International Balkan University

Faculty of Humanities and Social Sciences

PSYCHOLOGICAL ASSESSMENT

Case Study

Instructor: Melis Bilibani Student: Nesrin Memed

Skopje, 2021
Table of Contents
Section 1: Introduction ...............................................................................................3
Section 2: Interview ...................................................................................................5
Section 3: Genogram..................................................................................................7
Section 4: Home, Tree, Person- HTP.........................................................................9
Section 5: Family Drawing- KFDT .........................................................................11
Section 6: Personal Sphere.......................................................................................13
Section 7: Final Report ............................................................................................15
Section 8: Appendix .................................................................................................18

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Section 1: Introduction

The primary objective of this study is to better understand the advancement of the chosen client's
personality patterns and/or problems. This study strives to enhance the clients "fully functioning
totality" from within her environment. I was able to provide in-depth observations of the case by
utilizing various psychological assessments. As a result of these methods, qualitative information
was gathered, which was useful in attempting to find new evidence to support or refute a theory,
as it provided me with more information about my client.

In this case study, I examined behaviors in a real-life context and gathered information about my
client from a variety of sources, including parents, relatives, peers, teachers, and other relevant
people in the individual's life. Background variables that have contributed to the client's current
situation were also evaluated, such as her medical history, family, and social histories are all
considered in order to comprehend her unique experiences.

The process of finding a suitable client for this case study was indeed difficult. I tried my best to
contact people with whom I don't have much interaction and know little to no information about
their personal lives, because of the reason that it would be more accurate and authentic from both
sides. When I made my final decision on who would be my client and join me throughout this
process, I contacted the individual in question to explain the objective and purpose of this study in
depth and precise terms.

I introduced myself, my faculty, and my field of study. I personally invited the person to take part
in this case study. I stated that participation in the study is voluntary, so she could choose whether
or not to participate. There was no pressure applied. I also asked her if she had any questions and
assured her that I would be happy to answer them in greater detail. I explained why I'm asking the
individual to participate (a school assignment) and what she'll be asked to do during this process,
as well as how much time this could take her.

Most importantly, I made a concerted effort to inform the individual that demographic information
will be shared as part of this process, but her identity will be kept confidential, and responses from
the individual will never be identified. The participant was aware of all the requirements of the

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each assessment, how I will observe her behavior at all times, how I will go in depth for more
information about her personal life, and how this will be turned in as a report for all of her given
responses at the end. I wanted to record her responses during the interview and genogram
assessment so that I did not miss any detail; this was communicated with the client prior to the
beginning of the assessment. If the client was not comfortable giving or recording an answer, it
would not be documented.

Ultimately, the client will be informed of the final report and given the results prior to uploading,
in case the client wishes to have something removed for privacy reasons or if she feels
uncomfortable.

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Section 2: Interview

Natasha Romanoff, my client, is a 23-year-old female born and raised in Slovakia, but her
nationality is Albanian. She finished her studies by attending a private high school in Slovakia.
Her parents are both alive and married, and she has two siblings who own a family business with
their father. Her mother is unemployed whereas Natasha currently works part-time at a gift store.

Natasha was wearing black shirt and pants with a blazer on top. Her hair was simple, arranged in
a one-sided style, her skin was slightly pale, and her eyes were hazel brown. Her height was
somewhere in the middle, and she had a fine, curvy body figure.

She was initially at ease and made good social contact, her body scent was pleasant, but I noticed
sweating throughout the process which gave me the impression that she was getting nervous. Her
posture was relaxed, but it would occasionally shift into a more nervous or anxious posture for a
short period of time. Her mannerism was talking with hand movements and facial expressions,
she was energetic and interacted throughout the whole interview, she spoke freely, and her voice
quality was low pitch with an average volume, but there were some instances of vocal tics from
time to time.

Natasha began to answer my questions about her family environment, stating that her parents are
happily married and that she gets along well with her brothers. Overall, she drew a picture of a
happy family to me.

