Columbia University, NY, USA.
Transcult Psychiatry. 2012 Feb;49(1):121-39. doi: 10.1177/1363461511433144. Epub 2012 Jan 4.
Most case studies of the cultural formulation have focused on encounters with a single clinician. This article examines the assessment of a patient across different settings in which multiple clinicians developed separate understandings of the patient's identity. The formal cultural formulation prepared by the last clinician to work with the patient revealed a vastly different picture than what was previously recognized, reflecting both the impact of the identity of the clinician and the systematic evaluation process on the nature of the patient's responses. This suggests that cultural hybridity can stimulate new modes of inquiry as people integrate disparate cultural references to fashion a new identity. Intersubjectivity can also alter information elicited by clinicians. The conclusion highlights the need for practice guidelines for use of the cultural formulation across treatment settings.
大多数文化构念的案例研究都集中在与单个临床医生的接触上。本文考察了在多个临床医生对患者身份形成不同理解的不同环境中对患者的评估。最后一位与患者合作的临床医生准备的正式文化构念揭示了与之前所认识的截然不同的情况，这既反映了临床医生身份的影响，也反映了系统评估过程对患者反应性质的影响。这表明，文化混合可以刺激新的探究模式，因为人们整合不同的文化参考来塑造新的身份。主体间性也可以改变临床医生引出的信息。结论强调了在治疗环境中使用文化构念的实践指南的必要性。
