Use of standardized test in counselling

Assignment # 4
Submission Date (19 May2021)
BY
AYESHA RAUF 17271511-003
KAINAT ASHFAQ 17271511-015 
Ayesha Sajid 17271511-016
   Hira SIDDIQUE 17271511-050 
Memoona Javed 17271511-053 
laiba Sai 17271511-056 
PSY 413 (Counselling Psychology) 
Submitted to
Ma’am Erum Naz
Department of Psychology
 

 
UNIVERSITY OF GUJRAT
 
Case study

Bio data:

Name M. A
Age 16 year
Education F.A
Sibling 3
Gender Male
Birth Order 3rd
Religion Islam
Informant Client himself

Source of referral: Approached by me.

Reason of referral: For case study.

Presenting complaints :
According to client
Mujy bachpan m hi saf rhny pr zor diya jata tha. Is liye mujy hr waqat apny
ghanda hony ka hayal tang krta h. germs ki wja sy bar bar nhata hon. M hr do
ghanty k bad nhany pr majbor hota hon. Agr koyi mujy aisa krny sy roky to
mujy bhot gusa ata h. Rat ko sony m mushkil paish ati h kyu k bar bar
ghanda hony ka hayal tang krta h. M is wja sy bhot preshan hon.
Family history:

Father: The client father was a school teacher. Client told that his father was
very humble person. He loved his all family members, but loved the client
most of them. Client felt that his father was very conscious person. Client
loved his father very much, but his father was over protective and gives all
his attention. When client was child his father restricts him on the little tasks.
Family atmosphere was also good.
Mother: According to client his mother was very good and nice lady. Her
mother had well relations with her husband. She was very worried for client
and become very kind and corporative with him. Also take care of client.
Sister: Client has two sister. His elder sister was 24 years old. She was
married to businessman and live happily. She loved the client as his own
children. Client had a satisfactory relation with her.

History of present illness

Client illness started from childhood when he was 10 years old. As the client
was the youngest of his siblings and was the only son of his family so, all
family members loved the client and took a lot care of client. He became a
pampered child. His family was extra conscious regarding to his toilet
training. They ordered him to wash his hands before and after playing and
doing things. They asked client to take bath twice a day and kept his clothes
neat and clean. He liked to play foot ball. This affected client so much and he
also become extra conscious about cleanliness. At school he started to avoid
sitting with other children because he thought him that he became dirty if he
came in contact with other children.
Birth and early development
His birth place was Gujranwala and birth condition was normal. He
was healthy child. He started talking at the age of two and half years old. He
achieved her milestone at appropriate age. His sleeping pattern was normal.
No severe injury or accident was reported during childhood. Development
was also normal.
Educational history
The client started at the age of 4 years. He belong to middle class
family. So he started in government school. He was average student in
studies. He passed metric with 2nd division. Then he took admission in F.A.
he was obedient and punctual student. He passed his exams with average
marks.

Mental Status Examination

The client appeared neat and clean and he was not in a good
mood.His speech was clear and audible. He was oriented in time, place and
person. He was poor in attention and also a calculation. He had good ability
to recall. His repetitive ability was poor. His comprehension ability was good.
He did not experience hallucinations and delusions. He can easily read and
write simple sentences. His drawing ability was poor. He had insight in his
problems. The client had a normal orientation about person ,place and time.
Client also had normal past and recent memory. The client had good insight.
Behavioral observation
The client was 16 years old. He was normal heighted boy. He looked
emotionally disturbed. He was entered in room in lazy way. He wore a pent
shirt and appeared average in weight. His hair were neatly combed. He set on
the chair in normal way before sitting him clear the chair. His facial
expression was quite anxious. He looked very tensed about his problem and
wanted to get rid from it.
Gradually rapport was built, he answer all the question in normal way.
During interview he maintain his eye contact. He was speaking in low tone.
He answered politely, however he was cooperative and told that therapist
everything honestly.
 Client was willing to get treatment and after sometime he was
cooperating during the interview. He also seems to be motivated to get
treatment of her disorder. He was to much anxious. He was attentively and
carefully answering the question. He also had a good insight.
Pre morbid personality:
The client was very sensitive boy. He was not very social. He did not like to
share his feelings with anyone. He had lack of confidence. He was pamper
child. He was very aggressive during childhood. He was not an obedient boy
as he got too much love and attention from his parents. The client has poor
decision making power, he cannot make any decision. His power of
adaptability was also poor.

