Term paper/ Treatise etc.
Submitted as a partial fulfilment for the Degree
of
B.A. (Hons.) Applied Psychology
Submitted By: Ananya Sapra Supervisor: Dr.
Siddharth Soni
B.A. (Hons.) Applied Psychology Enrolment No, : A1506920557
AMITY INSTITUTE OF PSYCHOLOGY AND ALLIED SCIENCES
Amity University Uttar Pradesh, Noida
2022
OVERVIEW OF THE CLINIC
The organization is Founded by Ms. Samiksha Jain, A psychologist at AAM ADMI SCHOOL HEALTH
CLINIC (Government of NCT of Delhi) and a visiting Faculty at Amity University Noida. She is also a
Research Supervisor at IGNOU University, and Editor of Rivista Journal. She was Gold Medalist in MA
Clinical Psychology. She has completed her BA Psychology from DU, and MA clinical Psychology from
Amity University. She is also a certified Career Counselor, signature Analysts, CBT practitioner,
number analysts.
The mission of our organization is to provide more and more awareness to the people of the country
in order to make the idea of mental health more and more common among everyone. We want
people to recognize the idea of mental health to be as important as that of physical health.
We aim to provide mental health services to individuals who are in need.
The organization has a horizon that it looks toward and gives a framework of how mental health and
its view toward Psychology as a field of study is. The main framework of the organization is designed
in a way to bring about change in the way everyone looks at mental health. The basis of the
organization creates a more and more room for everyone to bring about change by providing
training to students& professionals and giving the right guidance to those who need it.
We were given a lot of tasks and new experience in the 90 hours internship which included
numerous amount of new things.
Starting with the Rapport Building with the client to teaching us how to conduct tests like CIS and
DBDA.
We were also taught about the happiness wheel, which has 10 elements in it and we had to rate the
happiness level of each element from the scale of 0-10.
Description of the tasks undertaken
My experience as an intern was a combination of both learning and performing tasks. I
learned a lot through role plays and presentations and learned basics of counselling, skills of a
counsellor, evolutions of self and some aspects of narrative therapy. The major components
of therapy like rapport formation, counselling skills and the role of assessment was taught by
Samiksha ma’am. Anxiety Disorders, Substance Use Disorders and Etiology of Disorders and
their treatments were taught by her.
Alongside, I learned more about different psychological assessments including Thematic
Apperception Test (TAT), David’s Battery of Differential Abilities (DBDA), I was also
taught about the Wheel of Happiness. I performed the scoring of two of these tests which
were DBDA and CIS. I was also given a detailed description about many psychological
disorders including phobias, sleeping disorders, anxiety disorder. I also got to know more
about career counselling and the conflicts related to it The most exciting part of my internship
was observing the clients both under a psychologist.
CASE STUDY 1
DEMOGRAPHIC DETAILS
Name: M.S.
Sex: Male
Age: 22 years
Marital Status: Unmarried
Occupation: Unemployed
Religion: Sikh
Mother Tongue: Hindi
Education: 10th standard
Residence: New Delhi
Income Monthly: Rs. 8,000/month
Source of Referral:
Number of sessions:
CHIEF COMPLAINTS
Decreased speech
Stay alone and does not interact with anyone
6 years
Slowed motor activity
SPECIFIERS
Duration: 6 Years
Onset: Sudden
Course: Episodic
Progress: Continous
Precipitating factors: Father’s death
HISTORY OF PRESENT ILLNESS
The patient was apparently maintaining well up to five to six years back, when after the death of this
Father, the family members noticed that he would keep to himself, would not interact much with
them, And not concentrate on his studies. He would be seen wandering about, muttering to self,
and many a Times he would sit in one position without blinking and staring in one direction. When
these symptoms Increased, the family members bought him to this institute for management. The
patient had been Admitted for the past one month diagnosed with undifferentiated schizophrenia
with catatonic Symptoms. Though the catatonic signs and the hallucinatory behavior had resolved,
it was observed that The patient would not interact with anybody in the ward, and would speak
extremely softly. He hardly Smiled, or greeted the doctor. Keeping these prominent negative
symptoms in view, he was referred for Psychosocial management.
NEGATIVE HISTORY
No history of organicity, elated mood, or depressive symptoms.
