Skip to main content

Main menu

  • Home
  • Current Issue
  • Ahead of Print
  • Past Issues
  • Info for
    • Authors
    • Print Subscriptions
  • About
    • About the Journal
    • About the Academy
    • Editorial Board
  • Feedback
  • Alerts
  • AAPL

User menu

  • Alerts

Search

  • Advanced search
Journal of the American Academy of Psychiatry and the Law
  • AAPL
  • Alerts
Journal of the American Academy of Psychiatry and the Law

Advanced Search

  • Home
  • Current Issue
  • Ahead of Print
  • Past Issues
  • Info for
    • Authors
    • Print Subscriptions
  • About
    • About the Journal
    • About the Academy
    • Editorial Board
  • Feedback
  • Alerts
Research ArticleRegular Articles

Clinician Perceptions of Implementing the Cultural Formulation Interview on a Mixed Forensic Unit

Neil K. Aggarwal, Peter Lam, Samantha Diaz, Amanda G. Cruz and Roberto Lewis-Fernández
Journal of the American Academy of Psychiatry and the Law Online June 2020, 48 (2) 216-225; DOI: https://doi.org/10.29158/JAAPL.003914-20
Neil K. Aggarwal
Dr. Aggarwal is Assistant Professor, Clinical Psychiatry, Columbia University Medical Center, and Research Psychiatrist, New York State Psychiatric Institute, New York. Mr. Lam is Data Analyst, New York State Psychiatric Institute, New York. Ms. Diaz is a PhD student, William James College, Boston, Massachusetts. Ms. Cruz is Research Assistant, New York State Psychiatric Institute, New York. Dr. Lewis-Fernández is Professor, Clinical Psychiatry, Columbia University Medical Center, and Director, Center of Excellence for Cultural Competence, New York State Psychiatric Institute, New York.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Peter Lam
Dr. Aggarwal is Assistant Professor, Clinical Psychiatry, Columbia University Medical Center, and Research Psychiatrist, New York State Psychiatric Institute, New York. Mr. Lam is Data Analyst, New York State Psychiatric Institute, New York. Ms. Diaz is a PhD student, William James College, Boston, Massachusetts. Ms. Cruz is Research Assistant, New York State Psychiatric Institute, New York. Dr. Lewis-Fernández is Professor, Clinical Psychiatry, Columbia University Medical Center, and Director, Center of Excellence for Cultural Competence, New York State Psychiatric Institute, New York.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Samantha Diaz
Dr. Aggarwal is Assistant Professor, Clinical Psychiatry, Columbia University Medical Center, and Research Psychiatrist, New York State Psychiatric Institute, New York. Mr. Lam is Data Analyst, New York State Psychiatric Institute, New York. Ms. Diaz is a PhD student, William James College, Boston, Massachusetts. Ms. Cruz is Research Assistant, New York State Psychiatric Institute, New York. Dr. Lewis-Fernández is Professor, Clinical Psychiatry, Columbia University Medical Center, and Director, Center of Excellence for Cultural Competence, New York State Psychiatric Institute, New York.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Amanda G. Cruz
Dr. Aggarwal is Assistant Professor, Clinical Psychiatry, Columbia University Medical Center, and Research Psychiatrist, New York State Psychiatric Institute, New York. Mr. Lam is Data Analyst, New York State Psychiatric Institute, New York. Ms. Diaz is a PhD student, William James College, Boston, Massachusetts. Ms. Cruz is Research Assistant, New York State Psychiatric Institute, New York. Dr. Lewis-Fernández is Professor, Clinical Psychiatry, Columbia University Medical Center, and Director, Center of Excellence for Cultural Competence, New York State Psychiatric Institute, New York.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Roberto Lewis-Fernández
Dr. Aggarwal is Assistant Professor, Clinical Psychiatry, Columbia University Medical Center, and Research Psychiatrist, New York State Psychiatric Institute, New York. Mr. Lam is Data Analyst, New York State Psychiatric Institute, New York. Ms. Diaz is a PhD student, William James College, Boston, Massachusetts. Ms. Cruz is Research Assistant, New York State Psychiatric Institute, New York. Dr. Lewis-Fernández is Professor, Clinical Psychiatry, Columbia University Medical Center, and Director, Center of Excellence for Cultural Competence, New York State Psychiatric Institute, New York.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • Article
  • Figures & Data
  • Info & Metrics
  • PDF
Loading

