SUMMER INTERNSHIP
REPORT
BY
Ms. Shambhavi Tripathi
Under the guidance of
Dr. Lakshmi TK
Internship fulfilled at THE MIND CARE INDIA
Supervised by Dr. Poonam Sharma
Workshop Coordinator: Dr. Deepti Puranik
Summer Internship report
Submitted for the Partial fulfillment of the Degree of Bachelor’s of Science in Clinical
Psychology
Department of Psychology
Amity Institute of Behavioral and Allied Sciences
(AIBAS) AMITY UNIVERSITY MUMBAI
Summer Internship Report: Internship fulfilled at The mind care India.
Name: Shambhavi Tripathi
School: AIBAS
Course: BSc Clinical Psychology
Semester: Second Summer Internship
Coordinator Professor: Dr. Lakshmi TK
Roll number: BSc PSY 19122
DECLARATION
I hereby declare that, this work submitted to Amity Institute of Behavioral and Allied
Sciences,
Amity University, Mumbai, is the record of my original work under supervision of Dr.
Poonam Sharma, Head of Department (AIBAS), Amity Institute of Behavioral and Allied
Sciences, Amity University, Mumbai and this work is submitted towards the partial
fulfillment of requirements for the degree of Bachelor’s of Science -Clinical Psychology,
Amity University, Mumbai.
The results embodied in this report have not been submitted to any other Indian or
foreign university/ institute for award of any other course/degree/diploma.
Date: 01/10/2021 Shambhavi Tripathi
Semester 4 BSc (Clinical Psychology)
Amity University, Mumbai
ACKNOWLEDGMENT
I would like to thank Dr. Poonam Sharma & Dr. Deepti Puranik for their valuable time,
constant support, guidance and advice to help me complete my Summer
Internship report.
I would like to thank Amity University and AIBAS faculty for organizing this workshop and
giving me this opportunity to be a part of it and getting to learn so much as well as for
helping me in completing my report and being there constantly for support. I would also
like to thank for being so welcoming and warm to us and giving us immense knowledge
and helping us to comfortably fulfill this trip successfully. I am thankful to my classmates
and my seniors who were a great support and constantly encouraged and helped me
during this intense summer internship.
Shambhavi Tripathi
Semester 2 BSc PSY 19122
PREFACE
The Summer Internship Report that I submit to you is based on the workshop that was
organized by The Amity Institute of Behavioral and Allied Sciences department at Amity
University, Mumbai. For this workshop we were given an opportunity for online
internship. I chose to do my workshop with
The mind care India and the internship was in the field of counseling psychology. It was
held from 1st July 2021 to 15 July 2021.
During the workshop we focused on topics like:
A) Counseling psychology
B) Psychotherapy treatment
C) Addiction counseling
D) Educational counseling
INTRODUCTION TO THE ORGANIZATION
The Mind Care is the premier Counselling and Psychotherapy center in Chennai. It aims to
assist people to overcome the Emotional barriers or Psychological problems caused by
Stress, Relationship breakdown, Traumas, Lack of self-confidence etc.
With the guidance of an eminent Counsellor and Psychotherapist, a safe, supportive and
confidential environment is provided to the clients to explore the issues which may be at
the root of their problems and develop solutions to bring health and happiness in their
lives.
We follow professional ethics and ensure high degree of confidentiality in our counselling
and therapy sessions.
Treatment for psychological issues, such as Depression, Anxiety, Schizophrenia, Phobia
etc…
Psychotherapy is a way to treat people with any type of mental illness and to make them
understand their problem.
Our techniques are very simple to follow and highly effective. It helps our clients to deal
with their unhealthy thoughts and behaviors and change them to positive.
INTRODUCTION TO COUNSELING PSYCHOLOGY
Counseling psychology is a psychological specialty that encompasses research and applied
work in several broad domains: counseling process and outcome; supervision and
training; career development and counseling; and prevention and health. Some unifying
themes among counseling psychologists include a focus on assets and strengths, person–
environment interactions, educational and career development, brief interactions, and a
focus on intact personalities.