CONCURRENT MEDICAL HISTORY
None
PAST MEDICAL HISTORY
Herpes at the age of 16 years
PAST PSYCHIATRIC HISTORY
None
FORENSIC HISTORY
Had a physical fight with a neighbor, few years ago, ended up hitting him impulsively. Client was
around
18 years of age that time.
FAMILY HISTORY
Family history revealed depressive disorder in mother, and younger brother has mental retardation.
Family is reported to be low in cohesiveness, and high in Expressed Emotion
PERSONAL HISTORY
Birth and Developmental history was non-significant. Academically he was reported to be below
average
Throughout his student life. The client was reported to introverted as a child, and did not take much
Interest in extra curricular activities.
PRE-MORBID PERSONALITY
The client was reported to be shy and introvert by his Brother.
MENTAL STATUS EXAMINATION
The client appeared to be older than his stated age, was dishevelled, and had a stooped posture. Eye
to
Eye contact was absent, psychomotor activity was low and speech was soft and slow. Subjectively
Reported to be ok. Affect was flat, and non-communicable. Thought process was linear, but thought
Blocking present. The client was awake but appeared confused at times. The client was oriented to
person But not to place and time. Attention and concentration poor. Short -term memory was
impaired, remote Memory intact. Was unable to perform on abstraction and similarities, fund of
general knowledge was Poor. Overall higher mental functions were impaired. Personal and social
judgement was found to be Impaired. Insight Grade 2.
PROVISIONAL DIAGNOSIS
Schizophrenia
CASE STUDY 2
SOCIO-DEMOGRAPHIC DATA:
Name: V. S.
Age: 19 years
Sex:Female
Domicile: Urban
Occupation: Student, IInd year Graduation
Marital status: Unmarried
Religion: Hindu
Socio-economic status: Middle socio economic status
REFERRAL:
Psychotherapeutic Intervention
INFORMANTS
Self, Mother, and Brother
PRESENTING COMPLAINTS
• Headache
• Body ache
• Decreased sleep
• Sadness
• Fainting spells
• Anger outbursts
SPECIFIERS
Duration: 1 year
Onset: Insidious
Course: Continuous
Progress: Deteriorating
Precipitating factors: Sexual Abuse
HISTORY OF PRESENT ILLNESS
The client reported of intense headache about four years back, after her 12th standard examination.
Though she sought treatment from various doctors the headache still persisted. She also reported
being Tensed about her results during this period. Her family members took her to a faith healer,
who on the Pretext of curing her headache raped her twice. She did not report this incident to
anybody at home, but Refused to go to that faith healer again. She would feel very angry towards
her family members, however Did not share this with anybody. Following this incident, she started
to have frequent body ache. She Would remain sad most of the time, would get easily irritated,
preferred to lie down and remained Withdrawn. She was reported to have decreased interest in her
studies and household chores, and Stopped attending school. Since last two years she has been
having episodes of unresponsiveness that .Continue for about 15-20 minutes, these episodes are
usually preceded by headache. There has also been .A history of suicide threats and intentional self-
harm that do not seem to be motivated by a desire to end Life and rather appear to be manipulative
in nature. Most of the time she utilizes these above behavior to Get her demands fulfilled. Before
therapy started the client was being treated with antidepressants and Antianxiolytics since about
three-four months.
NEGATIVE HISTORY
No history of organicity, persistent pervasive elated mood, muttering, smiling, gesticulating to self.
CONCURRENT MEDICAL HISTORY
None
PAST MEDICAL HISTORY
None
PAST PSYCHIATRIC HISTORY
None
FORENSIC HISTORY
None
FAMILY HISTORY
Youngest of five siblings, the client has three elder sisters who are married. Her elder brother is
doing
Graduation. Her Father works in a private firm and mother is a full time homemaker. There was no
history Of any mental illness in the family.
PERSONAL HISTORY
Client’s birth and developmental history was uneventful. As a child, the client was reported to be
Pampered by her family, and they met all her reasonable and unreasonable demands. She
performed at An above average level up to 10th standard, however there was a significant decline in
her performance in 11th standard when she opted for science stream and was unable to cope with it.
During her adolescent . Interaction with her friends or talking with boys. They felt that this might
bring bad mane to family. The Client found this change difficult to adjust to as she was not used to
any restrictions and felt that parents Did not trust her.
