Kainat Khan

INTERSHIP REPOIRT
CLINICAL PSYCHOLOGY
Submitted To:
Sir Masood Riaz
Submitted by:
Kainat Khan (50469)
Advance Diploma in Clinical Psychology
2019-2020
Department of Applied Psychology
Government College University Faisalabad

TABLE OF CONTENTS
Sr. No Contents Page No
1 Case No.1
Drug Addicted Disorder
3 Case No.2
Major Depressive Disorder
4 Case No.3
Schizophrenia
Drug addict patient
People are most likely to begin abusing drugs*—including tobacco, alcohol, and
illegal and prescription drugs—during adolescence and young adulthood. ‡
By the time they are seniors, almost 70 percent of high school students will have tried
alcohol, half will have taken an illegal drug, nearly 40 percent will have smoked a
cigarette, and more than 20 percent will have used a prescription drug for a
nonmedical purpose. There are many reasons adolescents use these substances,
including the desire for new experiences, an attempt to deal with problems or perform
better in school, and simple peer pressure. Adolescents are “biologically wired” to
seek new experiences and take risks, as well as to carve out their own identity. Trying
drugs may fulfill all of these normal developmental drives, but in an unhealthy way
that can have very serious long-term consequences.
Many factors influence whether an adolescent tries drugs, including the availability of
drugs within the neighborhood, community, and school and whether the adolescent’s
friends are using them. The family environment is also important: Violence, physical
or emotional abuse, mental illness, or drug use in the household increase the
likelihood an adolescent will use drugs. Finally, an adolescent’s inherited genetic
vulnerability; personality traits like poor impulse control or a high need for
excitement; mental health conditions such as depression, anxiety, or ADHD; and
beliefs such as that drugs are “cool” or harmless make it more likely that an
adolescent will use drugs.
Case No 1
Bio Data:
Name R.R
Father Name M.R
Age 29 years
Sex Male
Religion Islam
Sibling 08(03 sisters and 05 brothers)
Birth order 4th
Address Faisalabad
Education F.A
Occupation shopkeeper
Monthly income 12,000
Children 1 daughter
Marital status Married
Father’s education Metric
Mother’s education Primary
Mother age 66 years
Father occupation factory worker
Mother occupation house wife
Father living\dead Dead
Mother living\dead Living
Socio – economic status middle
Identifying information from family

Reason and Source of referral:
The patient was referred by psychiatric Doc. Subhan Ansari .
Presenting Complaints:
Symptoms of illness:
Symptoms Duration
Dysphonic mood 1 month
Fever 12 days
Headache 10 days
Impairment in attention 10 days
Insomnia 10 days
Aggressive 7 days
Alcohol 3 years
Heroin 2 years
Patient’s Background Data

Family History:
The patient’s father had dead. His mother was a house wife. The patient has 8 siblings
(three sisters and five brothers) . The patient birth order is 4 th and he is married. The
patient has poor relation with his family, friends and peers.
Family History of Past Illness:
The patient’s mother was patient of high blood pressure.
Personal History
Early Childhood:
The patient childhood was very good. He was innocent boy. He spent most of the time
with his friends.
Adolescence:
The patient said the adolescence was unmemorable time of his life. He had very good
relationship with family and friends. He was good student.
Adulthood:
He was leading a happy life before smoking. He behaves very rudely with his family
after smoking and drugs. Because of his smoking his family suffered economically
and emotionally disturbed. He was much impressed by his friend . He left school and
spent more of the time in the company of bad friends. He started smoking and drugs
in company of his friends.
History of present illness:
Patient suffered from severe bodily pain, stress and headache.
History of past illness:
The patient was suffered from severe bodily pain, headache, stomach pain, low mood,
restlessness and aggressive behavior from the last one month.
Physical\Biological problems:
No physical problem was found in patient.
Psychometric Disturbance:
The patient suffered from headache and fever.
Psychological Assessment
Patient was assessed through:
 Clinical Interview
 Mental State Examination
 Behavioral Observation
 Psychological tests
Clinical interview:
The patient was brought by his brother. He wanted to manage his behavior with his
family.
The patient’s presenting complaints were headache, low mood, impairment in