Living abroad gave her family a sense of "fear," she described, because they saw a variety of
families who were divorced and abusive to one another; "We wanted to be different, so maybe
that's why we're still very close," she said. While observing her, I could tell she was very proud
of this fact because she tilted her head back and visibly expanded her posture. When I asked her
to describe her mother, her voice became higher pitched, like a child talking about his favorite
toy. She was described as having a calm and understanding personality. "She is my best friend,"
whereas for her father she described him as the smartest person she has ever met.

When I started asking about her school experiences she stated: "I was a chubby girl growing up,
and I was teased in school to the point that I became self-conscious about my appearance." At
this point, I realized she was losing eye contact with me, crossing her arms, and blinking rapidly

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due to distress or discomfort. She described a difficult school experience, which influenced in
her social skills and typical behavioral responses such as withdrawal and isolation, as well as her
becoming more self-reserved and having lower self-esteem. What I found most intriguing was
how her behavior toward her family remained consistent even while she was being bullied; she
described home as her safe place. She had no bad memories of her parents from her childhood,
only occasional fights between her brothers, which she described as harmless.

When I asked her how she chose her department, she gave me a straightforward answer. "My
parents did," very gleefully, as if she wasn't bothered at all. This leads me to the conclusion that
Natasha suffers from a neediness characterized by an excessive reliance on others. Her family is
responsible for her emotional and physical needs. The reason for this can be found in the fact that
she was separated from her culture from a very young age, and all she had was her closest
family.

She describes how she feels quite comfortable when she is actually engaged in a conversation,
however, "Sometimes I get so wrapped up in my insecurities that I start behaving awkwardly,
and people notice”, she revealed. She went on to say that she has a large group of friends but that
she doesn't communicate with them very much, and that she only hangs out with two or three
people on a regular basis. She despises going to bars and large parties. Her brows furrowed and
her arms were clasped around her waist, as if I were insulting her in some way with this question.

During this portion of the interview, I noticed her attempting to control her emotions by biting
her lips, which was a sign of discomfort, and the most eye-catching detail was her beginning to
bite her fingernails (which had scars from previous biting). Her social life, as she described it,
was dependent on how she felt that day and what social activity she would be participating in.

Natasha refused to give further information about her relationship with her fiancé.

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Section 3: Genogram

I found several shared traits as a result of both nature and nurture when examining her family
history for this assessment. I found the distinctive patterns fascinating in the way they were laid
down over the generations and the specific sides on which they happened to manifest
themselves.

The characteristics that exist within Natasha’s family that a result of nature are Lung Cancer, PP
disorder (paralysis) and vision problems ( bad eyesight). Cancer has recently been present on her
mother's side of the family, as her grandfather died suddenly of lung cancer at the age of 72, and
there were no patterns of this disease in previous generations. Her grandmother, on the other
hand, was paralyzed from the waist down for ten years and died when she was 65. Her mother
has two brothers, the youngest of whom is shown to have Hip Dysplasia, However, since no one
in the family had it before, this is not considered inherited.

Both grandparents on her father's side of the family died unexpectedly, with no natural causes
present.

All her mother's side of the family have medium height, which results in her and her oldest
brother being in the same category, whereas the father and younger brother are taller. She also
mentioned that her immediate family has a dominant eye color. "My mother and younger brother
have very light hazel brown eyes, while my father and older brother have bright blue eyes."

Natasha's brother has had bad eyesight since he was a kid, so this resulted for her to have the
same problem present since childhood.

She had no recollection of any drug/alcohol or mental health problems in her family.

Natasha gradually started to explain her family's insights. She was nervous at first, but she soon
calmed down. She portrayed the family's relationship as "very close and honest." She clarified
that even though the brothers live apart from the home, they try to see each other every day. "We
build a wonderful environment."

I began progressively adding questions to the evaluation. To whom are you closest? “My parents,
especially my mother, who understands everything, and we get along amazingly.” She went on
to say that she is a mash-up of her parents and her older brother, with whom she has a close
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bond. Her younger brother, on the other hand, she describes as having a very volatile
temperament, and they have a fused hostile relationship. Her father's relationship with her
brothers was not as close as it was with Natasha. Throughout their youth, he was more rigid and
passive. This may have been a character influence passed to the younger brother.

I noticed the same patterns of behavior in the brothers' relationships with their partners, since
they recently got married. The older brother as described by Natasha portrayed a more calm and
understanding relationship, whereas the younger was more passive and jealous.

