Cultural Formulation

DSM-5 Cultural Formulation Interview (CFI)
The Outline for Cultural Formulation, a tool intended to help health professionals gather and organize culturally-relevant clinical information, was included in DSM-IV-TR. DSM-5 has refined the Outline and introduced a Cultural Formulation Interview (with both patient and informant versions) and 12 supplementary modules.

DSM-5 CFI Supplementary Modules

  1. Explanatory Model
  2. Level of Functioning
  3. Social Network
  4. Psychosocial Stressors
  5. Spirituality, Religion & Moral Traditions
  6. Cultural Identity
  7. Coping and Help-Seeking
  8. Clinician-Patient Relationship
  9. School-Age Children & Adolescents
  10. Older Adults
  11. Immigrants and Refugees
  12. Caregivers

Other interviews have been developed by Mezzich and colleagues as well as others.

CCS Outline for Cultural Formulation
The McGill-JGH Cultural Consultation Service has developed two extended versions of the Cultural Formulation based on the DSM-IV outline. The guidelines for cultural assessment and formulation are intended to help the consultant collect, organize and integrate information pertinent to a cultural consultation. Two versions are available:

  • Version A, developed by the Cultural Consultation Service at the JGH, is an elaboration of the cultural formulation in DSM-IV. The first sections summarize information usually collected in a comprehensive psychiatric history but with questions added to address common issues and experiences for immigrants, refugees and members of ethnocultural minorities. The crucial section focuses directly on the cultural formulation.
  • Version B, developed by the Transcultural Child Psychiatry Clinic at the Montreal Children’s Hospital, is designed as a semi-structured interview to be used by a researcher interviewing a clinician/consultant after the fact. As a result, it is more retrospectively focused, aimed at reconstructing a case that may have been followed in treatment for some time.

Culture, Context and Psychiatric Diagnosis: A Manual for Interviewing According to the Cultural Formulation in DSM-IV
The Transcultural Centre in Stockholm Sweden developed a manual with guidelines for conducting clinical interviews to produce a cultural formulation according to DSM-IV-TR. This portion of the manual provides a translation of the questions and probes suggested for an interview to elicit information for a cultural formulation following the DSM-IV guidelines. It has been translated into other languages (Finnish).

Brief Cultural Interview
The Brief Cultural Interview 2009 (BCI-09) is an anthropologically revised version of the cultural formulation that includes specific questions covering the four categories of the CFD: cultural identity, cultural explanations of illness, cultural factors in the psychosocial environment and functioning and cultural elements in the relationship between individual and clinician. BCI-09 is authored by Dutch transcultural psychiatrist Hans Rohlof. The BCI-09 can be used after a free registration. You can register by email with Simon Groen.