attention , fever and aggressive behavior. The patient reported that he started smoking
in the first but after that he used heroine and alcohol very frequently and in very much
quantity. His friends were more responsible of his bad habit.
Behavioral Observation:
Patient was lying on bed, wearing dirty cloth and uncombed hair. He was in low
mood, suffering from high fever and wanted run from home .When I asked him about
to do work, he totally refused me but after developing rapport he agreed and complete
my task. He was looking so much restless
Mental state examination:
Before come to me, patient had totally cutoff from the society and the patients
attention and concentration was not good . But after his treatment his orientation
about time, place and person was not good. He recognize about surrounding people.
After the treatment the patient attention and concentration was good.
Attention:-
He had not good attention. He was trying focused to my questions.
Orientation:-
His perception and orientation of time, place and person was seems to be intact.
Memory:-
Memory was good. Insight was not present.
Language
His language is good .
Psychological Assessment:
Psychological assessment of the patient was done by using following tests:

Slosson Drawing Coordination test (SDCT)
DCT meaning is Nrst Software Diagnostics and Conformance Testing Division and
other full form of SDCT definition take part in below table. There are 12 different
meaning of SDCT acronym in the table which are compilation of SDCT abbreviation
such as Government, Us, Control, Administration etc. terminologies. Unless you
cannot find the meaning of SDCT acronym which you look for in 12 different SDCT
meaning table, please search again as using question model like “What does SDCT
mean?, SDCT meaning” or you can search by typing only SDCT abbreviation in the
search box. Meaning of SDCT acronyms are registered in different terminologies.
Especially, if you wonder, all meanings belonging to SDCT acronyms under a
terminology, click related terminology button at the right side (bottom for mobile
phones) and reach SDCT meanings which recorded to only that terminology.
Human Figure Drawing (HFD)
e medical eld has its relevance as a tool for decision-making

relating to the dierential diagnosis, type of treatment required and
prognosis. In this perspective, the psychological assessment purposes
are to identify the psychological and neurological repercussions caused
by the disease or injury process [1]. In opposed to medical tools, one
of the central assumptions during this procedure is the use of assessing
personality in an unconscious mind. From a psychoanalytic perspective
an indirect approach such as projective drawing is an eective
instrument that helps in viewing the inner world, unconscious defenses
and conscious resistance. Moreover, Projective drawing test is a tool
that allows also achieving information concerning the sensitivity and
maturity of the patient, as a part of integrated personality and his inter-
personal interaction with the environment [2]. In recent decades, a
widespread use with projective tests as a tool for psychodiagnostic and
neuropsychological assessments has become popular. Today there is no
doubt that drawing test is a tool that allows getting information about
the vulnerabilities, the maturity of the patient’s personality integration
and inter-personal interaction with his environment
The medical field has its relevance as a tool for decision-making relating to the
differential diagnosis, type of treatment required and prognosis. In this perspective,
the psychological assessment purposes are to identify the psychological and
neurological repercussions caused by the disease or injury process [1]. In opposed to
medical tools, one of the central assumptions during this procedure is the use of
assessing personality in an unconscious mind. From a psychoanalytic perspective an
indirect approach such as projective drawing is an effective instrument that helps in
viewing the inner world, unconscious defenses and conscious resistance. Moreover,
Projective drawing test is a tool that allows also achieving information concerning the
sensitivity and maturity of the patient, as a part of integrated personality and his
interpersonal interaction with the environment. In recent decades, a widespread use
with projective tests as a tool for psychodiagnostic and neuropsychological
assessments has become popular. Today there is no doubt that drawing test is a tool
that allows getting information about the vulnerabilities, the maturity of the patient’s
personality integration and inter-personal interaction with his environment.
Goodenough has already reported in the twenties of the last century on many clinical
findings that can be produced by children’s drawings and deduce the mental states
beyond the level of intelligence. The test can also provide a lot of information about
cognitive function, since it requires visual-spatial skills, attention and concentration
and accurate perception of visual stimuli. HFD test (Human Figure Drawing) is an
abbreviated test which was developed several decades later, with the aim to evaluate
various psychological states, such as psychosocial status [5]. The practice of using
human figure drawings (HFDs) to assess intellectual and psychological ability is
pervasive among psychologists and therapists in many countries [6]. Recently a
positive relationship was found between the size of the painting and the self-esteem of
students in secondary division. Also found a positive correlation between the size of a
cartoon character and its details and the degree of self-esteem in men
Rotters incomplete test sentence blank (RISB)

