Using Cultural Formulations to Enhance Adolescent Assessment and Psychotherapy
Treniece Lewis Harris
Affiliation: Cambridge Health Alliance/Harvard Medical School, Macht Building, Room 330, 1493 Cambridge Street, Cambridge, MA 02139, USA.
Keywords: Adolescent psychotherapy, alliance building, case formulation, culture, cultural transference, explanations of
illness, identity development.
Case formulation that incorporates cultural factors is an important clinical tool for use in initial and ongoing
treatment with adolescents. Providing culturally-responsive psychotherapy to adolescents requires the therapist to
understand the complex cultural context in which adolescents live. Adolescent identity development and psychological
functioning are influenced by an evolving matrix of social identities (race, ethnicity, sexual orientation, spirituality etc.)
that may shift and change at each stage of the teen’s developmental life as well as within different contexts. This paper
will compare and contrast the DSM-IV-TR Outline for Cultural Formulation with the ADDRESSING and RESPECTFUL
mnemonic models of cultural formulation in the evaluation and treatment of teenagers. Case examples will illustrate how
each model may be used to create a synopsis of the patient’s experience in cultural context as well as how they are used to
conceptualize change over time. The case examples will highlight the utility of cultural formulations in alliance building,
in understanding the patient and parents’ explanations of illness as well as in examining cultural transference issues in
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