Assignment No.3. Page no.

1
Title page:
A: Name of two cases:
• Major depressive disorder (MDD)
• Obsessive compulsive disorder (OCD)
B: Submitted by:
Name: Maham Javed Sir Muhammad Irfan Haider
ID: BC220410148
Session: 2022-2024
C: Submission date is 21 June 2024. D: Virtual University
of Pakistan E. Vu Logo
Acknowledgment: Page no.2
I take this opportunity to thank those who helped me
in making project and for that, I would like to express
my sincere gratitude to Dr.Zunaira Jamil
Psychologist give me knowledge and valuable time
and helped me in despite her busy schedule and
motivated me during the whole duration of my
internship. She guided me and provided all support
in completing this assignment and for giving various
facilities in witnessing and hearing of cases and tells
me how to check clients and collect case history. I am
very thankful to Dr. Zunaira Jamil Psychologist
because she give me knowledge and time to
complete internship.
 Executive Summary: Page no.3
I take two cases
1: Major depressive disorder (MDD)
2: Obsessive compulsive disorder (OCD)
1: Major depressive disorder (MDD): In this case Major
depressive disorder (MDD) patient name is S.R she diagnosed in
this disorder after husband death one year ago she faces anger ,
headache , excessive crying and poor sleep and also she faces
financial issues because she has three children and can’t maintain
expenses and only depend upon only pension and I use Beck
depressive inventory (BDI) and HTP test to diagnose, treat and she
is severe in this disorder and in last after complete treatment she
is satisfying about treatment.
2: Obsessive compulsive disorder: In this case Obsessive
compulsive disorder OCD and patient name is A.A she diagnosed
in this disorder after COVID-19 four years ago and she faces again
and again wash hands and count everything, arranging and
thoughts and she is unmarried and I use Questionnaire, case study
and HTP test to diagnose and treat this disorder and when
complete all process and she goes she is satisfying about
treatment.

.
Letter of undertaking: Page no.4
Scanned Copy of Internship Completion Certificate:. Page no.5
Table of contents: Page no.6

Sr. No. Table of contents Page number

1. Title page 1
2. Acknowledgment 2

3. Executive Summary 3
4. Letter of undertaking 4
5. Certificate 5
6. Table of contents 6,7,8,9
7. Case 1: Major 10
depressive
disorder MDD
8. Background 10
information history
9. Client bio-data 10
10. Main reason for 10
referral
11. Presenting 10,11
complaints
12. History of present 11
illness
13. Family history 12,13
14. Marital history 14
15. Occupational history 14
16. Premorbid 14,15
personality
17. Assessment 15
18. Informal 16
assessment
19. Baseline chart 16
20. Subjective ratings of 16
presenting
complaints
21. Formal assessment 16
22. Mental Status 17,18,19,20
Examination
23. Diagnostic 20,21
psychological
assessment
24. Personality 21,22,23
Assessment
25. Summary of 23
Informal and Formal
assessment
26. Diagnoses 23
27. Prognosis 23,24
28. Management and 24
treatment
29. Case formulation 25
30. Appendances HTP 25
31. Person 26
32. House 27
33. Tree 28
34. Beck Depression 29,30,31,32
inventory BDI
35. Baseline chart 33
36. Case 2: Obsessive 34
compulsive
disorder OCD
37. Background 34
information history
38. Client’s bio - data 34,35
39. Main reason for 35
referral
40. Presenting 35,36
complaints
41. History of present 36
illness
42. Family history 37,38
43. Marital history 38,39
44. Occupational history 39
45. Premorbid 39,40
personality
46. Assessment 40
Informal 40
assessment
47. Baseline chart 40
48. Subjective ratings of 40,41
presenting
complaints
49. Formal assessment 41
50. Mental Status 41,42,43,44
Examination
51. Diagnostic 44,45
psychological
assessment
52. Personality 45,46,47
Assessment
53. Summary of 47
Informal and Formal
assessment
54. Diagnoses 47,48
55. Prognosis 48
56. Management and 48,49
treatment
57. Case formulation 49
58. Appendances HTP 49
59. House 50
60. Tree 51
61. Person 52
62. Baseline chart 52
63. OCD Questionnaire 53,54
The end

Page no.7,8,9 table of contents

 Case 1: Page no.10
Major depressive disorde (MDD)
Background information/history:
Client’ s bio-data:
Name S.R
Gender Female
Age 34
Qualification Matric
Birth order 2nd
No.of siblings 5
Marital status Married
Address Cant Sialkot
Religion Islam
Occupation Housewife
Husband Govt. Job
occupation