Counseling psychologists are employed in a variety of settings depending on the services
they provide and the client populations they serve. Some are employed in colleges and
universities as teachers, supervisors, researchers, and service providers. Others are
employed in independent practice providing counseling, psychotherapy, assessment, and
consultation services to individuals, couples/families, groups, and organizations.
Additional settings in which counseling psychologists practice include community mental
health centers, Veterans Administration medical centers and other facilities, family
services, health maintenance organizations, rehabilitation agencies, business and
industrial organizations and consulting within firms.
Counseling psychologists are interested in answering a variety of research questions
about counseling process and outcome. Counseling process refers to how or why
counseling happens and progresses. Counseling outcome addresses whether or not
counseling is effective, under what conditions it is effective, and what outcomes are
considered effective—such as symptom reduction, behavior change, or quality of life
improvement. Topics commonly explored in the study of counseling process and outcome
include therapist variables, client variables, the counseling or therapeutic relationship,
cultural variables, process and outcome measurement, mechanisms of change, and
process and outcome research methods. Classic approaches appeared early in the US in
the field of humanistic psychology by Carl Rogers who identified the mission of counseling
interview as “to permit deeper expression that the client would ordinarily allow himself”
SCOPE OF COUNSELING PSYCHOLOGY
The scope for counselors/ counseling psychologists are in schools, work places, mediating
family problems, stress management, mental health units. The scopes for clinical
psychologists are in private practice and hospitals. There is always the added scope of
research and/or teaching in some college/university.
Adolescent identity, concerns, teen-parent relationships, peer relationships.
Anxiety.
Anger management.
Children’s concerns within the family unit, sibling relationships, school experiences, peer
relationships.
Depression.
The Difference Between Counselors and a Counseling Psychologists
Both counselors and psychologists must also be licensed to practice within the state
where they work. To become licensed, counselors and psychologists must meet specific
education, training, and testing criteria established by the state.
The requirements typically include meeting a minimum education level, completing
required supervised experience hours, and passing state certification exams.
Counseling psychologists typically work with clients who have serious mental health
conditions. Clients with emotional, relationship, social, and academic problems, on the
other hand, are often referred to a counselor because these professionals typically offer
more cost-effective treatments.
Counselors and psychologists can both choose to specialize in a particular area, which can
be related to the setting they practice in or the type of clients they work with. Specializing
generally requires additional education, training, and licensure, and may require
research, internships, or fieldwork.
Counselors may choose to focus on a specialty area such as school counseling, career
counseling, marriage and family counseling, mental health counseling, and addiction
counseling.
While counselors and counseling psychologists perform many similar job duties in the
field of mental health, it is important to be aware of the differences between the two
professions. If you are thinking about entering one of these fields, you will need to
determine which one is right for you and adjust your educational plan to meet the
requirements in the state where you intend to practice.
If you are looking for mental health services, talk to your health care provider about the
type of mental health provider who would best meet your needs. For example, if you
need help coping with stress at school or work, a counselor might be able to help. If you
have a mental health condition that requires treatment, you might be referred to a
psychologist or psychiatrist who can manage your care.
The mind care India- Our Counselling Services
1) RELATIONSHIP COUNSELLING
Our effective psychological approach will help couples to understand and identify
behaviours affecting their relationship. Our therapists guide you to enhance healthy
communication, emotional intimacy and trust in your life.
2) INDIVIDUAL COUNSELLING
I therapy is a process through which you work one-on-one with an eminent therapist in a
safe, caring, and confidential environment. Our Psychologist is experienced APA licensed
or certified therapists.
3) MENTAL HEALTH COUNSELLING
We provide effective treatment without medicine for depression, anxiety, PTSD, ADHD,
bipolar disorder, eating disorders, personality disorders, and just about any psychological
issue you can think of.
Mental Status Examination
Client Name : WK Time: Date :
Gender : Male ☐ Female ☐Other
Family History : MK is the fourth child; he has 3 elder sisters and 1 younger sister. His father passed away a
few years ago. MK has three children - a pair of twin boys and a girl.
