Role-Playing Practice: Using The CFI To Individualize Anxiet ✓ Solved

Role-Playing Practice: Using the CFI to Individualize Anxiet

Role-Playing Practice: Using the CFI to Individualize Anxiety Care. Read Díaz (2017) and the DSM-5 Cultural Formulation Interview. Meet a collaboration partner and administer the CFI while your partner role-plays an anxiety issue. Based on what you learn and additional research, submit a 4-page paper that does the following: Describe the skills or techniques you used to engage your partner during the CFI. Explain which aspects of the CFI were most helpful in learning about your partner’s personal view of the problem and situation from a cultural perspective. Describe the cultural components (e.g., race/ethnicity, religion, geographic region, socio-economic status) that may influence your partner and analyze how those components influence their mental health experience. Identify which relevant subsections of the CFI you used and explain why you did or did not use a subsection. Analyze how you, as a social work treatment provider, might adjust interventions for the client’s individualized circumstances and culture of origin. Recommend a specific evidence-based measurement instrument to validate the diagnosis and assess outcomes of treatment; explain cultural considerations when determining appropriateness, including whether the instrument was validated with diverse populations. Use Díaz (2017) and additional resources about culture.

Paper For Above Instructions

Introduction

This paper reports on administering the DSM-5 Cultural Formulation Interview (CFI) in a role-played anxiety case, summarizes engagement techniques, identifies the most informative CFI components, analyzes salient cultural factors, explains which CFI subsections were used and why, and recommends an evidence-based outcome measure with cultural considerations. The work draws on Díaz et al. (2017) and DSM-5 guidance for culturally responsive assessment (APA, 2013).

Engagement Skills and Techniques

To establish rapport and facilitate open disclosure during the CFI, I used reflective listening, open-ended prompts, and empathic validation (Díaz et al., 2017). I began with normalizing statements (e.g., “Many people experience worry — tell me how it has been for you”), alternating clarification questions with silence to allow narrative elaboration. I confirmed confidentiality and framed the CFI as co‑authored meaning-making, which reduced threat and promoted trust (APA, 2013). I also used culturally attuned nonverbal cues (leaning forward, maintaining culturally appropriate eye contact) and invited the partner to define culturally relevant terms (e.g., spiritual idioms), avoiding pathologizing language. These techniques aligned with Díaz et al.’s (2017) recommendations to orient participants to the interview and validate cultural perspectives.

CFI Components Most Helpful

Three CFI domains were most informative: 1) cultural definition of the problem, 2) cultural perceptions of cause, context, and support, and 3) cultural factors affecting help-seeking and treatment expectations. Asking “How do you understand your problem?” elicited the partner’s idioms (somatic metaphors and family-focused framing) that would not have emerged in a standard symptom checklist (APA, 2013). Questions about supports and barriers revealed stigma within the partner’s community and preferences for faith-based coping, which clarified likely engagement challenges (Díaz et al., 2017). The CFI’s structured prompts helped surface family obligations, migration stressors, and economic pressures affecting symptom maintenance (Kirmayer et al., 2011).

Cultural Components and Their Influence on Mental Health

The partner’s profile included: race/ethnicity (first-generation immigrant), religion (active congregation member), geographic origin (region with collectivist norms), and socioeconomic status (low-income, precarious employment). Collectivist family values influenced the partner’s tendency to somaticize distress and prioritize family reputation over individual disclosure (Kleinman, 1988). Religious frameworks shaped causal attributions (e.g., spiritual testing) and preference for pastoral support before mental health care (Hodge & Nandy, 2011). Migration-related stressors — language barriers, loss of social status, and discrimination — exacerbated hypervigilance and worry consistent with anxiety disorders (Bhugra & Becker, 2005). Socioeconomic precarity increased chronic stress and limited access to sustained therapy, pointing toward brief, pragmatic interventions and community resource linkage (Alegría et al., 2017).

CFI Subsections Used and Rationale

I used the core 16-question CFI and two subsections: the explanatory model probes (to clarify causal beliefs and idioms) and the cultural identity and supports subsection (to map social networks and clergy involvement). I did not use the extended help-seeking or stressors-and-context subsections in full because time constraints and role-play boundaries limited exhaustive coverage; however, I integrated targeted stressor questions (employment, migration) from those subsections. The selected subsections provided focused information directly relevant to treatment planning: causal beliefs, supports, and barriers to care (APA, 2013).

