What Are the Factors to Consider When Establishing and Navigating Boundaries Across Diverse Cultures? An Integrative Review

Background: Therapeutic boundaries refer to the limits governing a therapeutic relationship. Although mental health services strive for culturally sensitive practices, how boundaries are understood and managed across cultures is often overlooked.

Aim: This review explored key factors related to therapeutic boundaries when working with culturally diverse clients in mental health settings internationally.

Methods: A systematic integrative review screened 663 articles from five databases, resulting in 14 papers, including theoretical and empirical studies, all of which were quality appraised.

Results: Thematic analysis identified four main themes: Power Dynamics; Culture; Harm versus Benefits; and What Might Help in decision- making.

Conclusions: Findings highlight that responsiveness in therapeutic boundaries involves understanding clients' cultural values and collaboratively negotiating boundaries to promote trust and address power imbalances. Expanding training, supervision and research, including clients' perspectives on boundaries across cultures, can enhance culturally sensitive and ethical practice.