Diagnostic Test:

Yale Brown Obsessive Compulsive Scale (Y BOOS):

The Y-BCOS consists of 10 items including. 5 for obsession and 5 for
compulsions. For obsessions and compulsions these items rate time spent
interference with functioning distress, resistance and control. If client have
both obsessions and compulsions, and your total score is: 8-15=Mild OCD:
16-23 Moderate OCD: 24-31 Severe OCD 32-40 Extreme OCD.
Quantitative analysis:
Score of the client on Y-BCOS-30-SEVERE OCD
Qualitative analysis:
Client's score on Y-BCOS is 30 which show Severe OCD level which means
that time spent interference with functioning distress resistance and control
all these aspects are affected and need therapy.

The PTSD Checklist for DSM-5 (PCL-5):

• The PTSD Checklist for DSM-5 (PCL-5):
 • The PTSD Checklist for DSM-5 (PCL-5) is a 20-item self-report
measure that assesses the presence and severity of PTSD symptoms.
Items on the PCL-5 correspond with DSM-5 criteria for PTSD. The
PCL-5 can be used to quantify and monitor symptoms over time, to
screen individuals for PTSD, and to assist in making a provisional or
temporary diagnosis of PTSD.

Quantitative analysis:
Client's score on PCL-S=27= Lower than cut off (33)
Qualitative analysis:
Scores lower than 55 indicate the client does not meet criteria for PTSD, and
this information should be incorporated into treatment planning.
Case formulation:
Client’s illness started from his childhood when he was 10 years old. As the
client was the youngest of his siblings and was the only son of his family so
all family members loved the client and took a lot care of client. He became a
pampered child. His family was extra conscious regarding to his toilet
training. They ordered him to wash his hands before and after playing and
doing things. They asked client to take bah twice a day and kept his clothes
neat and clean. He liked to play football. But they did not allow to play
football with other children. They did not allow him to play any outdoor
games. They gave him all opportunities of outdoor games in home. This
affect client so much and he also became extra conscious about cleanliness.
At school he started to avoid siting with other children because he thought
him that he became dirty if he came in contact with other children. His
condition became worst day to day. Even when he took admission in collage
before 2 year, he did not control his thought. He started to wash his hand
frequ cleaned his chair before sitting and then after some time he again
started to clean his chair. He was very upset due to this. He took much time in
doing even small task. He could not stop himself from doing all these. He got
anger when someone changed the order of things that the client had arrange.
He took a lot time in taking bath. His family was very disturbed because of
client’s condition. Client did not meet people because he had guilty feelings.
His sleep was disturbed. If someone put hurdles in client action, he became
very anxious and irritated. So his family brought him hospital for his proper
treatment.
According to DSM-V, the diagnostic criteria for OCD are as follows; the
person with OCD has obsession and compulsion and these obsession and
compulsions significantly impact his daily life. The person may not realize
that these obsession and compulsions are excessive or unreasonable. The
people tries to suppress or ignore the disturbing thoughts. Repetitive behavior
that the person feels that must perform, or someone bad will happen. The
ritualistic compulsion action to reduce severe anxiety caused by the obsessive
thoughts. MSE and OCI-R have been used as assessment tools to assess
functioning of the client in various areas. As the client meets these criteria, he
is diagnosed as suffering from Obsessive Compulsive.
Goals:
Follow goals are identified for treatment of the client.

Short-term goals
 To use relaxation technique in order to reduce the anxiety problems
related to OCD and PTSD.
 To use CBT in order to make client change his thoughts and behaviors.
 To use exposure and response prevention therapy in order to make
 client immune to always showing the compulsions.
 To use gratitude therapy to reduce the effects of all the negative
incidents happened in child’s life.
 To use Art exercises to get client back to his life joys.
 To use journaling in order to get client know himself more and to figure
his anxieties himself.
Long term goals:
 Getting obsessive thoughts and compulsive behavior to their minimum.
 Improvement in social and personal standard of living.
 To psycho-educate the client’s family about the benefits of the therapy.
 To take monthly sessions to give protection against relapse
 REFERENCES

• Diagnostic and Statistical Manual of Mental Disorder 5th (DSM-V)

Washington DC American Psychiatric Association; 2000.
• Anne Anastasi, Sudana Urbina. (n.d.). Psychological testing (7th ed).
Foa, E>B., Huppert; J.D., Leiberg S., Hajcak, G., Langner, R., et al (2000).
The Obessive-Compulsive Inventory: Development validation of a short
version. Psychological Assessment,, 14,485-496.