Case Study
Patient Demographic: Client Age: 26 Sex: Male Gender: Male Sexuality: Heterosexual Ethnicity: African American Relationship Status: Single Counseling Setting: Community Mental Health Center Type of Counseling: Individual Presenting Problem: Depressive Symptoms Diagnosis: Persistent Depressive Disorder (PDD) (Dysthymia) Diagnostic Criteria 300.4 (F34.1)
Mental Status Exam: Mental Status Exam: The client is dressed in age-appropriate clothing and is well groomed. His affect is blunted and anxious at times. The client denies anxiety but discloses that he is nervous about the counseling process and doesn’t know what to expect. He is cooperative but hesitant to offer more information than is asked. The client is tearful when discussing his breakup and states that there are days when it is a struggle to get out of bed and go to work. He denies suicidal ideation, and he says that he has had no previous attempts. The client is oriented to person, place, time, and situation, and his thought content is organized. Fam
Presenting Problem: You are a counselor working in a community mental health center. Your initial intake appointment is with a 26-year-old African American male who presents with symptoms of depression. The client states that he has felt depressed since his teens, with symptoms increasing within the last couple of months. He reports feelings of worthlessness, fatigue, and occasional bouts of insomnia. In addition, the client indicates that his symptoms worsened after his girlfriend of 2 years broke things off with him. He explained that she grew tired of his low energy and pessimistic outlook on life. As a result, he has been hesitant to seek help, believing that he just needed to “man up” and handle his problems privately. The client is unsure of his insurance benefits but thinks his policy allows for a limited number of counseling sessions.
Other Contexts:    ily and Work History: The client grew up in a home with his mother, father, and maternal grandmother. He has a 22-year-old sister who he believes also experiences depression, but he is unsure if she has received treatment. The client says that he attends church “most Sundays” with his family, primarily because he knows it is important to his grandmother. The client holds an associate degree in information technology and is a computer network support specialist. He has worked for the same company for the past 4 years

Question: Considering the client’s hesitancy to participate in counseling, which of the following instruments would you select to better understand his help-seeking behaviors?
(A): Ethnic-Sensitive Inventory (ESI)
(B): Munroe Multicultural Attitude Scale Questionnaire (MASQUE)
(C): Iowa Cultural Understanding Assessment—Client Form
(D): Cultural Formulation Interview (CFI)

Correct Answer: Cultural Formulation Interview (CFI)
Explanation: Developed for the DSM-5-TR, the CFI is a tool used to collect culturally relevant information related to the client’s current and past help-seeking behaviors, coping skills, treatment expectations, and other relevant socially and culturally contextualized factors (Lewis-Fernandez et al, 2020). The Ethnic-Sensitive Inventory (ESI) is a self-assessment questionnaire for counselors and related practitioners that measures counselor-client interactions in four phases of counseling (ie, from precontact to termination). The Munroe Multicultural Attitude Scale Questionnaire (MASQUE) is a tool that measures multicultural knowledge, care, and active experiences among students attending secondary educational institutions (Monroe & Pearson, 2006). Finally, the Iowa Cultural Understanding Assessment—Client Form is a questionnaire intended to provide feedback on culturally responsive care for clinical and program services. Therefore, the correct answer is (B)
Competency: intake, assessment, and diagnosis