Case Study
Patient Demographic: Client Age: 22 Sex: Male Gender: Male Sexuality: Homosexual Ethnicity: Latino American Relationship Status: Single Counseling Setting: Community Mental Health Center Type of Counseling: Individual Presenting Problem: Depression Diagnosis: Major Depressive Disorder, Moderate
Mental Status Exam: Mental Status Exam: The client is pleasant and dressed in age-appropriate attire. He is tearful when discussing his family and states this has been difficult for him. The client has had no previous suicide attempts. He is observed biting his nails. He describes feeling sad daily and states he sleeps during the day because he cannot sleep at night. He is slightly underweight but denied any difficulties with appetite. The client’s speech is coherent and clear. He denies suicidal ideation but often questions his worth and purpose. Fam
Presenting Problem: You are providing counseling services at a Community Mental Health Center. A 22-year-old Latino male, accompanied by his aunt, presents with symptoms of depression. The aunt is concerned about the client’s social isolation, feelings of hopelessness, and excessive daytime sleeping. Four months ago, the client’s parents kicked him out of their home after discovering a suggestive social media post of him with another male. He is close with his aunt and uncle, who have allowed him to stay in their basement. The client’s father refuses to speak to him and has told him he is “less than a man” and an embarrassment to the family. The client’s symptoms worsened last month when he was laid off from his job as a server.
Other Contexts: The client displays a blunted affect and remains pleasant and cooperative. He reports that he did apply for a few jobs, but it has been difficult due to his past experiences of workplace harassment and discrimination. He is socializing more frequently, primarily at LGBTQ-friendly bars and clubs. The client states he used to go to the gym daily and has recently started going some on the weekends. He explains that he has felt less depressed but remains poorly motivated. He denies suicidal ideation. The client is unsure how to prioritize goals for treatment.  You conduct a DSM-5-TR Cultural Formulation Interview (CFI) with the client

(A): To establish a means for incorporating cultural considerations and clinical symptoms as the sole basis for making an accurate DSM-5-TR clinical diagnosis
(B): To provide culturally specific guidelines to assist with determining the client’s readiness and motivation to change
(C): To enhance clinical understanding of the client’s cultural identity and the cultural definition of the identified problem
(D): To help determine if the client is open to working with a culturally different counselor

Correct Answer: To enhance clinical understanding of the client’s cultural identity and the cultural definition of the identified problem
Explanation: The benefits of using the DSM-5-TR CFI would be to enhance clinical understanding of the client’s cultural identity and the cultural definition of the identified problem. The APA developed the CFI as a holistic, person-centered approach to better understand the influence of cultural identity on the client’s clinical presentation and treatment. The CFI is a 16-question interview that covers four domains of assessment: cultural definition of the problem (questions 1–3); cultural perceptions of cause, context, and support (questions 4–10); cultural factors affecting self-coping and past help seeking (questions 11–13); and cultural factors affecting current help seeking (questions 14–16). The CFI is not to be used as the sole basis for determining a diagnosis. Although use of the CFI may help determine the client’s readiness and motivation to change, this is not the primary purpose of the interview. Determining if the client is open to working with a culturally different counselor is not the intended purpose of the CFI. Therefore, the correct answer is (D)
Competency: counseling skills and interventions