Walking gently, reflections from a non-indigenous Family Therapist supporting cultural safety in the workplace.

By Stacey Horomia, Clinical Family Therapist and Accredited Mental Health Social Worker in collaboration with Renee Watts Identified First Nations Health Worker (Wiradjuri) 

I would like to begin by acknowledging the Yugambeh-speaking language group as the traditional custodians of the land on which I live and work on the Gold Coast. I recognise and honour their continuing connection to the lands, waters, and communities, which have nurtured and sustained them for thousands of years. I pay my deepest respects to Elders past and present whose wisdom, culture, and traditions continue to shape and enrich this land.

As a Māori therapist living and working in Australia, I write these reflections with deep respect and appreciation of the importance of Aboriginal and Torres Strait Islander knowledge and culture. While I bring with me an understanding of the importance culture, I recognize the limitations of my understanding of Aboriginal and Torres Strait Islander cultural safety in Australia and acknowledge that my perspective and ideas may not fully capture the needs of our Aboriginal and Torres Strait Islander clients. I am an ally and a learner, not an authority. I am also a guest here, on Country, in community, and in the lives of the Aboriginal and Torres Strait Islander families I work with.  I have been fortunate enough to hold both clinical and operational positions within my organisation, which has meant that I often reflect on the deep privilege and responsibility I carry in these role’s. It's important for me to be transparent about this and to approach the topic with humility; understanding that while I can contribute to the conversation and provide ideas on how my team creates a culturally aware service, I am not an expert.    

During my time as a team leader in a child and youth mental health service, I was in a position of privilege where I could champion in collaboration with our identified First Nations health worker cultural awareness and actively work toward supporting cultural safety for our Aboriginal and Torres Strait Islander clients and their families.  Cultural safety is not about knowing everything about a different culture, it's about working in a way that is free from racism, power imbalances, and judgment. It means creating space where cultural identity is respected and affirmed, not overlooked or tokenized. Cultural safety is a deeply personal experience and only the person who is the recipient of a service or interaction can determine whether it is culturally safe.  

The three areas we focused on, were creating a learning circle for the team to have courageous conversation around race and racism, establishing partnerships with our indigenous health care provider and creating a drop-in group for our young people.  Our aim was to create a team and service where Aboriginal and Torres Strait Islander clients feel their identity, culture, and experience are genuinely respected, heard and seen. 

In clinical practice, cultural safety asks us to not only understand trauma and cultural context, but to critically reflect on how we, as therapists and representatives of systems, may consciously or unconsciously contribute toward harm.  The space the team created to have courageous conversations about race and racism was inspired by the award-winning protocol COURAGEOUS CONVERSATION®, which is a framework for Systemic Racial Equity Transformation.  The space focused on creating opportunities for reflection and ongoing learning. It encouraged clinicians to examine their own biases, recognise how they contribute to systemic racism, and actively work towards creating more inclusive environments.  This was a safe space, where there was no judgement or consequence. The primary goal of this learning circle was for clinicians to deepen their understanding of the impact of race and racism on client engagement and outcomes, through reflecting on how their own perspectives and biases can affect their work.

As we know therapy is not isolated from the larger context in which it happens, the therapeutic process is influenced by the client's broader life experiences, societal structures, and historical factors.  Aboriginal and Torres Strait Islander families have endured the profound impacts of colonisation, including deliberate attempts to dismantle their cultures. These attempts involved prohibiting the practice of everyday traditions and important ceremonies, punishing those who spoke their languages, and enforcing dispossession. Families also faced the trauma of the Stolen Generations and decades of systemic discrimination.  These experiences are not historical footnotes, they are alive in the present-day narratives of families sitting across from us in the therapy room. These histories are not distant or abstract; they manifest in everyday struggles and resilience within families. Whether through disrupted kinship systems, ongoing trauma, or mistrust of institutions, the effects of this history are alive in the stories and experiences of the individuals and families sitting across from us in the therapy room.

We all know that Aboriginal and Torres Strait Islander people experience significantly higher levels of psychological distress, suicide, and trauma-related challenges than non-Indigenous Australians, however how often do we privilege time to reflect on this and actively hold space for understanding the wider context of our Aboriginal and Torres Strait Islander families?

One of the most rewarding aspects of my work is the opportunity to engage in initiatives that bridge clinical care with community, respect, and culture.  The partnership with our local Aboriginal and Torres Strait islander health service, where we developed a shared care model was an opportunity to weave together cultural safety, community involvement, and holistic support for our Aboriginal and Torres Strait Islander clients. At the heart of our partnership was a commitment to creating a care model that was not just responsive, but proactive in meeting the unique and complex needs of the families we work with. By developing a joint care planning model, we ensured that both mental health professionals, physical health professionals and cultural consultants collaborated closely, shared information and created care plan’s that were both clinically sound and culturally appropriate. This collaborative process allowed us to consider not only the health needs of our young people but also the broader social, emotional, and cultural factors that influence well-being. The results of this collaboration were incredibly rewarding. By adopting a shared care model, we were able to provide more continuity of care for our Aboriginal and Torres Strait Islander families while enhancing our community partnerships. Our collaboration with the local Aboriginal and Torres Strait Islander health service is a powerful example of how a systemic approach can weave together the diverse threads of care, culture, and community. By integrating these elements, we've created a more holistic and effective model of support that addresses the needs of our clients.   

