The Catholic Church in Scotland must make an "unmistakeable and unequivocal" apology to survivors of abuse, according to an independent review of its handling of allegations.
A commission led by the Very Rev Andrew McLellan has made eight recommendations, including calling for support for survivors of abuse to be an "absolute priority".
It also says justice must be done for those who have been abused.
Mr McLellan, a former moderator of the General Assembly of the Church of Scotland and one-time chief inspector of prisons, was tasked with evaluating the procedures in place to protect vulnerable children and adults and ensure that the church is ''a safe place for all''.
At a press conference in Edinburgh to set out the findings of his 11-member commission, he said: "Support for the survivors of abuse must be an absolute priority for the Catholic Church in Scotland.
"The Bishops' Conference of Scotland should make a public apology to all survivors of abuse within the church.
"An apology must be made in a way that is unmistakeable and unequivocal."
He added: "The Bishops have said from the outset that they will accept our recommendations.
"That means that three things will happen.
"First and most important a beginning will be made to heal the hurt and address the anger which so many survivors feel.
"Second, the Catholic Church in Scotland will begin to confront a dark part of its past and find some healing for itself.
"Third, a significant step will be taken in restoring public credibility for the Catholic Church."
The report also recommends that the church's safeguarding policies and practices be completely rewritten and subject to external scrutiny.
It calls for a consistent approach to dealing with allegations across Scotland and improved training for those in the church.
The commission was set up in November 2013 by the Bishops' Conference of Scotland in response to a series of scandals, including the resignation of disgraced cardinal Keith O'Brien.
He stepped down from the archdiocese of St Andrews and Edinburgh in February 2013 after three priests and a former priest made allegations of inappropriate behaviour against him.
As part of its work, the commission heard from victims of abuse but its remit did not extend to investigating or ruling on current or historical allegations.
Its members included Malcolm Graham, Assistant Chief Constable of Police Scotland, Ranald Mair, chief executive of Scottish Care, and Kathleen Marshall, former Commissioner for Children and Young People.
Alongside the review, the Catholic Church in Scotland published details of diocesan safeguarding audits from 2006 to 2012 giving a breakdown of incidents reported during that time.
A total of 46 allegations were made, of which 55% related to sexual abuse, 19% to physical abuse, 11% were allegations of verbal abuse and 15% were in connection with emotional abuse.
Of those accused, 56% were priests, 22% were volunteers, 11% were parishioners and the remainder were staff or other people connected to the church.
There have been no prosecutions in relation to 61% of all cases reported, the church said.
Details of incidents are now published annually, with 15 allegations made in 2013, six of which were historical.
It also announced a third measure of a review of all cases of historic abuse allegations between 1947 and 2005, to be published at a later date.
Mr McLellan said: "Our report gives the Catholic Church a chance - an unrepeatable chance - to make things better.
"If this opportunity is not taken, survivors will know there is no hope left for them within the Catholic Church in Scotland.
"If this opportunity is not taken, many Catholics who are longing for a new beginning will feel betrayed by their church.
"If this opportunity is not taken, the public credibility of the Catholic Church in Scotland will be destroyed.
"I believe our report gives the Bishops the beginning of a way to change.
"The way to change which they all say they want - from secrecy to openness, from systems which allow evil to survive to systems which ensure that good is done."
Mr McLellan said the church must "reach out" to survivors and take responsibility for them.
The commission said it recognised a willingness in the church to change from "a culture of secrecy to a culture of openness" and recommended that it clarify its policy on whistleblowing.
He said: "Justice must be done, and justice must be seen to be done, for those who have been abused and for those against whom allegations of abuse are made."
Concluding, Mr McLellan added: "This is not simply the greatest challenge facing the Bishops' Conference.
"It is the greatest challenge facing the whole Catholic Church in Scotland.
"Change will come when - and only when - the whole membership of the Church own this desire for change and embrace for themselves the agenda set out in our report.
"If they take this opportunity, if the Catholic Church in Scotland grabs this opportunity, then that church will be a safer place for all."