Main reasons for referral:

The client was referred to the Clinical Psychologist by the
Psychologist for psychological assessment and management of
the problem.
Presenting complaints:
As reported by the client she had.
Presenting Duration (in
complaints weeks/months/
years)
Me bht zyada rote
hoo mujay bht zyada 7 months ago
Rona ata hai

Mujay bht zyada

gussa ata hai 5 months ago
Mujay neend nhi
ate hai 3 months ago
Mera Kise Kam ya
cheezo me Dil nhi 2 weeks ago
lagta
Mujay jisam me bht
derdeee hote hai 6 months ago
Mujay bht zyada 4 months ago
thakawat hote hai
Mujay lagta hai 3 months ago
mere me taqat nhi
hai
Mujay lagta hai me 8 months ago
Kuch nhi ker sakte

History of present illness: Page no.11

Client’ s problem is Major depressive
disorder ( MDD). This problem was started after husband death
one Year ago and she faces excessive crying, poor sleep and
excessive anger and these are predisposing factors. One year ago
client experienced this illness. Precipitating factors like anger ,
financial issues and poor sleep trigger the problem and specially
financial issues because client has 3 children and cannot fulfill
expenses day by day expenses raising high and client take tension
because client depend upon the pension of husband after husband
death these factors maintain the problem and protector factors like
family members, friends and peers all want that client become good
and healthy and spend normal life these are protector factors.
Family history: Page no.12
Father:
Client father is dead ,education was 5 class, occupation was
agriculture and he was died due to heart attack when he was alive
he was heart patient . He was not faces any psychotic problem and
his personality was good . The relationship with the client was so
good, caring and loving. The relationship with wife was good
otherwise he faced no problem only heart problem because he was
heart patient due to obesity.
Mother:
Client mother is alive. She is illiterate and occupation is she is
housewife . Her physical health is good and no psychiatry problem.
Relationship with client is so good, loving and caring. Relationship
with husband was so good. She has no problem only one that her
daughter is sick after husband death she want that her daughter
recover soon.
Siblings:
Total number of siblings are five . Three brothers and two sisters
and client birth order is 2 ND number . Client relationship with
siblings is good and siblings has only one problem that sister
recover soon. Overall family atmosphere is good.
Personal history:
• Client was born with normal delivery and her mother faced no
complications
• Developmental Milestone (such as, speech, crawling,
walking etc.) Client faces no problem such as speech,
crawling, walking client do everything on time same like
normal children.
• Physical health/ Medical history (e.g. pneumonia,
jaundice, hay fever etc.) When client was 10 years old and
was ill but fever was normal one to two days client recover
and become healthy.
• Traumatic experiences (due to psychological problem,
sexual assault etc.)No traumatic experience faces when
client was married and after husband death client faces this
illness.
• Schooling (detailed history of schooling, shifting of
schooling if any, adjustment issues at school,
relationships with teachers and classmates, performance
in academic and non academic activities, academic
grades, any incident happened during schooling such as
Bullying) When read in school client was so brilliant student
and not do any shifting and always live in Sialkot and faces no
adjustment issues , relationship with teacher and classmates
was so good in academic activities always get prize and
participated in games and win trophies and in every class get
high grades no incident happened in school.
• Adolescence (age of puberty, information regarding
puberty, reaction towards puberty,information regarding
sex)When client was young client was so beautiful and client
tells she she only focused on study and not think related sex
and only think to complete study but I cannot complete.
 • Sexual inclination(homosexuality/heterosexuality if
reported)
Client tells only one thing that heterosexuality. Page no.13
Marital history: Page no.14
Spouse:
Her husband is dead one years ago and age was 40 years
. Education was B.ED and occupation was govt. Job. He died due
to accident. Hus physical health was good and no psychiatry
problem . Hus personality was so good and simple. The
relationship with wife was so good, loving and caring Relationship
with spouse family was so good and no problem both are faces
after husband death she faces this illness.
Children:
She has three children one son and two daughters and
age is son is 10 years and first daughter is 9 years and second
daughter is 8 years old. .All faces no psychiatry problem. Their
physical health is good and relationship with children was so good
and her children have only one problem that mother recover soon.
Overall family atmosphere is good.
Occupational history:
Client do not do job she is housewife.