PRE-MORBID PERSONALITY
Pre-morbidly the client was described as being an introvert, quiet, hardworking but a headstrong
Individual, who would get upset with minor issues, disagreements or rejection.
MENTAL STATUS EXAMINATION
General Appearance &Behavior:
• Appearance: well kempt
• Eye Contact: Adequate
• Rapport: Easy
• Attitude Towards Examiner: Friendly
Speech:
• Intensity / Tone: Average
• Reaction Time to Stimulus: Appropriate
• Speed: Normal
• Prosody / Tempo: Monotonous
• Ease of Speech: Normal
• Productivity / Volume: Adequate
• Coherent
• Goal Directed
Mood / Affect:
• Subjectively: sad and helpless
• Objectively: Anxious
• Congruent to the Thought
• Appropriate
• Communicable
Thought:
• Stream- Adequate
• Form- Adequate
• Content- helplessness, sadness
Perception:
No perceptual abnormalities elicited
Cognitive Functions:
• Orientation: Well oriented
• Attention & Concentration: Sustained
Judgement- Intact
Insight – Grade 2
PROVISIONAL DIAGNOSIS
Dissociative Disorder
ASSESSED AND REPORTED BY
CASE STUDY 3
SOCIO-DEMOGRAPHIC DATA:
Name: M. M.
Gender: F
Age: 21 years
Date: 18/12/2019
Marital Status: Unmarried
Mother Tongue: Hindi
Education: Undergraduate
Occupation: Student
Religion: NA
Residence: NA
Family Type: Nuclear family
Income: NA
Number of Family Members: 5
REFERRAL:
Source of referral: Self
Reasons for referral: Psychotherapeutic Management
INFORMANTS
Informant is client herself and mother. Information provided was reliable, adequate and consistent.
PRESENTING COMPLAINTS
According to client
• Sadness
• Feelings of numbness
• Headaches with frequency of several times a week lasting more than 20 minutes each
• Loss of interest in daily activities
• Crying repeatedly
According to informant (Mother)
• Increased irritability
• Increased crying
• Agitated
• Tendency to stay alone
• Decreased appetite and increased sleep
SPECIFIERS
Duration: 6 months
Onset: Sudden
Course: Episodic
Progress: Improving
Precipitating factors: Not being elected for college society elections
HISTORY OF PRESENT ILLNESS
Client seemed to be functioning normally until a year back until she started to feel sad and numb all
of a Sudden. The symptoms started when she lost her College Society elections. Prior to the
elections, most of her friends, as well herself anticipated that the client would be selected as
president. However, she lost the election by a significant margin. Following this incident, she started
to remain aloof, withdrawn in college. She lost interest in her daily activities, started to miss college
frequently, and stopped interacting with her friends in college. She reported having concentration
difficulties and was often bothered by negative thoughts about her past and her family. She reported
that she felt worthless during this time and was unable to go about her daily routine due to frequent
crying and headaches. She started to sleep up to 10-11 hours in a day. Her appetite furthered
decreased and she lost significant amount of weight.
She stopped attending her College Society duties, and the above symptoms also started to affect her
relationship with her boyfriend and her family members. She reported that she often remained
irritable and would become agitated if anyone tried to explain her something or tried telling her that
she should try to resume her normal functioning. Her mother reported that client used to cry a lot.
She also reported finding it difficult to wake up in the morning and feeling highly nauseous.
She also reported that she had thoughts of hurting herself and often wished that she was dead. This
prompted her to speak with her mother and her ex-school counsellor with whom she took sessions
for 3 weeks. Simultaneously she tried to engage herself in music to get her mind off things but it did
not help much as her symptoms intensified. She started to take her psychiatric medication around
his time, however had to discontinue due to the side -effects she experienced. Meanwhile she broke
up with her boyfriend. This further intensified her difficulties.
Negative history
No history of organicity, persistent pervasive elated mood, muttering, smiling, gesticulating to self.
Concurrent Medical History
Celiac Disease
Past Medical History
Not significant
Past Psychiatric History
At the age of 10 years, the client had a history of school refusal and anxiety. Psychiatric consultation
was
sought upon which a diagnosis of Obsessive-Compulsive Disorder with Depressive Symptoms was
made. She received pharmacological treatment for a period of 2 years. As per the client, the
precipitating factor for then symptoms was physical abuse by her Mother who was undergoing a
Depressive episode during that time.
