Cultural Formulation


CCS Cultural Formulation

The McGill-JGH Cultural Consultation Service has developed two extended versions of the Cultural Formulation based on the DSM-IV outline. The guidelines for cultural assessment and formulation are intended to help the consultant collect, organize and integrate information pertinent to a cultural consultation. Two versions are available:

Version A, developed by the Cultural Consultation Service at the JGH, is an elaboration of the cultural formulation in DSM-IV. The first sections summarize information usually collected in a comprehensive psychiatric history but with questions added to address common issues and experiences for immigrants, refugees and members of ethnocultural minorities. The crucial section focuses directly on the cultural formulation.

Version B, developed by the Transcultural Child Psychiatry Clinic at the Montreal Children’s Hospital, is designed as a semi-structured interview to be used by a researcher interviewing a clinician/consultant after the fact. As a result, it is more retrospectively focused, aimed at reconstructing a case that may have been followed in treatment for some time.


Kirmayer, L. J., Thombs, B. D., Jurcik, T., Jarvis, G. E., & Guzder, J. (2008). Use of an expanded version of the DSM-IV outline for cultural formulation on a cultural consultation service. Psychiatric Services, 59(6), 683-686.


Transcultural Centre, Stockholm County Council

The Transcultural Centre has developed a manual with guidelines for conducting clinical interviews to produce a cultural formulation according to DSM-IV-TR. This portion of the manual provides a translation of the questions and probes suggested for an interview to elicit information for a cultural formulation following the DSM-IV guidelines: Culture, Context and Psychiatric Diagnosis [.pdf]

Evaluation of the Cultural Formulation, Questionnaire I  [.pdf]

The Centre publishes the electronic Newsletter "Nyhetsbladet" in Swedish free of charge, subscribe at: [at]

Director: Sofie Bäärnhielm, MD, PhD
sofie.baarnhielm [at] (Email) Website


Brief Cultural Interview

The Brief Cultural Interview 2009 (BCI-09) is a questionnaire that offers information for the Cultural Formulation of Diagnosis (CFD), as noted in the appendix of the DSM-IV. It is an anthropologically revised version of the cultural interview by Dutch transcultural psychiatrist Hans Rohlof. The BCI/09 offers 27 questions covering the four categories of the CFD: cultural identity, cultural explanations of illness, cultural factors in the psychosocial environment and functioning and cultural elements in the relationship between individual and clinician. The questions are about language capabilities, ethnic reference group, acculturation process, illness meanings, expectations towards treatment, partners, family, religion, social support, and attitude towards treatment.

The BCI-09 is a result of anthropological knowledge and experience in a centre for transcultural psychiatry, i.e. psychiatric treatment for asylum seekers and refugees. This may have a bias: most patients in the centre have PTSD, anxiety and/or depression disorders. Some questions may be more relevant than others, also depending on the countries and ethnic groups of origin where patients feel they belong to. The BCI-09 has been translated from Dutch into English once, so there may be a translating bias as well.

The BCI-09 can be used after registration. This is costless, however we want to stay updated on the use and the effects of the BCI-09. When using the BCI-09 you can be asked how often you use it, in what situations, by what disciplines and about the effects. The BCI-09 is most effective when it is well implemented in your organisation. This means it is embedded in medical files, treatment plans, and discussed within the group of relevant clinicians.

You can register by Simon.Groen [at] (email) with Simon Groen.

Requests for lectures, workshops and the like can be sent to the same e-mail address.

BCI-09 Questionnaire  [.pdf]

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