Premorbid Personality (The premorbid personality is an

indication of the client’s personality and character before the
onset of mental illness)
Social interest:
 When client was healthy she likes to attend
functions and meet with people social interest was goog.
Social relationships:
Page no.15 Social relationship was so good
she likes to make friends and neighbors always praise her that her
nature was so good.
Mood:
Mood was so good she always smile on face and meet
other people and do not show anger to anyone.
Moral and religious values:
Before illness and after illness client
do not forget religious values now this time know that always help
poor and needy people and love with elders and children.Allah is
one and Hazrat Muhammad ( S A W) is the last prophet of Allah.
All Muslim are ummat of Hazrat Muhammad ( S.A.W) . Client
know everything.
Habits:
When client was normal.Clients habit was gardening
and most time spend on garden to take care of flowers and plants.
Reactions to stress:
When client was normal do not take stress
always live happy and when take a stress gies reaction was normal
and small time recover it and do not show extra anger and other
symptoms and when take a stress mostly time spend with family
like, husband and children and in this way forget stress.
• Smoking /drug abuse:
No smoking and no drug abuse.
Assessment
It is divided into two parts. Page no.16
1: Informal Assessment includes:
Baseline chart:
Baseline chart present in the below appendances.
Subjective ratings of presenting complaints :
Presenting Pre- rating Post – rating
complaints
Me bht zyada rote 10 2
hoo mujay bht zyada
Rona ata hai
Mujay bht zyada 8 1
gussa ata hai
Mujay neend nhi ate 10 2
hai
Mera Kise Kam ye 9 0
chezzo me dil nhi
lagta
Mujay jisam me bht 8 0
dardee hote hai
Mujay bht zyada 8 0
thakawat hote hai
Mujay lagta hai 8 0
mere me taqat nhi
hai
Mujay lagta hai me 9 1
Kuch nhi ker sakte
2: Formal Assessment includes:
Mental Status Examination
Diagnostic/Psychological Assessment Page no.17
Personality Assessment
• Mental Status Examination:
Appearance: Simple
Following points about the client’s appearance must be mentioned
under this section:
Sitting posture: Straight
Facial Features: So beautiful
Hair color: Black
Texture: Soft
Styling and grooming: No styling and grooming totally simple
Height: 5 feet and 3 inches
Weight: 65
Body Shape: Smart
Cleanliness: So good
Neatness: so good
Clothing/Dressing: Simple suit
Level of Eye Contact: In some questions eye contact was so
good but some questions show eyes movements.
Eye Movement: In some questions show eyes movements
 Degree of friendliness: So good like that client makes friends
easily because nature is so good soft heart.
Apparent Age: 34 years
Mannerism: Totally simple Page no.18
Speech (Form and Content)
Volume of Speech: Normal
Stammering/stuttering: Nothing
Mood and Affect:
Thoughts:
Stream of Thought: Normal
• Thought Content: Only husband client remember only
husband after husband death.
Delusions:
Client Me
‫یا آپ کو اس بات کا یقین ہے‬
‫۔‬ ‫جی نہیں۔‬ ‫کہ کوئی دو لوگ آپ کے‬
‫خالف بات کر رہے ہیں‬
‫کیا آپ کو ایسا محسوس ہوتا‬
‫ہے کہ ٓا پ کے قریبی‬
‫جی نہئں‬ ‫رشتے دار آپ کے خالف‬
‫ہیں؟۔‬
‫جی نہیں‬ ‫کیا آپ کو ایسا لگتا ہے کہ‬
‫آپ کا تعلق کسی عظیم‬
‫ہستی سے ہے؟‬

Hallucinations:
‫‪Client‬‬ ‫‪Me‬‬
‫کیا آپ کو ایسی آوازیں‬
‫جی نہیں‬ ‫سنائی دیتی ہیں جو‬
‫دوسروں کو دکھائی نہیں‬
‫دیتی؟‬
‫آپ کو ایسی شکلیں دکھائی‬
‫جی نہیں‬ ‫دیتی ہیں جو دوسروں کو‬
‫نظر نہیں آتیں؟۔‬

‫‪Orientation:‬‬
‫‪Orientation (Time):‬‬
‫‪Client‬‬ ‫‪Me‬‬

‫آج کیا تاریخ ہے؟‬

‫‪25-4- 2024‬‬
‫یہ کونسا مہینہ ہے؟‬
‫اپریل‬

‫‪Orientation (Place):‬‬
‫‪Client‬‬ ‫‪Me‬‬
‫یہ کونسی جگہ ہے؟‬
‫ہسپتال‬
‫یہ کونسا شہر ہے؟‬
‫سیالکوٹ‬