At the age of 15 years, client had an episode characterized by persistent pervasive sad mood, crying
spells, decreased sleep and appetite, concentration difficulties. She made a suicidal attempt which
was deemed to be high in intentionality and lethality. Pharmacological treatment was again sought.
A diagnosis of Depressive Disorder was made. She took counselling sessions with the School
Counselor as well. She discontinued medication after 2 months due to side-effects. The episode
lasted for an year.
Precipitating factor for the episode could not be identified.
Forensic History
None
Family History
Consanguinity between parents: No
Family tree: Nuclear family with Mother (teacher), Father (businessman) and younger brother (13
years)
Father – History of ?Obsessive compulsive symptoms
Mother- Anxiety and depressive features
Father’s elder brother - depression and alcohol abuse, psychiatric treatment sought.
Family Interaction Pattern: Conflictual relationships b/w father and mother, keep verbally fighting,
disagreements, her relationship with mother is especially conflictual, and does not feel close to the
mother
Communication – is more with the mother and less with the father
Leadership – Mother is the leader, financial leader is Father
Decision making - Father (financial) and Mother(household and children)
Role of client – passive doesn’t take part
Family Rituals – poor and low, everyone eats in their own room and alone
Cohesiveness – very low
Family burden – Grandmother lives with the family
Expressed Emotions –Hostility, criticism, lack of warmth
Personal History
Birth and Developmental History:
No significant pre or post-natal problems, no significant developmental problems
Middle childhood:
The client reported that she used to top her class till Grade 4. From 5th onwards as competition
increased; she started to score average. Peer relationships were satisfactory. Was subjected to
physical
abuse by Mother often. She was reported to be active in extra-curricular activities during this time.
Adolescence:
Menarche achieved at 13 years. Soon after that during the episode of Depression, she lost interest in
studies by Grade 9. However still went on to perform competently in Grade 10 and 12. Secured
above
95% in Grade 12 (however client and her family remained dissatisfied with the academic
performance)
Early Adulthood:
She is currently in Final year of her Graduation. Academically reported to be average. Peer and
family relationships reported to be conflictual. Got sexually active at the age of 19 years. She learns
Western Music and has given multiple public musical performances.
Pre-Morbid Personality:
Attitude towards self- competitive, set own standards, generally negative, lacked confidence
Moral & Religious attitudes and standards- practicing Buddhism
Work and Leisure- singing, derived pleasure from activities
Mood- fine
Fantasy Life- did not explore
PROVISIONAL DIAGNOSIS
Recurrent Depressive Disorder, current episode moderate, without somatic syndrome and without
psychotic symptoms
Assessed and Reported by:
ANALYSIS OF THE SKILLS ACQUIRED
Using the knowledge you receive in the classroom in a
professional setting, internships enable you to expand your
education from an abstract to an applied perspective. . This
internship will helped me gain more career options, like being a
psychologist or a counselor, if you choose to pursue that path in the
future . It helped me with market knowledge is important before you
enter the corporate world. Through the internship, i gained marketable
knowledge and get a better understanding of industries and different
fields. As an intern in psychology, I was able to interact with
professionals and develop professional skills. This internship helped with
contacting clients and consulting them about their ailments, medications,
and tests. I was able to develop my communication skills, as well as how
to contact clients and deal with them. Well, good listening skills are
needed in almost all jobs and internship for psychology students. But,
psychologists have to deal with people who are suffering from crisis and
are not in a position to explain their situations nicely. In this case, not
only psychologist will have to constantly pester them with questions but
also record everything they utter for proper diagnosis. I learned that to
be a good therapist one really needs to have a control over their
emotions and differentiate well between personal and professional life. I
learned that it is not a therapist’s job to make decisions for the client with
indirect cues to help them make further decisions in their life. It was a
novel experience for m e to observe clients under a psychiatrist .
Although psychiatry is not a field I plan going for, but I am glad that
explored a new and different field. It contributed to knowledge. My career
plans haven’t shifted and still plan to grow in the filed of psychology.
After the internship , I am keen to intern at a lot of different places and
learn more. I feel motivated and excited to experience more in the field. I
still need to learn a lot more skills for example , sometimes I feel like
observing people with extreme cases , like that of schizophrenia,
frightenes me.
