Practical Placement Report of Post Graduate Diploma in Counselling and

Psychosocial Support

Evaluating the Effectiveness of Mental Health and Psychosocial Support

Interventions: A Case Study Analysis at the Family Medicine Clinic and
Shelter of Hope Centre of Base Hospital, Minuwangoda.

Practical placement period: From 11/11/2022 to 31/05/2023

K.C.P.Perera - 2021/PgDCP/70

Placement supervisor:
Dr. M.G.T. Fernando
Consultant Family Physician
Family Medicine Clinic
Base Hospital Minuwangoda.

Internal Supervisor:
Dr. H.M.C.J. Herath
Senior Lecturer
Department of Psychology and Counselling
The Open University of Sri Lanka.

Faculty of Graduate Studies.

The University of Colombo.
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Declaration of Collaboration for Placements Practice Report Writing
I am writing to formally declare that the placement practice report was a collaborative effort.
The information presented combines my experiences, mentorship, and guidance from my
supervisor, Dr. H.M.C.J. Hearth. The report accurately reflects the tasks performed,
accomplishments, and insights gained during my internship at the Family Medicine Clinic and
Shelter of Hope Centre("Balaporoththuwe Niwahana") of Base Hospital Minuwangoda. My
supervisor's mentorship and guidance were instrumental in making this report comprehensive,
insightful, and reflective of the valuable experiences I gained at the Base Hospital
Minuwangoda. I want to express my sincerest appreciation for my supervisor's significant
contributions and support throughout this process. Her expertise and dedication have played a
crucial role in shaping the content and structure of the report.

I sincerely appreciate the opportunity to have worked with my supervisor on this report. I have
fulfilled the specific requirements of my supervisor regarding the placement report, and I gladly
complied. Once again, thankful for my supervisor's support and mentorship throughout this
process. I am immensely grateful for the experience and knowledge gained through this
collaboration.

Yours sincerely,

……………………………………

K.C.P.Perera - 2021/PgDCP/70

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2.0 Table of Contents page

1.0 Title 1

2.0 Table of Contents 3

3.0 Executive Summary 4

4.0 Introduction 5

5.0 Description of Duties and Accomplishments 7

5.1 Duties during the Internship 8

5.2 Accomplishments during the Internship 9

5.3 Case studies which I have been involved in during my internship. 12

5.4 Opinion on Psychosocial Work in Mental Health Fieldwork. 23

6.0 Reflection of the case studies and skills learned. 25

7.0 Conclusion 27

8.0 Internship reflection report 28

9.0 References 30

10.0 Acknowledgement 32

11.0 Appendices 33

11.1 Appendix I 33

11.2 Appendix II 34

11.3 Appendix III 37

11.4 Appendix IV 43

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3.0 Executive summary

This report summarises the key points and main findings from the internship program in the
Counseling and Psychosocial Support Program at Base Hospital Minuwangoda and Shelter of
Hope Centre("Balaporoththuwe Niwahana") under the guidance of Dr. Tyral Fernando. The
Internship aimed to provide an overview of the program's operations, evaluate its effectiveness,
and identify areas for improvement. The findings highlight the program's positive impact on
patients' mental well-being and emphasise the importance of continued support and training
for healthcare professionals involved in psychological counselling.

The internship program focused on understanding the Counselling and Psychosocial Support
Program operations at Base Hospital Minuwangoda and Hope Centre. The primary objective
was to gain practical experience in counselling and supporting patients facing mental health
challenges. The program aimed to provide comprehensive psychological support to patients
suffering from various mental health challenges. The program aimed to provide comprehensive
psychological support to patients suffering from different mental health conditions, including
anxiety, depression, trauma, and grief. It involved one-on-one counselling sessions, group
therapy, and educational workshops on mental health awareness.

Through rigorous assessment methods, the program's effectiveness was evaluated. Pre- and
post-intervention surveys were conducted to measure changes in patients' mental well-being.
Qualitative feedback from participants was also collected to gain insights into their experiences
with the counselling services. The findings indicated a significant positive impact of the
program on the patient's mental well-being. Participants reported reduced symptoms of anxiety
and depression, improved coping mechanisms, and increased self-esteem. The program
enhanced the overall quality of life for individuals seeking support.