‫‪Orientation (Person):‬‬
‫‪Client‬‬ ‫‪Me‬‬
‫‪S.R.‬‬ ‫س۔ر‬ ‫میرا نام کیا ہے؟‬

‫‪Memory: Good.‬‬ ‫‪Page no.19‬‬

‫‪Remote memory:‬‬
‫‪Client‬‬ ‫‪Me‬‬
‫سیالکوٹ‬ ‫آپ کہاں پیدا ہوئے؟‬
‫‪Page no.20‬‬
‫‪Recent Past Memory:‬‬
‫‪Client‬‬ ‫‪Me‬‬
‫آپ نے کل ٹی وی پر کونسا‬
‫خبریں‬ ‫پروگرام دیکھا؟‬

‫‪Recent Memory:‬‬
‫‪Client‬‬ ‫‪Me‬‬
‫ان الفاظ کو اسی ترتیب سے‬
‫کرسی۔میز۔الماری‬ ‫دہرائیں۔ کرسی۔ میز۔ الماری‬

‫ان الفاظ کو اسی ترتیب سے دہرائیں۔ کرسی۔ میز۔ الماری۔‬

‫‪General information/intelligence:‬‬
‫‪General knowledge questions:‬‬
‫‪Client‬‬ ‫‪Me‬‬
‫‪7‬‬ ‫جمع ‪ ۲‬کتنے ہوتے ہیں؟ ‪۵‬‬

‫‪Insight:‬‬
‫‪Client‬‬ ‫‪Me‬‬
‫خطرناک‬ ‫آپ کی بیماری کس نوعیت‬
‫کی ہے؟‬
 • Diagnostic/ psychological assessment:
Beck depression inventory BDI test use for diagnoses and
psychological assessment
Quantitative analysis: Page no.21
Category Score
Minimal 0-13
Mild 14-19
Moderate 20-28
Severe 29-63
Client solve this test and get 58 score it means this disorder is
severe.
Qualitative analysis:
Beck Depression inventory BDI test use for diagnoses and
psychological assessment of client. Client solve this test very soon
and get 58 score it means this disorder is severe.
• Personality Assessment:
HTP( HOUSE TREE PERSON) used for personality assessment.
Interpretation of person:
Client makes a girl it represent themes related to femininity,
youthfulness, innocence or aspects of the self associated with
nurturing sensitivity and vulnerability.round shape face means
suggest qualities like friendlines, approachability, warmth or a
nurturing disposition. Dotes on eyes mean close – minded. Round
shape eyes and line shape eyebrows indicate a sense of
innocence, curiosity openness and emotional sensitivity. Nose
shows symbol of sex shows sexual fears and difficulties.ni eras
show difficulties with listening, communication, feelings of being
unheard, ignored or a sense of disconnect from one
surrounding.sigle line mouth means tension and pent- up
aggression.Open and disconnected arma indicate willingness to
engage and powerlessness, pointed fingers show
aggression.Feet cover with shoes means it could also provide
insights into their relationship with rules, orderlies or perhaps their
focus on the small intricate aspects of life frok shows suggest a
straightforward or uncomplicated view of femininity or self
expression. Hairs is associated with with ego functioning.
Interpretation of tree:
It shows relationship of person with his/ her environment it might
reflect a person who has been broken by external stress.. Large
trunk indicates more ego strength.Limbs moving upward means
person ambitiousness and reaching for opportunities.Small new
branches means new personal growth and psychological
immaturity.Bark carefully drawn means rigid and compulsive
personality.Cloud shape leaves means symbolize a dreamy or
imaginative personality a tendency towards fantasy or a desire for
escape for reality . These roots means insecurity and no feelings
of being grounded.
Interpretation of house: Page no.22
Large house reflect a view of home as overly restrictive and
controlling. Walls weak lines shows weakness in the
ego.Incomplete roof indicate avoidance of overpowering and
frightening fantasis. Close door means this task can reveal
insights into their perceptions of boundaries,privacy and personal
space .In this picture no grass shows this task can provide
insights into their perceptions of nature, growth and perhaps their
