Efficacy pilot study of the DSM-5 Cultural Formulation Interview in a specialized mental healthcare inpatient unit for adolescents in Norway

Background: The DSM-5 core Cultural Formulation Interview (CFI) is designed with the agenda of letting the patient's perspective become as important for treatment and care as the clinician's assessments. This is in line with the person-centered turn in every part of the health care system in Norway. However, international CFI research on majority populations and on adolescents remains scarce. This study is the first to test the feasibility, acceptability, and clinical utility of core CFI with adolescents in a specialized mental healthcare inpatient unit in Norway. Methods: The study used a mixed methods design with three stages, inspired by and expanding the CFI testing research in the United States: 1) Cultural analysis of the clinical context and CFI training, 2) Data gathering with CFI interviews, debriefing instruments, and semi-structured interviews with six consecutive adolescents (aged 14-17 years) with various severe mental health problems, and multi-method data gathering with three interdisciplinary CFI-trained clinicians, and 3) Efficacy evaluation of the CFI. Results: Adolescents and clinicians reported positive perceptions of the CFI's feasibility, acceptability, and clinical utility. The CFI supported service user involvement and treatment planning, consistent with international evidence. Both patients and clinicians described the CFI as a type of intervention that initiated a process of reflection and deeper understanding of challenges as well as resources, with patients expecting their narratives to be understood, shared, and integrated into treatment planning. Conclusion: This study contributes to person-centered care (PCC) research by underscoring the importance of actively involving adolescents in their treatment processes. Based on these findings, the clinic initiated a request to evaluate the integration of the CFI process (core interview and use of this information in treatment planning) into standard treatment protocols through an implementation study, which is currently underway.