Three hundred sixty-eight high school students and 136 college students were
administered the Rotter Incomplete Sentence's Blank (RISB; Rotter & Rafferty, 1950)
and the Maudsley Personality inventory (MPI; Eysenck, 1962). Scores on the RISB
and MPI were compared to scores for the normative samples published in each test's
manual. Using the RISB manual scoring criteria, over half of high school students
(55%) and over 40% of college students scored above the RISB cutting score,
signifying "maladjustment." Reasons for this high proportion of adolescents scoring
in the maladjusted range include the fact that the RISB was normed on a college
student sample from the late 1940s and the fact that the manual has never been
updated. These results indicate that extreme caution should be exercised when using
the RISB with adolescent populations. In addition, suggestions are made for revisions
to the RISB and raising of the maladjustment cutting score.
Depression anxiety Stress Scale
The Depression, Anxiety and Stress Scale - 21 Items (DASS-21) is a set of three self-
report scales designed to measure the emotional states of depression, anxiety and
stress. Each of the three DASS-21 scales contains 7 items, divided into subscales with
similar content. The depression scale assesses dysphoria, hopelessness, devaluation of
life, self-deprecation, lack of interest / involvement, anhedonia and inertia. The
anxiety scale assesses autonomic arousal, skeletal muscle effects, situational anxiety,
and subjective experience of anxious affect. The stress scale is sensitive to levels of
chronic nonspecific arousal. It assesses difficulty relaxing, nervous arousal, and being
easily upset / agitated, irritable / over-reactive and impatient. Scores for depression,
anxiety and stress are calculated by summing the scores for the relevant items. The
DASS-21 is based on a dimensional rather than a categorical conception of
psychological disorder. The assumption on which the DASS-21 development was
based (and which was confirmed by the research data) is that the differences between
the depression, anxiety and the stress experienced by normal subjects and clinical
populations are essentially differences of degree. The DASS-21 therefore has no
direct implications for the allocation of patients to discrete diagnostic categories
postulated in classificatory systems such as the DSM and ICD.
Interpretation of the Result
SlossonDrawingCoordinationTest:
Quantitative Analysis:
Patient age 29 years
Error 6
Accuracy Scores 83%
Time taken 18 minute
Eyes – hand coordination poor
Qualitative Analysis:
According to the SDCT score the patient eye – hand coordination does not seems to
be intact.
Human Figure Drawing:
Qualitative analysis:
The profile of HFD shows that the patient seems to have poor coordination, poor fine
muscles control, physical inadequacy and it’s at also seems to the patient have
dependent behavior.
Rotter’s incomplete sentence blank (RISB):
Quantitative Analysis :
Categories of No.of Responses Value Total

Responses in Categories
C3 0 6 0
C2 6 5 20
C1 10 4 45
N 7 3 9
P1 17 2 34
P2 8 1 5
P3 0 0 0
Total 150
T0TAL = 150
CUT OF SCORE = 135
The client is maleadjusted
Depression anxiety stress scale (DASS)
Quantitative Analysis:
Depression 27 Severe
Anxiety 29 Extremely severe
Stress 27 Severe
Qualitative Interpretation
According to our analysis, the value of depression is 27, the value of anxiety is 29 and the
value of stress is 27.
Prognosis:
At the time of admission the patient was so much aggressive and impairment in
attention . But now with the help psychiatric and therapies the problem of the patient
seems to somewhat settled now and his achievement indicates that with the help of
biological and psychological treatment and with the cooperation of family the patient
may become healthy.
Diagnosis:
On the basis of history, behavioral observation, clinical interview, and psychological

