Applications of cultural safety in psychotherapy: A scoping review

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).