Influence of the DSM‐IV Outline for Cultural Formulation on multidisciplinary case conferences in mental health

Abstract

The Diagnostic and Statistical Manual of Mental Disorders of the American Psychiatric Association (DSM-IV-TR) includes an Outline for Cultural Formulation (CF) that identifies cultural information that can be used to modify diagnosis, clinical assessment and treatment plan. This study examined the use of the CF by a Cultural Consultation Service in the psychiatric assessment of patients referred by primary care providers. The study uses conversation analysis of 12 clinical case conferences to explore the ways in which the CF influenced the interaction of a multidisciplinary group of mental health professionals in conceptualizing the implications of patients' cultural background and current context for diagnosis and treatment planning. The results suggest that the CF can be a useful tool for interdisciplinary collaboration and knowledge transfer by providing a framework to systematically introduce different disciplinary perspectives and levels of description that transcend the narrow frame of disorder-centred psychiatric diagnosis, assessment and care.

Culture and Psychiatric Evaluation: Operationalizing Cultural Formulation forDSM-5

“…In Montreal's CCS, the perceived utility of the OCF did not differ between clinicians and non-clinicians (e.g., culture brokers), though psychologists found it more useful than did physicians (Kirmayer, Thombs et al, 2008c). Dinh and colleagues (2012) showed that the OCF changed dynamics of a multidisciplinary group by increasing the participation of non-medical professionals who could contribute to understanding the patient's social world. Assigning this task of cultural assessment to specialized personnel may enhance the cultural information gathered, but deprive treating clinicians of interacting with the patient directly.…”

Recommendations for Canadian Mental Health Practitioners Working With War-Exposed Immigrants and Refugees

“…Though slow to emerge, it is promising that research is evolving in this area (Dinh, Groleau, Kirmayer, Rodriguez, & Bibeau, 2012) and the challenges in its application, including a need for theory, is being recognized (Aggarwal, 2014). Undoubtedly, more research is needed to evaluate the effectiveness of applying cultural formulation as a tool to improve diagnosis and treatment, the findings of which would inform further development and modification in the utilization of this tool.…”

A change in practice after the introduction of a state-wide service plan: standardisation of the provision of care to patients with an eating disorder in a regional hospital including support from a new Eating Disorders Outreach Service

“…13 As per Korner, our team model fits an interdisciplinary team model as we ‘meet regularly in order to discuss and collaboratively set treatment goals for the patients and jointly carry out the treatment plans’. 14 There is positive evidence for case conferencing 15 in mental health to improve interdisciplinary collaboration and knowledge transfer, and it is shown that utilising a case template 16 can improve medical care in other settings.…”