Leslie Goertzen grew up in a small rural community in south-central Kansas. She knew she wanted to get into some kind of helping profession, but it was not until she was in college that she decided on social work. She was in the largest city in Kansas, which was in close proximity to her home community but far away in culture and comfort. It was there, while researching the job opportunities that might be available to a sociology graduate, she discovered the vast options available to social workers. Her undergraduate practicum was in macro-level social work, which was not her career interest, but her future direction would not waver from social welfare. When she graduated with a BSW, Leslie found work at a community mental health center in the city where she went to college. There, working to support individuals experiencing mental illness and related challenges, Leslie found that she excelled at relating to people one-on-one, even when their backgrounds and journeys were very different from her own.
After several years of mental health work in an urban setting, Leslie longed to get back to a rural community like the farm where she grew up. When a job with a community mental health center that had a presence in far southwestern Kansas became available, Leslie and her family relocated. It was an ideal fit. She describes her current role as the perfect melding of the kind of work she loves—supporting people in their struggles and helping them recover mental health—with the rural context where she feels most comfortable.
Leslie’s job title is outpatient therapist. She serves people across three counties and, because there are not many social workers and everyone needs to wear multiple hats, every day is different. Leslie describes it as “exciting, chaotic, and rewarding.” She provides individual therapy, facilitates group therapy, responds to crises, and serves on several community coalitions. Though she is a skilled clinical social worker, she frequently draws on her generalist education, using her skills not just to forge strong working relationships with individual clients, but also to educate the community about mental health, to reduce stigma, and to develop community resources. Recently, suicide rates in her community have increased; from these tragedies, Leslie and her colleagues are forging more partnerships with schools, primary care providers, and other community leaders in the hope of making mental health care a normal part of the infrastructure in their rural area.
Most of Leslie’s clients deal with depression and generalized anxiety, although she may also work with individuals who experience more severe and persistent mental illness. Leslie plays several roles in order to support her clients’ recovery, including helping them connect to resources in her community or a neighboring area. She often has to draw on different theories and intervention approaches to find the best way to approach a particular individual. Although there is usually a waitlist for a client to see a psychiatrist for prescription medication, Leslie works closely with those health care providers when a client needs psychopharmacology assistance. She advises that those seeking to practice social work in rural communities should “keep an open mind, since community mental health, especially in a rural setting, requires a lot of flexibility and versatility.”
While cultural competence is a critical practice standard for all social workers, Leslie explains that it is a daily imperative in rural social work, where there are seldom enough providers to make referrals if a worker is unfamiliar with a particular population—or enough clients for a social worker to have the “luxury” of specializing. In her mental health practice, she works with farmers and ranchers, police officers, nurses, and teachers. She has seen clients who are in their 90s and she has worked with toddlers. She has clients whose families have been on the same rural land for generations and some who are Somali refugees or Latinx immigrants. She has seen how, in some cases, these clients’ experiences are vastly different from each other, and how they often face universal challenges and have remarkably similar journeys to mental health.
To sustain herself in a practice that can be both incredibly satisfying and tremendously difficult, Leslie draws on the same sorts of resources that support many social workers: a foundation of knowledge from her social work education, accumulated practice wisdom from her years in the field, a strong working relationship with her supervisor, and positive self-care practices.
While her community is constantly changing, Leslie feels grounded by her connection to a place that is familiar and her strong identification with the community and its people. Today, she draws hope from how her local community finds ways to apply new knowledge about suicide prevention and community mental health to their particular context. A strong commitment to the NASW Code of Ethics, a belief in the dignity and worth of every person, and an abiding conviction that relationships can lead to lasting change are all constants in her social work practice. So, although some aspects of Leslie’s social work practice look very different to those of a social worker in Los Angeles or New York or even Wichita, Kansas, some parts are not different at all.