Parent 1 Parent 2
Name : Father Name : Mother
Age : Age :
Occupation: Occupation:
Alive/dead : Dead Alive/dead: Alive
Brothers Sisters Spouse/ Partner
None - 3 Elder sisters Name :
- 1 Younger sister
Age :
Occupation:
Alive/dead : Alive
Children (If Any): 3 children - a pair of twin boys and a
girl
Medical History: He started having gastric problems Menstrual History : N/A
and irritation in the lower abdominal area 20 years
ago. He damaged his lower oesophageal sphincter
while doing crunches. He also has breathing difficulty
and has to sleep on his back. He also reported to be
having chest tightness and feels muscle spasms. MK Pregnancy History : N/A
has taken a number of tests and
X-rays which have come out normal.
Sleep : Normal Comments:
Appetite : Normal Comments:
Assessment Scores : Beck’s Anxiety Inventory (BAI) – 21 (Moderate Anxiety)
Psychosocial Concerns:
☐Financial Issues ☐Sexual Issues ☐Couple/Family Issues ☐Academic/Job Pressures ☐Addiction
No psychosocial concerns were reported.
Social Relationships: Good
Recreational Activities : None
Obsessive traits (If any) : None
OBSERVATIONS
Appearance: ☐ Normal ☐ Dishevelled ☐ Inappropriate ☐ Bizarre Neat
Speech: Normal ☐ Tangential ☐ Pressured ☐ Impoverished ☐ Other
Eye Contact: Normal ☐ Intense ☐ Avoidant ☐ Other
Motor Activity: Normal ☐ Restless ☐ Tics ☐ Slowed ☐ Other
Affect: Normal ☐Full ☐ Constricted ☐ Flat ☐ Labile ☐ Other
Comments :
MOOD
☐ Euthymic Anxious ☐Angry ☐ Depressed ☐Euphoric ☐Irritable ☐ Other
Comments : Anxious about Irritable Bowel Syndrome (IBS) from past 20 years.
COGNITION
Orientation None ☐Place ☐ Object ☐Person ☐Time
Impairment
Memory Impairment None ☐Short -Term ☐Long-Term ☐Other
Attention Normal ☐Distracted ☐Other
Comments
PERCEPTION
Hallucination None ☐Auditory ☐Visual ☐Other
Other None ☐Derealization ☐Depersonalization
Comments
THOUGHTS
Suicidality None ☐Ideation ☐Plan ☐Intent ☐Self- Harm
Homicidality None ☐Aggressive ☐Intent ☐Plan
Delusions None ☐Grandiose ☐Paranoid ☐Religious ☐Other
Comments
BEHAVIOUR
Cooperative ☐Guarded ☐Hyperactive ☐Agitated ☐Paranoid ☐Stereotyped ☐Aggressive
☐Bizarre ☐Withdrawn ☐Other
Comments :
INSIGHT
Good ☐Fair ☐Poor Comments:
JUDGEMENT
Good ☐Fair ☐Poor Comments:
Diagnosis: The client has been diagnosed to have moderate anxiety regarding his health. The resulting stress
from his anxiety leads to physical pain in his body.
Suggestion:
Follow up sessions:
Mental Status Examination
Client Name : AA Time: Date :
Gender : Male ☐ Female ☐Other
Family History : AA is the third child; he has 2 elder sisters who are married. He is very close to his mother but
does not like his father.
Parent 1 Parent 2
Name : Father Name : Mother
Age : Age :
Occupation: Occupation:
Alive/dead : Alive Alive/dead: Alive
Brothers Sisters Spouse/ Partner
None 2 Elder sisters Name :
(Both married)
Age :
Occupation:
Alive/dead :
Children (If Any):
Medical History: N/A Menstrual History : N/A
Pregnancy History : N/A
Sleep : Normal Comments:
Appetite : Normal Comments:
Assessment Scores : Beck’s Anxiety Inventory (BAI): 16 (Low Anxiety)
Beck’s Depression Inventory (BDI): 20 (Borderline Clinical Depression)
Psychosocial Concerns:
☐Financial Issues ☐Sexual Issues ☐Couple/Family Issues ☐Academic/Job Pressures ☐Addiction
No psychosocial concerns were reported.