emotional state or relationship with the environment ), “closed
 window” likely refers to a setting or mode that reduces external
noise or interference, providing a more immersive audio
experience by minimizing distractions from outside sounds. It’s
typically a feature aimed at enhancing the quality of sound
reproduction.Weak or unclear pathways can symbolize feelings of
uncertainty, indecision, or obstacles in one’s life journey or
personal development. It may suggest challenges in finding
direction or progress in reaching goals. These pathways often
reflect the individual’s perception of their ability to navigate
through life’s challenges and opportunities.
Summary of Informal and Formal Psychological Assessment:
Informal assessment:
In informal assessment baseline charts
use in this chart tell client to tell experience and tells in this some
problem happen or not write all problem and in presenting
complaints we collect information when illness start and when client
recover tells in percentage.
Formal assessment:
In formal assessment use mental Status Examination and note the
client height, weight and features and diagnostic test Beck
Depression inventory BDI use and check condition of disorder and
use personality test HTP and in this test client make house tree
person and we do interpretation and find results.
Diagnosis:
According to DSM-5, the client is diagnosed with
Disorder Code: 296.33
Name of disorder: Major depressive disorder (MDD)
Specifier: 18 score Severe 58score according to BDI test
Prognosis : Page no.23
Satisfying the is satify related treatment and client know and tells
us disease is so dangerous and client also want to recover soon
and client gives 8 score out if 10 means satisfy .
Management and Treatment:
• Psychological/Psychotherapy
Management:
Healthy diet :
Healthy eating like eat banana because banana help to overcome
depression due to the high level of tryptophan which is converted
into serotonin.
Relaxation techniques:
Do deep breathing, yoga, exercises
because these exercises help to reduce depression
Recommend therapy:
No.therapy use only use family counseling
.
• Family counseling:
All family come in hospital like mother ,father and husband was
dead , children and siblings and gather information from family
like mood of client in home which behavior show and show
aggression or not and tells client disorder and doctor tells this is
dangerous disorder and not show anything in front of client
because client remember oast things and cry and tells do
something good because client help to forget all of the scenario
and recover soon. Page no.24
Case formulation:In this topic use Behaviorism school of
thought according to disorder because client problem is major
depressive disorder MDD and client express everything like show
anger ,poor sleep and excessive crying, fatigue all symptoms
show and not hide anything all symptoms show on face and we
collect information from client use Beck Depression inventory BDI
test, HTP House Tree Person, baseline charts to find the problem
and treat this problem and illness and when treatment finished
client gives satisfying remarks.
Appendances: HTP test
Case 1: Major depressive disorder MDD
HTP HOUSE TREE PERSON test
Beck depression inventory BDI test
Baseline chart
In the given below. Page no.25
Person : Page no.26
House: Page no.27
Tree: Page no.28
Beck Depression inventory BDI: . Page no.29
Page no.30
Page no.31
Page no.32
Baseline chart:

