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Many clinicians conduct a cultural formulation interview to gather data about clients’ racial, ethnic, and cultural identities. Clinicians can use this information to understand the way these identities might influence their clients’ mental health problems, psychosocial stressors, and willingness to participate in treatment (American Psychiatric Association, 2013; Lewis-Fernandez, Aggarwal, Hinton, Kirmayer, & Hinton, 2016).

During the interview, the clinician asks open-ended questions to children and their caregivers to see the child’s problem from their point of view. The complete interview consists of four parts, as shown in the From Science to Practice section.

Table 4.1

Note: Adapted from Garcia-Barrera and Moore (2013) and Reynolds and Kamphaus (2015).

First, the clinician looks for a cultural definition of the child’s problem. How does the family understand the problem? How would family members describe the problem to others in their community, such as a relative or close friend? For example, we might learn that Sara’s family immigrated to the United States from El Salvador when she was little. They sought asylum in the United States because of violence at home. Sara has been living in the United States for 5 years and has generally been a good student. This academic year, however, she has been more irritable than usual. Her physician diagnosed her with depression, but her family members describe her problem as “spells” or “attacks of stubbornness.” Initially, we might use these same words with her family to show we are trying to see the problem from their perspective (Boehnlein, Westermeyer, & Scalco, 2016).

Second, the clinician assesses the family’s cultural perceptions of the problem’s cause and context. According to family members, how did the problem come about? What aspects of the family’s cultural identity might contribute to the problem or be a source of support? For example, we might discover that Sara’s parents are ashamed and disappointed by her behavior. They attribute her low grades to “laziness” and her tantrums to “disrespect for her family.” In contrast, Sara might feel “caught between her family and the school.” She knows that her parents are disappointed in her and have many other stressors in their lives—working multiple jobs, caring for her younger siblings, and trying to establish a new home in the United States. “They came to this country so we could have a better life and I have let them down,” she might say (Rousseau & Guzder, 2016).

Third, the clinician gathers information about cultural factors that affect coping and past help-seeking. How has the family responded to this problem? What has worked and what has been less effective? Although Sara’s parents lead busy lives, they might be willing to participate in therapy to help manage her school refusal. We might work with her parents to identify barriers to treatment such as their work schedules, access to childcare, or the cost of treatment.