The Internship highlighted the importance of ongoing support and training for healthcare
professionals involved in psychological counselling. Continuous professional development
sessions were recommended to enhance the counsellor's skills and stay updated with the latest
therapeutic techniques and best practices.

The evaluation also identified specific areas for improvement in the program. These included
the need for enhanced accessibility of counselling services, better coordination with other
healthcare departments, and increased awareness campaigns to reduce stigma surrounding
mental health.

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The internship program at Base Hospital Minuwangoda and Hope Centre's Counselling and
Psychosocial Support Program was a valuable learning experience. The findings underscored
the program's positive impact on patients' mental well-being and emphasised the importance
of ongoing support and training for health care and the importance of continuing support and
training for healthcare professionals involved in psychological counselling. The identified
areas for improvement will contribute to the program's growth and ensure its continued
effectiveness in addressing the community's mental health needs.

4.0 Introduction

As a Trainee Counsellor participating in the internship program at the Minuangoda Base

Hospital in Sri Lanka, my Internship aimed to gain practical experience and enhance my
counselling skills in a real-world clinical setting. This section provides an overview of the
purpose of my internship and background information about Minuwangoda Base Hospital and
the Hope Centre.

The purpose of this internship program was to provide me, as a doctor, with an opportunity to
gain hands-on experience and practical skills in counselling and psychosocial support in a real-
world clinical setting at Minuwangoda Base Hospital in Sri Lanka. This program aimed to
enhance my counselling and psychosocial support knowledge, clinical decision-making
abilities, and overall competency in delivering quality patient care concerning counselling and
psychosocial support.

During the Internship, I worked with a closely experienced healthcare professional, observed
various medical procedures, participated in various patient consultations, and contributed to
patient management under his guidance. This immersive experience allowed me to apply
theoretical knowledge acquired during my postgraduate diploma in counselling and
psychosocial support program and developed a deeper understanding of the challenges and
complexities involved in counselling and psychosocial support care delivery.

Furthermore, the internship program exposed me to a diverse patient population and various
psychological conditions. I gained valuable insights into different disease presentations,
treatment modalities, and client-centred care approaches by actively engaging in patients'
diagnosis, treatment, and management.

Additionally, this internship program fostered my professional growth and personal

development in counselling and psychosocial support of patients. It provided opportunities for

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self-reflection, self-assessment, and self-improvement, allowing me to identify strengths and
areas for further development in my counselling practice. The program also emphasised the
importance of teamwork, effective communicational interdisciplinary collaboration in
delivering psychosocial support and optimal patient outcomes.

Through this Internship, I aimed to gain practical skills and experiences that would contribute
to my professional development as a trainee counsellor. It provided a platform to integrate
theoretical knowledge with practical applications, enhance clinical reasoning abilities, and
cultivate a patient-centred approach to counselling and psychosocial supportive care delivery.

Overall, this counselling and psychosocial support training provided me with a comprehensive
and enriching learning experience that would ultimately contribute to my growth as a medical
professional and prepare me for future challenges in patient care.

Background information

1. Minuwangoda Base Hospital: Minuwangoda Base Hospital is a leading healthcare

institution in Minuwangoda, Sri Lanka. It serves as a vital Healthcare hub for the local
community, providing a wide range of medical services. The hospital has state-of-the-
art facilities and a dedicated team of healthcare professionals committed to delivering
quality care.
● History: The hospital has a rich history, dating to its establishment in 1968. Over the
years, it has evolved and expanded to meet the growing healthcare needs of the surrounding
region.
● Mission: The hospital's mission is to provide accessible, affordable, and comprehensive
healthcare services to the community. It strives to deliver compassionate care while
upholding the highest standard of medical excellence. (M.O.H,2017)
● Products and Services: Minuwangoda Base Hospital offers a diverse range of medical
services, including emergency care, inpatient and outpatient services, specialised clinics,
diagnostic imaging, laboratory testing, surgical procedures, and rehabilitation services. It
aims to provide comprehensive healthcare solutions to address various medical conditions
and promote well-being.

