The practice and operationalisation of “Cultural Humility” across disciplines: A scoping review protocol

Introduction

In the last decade, cultural humility has gained increased traction as an approach to promote inclusion, equity, and sense of belonging (Barnes et al., 2023; Schiavo, 2023). In the field of human services (e.g., social, health, and mental health services), systemic implementation of cultural humility is proposed as a solution to improve service delivery through connecting more effectively with service users (Schiavo, 2023; Tham & Solomon, 2024). Within the context of health and mental healthcare more specifically, embracing cultural humility is considered essential for cultivating a sense of belonging, tackling systemic inequities and biases, building trust, and enhancing service users’ positive experiences and outcomes (Jonas et al., 2021; Schiavo, 2015, 2023). Within mental health practice, cultural humility has been proposed as a valuable framework for engaging with culturally diverse service users. Rather than emphasising mastery of cultural knowledge, cultural humility encourages ongoing self-reflection, openness to learning from service users, and recognition of the influence of culture, context, and power within therapeutic relationships (Hook et al., 2017; Mosher et al., 2017). Emerging literature suggests that culturally humble approaches may support stronger therapeutic alliances, facilitate engagement with diverse understandings of distress, wellbeing, and recovery, and enhance practitioners’ capacity to provide person-centred, antiracist, and trauma-informed care (Mosher et al., 2017; Ranjbar et al., 2020). The emphasis on partnership, trust, and responsiveness to individuals’ lived experiences also aligns closely with principles of recovery-oriented mental healthcare and may be particularly important for supporting the recovery journeys of people from minoritised and culturally diverse communities (Jacobson & Farah, 2012; Levy-Fenner et al., 2022). As such, cultural humility is increasingly recognised as an important component of equitable mental health practice, particularly when working with people from minoritised communities whose experiences are shaped by broader social, cultural, and structural factors.

The body of literature on cultural humility, however, remains relatively recent, with much of extant literature focusing on theoretically describing cultural humility, its definition, and conceptualisation. Theoretically, cultural humility is understood as a practice that acknowledges the dynamic nature of cultural identity, focuses on life-long learning of the self in relation to others, and challenges individuals and organisations to address systemic inequalities (Fisher-Borne et al., 2015; Foronda, 2020). Importantly, there appears to be a consensus across definitions that cultural humility goes beyond a sole focus on the accrual of knowledge about ‘the other’ and a decontextualised and static view of cultural identity to address the integral interconnected role of organisational climate and the need for whole system approaches to cultural responsiveness (Beagan, 2018; Jongen et al., 2018; Kirmayer, 2012). In other words, cultural humility shifts the focus from learning about ‘the other’ to self-reflection and action on how our cultural identity and the organisational culture we work in can perpetuate societal patterns of inequity and reinforce structurally embedded injustice and exclusion experienced by minoritised populations. More recent work on the conceptualisation of cultural humility has further teased out these theoretical definitions. For example, according to Foronda et al.’s (2016) concept analysis of 62 articles discussing cultural humility, five common attributes of cultural humility are: openness, self-awareness, egoless [ness], supportive interactions, and self-reflection and self-critique. Aligned with Foronda’s conceptualisation, Abe (2020)‘s use of a liberation psychology framework conceptualised cultural humility across multiple levels: developing a critical consciousness (individual level), seeing the other (interpersonal level), and psychosocial accompaniment (collective level). According to this framework, cultural humility is a social practice which involves a commitment to working with communities; respect for their experiences, culture and perspectives; building relationships with them; learning from them; and paying attention to the structural forces, power imbalances, and social inequities that shape lived experience (Abe, 2020).

A common thematic thread running across many of the theoretical definitions and conceptualisations of cultural humility is the focus on systemic change. Yet, to date, the discourse surrounding cultural humility has strongly focused on its operationalisation within the individual practitioner and/or the therapeutic relationship. Commensurate amplification and discussion on the systemic and social aspects of cultural humility and its manifestation at institutional and organisational levels is therefore required to ensure that, as Abe (2020) argues, cultural humility is not reduced to a list of individual characteristics at personal and interpersonal level.