Social Relationships: Does not like his father
Recreational Activities : None
Obsessive traits (If any) : None
OBSERVATIONS
Appearance: Normal ☐ Dishevelled ☐ Inappropriate ☐ Bizarre ☐Neat
Speech: Normal ☐ Tangential ☐ Pressured ☐ Impoverished ☐ Other
Eye Contact: Normal ☐ Intense ☐ Avoidant ☐ Other
Motor Activity: Normal ☐ Restless ☐ Tics ☐ Slowed ☐ Other
Affect: Normal ☐Full ☐ Constricted ☐ Flat ☐ Labile ☐ Other
Comments :
MOOD
☐ Euthymic ☐ Anxious ☐Angry ☐ Depressed ☐Euphoric Irritable ☐ Other
Comments : Feeling sad, low and annoyed.
COGNITION
Orientation None ☐Place ☐ Object ☐Person ☐Time
Impairment
Memory Impairment None ☐Short -Term ☐Long-Term ☐Other
Attention Normal ☐Distracted ☐Other
Comments
PERCEPTION
Hallucination None ☐Auditory ☐Visual ☐Other
Other None ☐Derealization ☐Depersonalization
Comments
THOUGHTS
Suicidality None ☐Ideation ☐Plan ☐Intent ☐Self- Harm
Homicidality None ☐Aggressive ☐Intent ☐Plan
Delusions None ☐Grandiose ☐Paranoid ☐Religious ☐Other
Comments
BEHAVIOUR
☐ Cooperative Guarded ☐Hyperactive Agitated ☐Paranoid ☐Stereotyped ☐Aggressive
☐Bizarre ☐Withdrawn ☐Other
Comments : Rigid
INSIGHT
Good ☐Fair ☐Poor Comments:
JUDGEMENT
Good ☐Fair ☐Poor Comments:
Diagnosis: Mild Depression & Low Self-Esteem.
Suggestion:
Follow up sessions:
Mental Status Examination
Client Name : MK Time: Date :
Gender : Male ☐ Female ☐Other
Family History : MK is the second child; he has 1 elder brother. He lives with his brother and his family. His
mother died.
Parent 1 Parent 2
Name : Father Age Name : Mother
: Age :
Occupation: Occupation:
Alive/dead : Alive Alive/dead: Dead
Brothers Sisters Spouse/ Partner
- 1 elder brother None Name :
(Married)
Age :
Occupation:
Alive/dead :
Children (If Any):
Medical History: N/A Menstrual History : N/A
Pregnancy History : N/A
Sleep : Less, disturbed Comments:
Loss of sleep
Appetite : Less, disturbed Comments:
Loss of appetite
Assessment Scores : Beck’s Anxiety Inventory (BAI): 20 (Low Anxiety)
Beck’s Depression Inventory (BDI): 30 (Moderate Depression)
Psychosocial Concerns:
☐Financial Issues ☐Sexual Issues ☐Couple/Family Issues ☐Academic/Job Pressures Addiction
He had addiction issue.
Social Relationships: Distanced
Recreational Activities : None
Obsessive traits (If any) : None
OBSERVATIONS
Appearance: Normal ☐ Dishevelled ☐ Inappropriate ☐ Bizarre ☐Neat
Speech: Normal ☐ Tangential ☐ Pressured ☐ Impoverished ☐ Other
Eye Contact: ☐ Normal ☐ Intense Avoidant ☐ Other
Motor Activity: ☐ Normal ☐ Restless ☐ Tics Slowed ☐ Other
Affect: Normal ☐Full ☐ Constricted ☐ Flat ☐ Labile ☐ Other
Comments : Low Energy Level and avoided eye contact while talking
MOOD
☐ Euthymic ☐ Anxious ☐Angry Depressed ☐ Euphoric ☐ Irritable ☐ Other
Comments : Loss of interest to do anything was reported. He was also depressed due to relationship break up
in 2019 (she was in the same college).
