Roberto Lewis-Fernández MD is Professor of Clinical Psychiatry at Columbia University; at New York State Psychiatric Institute, he is Director of the NYS Center of Excellence for Cultural Competence and the Hispanic Treatment Program, Research Area Leader for Anxiety, Mood, Eating, and Related Disorders, and Co-Director of the Anxiety Disorder Clinic. His research develops culturally congruent interventions and instruments to enhance patient engagement, reduce misdiagnosis, and help overcome disparities in the care of underserved cultural groups. He led the development of the DSM-5 Cultural Formulation Interview, a standardized cultural assessment protocol, and was the Principal Investigator (PI) of its international field trial. He has been PI or co-Investigator of 25 National Institutes of Health-funded studies and other research, and published over 225 articles, chapters, and books on culture-related topics in mental health. He is president of the World Association of Cultural Psychiatry, president-elect of the American Psychopathological Association, chair of the Group for the Advancement of Psychiatry Cultural Committee, and chair of the DSM Review Committee for Internalizing Disorders.  He was chair of the DSM-5-TR Culture-Related Issues Review Committee as well as co-chair of the DSM-5-TR Work Group on Ethnoracial Equity and Inclusion and the ICD-11 Working Group on Culture-Related Issues. 

President World Association of Cultural Psychiatry. 




Roberto (2)


The cultural formulation approach: A critical overview of the research evidence

The Cultural Formulation Interview (CFI) and other operationalizations of the Outline for Cultural Formulation (OCF) are increasingly being incorporated into mental health training programs and implemented in clinical care across a range of countries. There is general agreement as to the value of these approaches and a commitment to expand their use in routine clinical practice. However, what is the state of the research evidence on the outcomes of this implementation? AIMS: To critically review the research evidence on the impact of the OCF and CFI in mental health training and clinical practice. METHODS: Synthesis of the published literature. RESULTS: The talk will review the evidence on outcomes related to use of the OCF and CFI in: a) training on culture-related aspects of mental health work with diverse populations; b) contextualization of the person’s clinical picture within their larger social world; c) diagnostic validity; d) processual aspects of care such as patient engagement, satisfaction, or patient-provider communication; e) individual responses to treatment; f) implementation outcomes (e.g., feasibility, acceptability); and g) institutional or systemic aspects of mental health care. DISCUSSION: The research evidence in support of the OCF and CFI is compelling but sparse and uneven. Some outcomes are frequently assessed (e.g., acceptability) while others (individual treatment response) are seldom examined. Areas for future research will be highlighted. LEARNING OBJECTIVES 1. Clarify the state of the evidence on the impact of the OCF and CFI in mental health training and clinical practice. 2. Identify 3 OCF/CFI-related outcomes that have been emphasized in the existing mental health literature and 3 outcomes that have been relatively unexamined. 3. Discuss 3 directions for future research on the OCF and CFI. REFERENCES Aggarwal NK, Jarvis, GE, Gómez-Carrillo A, Kirmayer LK, Lewis-Fernández R (2020). The Cultural Formulation Interview since DSM-5: Prospects for training, research and clinical practice. Transcultural Psychiatry, 57(4): 496-514. Jarvis GE, Kirmayer LJ, Gómez-Carrillo A, Aggarwal NK, Lewis-Fernández R (2020). Update on the Cultural Formulation Interview. FOCUS, 18(1):40-46.