The Outline for Cultural Formulation (OCF) introduced with DSM-IV provided a framework for clinicians to organize cultural information relevant to diagnostic assessment and treatment planning. However, use of the OCF has been inconsistent, raising questions about the need for guidance on implementation, training, and application in diverse settings. To address this need, DSM-5 introduced a cultural formulation interview (CFI) that operationalizes the process of data collection for the OCF. The CFI includes patient and informant versions and 12 supplementary modules addressing specific domains of the OCF. This article summarizes the literature reviews and analyses of experience with the OCF conducted by the DSM-5 Cross-Cultural Issues Subgroup (DCCIS) that informed the development of the CFI. We review the history and contents of the DSM-IV OCF, its use in training programs, and previous attempts to render it operational through questionnaires, protocols, and semi-structured interview formats. Results of research based on the OCF are discussed. For each domain of the OCF, we summarize findings from the DCCIS that led to content revision and operationalization in the CFI. The conclusion discusses training and implementation issues essential to service delivery.

Religious or Spiritual Problem is a new diagnostic category (Code V62.89) in the 1994 Diagnostic and Statistical Manual of Mental Disorders. Although the acceptance of this new category was based on a proposal documenting the extensive literature on the frequent occurrence of religious and spiritual issues in clinical practice, the impetus for the proposal came from transpersonal clinicians whose initial focus was on spiritual emergencies-forms of distress associated with spiritual practices and experiences. The proposal grew out of the work of the Spiritual Emergence Network to increase the competence of mental health professionals in sensitivity to such spiritual issues. This article describes the rationale for this new category, the history of the proposal, transpersonal perspectives on spiritual emergency, types of religious and spiritual problems, differential diagnostic issues, psychotherapeutic approaches, and the likely increase in number of persons seeking therapy for spiritual problems. It also presents the preliminary findings from a database of religious and spiritual problems.

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This paper presents Asian‐Americans' experiences of mass violence with the hope of stimulating much‐needed research and clinical activities in this area. After a discussion of the literature on the types of traumatic events leading to Post‐traumatic Stress Disorder (PTSD) and other psychological sequelae, the occurrence of similar events in Asia during the past 40 years which may predispose Asian people to PTSD will be reviewed. Asian cultural coping styles which mitigate against or conceal PTSD will be discussed. Assessment and treatment methods tailored for Asian patients will be outlined. Finally, recommendations for clinical service, training, and research in this area with Asian patients will be presented.

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