Person-Centered Cultural Assessment Can Improve Child Mental Health Service Engagement and Outcomes

Amanda L. Sanchez, Jason Jent, Neil Krishan Aggarwal, Denise Chavira, Stefany Coxe, Dainelys Garcia, Martin La Roche, Jonathan S. Comer

Research output: Contribution to journalArticlepeer-review

1 Scopus citations


Objective: Disparities in child mental health service engagement suggest traditional evidence-based practices do not properly consider cultural and contextual factors relevant for marginalized families. We propose a person-centered approach to improve the cultural responsiveness of services. Preliminary research supports broadening standard assessments to include a person-centered evaluation of patient cultural factors, however, controlled studies have not been conducted in the context of children’s mental health care. Methods: Participants included families (N = 89; 89% racial/ethnic minority) receiving services for child externalizing problems. Prior to intake, caregivers were randomized to receive either Assessment as Usual (AAU) or AAU augmented with the Cultural Formulation Interview (CFI+AAU), a brief caregiver assessment of cultural factors affecting their child’s problems and family help-seeking. Results: Implementation data showed strong provider fidelity and clinical utility. Following assessments, CFI+AAU caregivers (relative to AAU caregivers) reported feeling better understood by their provider, and providers reported better understanding CFI+AAU families’ values. Caregiver satisfaction was rated highly overall, yet providers reported being more satisfied with the assessment when the CFI was incorporated. Engagement outcomes found CFI+AAU families were significantly more likely than AAU families to subsequently complete the first phase of treatment. Further, among families receiving services in Spanish, CFI+AAU, relative to AAU, was associated with significantly higher treatment attendance, homework completion, and treatment response. Conclusions: The results underscore the utility of incorporating a brief cultural assessment in pretreatment assessments. To improve the cultural responsiveness of services, efforts may do well to promote the uptake of person-centered approaches such as cultural assessment into usual care. Registered at (NCT03499600).

Original languageEnglish (US)
JournalJournal of Clinical Child and Adolescent Psychology
StateAccepted/In press - 2021

ASJC Scopus subject areas

  • Developmental and Educational Psychology
  • Clinical Psychology


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