assessment the patient has suffered from opioid withdrawal and drug addicted.
Case Formulation :
The client is 29 years old male who belong to a low middle class family . He is the
middle child of his parents and he is a shopkeeper . His father was deid and he was a
factory worker and his mother was a house wife . He was referred due to his drug
addict problem . It was reported that he use drug from last 3 years . He is showing
aggressive behavior with his family . Three session were conducted with the client
and psychological assessment was done . The three psychological tests that were
administered were RISB , HFD and SDCT . Through the result of the administered
tests it was interpreted that through SDCT it was observed that his eye – hand
coordination does not seems to be intact and no physical problem was found with the
client .
The HFD test interpret that poor coordination, poor fine muscles control, physical
inadequacy and have dependent behavior . The client was given some suggestions
during his sessions which he followed properly due to which an improvement was
observed in his behavior during the sessions . At the end of the session he was given
some recommendations that will be helpful for his in the future .
Sessions with client :
1st Session:
First session was started with informal information. I introduced myself to client. The
client was referred by Dr. subhan Ansari . The client was little bit hesitated and shy.
In the 1st session I built rapport with my client. I asked him about his interests. I asked
him of about his siblings and family members. I also asked about his favorite dish and
favorite T.V programs. After discussion he was cooperative with me during interview.
2nd Session:
In 2nd session I met to the client’s parents. I introduced myself. Clinical interview was
conducted with his brother . His brother was asked to describe his brother problem. I
asked his story of the clients from the brother. Personal information, duration and
severity and presenting complaints were also asked from brother. I asked about his
relationship with his siblings and parents from his brother.
3rd Session:
In 3rd session I asked him about his hobbies just to take his in confidence. Then I
asked him about daily preoccupation. Then informal assessment procedure was
started. In this session psychological test was administered to assess the client’s
current problem and functioning. At 1 st Slosson drawing coordination test (SDCT)
was administered. All necessary instructions are given to the client . At 2 nd Human
figure drawing (HFD) was administered . All necessary instructions are given to the
client . I also applied RISB. After completion of the psychological test and their
evaluation different therapies was selected by me to deal with the current problems of
the client. I applied deep breathing exercise to him. I said to my client to take a deep
breath. He did so and said to me that he feel relax .
Conclusion:
On the basis of presenting complaints, clinical interview and psychological

assessment that reveal Mr.R. R suffered from opioid withdrawal and Drug addicted .
Recommendations:
 Family therapy
 Cognitive behavior therapy
Depression adult patients
Depression is a broad and heterogeneous diagnosis. Central to it is depressed mood
and/or loss of pleasure in most activities. Severity of the disorder is determined by
both the number of and severity of symptoms, as well as the degree of functional
impairment. Mild depression accounts for 70%, moderate depression 20% and severe
depression 10% of all cases. Estimates of the incidence of depression within the
population range from 3-6% of adults and the number of people identified with and
requiring treatment for depression is estimated to increase by 17% to 1.45 million in
2026. It is estimated that depression is two to three times more common in people
with a chronic physical health problem (such as cancer, heart disease, diabetes or a
musculoskeletal, respiratory or neurological disorder), occurring in about 20% of this
population. The annual service costs to treat people with depression in 2007 were
estimated to be £1.7 billion, far less than the cost to the economy attributed to
depression (£7.5 billion).
This quality standard describes markers of high-quality, cost-effective care that, when
delivered collectively, should contribute to improving the effectiveness, safety and
experience of care for people with depression in the following ways:
 Preventing people from dying prematurely.

 Enhancing quality of life for people with long-term conditions.
 Helping people to recover from episodes of ill health or following injury.
 Ensuring that people have a positive experience of care.
 Treating and caring for people in a safe environment and protecting them from
avoidable harm.
Case No. 2
Bio Data
Name A.S
Father name M.K
Age 22 year
Sex female
Religion Islam
Sibling (04brother and one sister)
Birth order 5th
Address Faisalabad
Education metric
Occupation steching
Marital status unmarried
Father living/dead alive
Mother living/dead died
Father occupation employ
Socio-economic status lower middle class
Source of referral:
The Client was referred by psychiatric Dr. Subhan Ansari .
Assessment Procedure:
Patient was assessed through behavioral observation, Clinical interview, and

Psychological test (such as DASS, RISB and HFD) .
Presenting Complaints:
Symptoms of illness:
Symptoms Duration
Feel sad 6months
hopeless 2 months
loss of interest 1 month
insomnia 3 months
suicidal thoughts 20 days
Lack of concentration 1 month
Restlessness 20 days
Fatigue 1 month
Pertinent Background Data
Family history:
The patient father was a employer and his education was metric. Her mother was died
when she was 12 years old . The patient father married to another women .The
patient has five sibling ( four brothers and one elder sister) they are all unmarried. The
patient birth order is 5th . The patient had not good relation with her family and
specially her step mother .
Family History of Past Illness:
The patient father was blood pressure patient.

