Adapting the Cultural Formulation Interview for the Military

Area of Science:

• Psychiatry
• Cultural Psychiatry
• Military Mental Health

Background:

• U.S. military service members, veterans, and their families often receive care from providers lacking military cultural understanding.
• The Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) Cultural Formulation Interview (CFI) aims to integrate cultural factors into mental health assessments.
• The efficacy of the core CFI in assessing military culture remains unexamined.

Purpose of the Study:

• To determine the necessity for a specialized version of the CFI for military populations.
• To outline a methodology for developing culturally specific CFI versions.
• To create a military-specific CFI to address the unique cultural needs of service members, veterans, and their families.

Main Methods:

• A systematic review of published articles on cultural competence within the military was conducted.
• Cultural domains were extracted, coded, and organized to evaluate the core CFI's coverage.
• A military CFI was developed, incorporating additional instructions and questions where the core CFI was insufficient.

Main Results:

• The review identified 22 distinct military culture domains, with only five covered by the core CFI without modification.
• Significant adaptations were needed for the core CFI, including additional instructions for 12 questions, edits for five, and new probing questions for 10.
• These findings led to the creation of a military version of the CFI.

Conclusions:

• The developed military CFI enhances the assessment of military culture, which is not fully captured by the core CFI.
• The methodology used can guide the creation of other culturally adapted CFI versions for diverse populations.
• This work supports improved mental health care for military-affiliated individuals by addressing specific cultural nuances.