Can the “Cultural Formulation Interview” be Made Useful for Social Workers? a Focus Group Study to Develop and Disseminate a Tool That Promotes Culturally Sensitive Communication

Background and Purpose

This poster will present results from dimensional analysis of expert focus groups that examined the American Psychiatric Association’s Cultural Formulation Interview (CFI), published in the most recent edition of the Diagnostic and Statistical Manual of Mental Disorders (The DSM-5). The CFI is a tool for promoting intercultural dialogue, and although published in a psychiatric text, social workers, whose clinical licensing requires expertise in the DSM-5, might also use it. Its merits include emphasizing the client’s subjective experience of the presenting problem and recognition of the importance of cultural identity, cultural explanations of illness, cultural-levels of psychosocial support and cultural elements of the client-practitioner relationship. However, presently the CFI is not widely used in social work, and arguments against its use by social workers have included its origins in a different discipline, and its length. However many vulnerable populations, including African-Americans, immigrants, and children and adolescents living in poverty, remain at high risk for receiving suboptimal health and mental health services due to poor communication by health and human service practitioners. Social workers who practice with proper tools and skills are uniquely poised to mitigate that risk. The purpose of this study was therefore to develop and promote the use of a tool that advances culturally sensitive communication between social workers and clients, beginning with an examination of the CFI. The routine use of such a tool has the potential to decrease health disparities across many groups.

Methods

Focus groups were used to garner expert opinions about the CFI. Focus groups consisted of experts across three realms of social work education: Social work faculty, social work field staff, and social work fieldwork instructors. Potential social work faculty and social work field staff participants were located via social work department websites and were sent emails requesting participation. Social work field instructors were identified by social work field staff, who then received a recruitment email from the study. Three focus groups were held, one with each type of expert. Focus groups had 4-8 participants and were 65-90 minutes long. All focus groups were audiorecorded and transcribed verbatim. Focus group data were then analyzed using dimensional analysis.

Results

The resulting tool is a modified version of the CFI, developed by analyzing and incorporating the data provided by all three groups of experts. The tool is shorter, easy to memorize, and in addition to the individual’s presenting problem also considers his or her strengths as part of the assessment process. It will be presented in full on the poster and provided as a hand-out to poster session attendees.

Conclusions and Implications

Marshaling the expert knowledge of social work faculty, field staff, and fieldwork instructors, to develop, modify, and distribute a tool that promotes culturally sensitive social work education and practice has the potential to benefit social work students, practitioners, and the communities they serve. The tool responds to the need of vulnerable populations to have social workers who can communicate effectively and dynamically.