Personal History
Early Childhood:
The patient childhood is very good. She was not a naughty girl. She was a shy girl.
She spends most of her time with her mother .She was very close with her mother .
Adolescence:
The patient said that adolescence was not good time of her life. Her mother was died
when she was 12 years old . She had not good relationship with her friends and
family. She was a shy girl . She was very missed her mother .She can't accept her step
mother.
Premorbid Personality:
The patient was very caring and friendly with her family when her mother was alive
and She was very happy with family and sibling but after her mother death she
remained silent and spent all the day in weeping . when she was going to her relative
house she remained silent she avoid to going in social places . Her orientation about
time, place and person was intact.
History of Present Illness:
Patient suffered in bodily pain. Lack of concentration , insomnia , hopeless and

suicidal thoughts .
Physical Problem:
No physiological problem was found in the patient.
Psychosomatic Disturbance:
The patient suffered from fatigue and restlessness .
Psychological Assessment
Patient was assessed through:
 Clinical Interview
 Mental State Examination

 Behavioral Observation
 Psychological tests
Clinical interview:
The patients presenting complaints were feel sad , restlessness and insomnia , lack
of concentration , hopeless and loss of interest . The patient reported that her step
mother behavior is not good with me and she always shouted on me . The patient said
that my step mother don't like me . The patient reported that she cannot properly
steach the clothes and she can’t concentrate on any work. The patient said that when
she was not steach the clothes ,her step mother shouted me . The patient reported that
she have economic problem .
Mental State Examination:
Before coming to the me patient had no insight, she had feel sad and hopeless ,
she behave aggressively but after the therapy her behavior was good with me . Her
was totally orientated about time place and persons.
Clint setting in front of my chair, wearing shabby clothes and uncombed hair. She was
looking very dull and depressed. When i asked her about to do work, she totally
refused me but after developing rapport she agreed and completed my task .
General appearance:
The client have in dirty clothes and uncombed hair . she look very depressed.
Talk and voice:
She talk not very well and she start the conversation but sometime stop the
conversation and then strart again .
Insight:
She had no insight . First of all I aware the client about disorder .
Psychological Test:
Psychological assessment of the patient was done by using following psychological

tests :


Interpretation of the Results
Rotter incomplete sentence blank

Quantitative Analysis :
Categories of No.of Responses Value Total

Responses in Categories
C3 0 6 0
C2 6 5 20
C1 10 4 45
N 7 3 9
P1 17 2 34
P2 8 1 5
P3 0 0 0
Total 137
Cut of score = 135
Total score = 137
The client is maladjusted .
Human Figure Drawing:
The profile of HFD shows that the patient has poor coordination and she has not has
any neurologically problem. The figure shows that the patient has the guilt , anxiety ,
poor achievement , instability and depression . She reflects the depressed behavior.
Depression, anxiety, stress scale:
Quantative analysis:
Depression Anxiety Stress
Extremely severe 36 Severe =19 Moderate =21
The patient have extreme severe depression , severe anxiety and moderate stress .
Slosson Drawing Coordination Test (SDCT)

Quantitative analysis
Age 25 years
Errors 25
Accuracy Score 33 %
Qualitative Analysis
According to the SDCT scores, the patient’s eye-hand coordination does not seems to be
intact.
Prognosis:
At the time of admission the patient was felt restless. But with the help
of the treatment problem of the patient seems to somewhat settled now. She feels
comfortable with the psychologist. After the session with counselor she feels relax .
Diagnosis:
On the basis of history, behavioral assessment, clinical interview, psychological

