across individuals and settings. A comprehens ive assessment may include place of birth,
age, gender, racial/ethnic origin, marital stat us, family composition,  education, language
fluencies, sexual orientation, religious or sp iritual affiliation, occupation, employment, in-
come, and migration history.
The CFI can be used in the initial assessment of individuals in all clinical settings, regard-
less of the cultural background of the individual or of the clinician. Individuals and clini-
cians who appear to share the same cultural background may nevertheless differ in ways
that are relevant to care. The CFI may be used in its entirety, or components may be incor-
porated into a clinical evaluation as needed. The CFI may be es pecially helpful when there is
• Difficulty in diagnostic assessment owing to  significant differences in the cultural, re-
ligious, or socioeconomi c backgrounds of clinician and the individual.
• Uncertainty about the fit between culturally distinctive symptoms and diagnostic criteria.
• Difficulty in judging illness severity or impairment.
• Disagreement between the individual an d clinician on the course of care.
• Limited engagement in and adherenc e to treatment by the individual.
The CFI emphasizes four domains of assessmen t: Cultural Definition of the Problem
(questions 1–3); Cultural Perceptions of Caus e, Context, and Support (questions 4–10); Cul-
tural Factors Affecting Self-Coping and Past Help Seeking (questions 11–13); and Cultural
Factors Affecting Current Help Seeking (questions 14–16). Both the person-centered process
of conducting the CFI and the information it el icits are intended to enhance the cultural va-
lidity of diagnostic assessmen t, facilitate treatment planning , and promote the individual’s