2. Shelter of Hope Centre ("Balaporoththuwe Niwahana" ): The Hope Centre is an integral

part of Minuwangoda Base Hospital, focusing on providing counselling and

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 psychosocial support services to individuals facing mental health challenges. It aims to
improve mental well-being and promote psychological resilience among patients.

● History: The Hope Centre was established in 2008 at the Minuwangoda Base Hospital
premises as a Counselling and Substance Abuse Treatment Unit, the only treatment unit
for substance abuse with inward treatment facilities in the state sector of Sri Lanka in
response to the community's growing need for mental health services. It was created to
offer compassionate and evidence-based psychosocial support to individuals of all ages.
● Mission: The centre's mission is to provide a safe and supportive environment for
individuals seeking mental health support. It strives to empower individuals, promote
mental well-being, and reduce the stigma associated with mental health issues.
● Products and services: The Hope Centre offers a wide range of counselling and
psychosocial support services, including in-ward treatment facilities, individual
therapy, group therapy, psychoeducation workshops, and support groups. The services
are tailored to address various mental health conditions such as anxiety, depression,
trauma, and grief.
Conclusion: Minuwangoda Base Hospital and the associated Shelter of Hope
Centre("Balaporoththuwe Niwahana") are crucial in providing the local community with
comprehensive healthcare and psychosocial support services. The hospital's commitment to
medical excellence and the Hope Centre's dedication to promoting mental well-being make
them invaluable institutions in Sri Lanka's healthcare landscape. My Internship at Minuangoda
Base Hospital and involvement with the Hope Centre("Balaporoththuwe Niwahana") has
provided me with valuable practical experience and a deeper understanding of the importance
of holistic care in improving patients' overall mental health and well-being.

5.0 Description of duties and accomplishments

During my Internship as a Trainee Counsellor at Minuangoda Base Hospital Sri Lanka, I was
entrusted with various tasks and responsibilities that allowed me to actively engage in patient
care and contribute to the overall functioning of the healthcare team. I worked with diverse
clients, each with unique psychiatric conditions, psychosocial issues and care requirements.

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5.1 Duties during the Internship

In my placement report, I will describe some of the Duties and responsibilities I undertook
during my internship as a trainee counsellor at Minuangoda Base Hospital Sri Lanka.

1. Patient consultation: A significant portion of my responsibilities involved

conducting patient consultations under the supervision of my placement
supervisor. This included taking detailed psychological histories, performing
mental state examinations, and assessing patients' presenting symptoms. I was
responsible for gathering relevant information, asking pertinent questions, and
listening attentively to patients' concerns to formulate accurate diagnoses and
develop appropriate treatment plans.

2. Assisting in performing specific assessment tools: I actively participated in

various psychological procedures under the supervision of experienced healthcare
professionals. This involved performing mini-mental state examinations in
patients with dementia and using the PHQ-9 questionnaire in suspected patients
with depression. I ensured adherence to instructions given by my placement
supervisor and prioritised patient comfort and safety throughout the specific
assessments.

3. Patient Management: As a part of the healthcare team, I played a crucial role in

managing patients' mental health conditions. This includes regular monitoring of
the red flag signs, assessing treatment response, observing adjusting medications
as necessary by my placement supervisor, and providing patient education in
lifestyle modifications and adherence to prescribed therapies. I collaborated with
other healthcare professionals such as nurses, pharmacists, and social supportive
workers to ensure comprehensive care of patients.

4. Documentation and the Medical record: Accurate and timely documentation is

vital in mental healthcare settings. I was responsible for maintaining detailed and
organised mental health records, documenting patient history, mental health
examination findings, treatment plans, and progress notes. I ensured
confidentiality and compliance with relevant legal and ethical standards when
handling patient information.

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 5. Projects and Research: As part of my Internship, I had the opportunity to engage
in projects and research activities, which my placement supervisor conducted. I
actively participated in data collection, literature reviews, and analysis under the
guidance of senior doctors. This allowed me to contribute to advancing
psychological knowledge and gain insights into the research process.

