The following nine stages will be followed at each of the clinical sites:
Stage 1: An initial inventory of instruments, measures, and process guidelines currently used at the clinic Method: Text analysis of planning and process documents, instruments and measures analysis for culture-related, person-centered robing, as well as analysis of cultural environment at each clinical site.
Stage 2: An initial interview with participating staff and directors to discuss the current system and its incorporation. Method: Semi-structured interview, audio-recorded, based on findings in stage 1.
Stage 3: Training with clinical staff in CFI method. Method: CFI training in Norway is under development through a national network in Norway, based at the Innlandet Hospital Trust, and in cooperation with the CFI international mental health center based in New York under direction of Professor Roberto Lewis-Fernández.
Stage 4: Clinical staff conducts CFI interviews with patients, audio-recorded. Method: Debriefing Instrument for patients (DIP) after completion of the CFI interview and Debriefing Instrument for clinicians (DIC) and debriefing with clinical staff after initial interview (Axelsson et al., 2020) .
Stage 5: Transcribing and analysis of CFI interviews. Method: Content analysis of all interviews through established methods. Content analysis is a systematic, objective method to describe and quantify phenomena through replicable, valid inferences from data to context (Krippendorff, 2013).
Stage 6: Semi-structured interviews with staff clinicians and patients to assess the Medical Communication areas in relation to the CFI, audio-recorded.
6a). Individual Interviews with clinical staff on interview process and interview content. Method: CFI initial assessment semi-structured interview.
6b). Two individual interviews with patients on interview process and interview content, the first 4-7 days after the CFI interview and the second in the final week of the treatment. Method: CFI initial assessment semi-structured interview
Stage 7: Monitoring of use of CFI information in Treatment Process and Efficacy evaluation for each patient case. Method: Case assessment: 1. Analysis of clinical staff notes, 2, CFI efficacy assessment with attention to feasibility, acceptability, and clinical utility with same semi-structured interview focused on actual use of information gained from CFI in therapeutic case application. Analysis: Content analysis of each case (see Step 5) in relation to assessment of CFI information’s efficacy (feasibility, acceptability, and clinical utility) in relation to actual application in treatment and coordinated therapeutic activities in relation to the categories and sub-categories of the Medical Communication Framework.
Stage 8: Group processing with clinical staff on Efficacy assessment for CFI based on Stage 7 results. Method: Audio-recording of group discussion. Analysis: The efficacy findings of Stage 7 will be augmented with information from group discussion. Both deductive and inductive analyses.
Stage 9: Final group meeting with clinical staff and directors to discuss project findings and CFI inclusion, as whole instrument or specific parts in clinic's process. Method: Audio-recording of group discussion. Both deductive and inductive analyses.