Adapting Interventions to the Client’s Culture

Given identified cultural factors, I would adapt evidence-based interventions in the following ways. First, employ culturally adapted cognitive-behavioral therapy (CBT) that incorporates somatic language and frames cognitive restructuring within culturally congruent metaphors (Hofmann et al., 2012; Bernal & Domenech Rodríguez, 2012). Second, include family or faith leaders in psychoeducation when appropriate and with consent, leveraging trusted community supports (Díaz et al., 2017). Third, use brief, modular interventions (e.g., 8–12 sessions) and integrate problem-solving modules addressing unemployment or legal stressors to align with socioeconomic constraints (Morrison, 2014). Fourth, offer materials and sessions in the client’s preferred language and, when necessary, use trained interpreters and culturally trained clinicians to reduce miscommunication (Kirmayer, 2012). Finally, address stigma by normalizing symptoms as common responses to stress and highlighting practical coping strategies acceptable to the community (Alegría et al., 2017).

Recommended Measurement Instrument and Cultural Considerations

I recommend the Generalized Anxiety Disorder-7 (GAD-7) as the primary outcome and screening instrument (Spitzer et al., 2006). The GAD-7 is brief, has strong psychometric properties, and is widely used to monitor symptom change across treatment (Spitzer et al., 2006; Löwe et al., 2008). Cultural considerations include confirming validated translations for the client’s language and awareness that somatic presentations may underrepresent cognitive symptoms on the GAD-7; thus, supplementing with a culturally sensitive somatic symptom checklist and the CFI narrative findings is essential (Hinton & Lewis-Fernández, 2011). When possible, use versions of GAD-7 validated in similar immigrant or language groups and triangulate self-report with clinician-rated measures and functional outcomes (employment, sleep, social engagement) to ensure cultural validity (Haroz et al., 2014).

Conclusion

Administering the CFI in a role-played anxiety case yielded rich contextual information that directly informed culturally attuned adaptations to assessment and intervention. Engagement techniques based on empathic validation and collaborative meaning-making encouraged disclosure of culturally shaped idioms and supports. Using selective CFI subsections allowed efficient focus on explanatory models and supports. Combining culturally adapted CBT, family/faith collaboration, practical problem-solving, language access, and brief modular treatment, monitored with the GAD-7 and culturally relevant indicators, provides a feasible, evidence-informed plan consistent with Díaz et al. (2017) and DSM-5 cultural guidance (APA, 2013).

References

  1. Alegría, M., Ten Have, M., Lin, J., et al. (2017). Disparities in treatment for substance use and co-occurring disorders for people of color. Journal of Substance Abuse Treatment, 77, 1–10.
  2. American Psychiatric Association. (2013). Cultural formulation. In Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: Author.
  3. Bernal, G., & Domenech Rodríguez, M. M. (2012). Cultural adaptations: Tools for evidence-based practice with diverse populations. American Psychological Association.
  4. Bhugra, D., & Becker, M. A. (2005). Migration, cultural bereavement and cultural identity. World Psychiatry, 4(1), 18–24.
  5. Díaz, E., Añez, L. M., Silva, M., Paris, M., & Davidson, L. (2017). Using the cultural formulation interview to build culturally sensitive services. Psychiatric Services, 68(2), 112–114.
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  7. Hinton, D. E., & Lewis-Fernández, R. (2011). The cross-cultural validity of posttraumatic stress disorder: Implications for DSM-5. Depression and Anxiety, 28(9), 783–801.
  8. Hofmann, S. G., Asnaani, A., Vonk, I. J., Sawyer, A. T., & Fang, A. (2012). The efficacy of cognitive behavioral therapy: A review of meta-analyses. Cognitive Therapy and Research, 36(5), 427–440.
  9. Kirmayer, L. J. (2012). Cultural competence and evidence-based practice in mental health: Epistemic communities and the politics of pluralism. Social Science & Medicine, 75(2), 249–256.
  10. Spitzer, R. L., Kroenke, K., Williams, J. B. W., & Löwe, B. (2006). A brief measure for assessing generalized anxiety disorder: The GAD-7. Archives of Internal Medicine, 166(10), 1092–1097.
  11. Morrison, J. (2014). Diagnosis made easier (2nd ed.). Guilford Press.

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