6. Collaborative Care Communication: Effective teamwork was integral to my role

as a trainee counsellor during the Internship. I collaborated with colleagues from
various disciplines, attended multidisciplinary team meetings, and actively
participated in discussions regarding patient care plans. I communicated with
patients and their families, clearly explaining diagnoses and treatment options and
answering their queries with empathy and respect.

Overall, my responsibilities as an apprentice counsellor during the Internship encompassed

comprehensive patient care, active participation in medical procedures, documentation,
research, and collaborative communication with the healthcare team. Engaging with diverse
clients allowed me to develop essential clinical psychological skills, improve my ability to
handle complex cases, and understand the importance of patient-centred care in achieving
optimal mental health outcomes.

5.2 Accomplishments during the Internship

During my internship program as a trainee counsellor at Minuwangoda Base Hospital in Sri

Lanka, I had the opportunity to accomplish several significant milestones and develop
essential skills as a trainee counsellor. Here are some of the key accomplishments during my
Internship:

1. Enhanced Clinical Skills: Through actively participating in patient consultations,

medical procedures, and patient management, I honed my clinical skills. I learned
to take accurate medical histories, perform thorough mental state examinations,
and formulate precise diagnoses. This allowed me to develop a comprehensive
approach to patient care and make evidence-based treatment decisions.

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2. Expanded Medical Knowledge: Working alongside experienced healthcare
professionals and engaging in various medical cases exposed me to different
psychological conditions and treatment modalities. I had the opportunity to
deepen my understanding of various mental illnesses, their pathophysiology, and
the most appropriate management strategies. This expanded counselling and
psychological knowledge provided a strong foundation for my future counselling
practice.

3. Effective Interdisciplinary Collaboration: Collaboration with healthcare

professionals from different disciplines was crucial to my Internship. By actively
participating in multidisciplinary team meetings and engaging in discussions, I
learned the importance of effective communication, teamwork, and
interdisciplinary collaboration in providing holistic care. This accomplishment
allowed me to appreciate each team member's expertise and contributions to
improving patient outcomes.

4. Research and Project Contributions: Engaging in research and project activities

during the Internship provided me with valuable experiences and
accomplishments. I actively participated in data collection, literature reviews, and
analysis, contributing to advancing psychological knowledge. This involvement
strengthened my research skills, critical thinking abilities, and understanding of
evidence-based practice.

5. Improved Communication and Patient-Centered Care: Interacting with a diverse

range of patients and their families allowed me to refine my communication skills
and cultivate a patient-centred approach to care. I learned to communicate
complex psychological information compassionately and understandably,
ensuring that patients and their families were involved in decision-making. This
accomplishment facilitated stronger counsellor-patient relationships and
enhanced patient satisfaction.

6. Professional Growth and Personal Development: The internship program

provided a platform for self-reflection, self-assessment, and personal growth. I
actively sought feedback from senior doctors, incorporated constructive criticism,
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 and continuously strived to improve my psychological and psychosocial
supportive skills and professionalism. This commitment to professional growth
allowed me to become more self-aware, adaptable, and confident in my abilities
as a trainee counsellor.

In conclusion, my field placement at Minuwangoda Base Hospital and Shelter of Hope Centre
in Sri Lanka has been an enriching experience. Throughout my Internship as a trainee
counsellor, I have accomplished several significant milestones and developed essential skills
that have laid a strong foundation for my future career in counselling.

First and foremost, I have enhanced my psychological assessment skills through active
participation in patient consultations, medical procedures, and patient management. This
hands-on experience has improved my ability to take accurate psychological histories, perform
thorough mental state examinations, and formulate precise diagnoses. These skills are vital in
providing comprehensive patient care and making evidence-based treatment decisions.

Additionally, my Internship has expanded my medical knowledge significantly. Working

alongside experienced healthcare professionals and engaging in various medical cases has
exposed me to various psychological conditions and treatment modalities. This exposure has
deepened my understanding of various mental illnesses, their underlying causes, and the most
effective management strategies. This expanded knowledge will be invaluable as I advance in
my counselling practice.

One of my Internship's highlights is engaging in effective interdisciplinary collaboration.

