The cultural formulation: a method for assessing cultural factors affecting the clinical encounter

Psychiatr Q. Winter 2002;73(4):271-95. doi: 10.1023/a:1020412000183.

Abstract

The growing cultural pluralism of US society requires clinicians to examine the impact of cultural factors on psychiatric illness, including on symptom presentation and help-seeking behavior. In order to render an accurate diagnosis across cultural boundaries and formulate treatment plans acceptable to the patient, clinicians need a systematic method for eliciting and evaluating cultural information in the clinical encounter. This article describes one such method, the Cultural Formulation model, expanding on the guidelines published in DSM-IV. It consists of five components, assessing cultural identity, cultural explanations of the illness, cultural factors related to the psychosocial environment and levels of functioning, cultural elements of the clinician-patient relationship, and the overall impact of culture on diagnosis and care. We present a brief historical overview of the model and use a case scenario to illustrate each of its components and the substantial effect on illness course and treatment outcome of implementing the model in clinical practice.

Publication types

  • Case Reports
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Attitude to Health
  • Culture*
  • Depressive Disorder, Major / diagnosis*
  • Depressive Disorder, Major / rehabilitation
  • Female
  • Hospitalization
  • Hospitals, Psychiatric
  • Humans
  • Language
  • Middle Aged
  • Patient Acceptance of Health Care
  • Professional-Patient Relations
  • Psychiatric Status Rating Scales*
  • Social Environment
  • Social Identification
  • Social Support