The use of the cultural formulation interview at Helen Joseph Hospital Psychiatric Unit
Date
2020
Authors
Tsikoane, Mpho
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Abstract
Introduction: The Cultural Formulation Interview (CFI) is an updated version of the
Outline of Cultural Formulation that has been included in the DSM-5. The CFI has
been identified as a cross-cultural assessment too and allows for a more structured
collection of data enabling the clinician to make a more comprehensive assessment.
Purpose and study objectives: The aim of this study therefore was to describe the
self-reported experience of culture in the expression of psychiatric illness and the role
of cultural factors in the presentation of psychiatric problems, by administering the
CFI in a group of patients in a local psychiatric unit.
Methodology: The study is a qualitative research that uses qualitative methods to
describe the answers to the 16 questions that comprise the CFI as given by
psychiatric patients. Interviews were conducted until data saturation had been
achieved, which resulted in 22 interviews being conducted.
Results: A brief descriptive analysis of the demographic variables of participants was
done, followed by a content analysis of their documented responses to the different
CFI questions. The most common themes identified in the process were: “culture”,
“religion”, “stigma”, “insight” and “integration of treatment modalities”. The field notes
of the investigator were also summarised, concluding that conducting the interview
was difficult at times especially, due to barriers resulting from language and
educational difficulties. CFI content themes were also compared with current
literature.
Conclusion: In this limited, local investigation, not all of the CFI questions in its
current format offered any additional information that was not already a component of
the current Colleges of Medicine of South Africa’s College of Psychiatrists’ long case
presentation format. It does not seem to be necessary to conduct the CFI as a
separate component of assessment, but some aspects of the CFI questions can be
incorporated in the current long case format to offer some elaborated insight into
local patients’ cultural explanation of illness. Some questions were repetitive and
could therefore be clustered together as a single question. It has also been of note
that patients felt misunderstood by their health-care providers if cultural considerations were not included and that they would prefer an approach which
integrates western and local (African) cultural treatment modalities
Description
A research report submitted to the Faculty of Health Sciences, University of the Witwatersrand, in partial fulfilment of the requirements for the degree of Master of Medicine in the branch of Psychiatry