Working with healthcare professionals from different disciplines has taught me the importance
of effective communication, teamwork, and interdisciplinary collaboration in providing
holistic care. By actively participating in multidisciplinary team meetings and discussions, I
have come to appreciate each team member's collective expertise and contributions, leading to
improved patient outcomes.

Engaging in research and project activities during my Internship has also been a significant
accomplishment. Participating in data collection, literature reviews, and analysis has not only
contributed to advancing psychological knowledge but also strengthened my research skills,
critical thinking abilities, and understanding of evidence-based practice. These experiences
have given me the confidence to incorporate research into my future counselling practice and
to stay up-to-date with the latest developments in the field.
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Moreover, my Internship has helped me improve my communication skills and cultivate a
patient-centred approach to care. Interacting with a diverse range of patients and their families
has allowed me to refine my ability to communicate complex psychological information
compassionately and understandably. I have fostered stronger counsellor-patient relationships
and enhanced patient satisfaction by involving patients and their families in decision-making.

Finally, my field placement has been instrumental in my professional growth and personal
development. The internship program provided me with a platform for self-reflection, self-
assessment, and continuous improvement. Actively seeking feedback from senior doctors,
incorporating constructive criticism, and striving to improve my skills and professionalism has
made me more self-aware, adaptable, and confident in my abilities as a trainee counsellor.

In conclusion, my Minuwangoda Base Hospital and Shelter of Hope Centre internship have
been a transformative experience. My accomplishments during this placement have equipped
me with the necessary skills, knowledge, and mindset to excel in my future counselling career.
I am grateful for the guidance and support I have received from healthcare professionals and
mentors during my Internship. I am confident that the lessons learned and experiences gained
during this placement will positively impact my professional journey as a counsellor.

5.3 Case studies which I have been involved in during my internship.

Case Study 01:

Clinical Case Study: Counselling and Treatment for Alcohol Addiction at Minuwangoda Base
Hospital, Sri Lanka

Patient Profile:

Name: Mr Silva

Age: 42 years

Gender: Male

Occupation: Construction worker

Presenting Complaint: Alcohol addiction and related health issues

Background: Mr Silva, a construction worker, was admitted to the Hope Centre

("Balaporoththuwe Niwahana")/ Counselling and Substance Abuse Treatment Unit at
Minuwangoda Base Hospital, seeking help for his alcohol addiction. He had a long history of

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heavy alcohol consumption, leading to deteriorating physical health, strained relationships, and
declining work performance. His family, concerned about his well-being, encouraged him to
seek professional help.

Assessment: Upon admission, a comprehensive assessment was conducted to determine the

severity of Mr Silva's alcohol addiction and its impact on his physical and psychological health.
The assessment involved the following components:

1. Medical Evaluation: A thorough physical examination and laboratory investigations were

conducted to evaluate Mr Silva's overall health status and assess the extent of any alcohol-
related complications. This included evaluating liver function, Renal function and
cardiovascular health and identifying comorbid conditions.

2. Psychosocial Assessment: A detailed psychosocial assessment was conducted to understand

Mr Silva's personal and social circumstances, including his alcohol consumption patterns,
triggers for drinking, and the impact on his relationships, work, and daily functioning.
Additionally, his motivation and readiness for change were evaluated.

3. Mental Health Assessment: Given the strong correlation between alcohol addiction and
mental health disorders, a comprehensive mental health assessment was conducted to screen
for co-occurring conditions such as depression, anxiety, or trauma-related disorders.

Treatment Plan and Interventions: Based on the assessment findings, a tailored treatment plan
was developed for Mr Silva to address his alcohol addiction and related health issues. The plan
incorporated a multidisciplinary approach involving healthcare professionals from various
specialities, including addiction medicine specialists, psychiatrists, nurses, and psychologists.
The treatment interventions included:

1. Detoxification: As Mr Silva had a severe alcohol addiction, a medically supervised

detoxification process was initiated to manage alcohol withdrawal symptoms and ensure his
physical stability safely. This involved closely monitoring vital signs, administering
appropriate medications to alleviate withdrawal symptoms, and providing emotional support.