Given that she lives abroad and has little contact with other relatives, the genogram is only three
generations long. She only stated that she is closer to her mother's side of the family and that her
father's side of the family is not very welcoming.

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Section 4: Home, Tree, Person- HTP

She was instructed to complete the HTP art projective test. It took her about seven minutes to
complete the sketch, including coloring and detailing.

The drawing of the house was overly simple and sparse. This is a reflection of feelings of
inadequacy which can be due to her low self-esteem. The house is small, and like her other
sketches, suggests vulnerability, frustration, and regression. The chimney represents comfort in
her household, she drew a normal amount of smoke. Natasha drew five windows, one of which
was in the roof, which may designate that she wants to be open to the world. However, there is no
walkaway in her drawing of the entrance. This gives me the idea how she is haunted by her
previous experiences and is afraid of how the world will judge her if she expresses herself outside
of that house. I can see how she is solely dependent on her family once more. When asked to
describe the house, Natasha stated, "It's my parents' house, but I live there too." She also said it
was built in her father's style. Furniture made of wood in a very traditional way. "We are happy
inside this house," she added, making direct eye contact with me while expressing no signs of
discomfort.

Her drawing of the tree is the same size as her house; it is slightly bent and not straight, which may
reflect the environmental strain she is experiencing, it may also represent her inadequate social
performance and insecurity. She also drew a variety of branches inside the tree to represent feeling
overwhelmed by incoming stimuli and outside pressures. The branches are also small and invisible,
giving the impression of an introverted personality. The trunk can be interpreted as reflecting inner
strength, self-esteem, and personality integrity. She drew the trunk with thin lines and shading at
the bottom, implying weakness, passivity, and insecurity. What I found very interesting was that
as she was finishing her drawing of the tree, she paused for a moment to observe what she had
drawn, tilting her head as if something was missing. She began adding cherries and small scales
to her tree. This gives me the impression that she is attempting to push herself out of her comfort
zone and become more open to new ideas.

Finally, she drew the person which was a female, giving the idea that she is certain about her sexual
identity. The drawing was cartoonish and irregularly shaped, similar to a child's drawing. The
person she draw was small, which could indicate low self-esteem, or lack of energy. She began to

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thicken the person's lines, much reinforced lines that may be attempts for her to shield herself from
anxiety-provoking factors, and she started to shade her whole body, which represents her previous
encounters when she was bullied for her appearance. She drew the hands in a mitten pattern, as if
punching someone, which could indicate that she has trust issues and does not open herself to
anyone. As she described her drawing of the person, her response to the question, "Is this person
happy?" was: "She has a lot going on, she's really stressed out, and she just wants to be alone,”
When she realized what response she had given away, she began to panic, as if she had somehow
exposed herself. She was very persistent in convincing me that the person wasn't herself and that
she was simply imagining someone. I can see how self-reserved she is when it comes to expressing
her emotions, this may be a result of her previous relationships with others.

Overall, I didn't see any signs of frustration or stress-related feelings during this phase. She was
relaxed and in a good mood, and she found a way to make jokes about her drawings, which gave
me the impression that she is having fun without putting too much pressure on herself.

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Section 5: Family Drawing- KFDT

Natasha's next drawing depicted her and her family engaging in a shared activity. This drawing
portrays her family's supposed intentional relationships. The drawing is located in the lower-left
corner of the page, which may represent isolation, regression, or ruminating on the past.

She began by drawing her father cooking; this is not a common practice of fathers, but hers
appears to represent a father figure who meets her nurturing needs. Father's eyes are oddly shaped,
but he has a smile, which suggests that he has a good attitude and behavior around the house. His
size is the largest of the family members, which may mean that he was more important or had a
greater psychological impact on her life. She drew her mother close to her father's figure, implying
a stable relationship between the parents. They both have identical facial features and were colored
in the same colors. This reflects her appreciation or fondness for identification with her parents
and her desire to be like them.

The mother is drinking coffee and watching television. In the interview, she describes her mother
as a very strong woman. I perceive this situation as if she wants her mother to rest and finally be
in harmony. This can be related to the fact that in the interview she also describes her mother's
struggles, how she was a foreigner trying very hard to be accepted by society.

