Epistemic trust and its utility in the psychotherapeutic context: a scoping review.

Abstract

Epistemic Trust (ET) refers to one’s willingness to acquire new social knowledge from another human as trustworthy, generalizable, and relevant to one’s self. As an emergent term commonly related to mentalization and the work of Fonagy and colleagues, ET has largely been foregrounded as a developmental concept with less focus on its application to treatment and psychotherapeutic concepts. A scoping review was conducted to identify and synthesize emerging evidence from the literature pertaining to the constituent elements of ET, its conceptual understanding, use, validation, and contemporary application within the psychotherapeutic context. Arksey and O'Malley’s (2005) scoping review framework informed the protocol and Rayyan AI software was used to assist with data management and analysis. The initial search yielded 591 sources. After steps of screening and additional searches, a total of 73 sources were included for analysis. Results clarify the conceptual uses of ET relating to the creation of valid measurement tools, as well as theories of psychotherapy and psychopathology. The application of ET in the psychotherapeutic context is reported and discussed in terms of the therapeutic alliance, and as a possible psycho-marker for treatment outcomes. Structural, environmental, theoretical, and therapist-related challenges to the implementation of ET in the psychotherapeutic context are explored in conjunction with gaps in the literature that may serve as springboard for future studies, given that research regarding the use of ET in applied settings is still in its infancy.