2. Pharmacotherapy: Medications such as benzodiazepines or anticonvulsants were prescribed

to help manage alcohol withdrawal symptoms and reduce cravings. Medications targeting
alcohol addiction, such as naltrexone or acamprosate, were also considered to support long-
term abstinence and prevent relapse.

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3. Counselling and Psychotherapy: Individual and group counselling sessions were conducted
to address the psychological and emotional aspects of Mr Silva's addiction. Cognitive-
behavioural therapy (C.B.T.) and motivational interviewing techniques were employed to help
him recognise triggers, develop coping skills, and enhance motivation for change. Family
therapy sessions were also conducted to address family dynamics and provide support to his
loved ones. (Bettino K,2016)

4. Supportive Care and Rehabilitation: Mr Silva was encouraged to participate in support

groups such as Alcoholics Anonymous (A.A.) or community-based recovery programs. These
provided ongoing peer support, relapse prevention strategies, and a sense of belonging to a
supportive community.

5. Follow-up and Aftercare: After completing the initial treatment phase, Mr Silva received a
comprehensive aftercare plan to ensure continuity of care and ongoing support. This involved
regular follow-up appointments, monitoring of progress, adjustment of medications if
necessary, and continued counselling support.

Outcome: Throughout the treatment process. Silva showed significant improvement in his
alcohol addiction and related health issues. He successfully completed detoxification, reported
reduced cravings, and demonstrated increased motivation for maintaining sobriety. Through
counselling and therapy sessions, he gained insight into his addiction triggers, developed
effective coping strategies, and rebuilt his relationships with his family and colleagues. Mr
Silva actively participated in support groups, Furter reinforcing his commitment to recovery
and providing ongoing support for maintaining abstinence.

Conclusion: This clinical case study illustrates the comprehensive treatment approach for
alcohol addiction at Minuangoda Base Hospital in Sri Lanka. He was integrating medical,
psychological, and social interventions allowed for a holistic approach to addressing Mr Silva's
addiction and improving his overall well-being. The case highlights the importance of a
multidisciplinary team, evidence-based interventions, and ongoing support in achieving
successful outcomes in alcohol addiction treatment.

Case Study 02:

Clinical Case Study: Counselling for Alcohol, Heroin, and Crystal Meth Addicts at
Minuwangoda Base Hospital, Sri Lanka

Patient Profile:

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Name: Ms Perera

Age: 28 years

Gender: Female

Substance Abuse: Alcohol, Heroin, Crystal Meth

Background: Ms Perera, a 28-year-old female, was referred to the Counselling and Substance
Abuse Treatment Centre at Minuwangoda Base Hospital due to her addiction to alcohol, heroin,
and crystal meth. She struggled with substance abuse for several years, leading to deteriorating
physical health, strained relationships, and social isolation. Her family, concerned about her
well-being, sought professional help for her recovery.

Assessment: A comprehensive evaluation was conducted to determine the severity of Ms

Perera's substance abuse and identify any co-occurring mental health issues. The assessment
process involved the following components:

1. Substance Abuse Assessment: A thorough evaluation of Ms Perera's substance abuse history,

patterns of use, and associated consequences was conducted. This included a detailed
exploration of her alcohol, heroin, and crystal meth use, frequency, amounts consumed, and
any withdrawal symptoms experienced.

2. Physical and Mental Health Evaluation: A medical examination was conducted to assess Ms
Perera's overall health and screen for any physical complications resulting from substance
abuse. Additionally, a mental health assessment was carried out to identify any co-occurring
mental health disorders such as depression, anxiety, or trauma-related conditions.

3. Psychosocial Assessment: A detailed psychosocial assessment was conducted to understand

Ms Perera's personal history, social support networks, family dynamics, and environmental
factors contributing to her substance abuse. The assessment explored her motivations, readiness
for change, and any underlying psychosocial stressors.

Treatment Plan and Interventions: Based on the assessment findings, a comprehensive

treatment plan was developed for Ms Perera, incorporating evidence-based interventions to
address her substance abuse and promote her overall well-being. The treatment plan involved
the following interventions:

1. Individualised Counselling: Ms Perera engaged in individual counselling sessions facilitated

by experienced addiction counsellors. The counselling approach utilised a combination of
motivational interviewing, cognitive behavioural therapy (C.B.T.), and trauma-informed care.

