Plenary 4

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For the past three issues of ACLP News we have announced plenaries one to three at the virtual CLP 2021 in November. In plenary four, we will learn about…

Cultural Concepts of Distress

from program chair, Lisa J. Rosenthal, MD, FACLP

Presenter Roberto Lewis-Fernández, MDprofessor of Clinical Psychiatry at Columbia University, director of the New York State Center of Excellence for Cultural Competence and the Hispanic Treatment Program, and co-director of the Anxiety Disorder Clinic, at NYS Psychiatric Institute—will take us on a journey through methods for individual cultural assessments and how to apply this data clinically to help overcome patient-provider discrepancies in illness representations and treatment expectations.

Roberto Lewis-Fernández, MD
Roberto Lewis-Fernández, MD

Individual illness experience is always understood within cultural frameworks that are learned, embodied, and reinterpreted,” he says. “These frameworks are diverse, emerging from the various social groups that shape a person’s intersectional identity.”

Cultural concepts of distress are key elements of these frameworks; DSM-5 defines these concepts as “ways that cultural groups experience, understand, and communicate suffering, behavioral problems, or troubling thoughts and emotions.”

Typically, cultural concepts of distress cut across biomedical dichotomies of mind-body, or even health-disease, and frequently invoke spiritual or supernatural etiologies or mechanisms.

“Clinically, it can be challenging to translate between patients’ cultural concepts of distress and professional nosologies and therapeutics,” says Dr. Lewis-Fernández.

His presentation will explore the construct of cultural concepts of distress and how to evoke these aspects of experience using the DSM-5 Cultural Formulation Interview, a 16-item, semi-structured protocol to individualize cultural assessment. Eliciting culture-focused information from patients and families can help clarify their illness representations and expectations of care in order to orient diagnosis, treatment planning, and engagement strategies.


Dr. Lewis-Fernández’s research focuses on developing culturally valid interventions and instruments to enhance patient engagement, reduce misdiagnosis, and help overcome disparities in the care of under-served cultural groups. He also studies how culture affects individuals’ experience of mental disorder and their help-seeking expectations, including how to explore this cultural variation during the psychiatric evaluation. 

He has been PI or co-Investigator of 25 National Institutes of Health-funded studies focused on enhancing cultural aspects of care for diverse under-served populations and has led the development of the DSM-5 Cultural Formulation Interview, a standardized method for cultural assessment for use in mental health practice.

Dr. Lewis-Fernández has published more than 200 articles, editorials, commentaries, books, and book chapters on the topic of culture and mental health. He is president of the World Association of Cultural Psychiatry, chair of the Cultural Committee of the Group for the Advancement of Psychiatry, immediate past-president of the Society for the Study of Psychiatry and Culture, 2nd vice-president of the American Psychopathological Association, and past-president of the American Society of Hispanic Psychiatry. He chairs the DSM Review Committee for Internalizing Disorders and the DSM-5-TR Culture-Related Issues Committee, and co-chairs the ICD-11 Working Group on Culture-Related Issues.

See this issue: Your Chance to Influence the Framing of ACLP’s Position Statement on Delirium‘This is one session you won’t want to miss’

And: ‘I Shall Always Be Proud to have been Part of That Team’How the Phoenix annual meeting rose from the ashes


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