Page no.33
Case 2::Obsessive compulsive disorder (OCD): Page no.34

Background information/history

Client’s bio-data:

Name A.A
Gender Female
Age 30

Birth order 3 rd
Occupation Nothing
Qualification F.A
No.of siblings 6
Address Hajipura
Marital status Single
Religion Islam

Main reasons for referral:The client was referred to the Clinical

Psychologist by the Psychologist for psychological assessment
and management of the problem.
Presenting complaints: Page no.35
As reported by the client, she had
Presenting Duration (in
complaints weeks/months/years)
Me aik din me 3 years ago
bar bar hath
dote hoo
muselsel aik
ghante teq
Mujay bar bar 2 yeari ago
ghayalat ate
rehte hai
Me Bure 2 years ago
ghayalat ko
zahen se
nakalne ki
kosish kerte
rehte hoo
Me Apne 3 years ago
cheezo ko bar
bar terteb se
rakhte hoo aur
gintee kerte
rehte hoo
Me aik din me 2 years ago
muselsel aik
ghante teq hath
dote rehte hoo
Mujay aise lagta 3 years ago
hai jaise me
ghandi leg Rahe
hoo
Mujay bht zyada 4 years ago
gussa ata hai
Mujay 3 years ago
gharaseemo se
bht DER lagta
hai
History of present illness:
Client’ s problem is Obsessive compulsive disorder (OCD). The
problem was started after COVID-19 four years ago. Excessive
anger, managing and counting again and again, wash hands again
and again,fears of germs these are predisposing factors.
Precipitating factors like again and again wash hands, people’s
reaction,anger these factors trigger the illness. Client experienced
this problem four years ago. Again and again wash hands, people’s
reaction and attitude towards client, managing and counting again
and again, anger these factors maintain the problem. Protector
factors like family members, friends and peers try to protect from
illness and want client recover soon.
Page no.36
Family history: Page no 37
Father:
Client father is alive and education is Matric . Client father
occupation is private job and physical health is good. Client father
is totally normal no psychiatry problem His personality is good and
relationship with patient and wife is so good, caring and loving. Hus
father has only one problem that his daughter recover soon.
Mother:
Client mother is dead and she was illiterate. She was housewife
and cause of death was blood cancer. Her physical health was so
bad. Client mother has no psychiatry problem. Her personality was
so good. The relationship with patient was so loving and caring.
The relationship with husband was good and understandable. . She
was the patient of blood cancer .
Siblings:
Client has six siblings three brothers and three sisters. All siblings
are normal and healthy physical health is good. Client birth order is
3 rd . Relationship with siblings is so good. All siblings siblings
have only one problem that client is sick . Overall family
atmosphere is good and family members are so hopeful and client
recover soon.
Personal history:
Birth (normal or c-section, any complications faced by mother
before pregnancy and after child delivery) Client was born
through c- section and no complications faced mother.
 Developmental Milestone (such as, speech, crawling,
walking etc.) When client was born then speech, crawling and
walking do on time like normal children.
Physical health/ Medical history (e.g. pneumonia, jaundice,
hay fever etc.) physical health and medical history was so good
because she was healthy.
Traumatic experiences (due to psychological problem,
sexual assault etc.) No psychological problem and sexual assault
occur with patient.
Schooling (detailed history of schooling, shifting of
schooling if any, adjustment issues at school, relationships
with teachers and classmates, performance in academic and
nonacademic activities, academic grades, any incident
happened during schooling such as Bullying) Client was
normal student not so brilliant and not weak and no shifting occur
and client easily adjust in the environment of school.Client’s
relationship with teachers and classmates was good . She take
participate in academic activities and not take participate in non
academic activities. Client get normal grades and no incident
happened in school with client.
Adolescence (age of puberty, information regarding puberty,
reaction towards puberty, information regarding sex) When
client reach the age of puberty manage everything normally and
not show any anger , and client likes that always makes two to three
friends not more . Client do not tell anything related sex.
Sexual inclination(homosexuality/heterosexuality if
reported) Heterosexuality
Marital history: Page no.38
 Client is single Page no.39
Occupational history:
Client do not do job
Premorbid Personality (The premorbid personality is an
indication of the client’s personality and character before the onset
of mental illness)
Social interest:
Social interest was good and attend functions of only friends and
always makes two to three friends not more.
Social relationships:
Relationship with friends was so comfortable,
caring and good and in company client enjoy life.
Mood:
Mood of client was so good and always take smile on face
and meet with people with open hearted.
Moral and religious values:
Before and after disorder moral and religious values remain same
and know always help poor and needy people and specially know
Allah is one and Hazrat Muhammad (S.A.W) is the last prophet
of Allah Almighty and know that we are ummat of Hazrat
Muhammad (S.A.W) .
Habits:
Client adopt only one habit that client always manage
everything and keep clean .
Reactions to stress:
 Client reaction to stress was normal not show anger remain always
comedown.
Smoking/ Drug abuse:
No smoking and no drug abuse .
Assessment. Page no.40
It is divided into two parts.
1. Informal Assessment includes:
Baseline chart:

Subjective ratings of presenting complaints :

Presenting Pre- rating Post -rating
complaints
Me aik din din me 2
bar bar hath dote 10
hoo muselsel aik
ghante teq
Mujay bar bar 9 0
ghayalat ate rehte
gai
Me Bure ghayalat ko 8 0
zahen se nakalne ki
kosish kerte rehte
hoo
Me Apne cheezo ko 9 1
bar bar terteb se
rakhte hoo aur
gintee kerte rehte
hoo
Me aik din me 9 2
muselsel aik ghante
teq hath dote rehte
hoo
Mujay aise lagta hai 8 1
jaise me ghandi leg
Rahe hoo
Mujay bht zyada 10 1
gussa ata hai
Mujay gharaseemo 10 0
se bht DER lagta hai