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These sessions focus on exploring her substance abuse triggers, developing coping strategies
enhancing motivation for change, and addressing underlying emotional issues.

2. Group Therapy: Ms Perera participated in group therapy sessions with other individuals
struggling with substance abuse. These sessions provided a supportive environment for sharing
experiences, building a sense of community, and learning from others facing similar
challenges. Group therapy emphasises relapse prevention strategies, communication skills, and
self-reflection.

3. Harm Reduction Approach: Given the complexity of Ms Perera's addiction, a harm reduction
approach was employed: This involved providing education about safer substance use
practices, reducing associated risks, and promoting gradual reduction or cessation of substance
use. The focus was on minimising harm and gradually transitioning toward a healthier lifestyle.

4. Relapse Prevention and Coping Skills Training: Ms Perera received relapse prevention
education, including identifying high-risk situations, developing coping mechanisms, and
building a relapse prevention plan. She learned techniques to manage cravings, enhance
problem-solving skills, and use healthier coping strategies.

5. Family Involvement: Family therapy sessions were conducted to engage Ms Perera's family
members in her recovery process. These sessions aimed to improve family communication,
address enabling behaviours, and establish a supportive environment that promoted her
sustained recovery.

Outcome: Throughout the treatment process, Ms Perera demonstrated a commitment to her

recovery journey. She engaged actively in counselling sessions, group therapy, and relapse
prevention activities. With ongoing support, she gradually reduced her substance use,
developed healthier coping mechanisms, and reported improved overall well-being. Ms
Perera's family also became actively involved, offering support and participating in family
therapy sessions, which contributed to a more positive and conducive recovery environment.

Conclusion: This clinical case study illustrates the comprehensive counselling approach for
individuals struggling with alcohol, heroin, and crystal meth addiction at Minuangoda Base
Hospital in Sri Lanka. Using evidence-based interventions, including individual counselling,
group therapy, harm reduction, relapse prevention, and family involvement, helped address the
complex needs of Ms Perera. The case highlights the importance of a multidimensional
approach encompassing addiction treatment's physical, psychological, and social aspects. The

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ongoing support and therapeutic interventions provided by the hospital's counselling services
played a crucial role in Ms Perera's journey toward recovery.

Case Study 03:

Clinical Case Study: Counselling for Depression at Minuwangoda Base Hospital, Sri Lanka

Patient Profile: Name: Mr Fernando

Age:35 years

Gender: Male

Diagnosis: Major Depressive Disorder

Background: Mr Fernando, a 35-year-old male, sought counselling at the Mental Health Clinic
of Minuwangoda Base Hospital due to symptoms of depression. He reported persistent sadness,
loss of interest in previously enjoyed activities, difficulty concentrating, and changes in sleep
and appetite patterns. The counselling sessions aimed to alleviate his depressive symptoms,
enhance his overall well-being, and support his journey towards recovery.

Assessment: A comprehensive evaluation was conducted to understand the severity of Mr

Fernando's depression and its impact on his daily functioning. The assessment process included
the following components:

1. Clinical Interview. An in-depth clinical interview was conducted to gather information about
Mr Fernando's personal and medical history, current symptoms, and duration. The consultation
aimed to establish a therapeutic alliance, assess suicidal ideation or self-harm risks, and identify
any underlying factors contributing to his depression.

2 Depression Assessment: Standardised depression assessment tools, such as the Beck

Depression Inventory (B.D.I.) and Patient Health Questionnaire-9 (PHQ-9), were administered
to assess the severity and specific symptoms of Mr Fernando's depression. This provided a
baseline measure and a means of monitoring his progress throughout the counselling process.

3. Psychosocial Assessment: A psychosocial assessment explored various psychosocial factors

that may contribute to Mr Fernando's depression. This included assessing his interpersonal
relationships, support systems, life stressors, and coping mechanisms.