assessment and mental state examination that the patient has suffered from
depression.
Case Formulation :
The client is 22 years old female who belong to a lower middle class family . She is
the 3rd child of her parents and she steach the clothes. Her father was alive and he is
a factory worker and her mother was died when she was 12 years old . She was
referred due to her feel sad ,hopless and suicidal thoughts problem . It was reported
that she suffered from this problem last 6 month . She is showing aggressive
behavior with her family . Three session were conducted with the client and
psychological assessment was done . The three psychological tests that were
administered were RISB , HFD ,and DASS. Through the result of the administered
tests .The HFD test interpret that poor achievement , guilt , anxiety and depressed
behavior. The RISB test score interpreted that the patient is maladjusted .The DASS
test interpreted that the patient have extreme severe depression , severe anxiety and
moderate stress .
The client was given some suggestions during her sessions which she followed
properly due to which an improvement was observed in her behavior during the
sessions . At the end of the session she was given some recommendations that will be
helpful for her in the future .
Sessions with client :
1st Session:
In the 1st session I built rapport with my client. I asked her about her interests. I asked
her of about her siblings and family members. I also asked about her favorite dish and
favorite T.V programs. After discussion she was cooperative with me during
interview.
2nd Session:
In 2nd session I met to the client father and step mother. I introduced myself. Clinical
interview was conducted with parents. Her parents were asked to describe her
daughter’s problem. I asked history of the clients from the parents. Personal
information, duration and severity and presenting complaints were also asked from
parents. I asked about her relationship with her siblings from her parents.
3rd Session:
In 3rd session I asked her about her hobbies just to take her in confidence. Then I
asked her about daily preoccupation. Then informal assessment procedure was
current problem and functioning. At 1 st Depression , Anxiety , Stress test (SDCT)
figure drawing (HFD) was administered .
All necessary instructions are given to the client . I also applied RISB. After
completion of the psychological test and their evaluation different therapies was
selected by me to deal with the current problems of the client. I applied deep
breathing exercise and systematic desensitization to her. I said to my client to imagine
the anxiety situation and take a deep breath. she did so and said to me that she feel
relax .
Conclusion:

assessment that reveal A.K suffered from depression .
Recommendations:
1. Cognitive behavior therapy

2. Family therapy
3. Behavior therapy
4. In behavioral modification techniques, aversive technique, assertive therapy
and Token economy can be successfully used.
5. Deep breathing and other relaxation should be done for the management of
restlessness.
6. Environmental conditions, which force him to take drugs, should be
eliminated.
7. Family members should pay attention to him because co – operation of the
family is very important for patient.

8. Cognitive – behavioral treatment should be used to maintain and enhance the
better cognition.
Schizophrenia disorder patient

Schizophrenia is a brain disease that interferes with normal brain functioning. It
causes affected people to exhibit odd and often highly irrational or disorganized
behavior. Because the brain is the organ in the body where thinking, feeling and
understanding of the world takes place (where consciousness exists), a brain disease
like schizophrenia alters thinking, feeling, understanding and consciousness itself in
affected persons, changing their lives for the worse. Schizophrenia symptoms include
difficulty thinking coherently, interacting with others normally, carrying out
responsibilities and expressing emotions appropriately. Even simple everyday tasks
like personal hygiene can become unmanageable and neglected. The disease can thus
impact every aspect of affected people's work, family, and social life. Though not
affected directly, family members also frequently become distressed and
overwhelmed by the difficulties involved in providing care and in coming to terms
with the transformation of their loved one into a patient with a serious chronic illness.
Case No 3
Bio Data
Name A.R
Father R
Age 45 Years
Gender Male
Address Faisalabad
Education Graduation
siblings 2
Birth order 1st
Religious Islam
Marital status Single
Father Alive/Dead Alive
Father Occupation Business
Mother Alive/Dead Alive
Socioeconomic Status Middle class

