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 and 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.

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.