Present study

The CHUMS Study (Cultural HUmility in Mental health Services) is a four-year research program with an overall goal of strengthening cultural humility for Irish mental health services. Epistemologically informed by Community Based Participatory Research (CBPR), The CHUMS Study aims to progress the operationalisation of cultural humility from its current, abstract nature into distilled principles of practice and concretised strategies that can be feasibly implemented and measured within existing mental health systems. By working to strengthen cultural humility in Irish mental health services, the CHUMS Study has the potential to inform current and future national policy frameworks, such as Sharing the Vision, and contribute to ongoing discussions regarding the role of cultural humility within Irish mental health policy and service development.

To inform the work of The CHUMS Study, a comprehensive knowledge synthesis will be carried out to map the current knowledge landscape on cultural humility, as an evolving and emerging topic, and to identify existing knowledge gaps. A preliminary search of several databases, including PsycINFO, Scopus, Web of Science, the Cochrane Database of Systematic Reviews, and JBI Evidence Synthesis, identified existing scoping and systematic reviews on cultural humility. These are largely situated within single disciplines, such as occupational therapy (Singh et al., 2022; Kokorelias et al., 2025), or focused on training and education (Konidaris & Petrakis, 2025; Lambor et al., 2024; Gonzales-Walters et al., 2024), psychotherapy outcomes (Orlowski et al., 2025), or specific applied tasks such as research recruitment and retention (Chehade et al., 2025). However, a cross-disciplinary synthesis examining how cultural humility has been conceptualised, operationalised, practised, and assessed across different fields and levels of practice remains lacking.

As such, the specific aims of the planned scoping review are to identify and synthesise the available literature regarding 1) Measures and indicators of “Cultural Humility” across different disciplines and 2) Practice and operationalisation of cultural humility at individual, interpersonal, and collective levels (Abe, 2020). In mapping measures and indicators of cultural humility, we do not treat it as a fixed attribute to be scored, in the way cultural competence has often been framed. Consistent with its conceptualisation as a dynamic, ongoing process of self-reflection and lifelong learning (Fisher-Borne et al., 2015; Foronda, 2020; Abe, 2020), our interest is in understanding how cultural humility has been conceptualised, operationalised, and assessed across disciplines, including the measures, indicators, and other approaches that have been used to capture the construct in research and practice.

This review will extend beyond the health and mental health literature to cover humanity, social, and other health sciences with the aim of learning about different approaches to this newly emerged concept and consequently consider its application in the field of mental health.

Methods

This protocol and the subsequent scoping review will be guided by the methodological frameworks proposed by the Joanna Briggs Institute (JBI) Manual for Evidence Synthesis guidelines (Peters et al., 2020). In addition, the reporting guidelines from the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (Tricco et al., 2018) will be adhered to. This review will begin in the first quarter of 2025 and completion anticipated within 6 months.

According to Arksey and O’Malley (2005), scoping reviews consist of six stages: (1) identifying the research question, (2) identifying relevant studies, (3) selecting studies, (4) charting the data, (5) collating, summarising, and reporting results and (6) consultation. The proposed methodological approaches across each of these stages is further outlined below.

Conclusion

The proposed scoping review will address the gap within the current evidence synthesis by describing the existing knowledge on cultural humility, its operationalisation, and measurement across different disciplines. Findings of this review will map the current literature to the multilevel approach to cultural humility and allow for further exploration of its systemic operationalisation. The wide scope of this review in considering a wide range of disciplines as sources of knowledge will inform and further expand the current literature of cultural humility within the health and mental health fields and facilitates more innovative approaches towards its operationalisation. Furthermore, this review will provide an example of applying CBPR principles and methods in conducting scoping reviews.

Ethics and consent

Ethical approval and consent were not required.