I’ve seen firsthand the profound impact that culture can have on the well-being of young people, particularly for Aboriginal and Torres Strait Islander youth who may feel disconnected from their cultural heritage due to historical and systemic factors.  One initiative I’m particularly proud of, is the creation of a drop-in group aimed at providing a safe and informal space for young people to connect with their culture. This outreach model was co-designed with our identified First Nation Health Worker to be a therapeutic intervention, a celebration of culture, community, and identity. At the heart of this initiative was the simple yet powerful idea of creating a space where young people could come together, feel accepted, and reconnect with the richness of their cultural heritage. We intentionally chose an informal gathering in a park, a familiar and relaxed environment that allowed for a sense of freedom and openness. The goal was to make it clear that this wasn’t a traditional therapy group, this was a space for connection, where culture could be expressed through music, art, and storytelling. One of the key features of this group was the embedded cultural consultation. This wasn’t just about having a culturally safe environment; it was about actively integrating cultural wisdom into the heart of our interventions. Our identified First Nations Health Worker worked closely with community elders to ensure that the group was culturally informed and respectful of the traditions, practices, and values of the community. This partnership helped guide the structure of the group and ensured that it remained grounded in the cultural needs and perspectives of the youth we were serving.

This initiative also highlighted the power of interagency collaboration. We worked closely with our community partnerships, bringing together professionals from both government and non-government sectors. It was inspiring to see how diverse agencies could come together, united by a common goal: to support these young people in a way that was culturally appropriate, healing, and empowering. The collaboration allowed us to pool resources, share insights, and provide a more holistic support system for the youth.  For me, this initiative was a reminder of the power of culture in the therapeutic process and how important it is to meet young people where they are, celebrating their identity, honouring their heritage, and supporting them in their journey towards healing and empowerment.

Cultural safety is not about having all the answers, it’s about asking better questions. It means integrating cultural respect and systemic insight into every interaction. Cultural safety is not a box to tick, it is a way of being and it starts with asking ourselves, every day: What do I need to unlearn to be truly present, respectful, and safe in my practice?

Cultural safety is not created by neutrality; it is created through commitment. A commitment to understanding trauma, acknowledging privilege, and standing alongside, not in front of Aboriginal and Torres Strait Islander families on their healing journey.  As therapists, we must recognise that mistrust is not a barrier, it is a form of wisdom, built on survival. My hope is that we continue to deepen our understanding, stay accountable to the communities we serve, and hold space for healing that is led by culture, not constrained by it. Cultural safety is not a destination, it is a commitment. It requires humility, courage, and the willingness to be uncomfortable. Leaning into the uncomfortable is crucial because it creates opportunities for growth, healing, and deeper understanding.  

As a non-Aboriginal therapist, I know I will make mistakes, but I also know the importance of showing up, listening, learning, and growing. Being an ally is not about being the hero. It’s about standing beside, walking with, and ensuring that the voices of Aboriginal and Torres Strait Islander families are heard, honoured, and centred.

We walk on sacred ground every day in this work. May we tread lightly and listen deeply.

Reflections from a colleague: “Participating in CCAR [courageous conversations] has exposed me to conversations about race and allowed me a glimpse of the impacts of existing as a minority culture with structures designed for the dominant culture. This has given me a perspective I would not otherwise have experienced and allows me to create spaces to invite conversations about race and culture rather than working from assumptions based from within my own culture (the dominant culture). This is ongoing learning but it has given me pause to at least sometimes catch and challenge these assumptions when I do observe them, and question whether there are alternative views and perspectives that could give valuable insights into the experiences of the families and communities we work with.

Further Resources

• Australian Government. (n.d.). Closing the Gap. https://www.closingthegap.gov.au/

• Australian Human Rights Commission. (2020). Wiyi Yani U Thangani (Women’s Voices): Securing Our Rights, Securing Our Future Report.

• Australian Institute of Health and Welfare (AIHW). (2022). Australia’s Health 2022: Indigenous health and wellbeing.

• Atkinson, J. (2002). Trauma trails, recreating song lines: The transgenerational effects of trauma in Indigenous Australia. Spinifex Press.

• Dudgeon, P., Milroy, H., & Walker, R. (Eds.). (2014). Working together: Aboriginal and Torres Strait Islander mental health and wellbeing principles and practice (2nd ed.). Commonwealth of Australia.

• National Aboriginal Community Controlled Health Organisation (NACCHO). (2016). Cultural safety and healthcare: The role of health professionals. https://www.naccho.org.au/

• Ramsden, I. (2002). Cultural Safety and Nursing Education in Aotearoa and Te Waipounamu. Doctoral thesis, Victoria University of Wellington.

• SNAICC – National Voice for Our Children. (n.d.). SNAICC. https://www.snaicc.org.au

• The Healing Foundation. (n.d.). The Healing Foundation. https://healingfoundation.org.au

• The Lowitja Institute. (n.d.). The Lowitja Institute. https://www.lowitja.org.au

Artwork 1: This photo was taken by my friend Dr Lucas Ford (clinical psychologist).  This photo was taken in Germany at a lake called Hintersee and is a beautiful image capturing the reflective imagery.

Artwork 2: This artwork was commission for my team in 2016 by Christine Slabb (Bundjalung).  The artwork represents our team (the circular design in the middle).  The middle is the heartbeat or pulse acknowledging that people travel near and far, and no matter their nationality we come together to share stories.  The U shape designs represent the imprint left after sitting and the connection to the land.  The grey coloured U represent leaders or elders highlighting the importance of stopping, listening, and learning.  The blue background with the dolphins and turtles is to represent the Gold Coast and the connection to the salt water.

Artwork 3: This photo is a small representation of the some of the cultural resources that we use including puzzles, strengths cards, toys, games, books and arts and crafts.  We take a variety of resources to the group with the idea that our young people can explore, play, and interact with whatever they are drawn to. 

Stacey Horomia

Stacey.horomia@health.qld.gov.au