Table 1.
The DSM-IV Outline for Cultural Formulation
| Cultural Formulation Dimension | Sample Questions |
|---|---|
| Cultural Identity | Where are you and your family from? |
| Individual’s Ethnic or Cultural Reference Group | Are you and your parents from the same place? |
| Degree of Involvement with Cultures of Origin and Settlement | How do you identify yourself culturally? |
| Language Abilities, Use, and Preference | Do you feel connections to any particular groups of people? |
| What languages do you know? | |
| What languages do you speak at home? At work? | |
| What language would you like to speak with your physician? | |
| Do you practice a religion now? If so, what? | |
| Are there religious beliefs that can impact your treatment? | |
| What activities do you enjoy? | |
| What are your sources for news and entertainment? For health news? | |
| Cultural Explanations of Illness | What happened when you got sick? How did others respond? |
| Idioms of Distress Communicating Symptoms or Need for Supports | Have you ever had anything like this? Do you know anyone who has? |
| Meaning and Severity of Symptoms Compared to the Group | What do you call the problem in your language or when you describe it to provide |
| Local Illness Categories Used by the Family or Group for Symptoms | What kind of problem is it? |
| Perceived Causes and Explanatory Models for the Illness | How serious is the problem? How has it affected your life? |
| Current Preferences and Experiences with Professional and Popular Sources of Care | What are the causes of the problem? |
| What do others in your family think about this problem? | |
| Who have you consulted to get help for this problem? | |
| What kind of treatment do you want? | |
| What will the treatment do for you? | |
| Do you have any concerns about the treatment? | |
| Cultural Factors of Supports and Functioning | What stressful situations or events have played a role in your illness? |
| Relevant Interpretations of Social Supports, Stressors, and Level of Functioning | How are these stressors affecting your life and family? |
| Stresses in the Local Social Environment | What do others in our community think about the stresses? |
| Role of Religion and Kin Networks in Providing Support | How are these stresses viewed in your culture? |
| Is there someone you can trust and discuss personal matters with? | |
| Who else can you turn to? | |
| What are your main sources of daily and financial support? | |
| How important are family, friends, and community in your life? | |
| What role does religion and spirituality play in your life? | |
| How does your illness affect your ability to care for yourself? | |
| How does your illness affect your ability to work? | |
| How does your illness affect your interactions with family and others? | |
| How are these difficulties viewed in your culture? | |
| Cultural Elements of the Physician-Patient Relationship | Questions the clinician can ask for self-reflection: |
| Individual Differences in Culture and Social Status Between Patient and Clinician | What is my ancestry and cultural reference group? |
| Problems of Individual Differences in Diagnosis and Treatment | How does my cultural identity relate to the patient’s language, values, and relatio |
| How do intercultural relations influence eliciting symptoms and their significance? | |
| How do intercultural similarities mask other sources of social difference or psycho | |
| How do intercultural differences influence whether this is normal or pathological? | |
| How do intercultural differences influence treatment and care? |