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Clinicians who practice and reside in small or rural communities face a unique challenge in managing dual relationships which are not experienced by clinicians in large urban areas. Effective clinical practice in small communities requires a unique understanding and flexibility regarding transference and countertransference issues. Most psychotherapy theory and practice techniques do not adequately prepare clinicians for the necessary adaptations they must make when practicing and residing in the same small community. Suggestions regarding procedural, ethical and practice oriented issues for the clinicians in such situations are addressed....