A national study of doctoral-level, licensed psychologists practicing in rural settings was conducted. The study had three main objectives: to assess the degree of challenge and trouble associated with variations in timing and type of unavoidable, multiple-role relationship dilemmas and the likelihood of engaging in therapy; to measure job burnout among a national sample of licensed, doctoral-level psychologists practicing in rural settings; and to examine potential predictors of job burnout. One hundred sixty participants completed and returned surveys yielding a 44% return rate. The survey consisted of three parts: a 14-item demographics section, seven items corresponding to one of six multiple-role relationship (MRR) ethical dilemma situations (vignette), and the 22-item Maslach's Burnout Inventory-Human Services Survey (MBI-HSS). Six ethical dilemma situations were included in this study to allow for the manipulation of the timing (pre, concurrent, and post) and type (professional and social) of the MRR.

Rural psychologists reported that the concurrent ethical dilemma situation was less troubling, in terms of therapist resources, than both the pre- and post-MRR dilemmas. The results also indicated that rural psychologists perceive professional MRR ethical dilemmas as more challenging and more troubling, in terms of out-of-therapy variables, than the social MRRs. In addition, negative correlations were found between the respondents' likelihood of engaging in (or continuing) a therapeutic relationship and the level of challenge and trouble reported in the given situations.

A comparison was made between the job burnout scores reported by this study's sample of respondents and those scores obtained by MBI-HSS normative sample of mental health practitioners. This national sample of rural psychologists reported less job burnout than what was reported by the normative sample. The relationship between levels of burnout and the following variables were also examined: (1) frequency of experiencing multiple-role relationship dilemmas, (2) degree of challenge or intensity of usual multiple-role dilemmas, (3) accessibility of a referral source, (4) adequacy of opportunities for consultation, and (5) adequacy of opportunities for supervision. Frequency of multiple-role relationships, accessibility of referral sources, and adequacy of opportunities for consultation were found to be significant predictors of job burnout.