The two brothers are at the bottom of the page; one is working and the other is taking his car to
work. This can refer to the brothers being on the outside of the family rather than being an integral
part of it. This reflects a deterioration in the relationship between her parents and her two brothers.
Considering she didn't mention her brothers living in the house in the HTP test and also, Natasha
claimed in the genogram evaluation that the father was not very engaged and had a stricter father
figure towards them. This may be due to parental favoritism, or it may simply be the age gap
between the siblings; given that the brothers are much older than Natasha, they could now want to
live more independently, not engaging in family activities that much.

Now comes the most critical aspect of the assessment. Natasha did not draw her own image in the
family portrait. This reflects low self-esteem, feelings of exclusion, and feelings of insignificance.
However, if I consider Natasha's observations in this process, I can see how much she values and
desires to be a part of the family. This could indicate a selfless act from her side, meaning that she

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is more concerned with the well- being of her family. That's why she only did the drawing of them
and did not think of herself at the moment.

Natasha presented herself calmly and slowly but surely during this assessment. Her feelings for
this drawing came to her in a primal, natural way, and the drawing happened without her having
to think too hard about it.

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Section 6: Personal Sphere

It took her about 25 minutes to draw the circle with the objects, and another five minutes to
finish the drawing by inserting crossbars. Throughout the process, she appeared to be very
confused and lost in the drawing, stating, "I don't have many things or people around me." Her
nervousness was palpable, as if she was afraid I’d judge her for it.

The finished drawing depicted ten items arranged in a circle, which conveyed a rather positive
and friendly tone; all of the objects were portrayed with nice and pleasant symbolism. The
drawing is in the center of the page, taking up a quarter of its space.

The use of space and distance between the objects is very close to one another. She began by
first drawing five symbols of people and proceeded to draw two symbols of things and three
ideas. Which indicates that the nature ratio of the drawing is (P-I-Th)

The first symbol she drew was a small heart which represented her mother. She continued to
draw the symbol of her fiancé with the same symbol, leaving a little space in between. She took a
minute and then proceeded to draw in between these two objects the symbol of a smiley face
which represented happiness. Three of the symbols had three connecting lines and one crossbar.
This implies that her mother and finance play critical roles in her happiness.

Next, she drew a small sun to represent her freedom, and next to it, she drew her father with a
smiley face, which represents how she feels around her father. Free and able to express herself
for who she truly is. Both the symbols had three connecting lines and one crossbar.

She then drew her brothers with the symbol of two stick figures standing together, followed by a
book representing her faith. Both symbols were linked together by three lines and one cross bar.

As she worked on the assessment, I could see how it grew on her and she began to have a more
positive attitude about it. She was more certain.

The next symbol she drew was of her friends with a face and heart eyes, and right next to it she
drew her cat with little ears and a moustache. Two connecting lines and two cross bars connected
her friends. Which wasn't surprising given how her social life was illustrated in the previous
assessments. The cat was linked with three connecting lines and one cross bar.

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Her final symbol was a sketch of her house. It was connected by a single connecting line and two
cross bars. When asked why, she said, "I am not attached to places, I am more interested in who
is in that house; for me, home is where my family is."

Her drawing consisted of 28 connecting lines and ten objects. As a result, the Bond Index (C/O)
was 2.8, suggesting that the intensity of relationships is better than average. Indicating a very
strong bond.

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Section 7: Final Report

Natasha's performance on psychological assessment measures suggested that she was not
suffering from any major behavioral changes at the time of her examination. Her ability to
communicate and coordinate with her visual perceptions and her hand movements was very
helpful for my further observations. There were no exceptional events or disruptions during
Natasha's testing that could have prevented her from giving her best performance.

The findings of this report's interview portion are regarded as a valid assessment of Natasha's
portrayal of herself, where it appears that she can occasionally feel powerless, subservient, or
incapable of being apart from her family. Her interview suggests that she may be attempting to
appear less in need than she truly is. This was especially noticeable in cases where the questions
were clearly intended to probe her familial surroundings and relationships. Natasha spoke
frankly about herself and her sentiments, pausing to ponder the questions. The general themes
included a strong attachment to and love for her family, as well as negative thoughts towards
school bullies. She had difficulty recalling unfavorable memories with her family (i.e., occasions
of rage), yet she could easily recollect specific memories of being bullied.

