Epistemic Trust in Psychotherapy with Patients Who Have Experienced Relational Trauma: A Scoping Review

Abstract

Relational trauma significantly impairs the ability to trust others as valid sources of knowledge, hindering social learning and therapeutic impact. In this context, epistemic trust has been proposed as a central mechanism of clinical change, although empirical research on its application remains limited. Objective: To explore the available empirical evidence on the use of epistemic trust in psychotherapeutic interventions with individuals who have experienced relational trauma. Method: A scoping review was conducted following the PRISMA-ScR methodology, complemented by the framework proposed by Arksey and O’Malley. The search was carried out across six international databases (PubMed, Scopus, ProQuest, SciELO, EBSCO, and Web of Science), including empirical studies that explicitly addressed epistemic trust within clinical contexts. Results: Two studies were identified showing that strengthening epistemic trust enhances the therapeutic alliance, reduces clinical symptomatology, and fosters openness to social learning. Both studies highlight the role of mentalization and the therapist’s communicative coherence. Conclusions: Epistemic trust should be considered an explicit therapeutic goal in the treatment of relational trauma. Further empirical research—particularly in Latin American contexts—is needed to operationalize the construct and evaluate its clinical relevance and public health implications.