COGNITION
Orientation None ☐Place ☐ Object ☐Person ☐Time
Impairment
Memory Impairment None ☐Short -Term ☐Long-Term ☐Other
Attention Normal ☐Distracted ☐Other
Comments
PERCEPTION
Hallucination None ☐Auditory ☐Visual ☐Other
Other None ☐Derealization ☐Depersonalization
Comments
THOUGHTS
Suicidality ☐ None ☐Ideation ☐Plan ☐Intent Self- Harm
Homicidality None ☐Aggressive ☐Intent ☐Plan
Delusions None ☐Grandiose ☐Paranoid ☐Religious ☐Other
Comments Previously attempted suicide
BEHAVIOUR
☐ Cooperative ☐ Guarded ☐Hyperactive ☐Agitated ☐Paranoid ☐Stereotyped ☐Aggressive
☐Bizarre ☐Withdrawn Other
Comments : Low Energy
INSIGHT
Good ☐Fair ☐Poor Comments:
JUDGEMENT
Good ☐Fair ☐Poor Comments:
Diagnosis: Clinical Depression
Suggestion:
Follow up sessions:
Mental Status Examination
Client Name : AS Time: Date :
Gender : Male ☐ Female ☐Other
Family History : AS is the eldest child. He is married.
Parent 1 Parent 2
Name : Name :
Age : Age :
Occupation: Occupation:
Alive/dead : Alive/dead:
Brothers Sisters Spouse/ Partner
Name :
Age :
Occupation:
Alive/dead :
Children (If Any):
Medical History: N/A Menstrual History : N/A
Pregnancy History : N/A
Sleep : Disturbed Comments:
Appetite : Normal Comments:
Assessment Scores : Beck’s Anxiety Inventory (BAI): 3 (Low Anxiety)
Beck’s Depression Inventory (BDI): 2 (Normal)
Psychosocial Concerns:
☐Financial Issues ☐Sexual Issues ☐Couple/Family Issues ☐Academic/Job Pressures ☐ Addiction
No psychosocial concerns were reported.
Social Relationships:
Recreational Activities : None
Obsessive traits (If any) : Obsessive negative thoughts (unspecified)
OBSERVATIONS
Appearance: Normal ☐ Dishevelled ☐ Inappropriate ☐ Bizarre ☐Neat
Speech: Normal ☐ Tangential ☐ Pressured ☐ Impoverished ☐ Other
Eye Contact: Normal ☐ Intense ☐ Avoidant ☐ Other
Motor Activity: Normal ☐ Restless ☐ Tics ☐ Slowed ☐ Other
Affect: Normal ☐Full ☐ Constricted ☐ Flat ☐ Labile ☐ Other
Comments : Seems afraid and thinks too much.
MOOD
Euthymic ☐ Anxious ☐Angry ☐ Depressed ☐ Euphoric ☐ Irritable ☐ Other
Comments :
COGNITION
Orientation None ☐Place ☐ Object ☐Person ☐Time
Impairment
Memory Impairment None ☐Short -Term ☐Long-Term ☐Other
Attention Normal ☐Distracted ☐Other
Comments
PERCEPTION
Hallucination ☐ None ☐Auditory Visual ☐Other
Other None ☐Derealization ☐Depersonalization
Comments Sees black smoke coming out of his nose, also sees it everywhere whenever tensed.
THOUGHTS
Suicidality None ☐Ideation ☐Plan ☐Intent ☐ Self- Harm
Homicidality None ☐Aggressive ☐Intent ☐Plan
Delusions None ☐Grandiose ☐ Paranoid ☐Religious ☐Other
Comments
BEHAVIOUR
Cooperative ☐ Guarded ☐Hyperactive ☐Agitated ☐ Paranoid ☐Stereotyped ☐Aggressive
☐Bizarre ☐Withdrawn ☐ Other
Comments : Compulsive Behaviour - Moving, Walking
INSIGHT
☐Good Fair ☐Poor Comments:
JUDGEMENT
Good ☐Fair ☐Poor Comments:
Diagnosis: Psychosis Unspecified, Schizoaffective Disorder
Suggestion:
Follow up sessions:
Mental Status Examination
Client Name : SC Time: Date :
Gender : ☐ Male Female ☐Other
Family History : SC is the first child; has one younger brother. She has a 6 years old son.