Article Figures & Data

Tables

    • View popup
    Table 1

    Open-Ended Questions for the Study

    Introduction
    Hi my name is XXX, and I will be going through this interview with you, where you will be asked for your opinion on the usefulness of the Cultural Formulation Interview (CFI) at your work place. I want to begin by letting you know that we are really interested in making sure that the CFI can be used at your site, and we want to ensure that it is optimally useful to you. All of the information you provide us with here will help us to do that.
    Adoption
    FOR ALL TIME POINTS
        1. Do you plan on using the CFI questions within your practice? If so, how?
        2. What would be the barriers to using the CFI questions in your practice?
        3. Do you think these barriers would change depending on how frequently you used the CFI? If so, how?
        4. What would help to overcome the barriers to using the CFI questions in your practice?
    FOR TIME 2 ONLY (AFTER PATIENT 1)
        5. After training, how did you first use the CFI with a patient?
    FOR TIME 3 ONLY (AFTER PATIENT 3)
        6. How did you use the CFI the second time you used it with a patient? Is this different from where you started? What about the third patient?
        7. With whom are you using the CFI?
    FOR TIME 4 ONLY (AFTER LAST PATIENT)
        8. What has influenced your use of the CFI over time?
        9. Did the way you work with patients change from before you had the CFI training? If so, what do you do differently now? If not, why not?
    Sustainability
    FOR ALL TIME POINTS
        1. What do you feel you would need to be able to keep using the CFI?
        2. What types of policies, procedures, or characteristics of your agency make it easier to use the CFI?
        3. What types of policies, procedures, or characteristics of your agency make it harder to use the CFI?
        4. Does management support your use of the CFI? If so, how?
        5. What else could or should they do to support the use of the CFI?
    • View popup
    Table 2

    Sample Characteristics

    Age, years46.31 (8.46)
    Gender
        Male3
        Female10
    Race/ethnicity
        Non-Hispanic white12
        Hispanic/Latino1
    Profession
        Psychologist4
        Social worker9
    Years of providing mental health care19.5 (7.53)
    Primary work location
        Civil unit8
        Forensic unit5
    Number of hours in cross-cultural training
        < 10 hours2
        10–25 hours5
        26–50 hours2
        51–75 hours1
        > 75 hours2
    • n = 13 respondents. Data are presented as n or mean (SD).

    • View popup
    Table 3

    Clinician EBPAS Mean Scoresa

    EBPAS DomainT0T1 (n = 14)T2 (n = 12)T3 (n = 10)T4 (n = 13)Beta (95% CI)bP
    MeanSDMeanSDMeanSDMeanSDMeanSD
    Requirements2.951.032.881.092.56.802.571.192.411.36−.13 (−.27 to .02).1970
    Appeal3.11.723.09.842.60.632.80.982.85.54−.07 (−.18 to .04).0800
    Openness2.96.922.98.893.02.672.55.942.81.76−.06 (−.18 to .06).3056
    Divergence2.95.863.05.662.02.672.83.882.73.85−.07 (−.16 to .02).1122
    Overall3.00.673.01.632.66.492.69.752.72.64.01 (−.25 to .28).9089
    • ↵a EBPAS mean scores range from 0–4.

    • ↵b Based on n = 63 EBPAS scores, mixed-effect model controlling for clinicians administering multiple CFIs.

    • EBPAS, Evidence-Based Practices Attitudes Scale.

