Time and social space in South Australian rural health social work practice (2023)


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Journal of Rural Studies

Volume 97,

January 2023

, Pages 467-473

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To gain a deeper understanding of rural health social workers' professional judgement and decision-making in the complex rural and regional environments within which they work. Methods: In-depth semi-structured interviews were undertaken with South Australian rural health social work leadership team members (n=10), with focus groups (n=14) before and after the interviews. Findings: Rural health social workers drew on both spatial and temporal understandings of their professional judgements and decision-making when explaining their rural health social work practice. Concepts of rural time, rural social space and acts of resistance were identified within the rich descriptions of professional judgement and decision-making in practice provided by the rural health social workers. ‘Rural time’ refers to the additional work that is done by rural health social workers across both their rural personal and professional social spaces. Conclusions: Institutional, systemic and spatial factors, constituted as they are of power dynamics, have implications for the skills needed to maintain a social justice practice. Clear-sighted analysis of these complexities, in the context of social power, can support this ongoing and longer-term project.


Rural health social workers (RHSW) occupy a professional space framed by the dynamic situations for the people with whom they work, limited resources, multiple and often competing institutional demands on their time, and, values dissonance (Cleak and Turczynski, 2014; Harvey and Jones, 2021; Saltman et al., 2004; Waltman, 2011). Belonging-in-place (Malatzky et al., 2020) and embeddedness in rural places and cultures can be productive but also generate practice tensions and dilemmas. Saltman et al. (2004, p.526-528) in their US/Australian comparative study of rural social work, report that Australian respondents' comment on the stresses of ‘ … being constantly visible’ within the rural community. Waltman (2009) in a review of papers published about rural social work, highlights dual relationships, boundaries and confidentiality as common themes. She writes: ‘[M]aintaining confidentiality, observing appropriate professional boundaries, and dealing with multiple overlapping relationships are issues that are intensified in rural areas’ (2009, p.237).

The nature of health social work practice in rural settings has elevated the need for integrative thinking, adaptability, flexibility, and the creative use of resources (Dellemain et al., 2017; Green et al., 2009; Harvey and Jones, 2021; Mason, 2011; Saltman et al., 2004). Mason (2011) contends that much of the ingenuity and creativity unique to rural practice is made possible through social workers being embedded in the life and identity of the communities they live and work in, simultaneously inhabiting professional spaces, organisational spaces and social spaces. Each rural hospital setting has its own organisational culture (Farmer, Bourke, et al., 2012). Australian rural social work researchers (Dellemain et al., 2017, p. 55) found that rural case managers' ability to make decisions, and to think outside of the box in terms of solutions for clients, was ‘ … highly dependent on collective and cooperative relationships with other rural professionals, particularly those prepared to work flexibly with eligibility criteria’. Australian rural researchers note the issues with attracting health workers to take up posts in rural areas (Brown and Green, 2009; Malatzky et al., 2020; Roberts et al., 2020).

Moreover, by virtue of geography and distance, the dynamics of time and space considerations are paramount. For the RHSW, distances to capital cities are considerable and distances between communities, that are geographically dispersed, have implications for the everyday ordering and use of time, and social connections (Phillips, 2009). Australian rural social work researcher Dellemain et al. (2017) highlighted the travel time that rural case managers were undertaking and explored the construct of travel time. Understandings and experiences of time are culturally located and have multiple meanings. In his study of busyness, US psychologist Robert Levine explored the cultural manifestations of time and the links between time, money and power, and found that time is connected to social status, however this was not consistent cross-culturally (Levine, 2005).

In this paper, we explore concepts of time within the context of the rural health social worker in South Australia and draw on the understanding of social space as defined by the French sociologist Pierre Bourdieu. For Bourdieu social space refers to how people are related to each other with respect to their occupation and their social positioning (Bourdieu, 1991). Social space is examined in the context of the rural health social worker and their professional judgement and decision-making. Bourdieu connects social practices, modes of sociality and physical space and states: ‘Space as we inhabit it, and as we know it, is socially constructed and marked’ (Bourdieu, 1991, p. 108). The concepts of both time and social space intersect in the rural and are imbued with power.

This research was initiated by the rural social work leadership group to seek greater understanding of their experiences in enacting the social work role in a rural health setting. This study provides an exploration of the dimensions of time, social space and power within the social workers particular rural context. This is a small-scale qualitative study which allows for in-depth exploration. The findings may be generalisable to other rural health practitioner contexts.

Section snippets

Methodology and method

There were three stages in the study as part of a Living Lab research design (Dutilleul et al., 2010). A Living Lab approach involves participants in the design of the research and was selected as part of a participatory approach (Donetto et al., 2015; Gibbs et al., 2008). The Social Work Leadership group participated in the design of the research. Their expertise was valued and provided them with capacity building in research processes. This approach fits within a critical interpretive


The results are reported in two parts; the demographics of the sample followed by the three themes identified from analysis of the interviews and focus groups.


The concepts of ‘rural time’ and ‘rural social space’ have been identified in this study to describe the work of the RHSW that occurs solely because of rurality. For example, focusing on the patient's access to services, rather than on their presenting social issue. Across epistemic fields time is conceptualised with various meanings (Evans, 2005) and structure; e.g. chronological time, historical time, synchronous time, time as a passage, time as a commodity, social time. In this study time is


Building on previous research examining rural social work practice, this paper explores the concept of ‘rural time’ and ‘rural social space’, a recognition of the way time is spent by RHSWs because of being rural across both their professional and personal social spaces. These findings have implications for metrocentric health policies, where there is a need to acknowledge notions of rural time.

RHSWs have engaged in ‘creative’ social work practice (Dellemain et al., 2017) or as Bourdieu and

Authorship contributions

Please indicate the specific contributions made by each author (list the authors’ initials followed by their surnames, e.g., Y.L. Cheung). The name of each author must appear at least once in each of the three categories below.

Conception and design of study: M Jones, acquisition of data: M Jones, E Harvey, analysis and/or interpretation of data; M JonesE Harvey, F Verity.

Drafting the manuscript: M Jones, revising the manuscript critically for important intellectual content: F Verity,E Harvey,


All persons who have made substantial contributions to the work reported in the manuscript (e.g., technical help, writing and editing assistance, general support), but who do not meet the criteria for authorship, are named in the Acknowledgements and have given us their written permission to be named. If we have not included an Acknowledgements, then that indicates that we have not received substantial contributions from non-authors.

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