Parent 1 Parent 2
Name : Name :
Age : Age :
Occupation: Occupation:
Alive/dead : Alive/dead:
Brothers Sisters Spouse/ Partner (Separated)
- 1 Younger None Name :
Brother
Age :
Occupation:
Alive/dead :
Children (If Any): 1 Son (6 years old)
Medical History: N/A Menstrual History : None
Pregnancy History : None
Sleep : Disturbed Comments:
Appetite : Normal Comments:
Assessment Scores : Beck’s Anxiety Inventory (BAI): 19 (Low Anxiety)
Beck’s Depression Inventory (BDI): 34 (Severe Depression)
Psychosocial Concerns:
☐Financial Issues ☐Sexual Issues Couple/Family Issues ☐Academic/Job Pressures Addiction
Client was married for 4½ and was then separated due to husband’s extra marital affair. She also has a smoking
habit, she smokes about 5 to 10 cigarettes per day.
Social Relationships:
Recreational Activities : None
Obsessive traits (If any) : None
OBSERVATIONS
Appearance: ☐ Normal ☐ Dishevelled ☐ Inappropriate ☐ Bizarre Neat
Speech: Normal ☐ Tangential ☐ Pressured ☐ Impoverished ☐ Other
Eye Contact: Normal ☐ Intense ☐ Avoidant ☐ Other
Motor Activity: Normal ☐ Restless ☐ Tics ☐ Slowed ☐ Other
Affect: Normal ☐Full ☐ Constricted ☐ Flat ☐ Labile ☐ Other
Comments : Fear of loving anyone, suspicious, sensitive to touch & smell.
MOOD
☐ Euthymic ☐ Anxious ☐Angry ☐ Depressed ☐ Euphoric ☐ Irritable ☐ Other
Comments :
COGNITION
Orientation None ☐Place ☐ Object ☐Person ☐Time
Impairment
Memory Impairment None ☐Short -Term ☐Long-Term ☐Other
Attention Normal ☐Distracted ☐Other
Comments
PERCEPTION
Hallucination None ☐Auditory ☐ Visual ☐Other
Other None ☐Derealization ☐Depersonalization
Comments
THOUGHTS
Suicidality ☐ None Ideation ☐Plan ☐Intent Self- Harm
Homicidality None ☐Aggressive ☐Intent ☐Plan
Delusions None ☐Grandiose ☐ Paranoid ☐Religious ☐Other
Comments Break glasses and walks on it.
BEHAVIOUR
Cooperative Guarded ☐Hyperactive ☐Agitated ☐ Paranoid ☐Stereotyped ☐Aggressive
☐Bizarre ☐Withdrawn ☐ Other
Comments : Shy
INSIGHT
☐Good Fair ☐Poor Comments:
JUDGEMENT
☐ Good ☐Fair Poor Comments:
Diagnosis: Bipolar Disorder
Suggestion:
Follow up sessions:
Mental Status Examination
Client Name : ML Time: Date :
Gender : ☐ Male Female ☐Other
Family History : ML has been married for 20 years and has a daughter studying in college.
Parent 1 Parent 2
Name : Name :
Age : Age :
Occupation: Occupation:
Alive/dead : Alive/dead:
Brothers Sisters Spouse/ Partner
Name :
Age :
Occupation:
Alive/dead : Alive
Children (If Any): 1 Daughter
Medical History: None Menstrual History : N/A
Pregnancy History : N/A
Sleep : Oversleeping
Comments: Sleeps for 16 hours
Appetite : Loss of appetite Comments:
Assessment Scores :
Psychosocial Concerns:
☐Financial Issues ☐Sexual Issues Couple/Family Issues ☐ Academic/Job Pressures ☐ Addiction
She reported to be very sensitive and that she gets angry very easily from the past 5 to 6 years. For the last
couple of months she has not been talking to her husband and daughter and has anger outbursts.