    • View popup
    Table 4

    Barriers and Facilitators by Study Period

    DomainDefinitionT1 (n = 14)T2 (n = 12)T3 (n = 10)T4 (n = 13)
    BarFacBarFacBarFacBarFac
    Systemic
        Environmental contextPhysical and structural resources of the context, its processes, and resources67110000
        CultureSystem culture, beliefs and behaviors in relation to change and staffing roles19070501
        Communication processesProcesses of conveying information within the system, online, and in-person00000003
        External requirementsAny external pressures or expectations that affect system deliverables45892646
    Staff
        Staff commitment and attitudesMicro-level beliefs, attitudes, and behaviors toward change in general and toward the intervention510232446
        Understanding, awarenessUnderstanding of the aims and methodology of the intervention16040519
        Role identityBeliefs and attitudes towards one's work role and responsibilities36323113
        Skills, ability, confidenceStaff's sense of their capacity to carry out the intervention while managing patients and the environment121111111071311
    Intervention
        Ease of integrationHow well the intervention “fits” with the system, resources, and needs, and its ability to adapt as needed7141905013
        Face validity, evidence baseWhether the intervention is grounded in evidence and how effective it looks to meet its aims23203320
        Safety, legal, and ethics concernsHow well an intervention addresses important concerns of safety and legality to protect staff and patients00000040
        Supportive componentsComponents of the intervention that work to support and facilitate necessary changes05090303
    • Barriers and facilitators were not examined at T0.

    • Bar, barrier; Fac, facilitator.

PreviousNext
Back to top

In this issue

Journal of the American Academy of Psychiatry and the Law Online: 48 (2)
Journal of the American Academy of Psychiatry and the Law Online
Vol. 48, Issue 2
1 Jun 2020
  • Table of Contents
  • Index by author
Print
Download PDF
Article Alerts
Sign In to Email Alerts with your Email Address
Email Article

Thank you for your interest in recommending The Journal of the American Academy of Psychiatry and the Law site.

NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address.

Enter multiple addresses on separate lines or separate them with commas.
Clinician Perceptions of Implementing the Cultural Formulation Interview on a Mixed Forensic Unit
(Your Name) has forwarded a page to you from Journal of the American Academy of Psychiatry and the Law
(Your Name) thought you would like to see this page from the Journal of the American Academy of Psychiatry and the Law web site.
CAPTCHA
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
Citation Tools
Clinician Perceptions of Implementing the Cultural Formulation Interview on a Mixed Forensic Unit
Neil K. Aggarwal, Peter Lam, Samantha Diaz, Amanda G. Cruz, Roberto Lewis-Fernández
Journal of the American Academy of Psychiatry and the Law Online Jun 2020, 48 (2) 216-225; DOI: 10.29158/JAAPL.003914-20

Citation Manager Formats

  • BibTeX
  • Bookends
  • EasyBib
  • EndNote (tagged)
  • EndNote 8 (xml)
  • Medlars
  • Mendeley
  • Papers
  • RefWorks Tagged
  • Ref Manager
  • RIS
  • Zotero

Share
Clinician Perceptions of Implementing the Cultural Formulation Interview on a Mixed Forensic Unit
Neil K. Aggarwal, Peter Lam, Samantha Diaz, Amanda G. Cruz, Roberto Lewis-Fernández
Journal of the American Academy of Psychiatry and the Law Online Jun 2020, 48 (2) 216-225; DOI: 10.29158/JAAPL.003914-20
Reddit logo Twitter logo Facebook logo Mendeley logo
  • Tweet Widget
  • Facebook Like
  • Google Plus One

Jump to section

  • Article
    • Abstract
    • Methods
    • Results
    • Discussion
    • Footnotes
    • References
  • Figures & Data
  • Info & Metrics
  • PDF

Related Articles

Cited By...

More in this TOC Section

  • A Proposal for the Capacity to Stipulate to Civil Commitment and a 50-State Review of Statutes
  • Psychiatric and Substance-Related Problems Predict Recidivism for First-Time Justice-Involved Youth
  • Ongwen and Mental Health Defenses at the International Criminal Court
Show more Regular Articles

Similar Articles

Site Navigation

  • Home
  • Current Issue
  • Ahead of Print
  • Archive
  • Information for Authors
  • About the Journal
  • Editorial Board
  • Feedback
  • Alerts

Other Resources

  • Academy Website
  • AAPL Meetings
  • AAPL Annual Review Course

Reviewers

  • Peer Reviewers

Other Publications

  • AAPL Practice Guidelines
  • AAPL Newsletter
  • AAPL Ethics Guidelines
  • AAPL Amicus Briefs
  • Landmark Cases

Customer Service

  • Cookie Policy
  • Reprints and Permissions
  • Order Physical Copy

Copyright © 2023 by The American Academy of Psychiatry and the Law