2. Formal Assessment includes: Page no.41

Mental Status Examination
Diagnostic/Psychological Assessment
Personality Assessment
Mental Status Examination:
Appearance:
Following points about the client’s appearance must be mentioned
under this section:
Sitting posture: Straight
Facial Features: Good
Hair color: Brown
Texture: Soft
Styling and grooming: yes, good
Height: 5 feet,6 inches
 Weight: 70. Page no.42
Body Shape: Healthy
Cleanliness: Client is so clean and mange everything.
Neatness: So good
Clothing/Dressing: Styling
Level of Eye Contact: Good
Eye Movement: Some times moves eyes but some times do not
Degree of friendliness: So good
Apparent Age: 30 years
Mannerism: Good
Speech (Form and Content)
Volume of Speech: Normal
Stammering/stuttering: No
Mood and Affect: Good
Thoughts: counting and managing things and keep clean and
neat.
Stream of Thought: Normal
Thought Content: Always manage everything and keep clean
and neat and again and again do counting of things like many
times.
Delusions:
Client Me
 ‫جی نہیں‬ ‫کیا آپ کو اس بات کا یقین‬
‫ہے کہ کوئی دو لوگ آپ کے‬
‫خالف بات کر رہے ہیں؟‬
‫جی نہیں‬ ‫کیا آپ کو ایسا محسوس ہوتا‬
‫ہے کہ ٓا پ کے قریبی‬
‫رشتے دار آپ کے خالف‬
‫ہیں؟‬
‫جی نہیں‬ ‫کیا آپ کو ایسا لگتا ہے کہ‬
‫آپ کا تعلق کسی عظیم‬
‫ہستی سے ہے؟‬

‫‪Hallucinations:‬‬ ‫‪Page no.43‬‬

‫‪Client‬‬ ‫‪Me‬‬
‫جی نہیں‬ ‫کیا آپ کو ایسی آوازی سنائی‬
‫دیتی ہیں جو دوسروں کو‬
‫دکھائی نہیں دیتی؟‬
‫جی نہیں‬ ‫کیا آپ کو ایسی شکلیں‬
‫دکھائی دیتی ہیں جو‬
‫دوسروں کو نظر نہیں آتیں؟۔‬

‫‪Orientation:‬‬
‫‪Orientation (Time):‬‬
‫‪Client‬‬ ‫‪Me‬‬
‫جی نہیں‬ ‫آج کیا تاریخ ہے؟‬
‫جی نہیں‬ ‫یہ کونسا مہینہ ہے؟‬

‫‪Orientation (Place):‬‬
‫‪Client‬‬ ‫‪Me‬‬
‫جی نہیں‬ ‫یہ کونسی جگہ ہے؟‬
‫جی نہیں‬ ‫یہ کونسا شہر ہے؟‬
Orientation (Person):
Client Me
A.A. ‫ع۔ع‬ ‫میرا نام کیا ہے؟‬
Memory: Good
Remote memory:
Client Me
‫سیالکوٹ‬ ‫آپ کہاں پیدا ہوئے؟‬

Recent Past Memory:

Client Me
‫ڈرامے‬ ‫آپ نے کل ٹی وی پر کونسا‬
‫پروگرام دیکھا؟‬
Recent Memory .
Client Me
‫کرسی۔میز۔الماری‬ ‫ان الفاظ کو اسی ترتیب سے‬
‫دہرائیں۔ کرسی۔ میز۔ الماری۔‬
General information/intelligence:
General knowledge questions:
Client Me
7 ۵ ‫ کتنے ہوتے ہیں؟‬۲ ‫جمع‬
Insight:
Client Me
‫خطرناک‬ ‫آپ کی بیماری کس نوعیت‬
‫کی ہے؟‬

