselves from drifting away from American Psychological Association ethical principles within the context of a multidisciplinary team while simultaneously providing valuable learning opportunities for trainees. This focus is particularly important in rural settings where access to specialty care and other resources are limited, and a psychologist may be the only licensed behavioral health provider on a multidisciplinary team.