Source of referral:
The client was reffered by psychiatric Doc. Subhan Ansari.
Symptom Duration
Lose interest 6 months
Delusions 6 months
Listen unfamiliar voices 4 months
Aggressive 2 months
Someone wants to kill me 6 months
Lack of attention 2 months
Disorganized speech 6 months
Negative emotions 6 month
Background history:
Family History
The client family lived in Faisalabad. His father is a business man and
mother is a housewife. His mother said that The patient is a 1 st child. She reported
that his relationship with his father and with his siblings is good. The clients parents
was very friendly and cooperative. His parents marital relationship is normal. His
sister is teacher and doing very well her job . The client interpersonal relationship is
very good. The patient attitude towards siblings and siblings attitude towards client is
also good.
Personal History
The client relationship with his friends, and family are good. He do not take
interest in work. He likes to watch T.V. He likes to eat fast food. Sometime he shows
aggression towards other. His mother reported that his birth was normal. He was
normal at the time of birth.
History of prenatal development and milestones
His mother reported that he was normal at the time of the birth . His development
was normal and at correct time .
Family history of illness:
Clients father and mother has suffering from high blood pressure .
History of past illness
His mother and the patient reported that he was show aggression sometime in the
past .
Clinical Interview:
Interview was conducted with the client to get information about the
presenting complaints, history and nature of presenting complaints and background
information of the client and to have clear picture of client’s problem. According to
client his education is B.com. He has one sister. Sister is married. He was a good
student at school. He passed his examination in first division. He did the job for 10
years before starting the problem. His relationship with her teachers, friends and
family members was good. He have a lot of interest in games. He likes to play cricket,
hockey and football. He told me that his childhood is very good. His mother has also
some psychiatry problem.
According to client at the age of 45 in June July some agencies like IBA chasing him.
He said that the agency accused him that he involved in terrorism activities. The
problem starts from 6 months before. They torched him. The client said that my
tension increased day by day. He said that one day he was coming from job the
peoples of his area accused him that he is not a good person. He said that he want to
rid of the activities of IBA. He said that I want to get back my dignity through court.
He said that now her condition is very low. He lost his interest in all activities. His
sleep is also disturb from 2,3 months. He is much worried about his condition.
He get medicine of his problem from Dr. Riaz Bhatti. He remain in fountain house for
one week. He said that he does not like the environment of Fountain house. He said
that the IBA agency will find him and kill him, they are finding him.
The client said that people around him think that he is a criminal, so he did not want
to talk anyone. He wants to live alone in his room and reading books and listening
music. He said that my mind creates different things. He said his activities are low. He
said that before his problem he pray Namaz but after this he did not pray.
According to the observation the client is dressed person of 45 years. He was a

gentleman. His attention is not good. His eye contact is good. He is shy man. His grip
on pencil was not good when he doing the test.
Mental Status Examination:
Attention:-
He had not good attention. He was trying focused to my questions.
Orientation:-
His perception and orientation of time, place and person was intact.
Memory:-
Memory was good. Insight was present.
Language
His language is not soo good. He has problem during speaking.
Test Administer
 Slosson Drawing Coordination Test (SDCT)

 Rotter incomplete sentence blank (RISB)
 Human Figure Drawing (HFD)
 Depression , Anxiety ,Stress scale (DAS


Analysis Quantitative :
Error Accuracy score Age
12 68% 45 years
Qualitative Results:
The score of the client on Slosson Drawing Coordination Test is 68. It reveals that his
eye hand coordination seems to be not good .
Human Figure Drawing Test (HFD)
The client’s emotional indicators were demonstrated by showing big figure appears to
be associated with a poor inner, immaturity and expressiveness paranoid delusion of
grandiosity. Client’s poor integration of parts shows that regression due to emotional
disturbance, immaturity.
Client’s hands cut off shows that he is shy and he have guilt feelings or poor school
achievement. Omission of neck shows that psychosomatic complaints, poor inner
control.
Rotter Incomplete Sentence Blank (RISB):
Quantitative Analysis
Categories No. of Value Total

of Responses in
Responses Categories
C3 2 6 12
C2 6 5 30
C1 14 4 56
N 0 3 0
P1 13 2 26
P2 3 1 3
P3 0 0 0
137
Cut of score = 135
Total score =137
The client is maladjusted
Depression, anxiety, stress scale:
Quantative analysis:
Depression Anxiety Stress
Severe = 22 Severe =18 Moderate =20
The patient have severe depression , severe anxiety and moderate stress
Diagnosis:
On the basis of the history, behavioral assessment, clinical interview, psychological

