Cultural competence has been discussed in professional disciplines. However, previous studies focused on ethnic sensitivity in practice, and limited work has addressed the cultural competence of rural social work practitioners. This study examined relationships between families’ perceptions of cultural competence, therapeutic alliance, and practice outcomes in rural practice settings. Forty-five youth and their parents receiving intensive in-home family preservation services at Integrated Services of Appalachian Ohio completed a questionnaire regarding their providers’ cultural competence in rural settings, and their therapeutic alliance, hopefulness, and satisfaction with services. Families rated their provider as culturally competent in rural practice settings; and provider competence in rural culture was positively associated with practice outcomes – satisfaction and hopefulness. Suggestions for enhancing social work practitioners’ cultural competence in rural settings are provided
