Developing A Family Version of the Cultural Formulation Interview

The Cultural Formulation Interview (CFI) in DSM-5 focuses on the cultural identity (CI) and illness explanatory models of individual patients. In India, clinicians frequently see patients with their family. A family version of the CFI is needed, especially in such family-centric societies like India.

Plan development and testing of a family version of the CFI (CFI-F) based on the framework that has been validated internationally with a field site in Pune.

Review topical themes identified in the CFI Pune validation study and a follow-up study of cultural identity. Field-trial data of the CFI (n=36), and narratives of 460 clinic and community participants from study of cultural identity (CI) and its impact were reviewed. Experience from these studies guided development of proposed items and plans to validate the proposed CFI-F.

The draft interview focuses on presenting problems of an index person in a family assessment, and it is designed to elicit consistent and divergent views among family members regarding illness explanatory models, cultural identity and the role of family in shaping problems, support and solutions.

Experience with the CFI and study of cultural identity indicate the relevance of concepts of Hindu philosophy, changing cultural concepts of family and the influence of global values. The roles and responsibilities of various family members further explain their practical significance. This report presents the structure of the proposed CFI-F and plans for validating and using it for clinical care and community mental health.

Symptom-based diagnostic assessment may fail to account for significant effects of cultural and family contexts that affect vulnerabilities and resilience to mental health problems. Development of the CFI-F provides a strategy that builds on achievements of the CFI by acknowledging the relevance of family relationships, which is particularly important in family-centric societies.