Applications of cultural safety in psychotherapy: A scoping review.
Bibliographic record
Abstract
Access to culturally appropriate care for Indigenous and other marginalized populations is hindered by several barriers, including the repercussions of colonialism (e.g., discrimination) and differences in cultural norms. Cultural safety (CS) is a participatory and transformative framework rooted in decolonization, aimed at improving access to culturally safe care. Although increasingly recognized across various fields, studies on CS in psychotherapy remain scarce. This study aimed to provide an overview of CS applications in psychotherapy by means of a scoping review. The research was conducted across multiple databases and gray literature. Data from the selected publications were analyzed descriptively and thematically. The scientific literature on CS in psychotherapy is limited, with only 10 studies meeting the inclusion criteria. These studies, conducted in Australia and Canada between 2009 and 2023, primarily involved Indigenous populations. Central features of CS include user-based care, therapist self-reflection, and community collaboration, offering a transformative framework for addressing systemic inequities and fostering culturally responsive care. Significant challenges in its application include reconciling conflicting Indigenous and Western paradigms, addressing ethical concerns in research methodologies, clarifying the definition of CS, and overcoming limited empirical data. This study synthesized current knowledge of CS in psychotherapy, providing insights to guide the adaptation of care for minoritized and marginalized groups. Addressing these challenges through further research is crucial to expand the application of CS in psychotherapy. (PsycInfo Database Record (c) 2026 APA, all rights reserved).
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.023 | 0.071 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.003 | 0.003 |
| Bibliometrics | 0.025 | 0.029 |
| Science and technology studies | 0.002 | 0.002 |
| Scholarly communication | 0.006 | 0.005 |
| Open science | 0.002 | 0.004 |
| Research integrity | 0.004 | 0.002 |
| Insufficient payload (model declined to judge) | 0.004 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".