assessment and mental state exams the patient has suffering from Schizophrenia .
Prognosis:
His prognosis seems to be better because he has motivation to recover his problems
and is motivated to solve these problems and his understanding about the problem is
healthy signs of his better prognosis.
Case formulation:
The client is 45 years old male who belong to a middle class family . He is the 3 rd
child of his parents and . His father was a business man and his mother is a house
wife . He was referred due to her aggressive and loss of interest problem . It was
reported that he suffered from this problem last 6 month . He is showing aggressive
behavior with her family . Three session were conducted with the client and
psychological assessment was done . The three psychological tests that were
administered were RISB , HFD ,and DASS. Through the result of the administered
tests .The HFD test interpret that poor coordination , aggressive behavior and
depressed behavior. The RISB test score interpreted that the patient is
maladjusted .The DASS test interpreted that the patient have extreme severe
depression , severe anxiety and moderate stress .The client was given some
suggestions during his sessions which he followed properly due to which an
improvement was observed in his behavior during the sessions . At the end of the
session he was given some recommendations that will be helpful for his in the future
Sessions:
1st Session:
In the 1st session I built rapport with my client. I asked him about her interests. I asked
him of about his siblings and family members. I also asked about his favorite dish and
favorite T.V programs. After discussion she was cooperative with me during
interview.
2nd Session:
In 2nd session I met to the client’s parents. I introduced myself. Clinical interview was
conducted with parents. His parents were asked to describe his son’s problem. I asked
history of the clients from the parents. Personal information, duration and severity and
presenting complaints were also asked from parents. I asked about his relationship
with her siblings from his parents.
3rd Session:
In 3rd session I asked him about her hobbies just to take him in confidence. Then I
asked him about daily preoccupation. Then informal assessment procedure was
current problem and functioning. At 1 st Slosson drawing coordination test (SDCT)
figure drawing (HFD) was administered . All necessary instructions are given to the
client . I also applied RISB. After completion of the psychological test and their
evaluation different therapies was selected by me to deal with the current problems of
the client. I applied deep breathing exercise to him. I said to my client to take a deep
breath. He did so and said to me that he feel relax .
Conclusion:

assessment reveal that the patient suffered from Schizophrenia .
Recommendations:
 Cognitive Behavior Therapy

 Behavior therapy
 Reality Therapy
 Rational Emotive Behavioral Therapy
 Cognitive Therapy
 ABC model would help the client to change irrational believes into rational
believes.
 Substitute the negative thinking with more realistic thinking.
 Coping skills would help client to cope over negative behaviors, frustration at
home due to loneliness that would be decrease in company of friends.

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INTERSHIP REPOIRT

Sir Masood Riaz

Kainat Khan (50469)

Advance Diploma in Clinical Psychology

Department of Applied Psychology

Government College University Faisalabad

Sr. No Contents Page No

Father Name M.R

Sibling 08(03 sisters and 05 brothers)

Birth order 4th

Monthly income 12,000

Marital status Married

Father’s education Metric

Mother’s education Primary

Mother age 66 years

Father occupation factory worker

Mother occupation house wife

Father living\dead Dead

Mother living\dead Living

Socio – economic status middle

Identifying information from family

The patient was referred by psychiatric Doc. Subhan Ansari .

Dysphonic mood 1 month

Impairment in attention 10 days

Patient’s Background Data

Family History of Past Illness:

The patient’s mother was patient of high blood pressure.

History of present illness:

Patient suffered from severe bodily pain, stress and headache.

History of past illness:

No physical problem was found in patient.

The patient suffered from headache and fever.

 Mental State Examination

The patient’s presenting complaints were headache, low mood, impairment in

Mental state examination:

He had not good attention. He was trying focused to my questions.

Memory was good. Insight was not present.

His language is good .

Psychological assessment of the patient was done by using following tests:

Human Figure Drawing (HFD)

e medical eld has its relevance as a tool for decision-making

Rotters incomplete test sentence blank (RISB)

Depression anxiety Stress Scale

Patient age 29 years

Accuracy Scores 83%

Time taken 18 minute

Eyes – hand coordination poor

Human Figure Drawing:

Categories of No.of Responses Value Total

CUT OF SCORE = 135

The client is maleadjusted

Depression anxiety stress scale (DASS)

Anxiety 29 Extremely severe

On the basis of history, behavioral observation, clinical interview, and psychological

Sessions with client :

On the basis of presenting complaints, clinical interview and psychological

 Preventing people from dying prematurely.

Father name M.K

Sibling (04brother and one sister)

Birth order 5th

Marital status unmarried

Father living/dead alive

Mother living/dead died

Father occupation employ