Culture shapes every aspect of patient care, influencing when, where, how, and to whom patients narrate their experiences of illness and distress, the patterning of symptoms, and the models' clinicians use to interpret and understand symptoms in terms of psychiatric diagnoses. Culture also shapes patients’ perceptions of care, including what types of treatment are acceptable and for how long. Even when patients and clinicians share similar cultural, ethnic or linguistic backgrounds, culture impacts care through other influences on identity, such as those due to gender, age, class, race, occupation, sexual orientation, and religion. Culture affects the clinical encounter for every patient, not only underserved minority groups, and cultural formulation, therefore, is an essential component of any comprehensive assessment. Cultural misunderstandings, biases, and communication gaps between providers and patients also contribute to disparities in the care of diverse populations, including by race/ethnicity, religion, gender identity, and sexual orientation, suggesting person-centered cultural evaluation may help reduce care disparities.
To address this need, DSM-5 introduced a Cultural Formulation Interview (CFI) that is comprised of three components: a 16-question “core” version for interviewing patients, an informant version for obtaining collateral information, and 12 supplementary modules for a more comprehensive assessment. Clinicians may choose to administer one or several of these components with individual patients. This factsheet includes brief information on this person-centered cultural assessment, the areas it evaluates as well as links to access the instrument.