About the Cultural Formulation Interview Project
Patients’ cultures and life experiences have a profound impact on their understanding of their symptoms and attitudes toward care. The Outline for Cultural Formulation (OCF) was introduced in DSM-IV as a narrative framework for what an open, empathic and thorough cultural assessment should consist of during a diagnostic interview. Although professional organizations and government guidelines recommend cultural competence training for providers, until recently the lack of a standardized cultural assessment format hindered research and training. The DSM-5 Cross-Cultural Issues Subgroup operationalized the OCF into a semi-structured questionnaire, the Cultural Formulation Interview (CFI), to facilitate the implementation of the OCF model in a routine evaluation.
The CFI was tested in an APA-supported field trial led by the NYS Center of Excellence for Cultural Competence at the NYSPI. The DSM-5 CFI field trial was the largest international collaboration for cultural assessment, involving 321 patients in 11 clinical settings and 6 countries, with the aim of assessing the CFI’s feasibility, acceptability and perceived clinical utility. To foster person-centered, culturally competent, recovery-oriented treatment planning, an interactive, online training module on the CFI is available to behavioral health providers around the world: https://rfmh.csod.com/selfreg/register.aspx?c=222333444555666. More research is needed on CFI implementation to explore how it is best used in clinical practice and how implementation of the CFI can affect patient satisfaction, symptoms, and quality of life as well as engage providers in lifelong learning about cultural competence.
The APA DSM-5 Cultural Formulation Interview is available at the following links:
CFI Informant Version
CFI Supplementary Modules
Lewis-Fernández R, Aggarwal NK, Hinton L, Hinton DE, Kirmayer LK (eds.): The DSM-5 Handbook on the Cultural Formulation Interview. Washington, DC: American Psychiatric Publishing, 2016.
Lewis-Fernández R, Aggarwal NK, Lam P, Galfalvy H, Weiss MG, Kirmayer LJ, Paralikar V, Deshpande S, Diaz E, Nicasio AV, Boiler M, Alarcón RD, Rohlof H, Groen S, van Dijk R, Jadhav S, Sarmukaddam S, Ndetei DM, Scalco M, Bassiri K, Aguilar-Gaxiola S, Ton H, Westermeyer J, Vega-Dienstmaier J: Feasibility, acceptability, and clinical utility of the Cultural Formulation Interview: Mixed-methods results from the DSM-5 international field trial. British Journal of Psychiatry, 2017, 210:290-297.
Aggarwal, N. K., Lam, P., Jiménez-Solomon, O., Desilva, R., Margolies, P. J., Cleary, K., … & Lewis-Fernández, R. (2018). An Online Training Module on the Cultural Formulation Interview: The Case of New York State. Psychiatric Services, 69(11), 1135-1137.
DeSilva, R., Aggarwal, N. K., & Lewis-Fernandez, R. (2015). The DSM-5 cultural formulation interview and the evolution of cultural assessment in psychiatry. Psychiatric Times, 32(6), 10-10.
TRINH, N., SON, M., & CHEN, J. A. (2019). Culture in the DSM-5. Sociocultural Issues in Psychiatry: A Casebook and Curriculum, 37.
Demonstration of Cultural Formulation Interview
Provided by the University of Wisconsin School of Medicine and Public Health
Roberto Lewis-Fernández on the Cultural Formulation Interview
Provided by McGill Transcultural Psychiatry
Roberto Lewis-Fernández on the DSM-5 in Global Mental Health
Dr. Roberto Lewis Fernandez, Professor in the Department of Psychiatry at Columbia University speaks on “Novel Uses of DSM-5 in Global Mental Health” at the 2nd Annual Global Mental Health Forum in May 2013. Provided by the New York Global Mental Health Program.
We invite you to read our Cultural Competence Matters reports on this topic:
- “Cultural Syndromes and the Cultural Formulation in Psychiatric Care”
- “The Center of Excellence for Cultural Competence leads the DSM-5 Cultural Formulation Field Trial”
You may see all our periodic Cultural Competence Matters reports here: Cultural Competence Matters.
Online Training Module: Using the DSM-5 CFI
The CECC has also partnered with Center for Practice Innovations (CPI) to create an online training program for the CFI that will be available to all providers in the New York State Office of Mental Health (OMH) system.
To download a copy of the CFI
To download your copy of the DSM-5 Cultural Formulation Interview for free, please click here: CFI from the American Psychiatric Association
To view and download the CFI Informant version, click here: CFI-Informant
To view and download supplementary CFI modules, click here: CFI-Supplemental
[The CFI is] Reprinted with permission from the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, (Copyright ©2013). American Psychiatric Association. All Rights Reserved.