She is perceived to be apprehensive, to have tense and repetitive habits, to be fidgety and
restless, and to have mood swings. She demonstrates a poor approach to planning and
communicating with others who are not members of her family. However, she becomes upset
and anxious when she recognizes she has a problem with social interactions and fears it will not
change.

She frequently recalled her school years, during which she was bullied for a lengthy period of
time, and she recalls feeling enraged and miserable, and she considers bullying to be the worst
thing that has ever happened to her. This led in her isolation from other people, and her looks
continues to make her feel as if everyone is still criticizing her.

She has low self-esteem, which is not a condition by itself, but when combined with other
symptoms, it can indicate the presence of more serious conditions.

Because she has been estranged from her relatives since childhood and lives in another country,
Natasha provided information only about her immediate family in the genogram assessment,

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rather than expanding the genogram to include additional relatives. This fact validates her
devotion and alertness she portrays for her family. Even though she is no longer a teenager, she
is extremely reliant on them. She appears naive and immature, with a strong desire for attention
and affection.

All of these behavioral patterns can be linked to how she handled previous school experiences
and the type of coping mechanism she developed. Based on the observations made on her, it is
possible to conclude that she developed maladaptive coping mechanisms. Specifically, an escape
mechanism in which she withdraws from friends and becomes socially isolated in order to cope
with her difficulties.

Natasha's profile suggests that her interpersonal functioning is significantly hindered, owing
primarily to her defensive avoidance of emotionality and connection. While she is capable of
normal levels of openness and tends to be only mildly suspicious and defensive in relationships,
she can only do so when interactions are kept at a surface level. Once formed, Natasha’s intimate
relationships are prone to a clingy character of relatedness as she seeks to meet her unmet
dependency demands. According to Natasha’s profile, others are likely to regard her as socially
awkward, shy, and possibly unfriendly.

Natasha's social profile indicates that she has antisocial tendencies and resents societal rules and
conventions when it comes to large social events.

Natasha has a tendency to underestimate her needs, as evidenced by her Kinetic Family Drawing
assessment. In the portrait, she did not draw herself. When asked why, Natasha replied, "I guess I
was so focused on portraying them in the drawing that I forgot about myself." This demonstrates
how she can be ready to push away herself just to portray a greater picture for her family.

This selfish act may be the result of her believing that her family is her only true path and that
they can only accept her as she is. Or she may feel as though she is a burden to them, which is
why she did not draw herself in the portrait. Whatever the case may be, this conduct might have
an impact on her irritation, negative perspective, and self-concept.

She considers herself to be inferior to others and insufficient to meet life's challenges. Her
responses indicate that these ideas are mostly a result of her poor academic achievement rather

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than a general sense of inadequacy. Natasha also appears to be extremely perplexed about her
potential role as an adult. This is owing to the fact that her parents made all of her life decisions.

However Natasha did draw five windows in the House drawing, indicating that she is working
towards a future in which she will be comfortable enough to be open to the world. The cherries
in the tree also signify "hope" for her. Hope to improve herself.

Recommendations:

Several areas may be targeted for intervention in order to better suit Natasha's needs.

Cognitive behavioral therapy is beneficial in the treatment of low self-esteem because it can help
her identify the source of her low self-esteem and monitor negative thoughts, doubt, and anxiety,
as well as alleviate painful feelings and empower her to take constructive action.

For persons like Natasha who are more reliant on others, psychotherapy is the primary treatment.
The goal of therapy is usually to assist people become more independent.

Please keep in mind that such observations and suggestions cannot compare to the judgment of a
real-life healthcare worker. It is recommended that she seek the advice of mental health
professionals in order to better understand her symptoms and conduct a proper clinical
diagnostic.

Natasha, my case study client, was a fascinating individual to work with. After all of the
observations, she portrayed herself as someone who had been influenced by her prior
experiences to develop certain changes in her personality. These changes are impediments to her
future growth. However, I feel she may accomplish her ideal self with the correct regimen and
dedication to herself.

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Section 8: Appendix

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