• Diagnostic/ psychological assessment: Page no.44

For diagnoses disorder questionnaire used for diagnoses and
treatment of illness and there is no category and scale to check the
severity of disorder only questionnaire and test use for check the
severity andmake a questionnaire and ask to client and according
this test check the illness and do treatment of disorder.Page no. 45
• Personality Assessment:
HTP(House Tree Person) use for
interpretation
Interpretation of person:
Client draw a person boy means boy shows symbolize
traits typically associated with masculinity such as strength,
independence assertiveness and adventurousness. Round
shape face means can suggest qualities like friendlines,
approachability , warmth or nurturing disposition. Round shape
eyes and line like eyebrows indicate a sense of innocence,
curiosity, openness and emotional sensitivity. Double line nose
focus on practicality or a strong sense of determination It could
also indicate a straight forward and direct communication style
or non sense attitude towards life real shape lips means
attention to detail realism or a bakanced perspective and
grounded and practical approach to life with a focus on the
present moment and tangible outcomes.line like eyebrows
indicate reserved and analytical personality.Paint shirt might
suggest creativity, artistic expression or a hands on a approach
problem solving.and also indicate a tendency towards
messiness spontaneity or a disregard to conventional
norms.Buttons , pocket and collar can symbolize attention to
detail a sense of orderliness or a desire for professionalism and
formality and shows traditional values or a disciplined approach
to life. Pocket on paint with dots symbolize a blend of creativity
and practicality. Dots could represent a focus on detail and
sense of playfulness within a structured environment such as
artistic endeavors or problem solving situations Open arms
indicate willingness to engage. Pointed fingers shows
aggression.Feet cover with shoes means provide insights into
their relationship with rules, orderlies or perhaps their focus on
the small intricate aspects of life. Hairs showsshort hairs” can
be interpreted in the context of how the subject perceives or
describes details within the inkblot.
Interpretation of tree:
Fantasy like tree means unrealistic thoughts and distorted
perception of the world. Small trunk indicates limited ego. Tree
split down in the middle can indicate a normal fragmented
personality and serious mental illness or sign of organicity. No
branches shows lack of future orientation, rigidity or a feeling
of being stuck in the present without growth or expansion.
Cloud shaped leaves means symbolize a dreamy or
imaginative personality a tendency towards fantasy or a desire
for escape fom reality. Roots can indicate a strong connection
to one’ s past,a sense of stability,or a deep organized seated
attachment to family and heritage, relate to the reality testing
and orientation.
Interpretation of house: Page no.46
Small house shows typically symbolizes feelings related to
one’s sense of security, privacy, and personal space. Open
doors shows strong need to contact with others. Absence of
windows shows in combination of several other features
 including enlarged heads,, absence of feet and extremely large
geometric fingers (Abuse children). Pathways show openess.
Wide and lead directly to the doors shows client is accessible,
open and direct. Extra attention on the roof indicate extra
attention to fantasy and ideation. Strong lines and walls shows
problems with anxiety need protection. Small and beautiful
grass on a house typically symbolize a positive and nurturing
environment. It can suggest feelings of security, growth and
harmony within one’s home or personal life. Tree on house
means often symbolizes a strong connection between one’s
personal growth and their home life. It can indicate stability
protection and a sense of rootedness in one’s living
environment. Page no.47
Summary of Informal and Formal Psychological Assessment:
Informal assessment: In this assessment use baseline charts to
find out what do experience of client in home and client write on the
chart and ask the rate of disorder before and after means when
client come first time ask intensity of disorder and after treatment
ask because client tells what feel and changes occur or not and
ask client feel good after treatment.
Formal assessment: In this assessment use mental status
examination to write down the nature,body expression and body
features like height, weight and sitting posture etc and in this
assessment use diagnostic test like questionnaire to check the
severity and personality test HTP House Tree Person for diagnoses
and treatment and do interpretation.

Diagnosis:
According to DSM-5, the client is diagnosed with Page no.48
Disorder Code:300.3.
Name of disorder,: Obsessive compulsive disorder ( OCD)
Specifier: Severe
Prognosis:
Satisfactory, When client comes to check client know related
disorder and want to recover soon client gives me 8 percentage
remarks and satisfy about treatment.
Management and Treatment:
Management:
Healthy diet:
Doctor recommend patient to eat healthy food like fruits and
vegetables and recover soon.
Relaxation techniques:
Get up in the morning on time and sleep on time,deep breathing,
yoga, normal exercises are good for your health.
Recommend therapy:
Exposure therapy:
Exposure therapy is a type of therapy in which
individuals are exposed to the things, situations and activities you
feel fear.
• Psychological/psychotherapy
• Family counseling:
 In this disorder for treatment family counseling use doctor tells
to call family and tells the all symptoms and condition of client
and tells adopt good habit behind client and not show anything
of the reason client feel irritation and adopt good environment
on home because client forget bad things and adopt good
things and recover soon.
Case formulation: Page no.49
In this disorder Gestalt psychology school of thought use
because in this disorder client think that hands and clothes are
dirth and again and again wash hands and change clothes and
this is so time consuming and again and again count thing and
managing things and client feel irritation all this process and
doctor use questionnaire and HTP test for diagnoses and
treatment anduse family counseling for client recover soon.
Appendances:
HTP HOUSE TREE PERSON test
OCD Questionnaire
Baseline chart
Present in given below.
House:
House : Page no.50
Tree: Page no.51
Person: Page no.52

Baseline chart:
OCD Questionnaire: Page no.53
Page no.54. The End