Social Relationships:
Recreational Activities : None
Obsessive traits (If any) : None
OBSERVATIONS
Appearance: Normal ☐ Dishevelled ☐ Inappropriate ☐ Bizarre ☐Neat
Speech: Normal ☐ Tangential ☐ Pressured ☐ Impoverished ☐ Other
Eye Contact: Normal ☐ Intense ☐ Avoidant ☐ Other
Motor Activity: Normal ☐ Restless ☐ Tics ☐ Slowed ☐ Other
Affect: Normal ☐Full ☐ Constricted ☐ Flat ☐ Labile ☐ Other
Comments :
MOOD
☐ Euthymic ☐ Anxious ☐ Angry ☐ Depressed ☐ Euphoric ☐ Irritable ☐ Other
Comments :
COGNITION
Orientation None ☐Place ☐ Object ☐Person ☐Time
Impairment
Memory Impairment None ☐Short -Term ☐Long-Term ☐Other
Attention Normal ☐Distracted ☐Other
Comments
PERCEPTION
Hallucination None ☐Auditory ☐ Visual ☐Other
Other None ☐Derealization ☐Depersonalization
Comments
THOUGHTS
Suicidality ☐ None Ideation ☐Plan ☐ Intent ☐ Self- Harm
Homicidality None ☐ Aggressive ☐ Intent ☐Plan
Delusions None ☐Grandiose ☐ Paranoid ☐Religious ☐Other
Comments Reported suicidal ideations.
BEHAVIOUR
☐ Cooperative ☐ Guarded ☐ Hyperactive ☐ Agitated ☐ Paranoid ☐ Stereotyped Aggressive
☐ Bizarre Withdrawn ☐ Other
Comments : She doesn’t talk to her husband & daughter. Also has anger outbursts in which she abuses them
and then goes of to sleep.
INSIGHT
☐Good Fair ☐Poor Comments:
JUDGEMENT
☐ Good Fair ☐Poor Comments:
Diagnosis: Bipolar Disorder, Severe Depression led to Narcolepsy
Suggestion:
Follow up sessions:
Mental Status Examination
Client Name : AB Time: Date :
Gender : Male ☐ Female ☐Other
Family History :
Parent 1 Parent 2
Name : Father Age Name : Mother Age
: :
Occupation: Occupation:
Alive/dead : Alive Alive/dead: Alive
Brothers Sisters Spouse/ Partner
Name :
Age :
Occupation:
Alive/dead :
Children (If Any):
Medical History: N/A Menstrual History : N/A
Pregnancy History : N/A
Sleep : Decreased
Comments: Reads late into the night & gets minimal sleep.
Appetite : Normal Comments:
Assessment Scores :
Psychosocial Concerns:
☐Financial Issues ☐Sexual Issues ☐ Couple/Family Issues ☐ Academic/Job Pressures ☐ Addiction
No psychosocial concerns were reported.
Social Relationships:
Recreational Activities :
Obsessive traits (If any) : working on the project he claimed would solve the fuel crisis.
OBSERVATIONS
Appearance: Normal ☐ Dishevelled ☐ Inappropriate ☐ Bizarre ☐Neat
Speech: ☐ Normal Tangential ☐ Pressured ☐ Impoverished ☐ Other
Eye Contact: Normal ☐ Intense ☐ Avoidant ☐ Other
Motor Activity: ☐ Normal Restless ☐ Tics ☐ Slowed ☐ Other
Affect: Normal ☐Full ☐ Constricted ☐ Flat ☐ Labile ☐ Other
Comments : His thought is difficult to follow and he keeps pacing around the examination room.
MOOD
☐ Euthymic Anxious ☐ Angry ☐ Depressed ☐ Euphoric ☐ Irritable ☐ Other
Comments :
COGNITION
Orientation None ☐Place ☐ Object ☐Person ☐Time
Impairment
Memory Impairment None ☐Short -Term ☐Long-Term ☐Other
Attention ☐ Normal Distracted ☐Other
Comments Keeps thinking about his project only.
PERCEPTION
Hallucination None ☐Auditory ☐ Visual ☐Other
Other None ☐Derealization ☐Depersonalization
Comments
THOUGHTS
Suicidality None ☐ Ideation ☐Plan ☐ Intent ☐ Self- Harm
Homicidality None ☐ Aggressive ☐ Intent ☐Plan
Delusions ☐ None Grandiose ☐ Paranoid ☐Religious ☐Other
Comments He claimed that his project would solve the fuel crisis and he will save the world.
BEHAVIOUR
☐ Cooperative ☐ Guarded Hyperactive ☐ Agitated ☐ Paranoid ☐ Stereotyped ☐ Aggressive
☐ Bizarre ☐Withdrawn ☐ Other
Comments :
INSIGHT
☐Good Fair ☐Poor Comments:
JUDGEMENT
☐ Good Fair ☐Poor Comments:
Diagnosis: Bipolar I – Single manic episode with psychosis.
Suggestion:
Follow up sessions:
Mental Status Examination
Client Name : NA Time: Date :
Gender : Male ☐ Female ☐Other
Family History : NA is the second child. He has 1 elder sister.
Parent 1 Parent 2
Name : Father Name : Mother
Age : Age :
Occupation: Retired Government Employee Occupation: Government Employee
Alive/dead : Alive Alive/dead: Alive
Brothers Sisters Spouse/ Partner
1 Elder Sister married & Name :
settled in US.
Age :
Occupation:
Alive/dead :
Children (If Any):
Medical History: N/A Menstrual History : N/A
Pregnancy History : N/A
Sleep : Disturbed
Comments: Enable to sleep
Appetite : Decreased
Comments: He is starving for 15 days because he thinks starving can help him come out of the negative
thoughts.
Assessment Scores : Beck’s Anxiety Inventory (BAI) – 2 (Low Anxiety)
Psychosocial Concerns:
☐Financial Issues ☐Sexual Issues ☐ Couple/Family Issues ☐ Academic/Job Pressures ☐ Addiction
No psychosocial concerns were reported.
Social Relationships:
Recreational Activities : Reading Samaveda
Obsessive traits (If any) : Starving because he wants to come out of irrational thoughts.
OBSERVATIONS
Appearance: Normal ☐ Dishevelled ☐ Inappropriate ☐ Bizarre ☐Neat
Speech: ☐ Normal Tangential ☐ Pressured ☐ Impoverished ☐ Other
Eye Contact: ☐ Normal Intense ☐ Avoidant ☐ Other
Motor Activity: ☐ Normal ☐ Restless ☐ Tics Slowed ☐ Other
Affect: ☐ Normal ☐Full ☐ Constricted Flat ☐ Labile ☐ Other
Comments :
MOOD
☐ Euthymic ☐ Anxious ☐ Angry Depressed ☐ Euphoric ☐ Irritable ☐ Other
Comments :
COGNITION
Orientation None ☐Place ☐ Object ☐Person ☐Time
Impairment
Memory Impairment None ☐Short -Term ☐Long-Term ☐Other
Attention Normal ☐ Distracted ☐Other
Comments
PERCEPTION
Hallucination ☐ None Auditory Visual ☐Other
Other None ☐Derealization ☐Depersonalization
Comments Someone is trying to marry him.
THOUGHTS
Suicidality None ☐ Ideation ☐Plan ☐ Intent ☐ Self- Harm
Homicidality None ☐ Aggressive ☐ Intent ☐Plan
Delusions ☐ None Grandiose ☐ Paranoid ☐Religious ☐Other
Comments He saw god Balaji in him.
BEHAVIOUR
Cooperative ☐ Guarded ☐ Hyperactive ☐ Agitated ☐ Paranoid ☐ Stereotyped ☐ Aggressive
☐ Bizarre Withdrawn ☐ Other
Comments :
INSIGHT
☐ Good ☐ Fair Poor Comments:
JUDGEMENT
☐ Good ☐ Fair Poor Comments:
Diagnosis: Schizophrenia
Suggestion:
Follow up sessions:
CONCLUSION
REFERENCES
INTERNSHIP CERTFICATE
Certificate is being attached to the report.