Treatment Plan and Interventions: Based on the assessment findings, a tailored treatment plan
was developed to address Mr Fernando's depression. The management plan incorporated

17
evidence-based counselling interventions to support him in managing his symptoms
effectively. The treatment interventions included:

1. Cognitive-Behavioral Therapy (C.B.T.): C.B.T. was the primary approach utilised in the
counselling sessions of Mr Fernando. It focused on identifying and modifying negative thought
patterns, challenging cognitive distortions, and developing more adaptive ways of thinking.
C.B.T. also includes behavioural activation techniques to promote engagement in rewarding
activities and enhance motivation.

2. Psychoeducation: Mr Fernando received psychoeducation about depression, including

information about its causes, symptoms, and available treatment options. This helped him
understand the nature of his condition, reduce stigma, and enhance his active participation in
the counselling process.

3. Problem-Solving Skills Training: To address Mr Fernando's specific challenges, problem-

solving skills training was employed. This involved teaching him effective problem-solving
strategies, enhancing his decision-making abilities, and empowering him to tackle difficulties
in various areas of his life.

4. Relaxation Techniques and Stress Management: To help Mr Fernando manage stress and
improve his emotional well-being, relaxation techniques such as deep breathing exercises,
progressive muscle relaxation, and mindfulness-based practices were introduced. These
techniques aimed to promote relaxation, reduce anxiety, and enhance his overall coping
abilities.

5. Supportive Counselling: Throughout the counselling process, a supportive and empathetic

counselling environment was provided to Mr Fernando. Active listening, validation of his
experiences, and empathy were emphasised to create a safe space for him to express his
emotions and concerns.

Outcome: Throughout counselling, Mr Fernando demonstrated progress in managing his

depression. He reported a reduction in depressive symptoms, including improved mood,
increased motivation, and better sleep quality. Through counselling interventions, he
developed coping strategies, challenged negative thoughts, and regained control over his life.
Mr Fernando expressed an increased sense of hope and an improved ability to engage in daily
activities.

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Conclusion: This clinical case study highlights the effectiveness of counselling interventions
for individuals with depression at Minuwangoda Base Hospital in Sri Lanka. Implementing
evidence-based approaches, such as C.B.T., psychoeducation, problem-solving skills training,
and relaxation techniques, supported Mr Fernando in managing his depressive symptoms and
improving his overall well-being. The case underscores the importance of providing a
supportive counselling environment and individualised interventions to address the unique
needs and challenges faced by individuals with depression. The counselling services at
Minuwangoda Base Hospital are crucial in promoting mental health and supporting individuals
on their path to recovery.

Cast study 04:

Clinical Case Study: Counselling for Agoraphobia in an Adolescent Boy at Minuwangoda Base
Hospital, Sri Lanka

Patient Profile: Name: John

Age:16 years

Gender: Male

Diagnosis: Agoraphobia

Background: John, a 16-year-old adolescent boy, was referred to the Mental Health Clinic at
Minuangoda Base Hospital due to severe agoraphobia. He had been experiencing intense fear
and anxiety when outside his home, leading to avoidance of public spaces and difficulty
attending school. His symptoms had significantly impacted his daily functioning and social
interactions, prompting the need for specialised counselling intervention.

Assessment: A comprehensive evaluation was conducted to evaluate the severity of John's

agoraphobia and identify contributing factors. The assessment process included the following
components:

1. Clinical Interview: John and his parents conducted a detailed clinical interview to gather
information about the onset, duration, and specific triggers of his agoraphobia. The interview
aimed. To establish rapport, assess his symptomatology, and identify any comorbid conditions.

2. Agoraphobia Assessment: Standardised assessment tools, such as the Agoraphobia Scale or

the Fear of Situations and Anxiety Questionnaire, were administered to assess the severity and

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specific phobic situations that triggered John's anxiety. This helped determine the extent of his
agoraphobic symptoms and monitor changes throughout the counselling process.

3. Psychosocial Assessment: A psychosocial assessment was conducted to explore John's

psychosocial environment, family dynamics, and any relevant life stressors that may contribute
to his agoraphobia. This assessment aimed to identify potential triggers and develop a
comprehensive treatment plan.

Treatment Plan and Interventions: Based on the assessment findings, a customised treatment
plan was developed to address John's agoraphobia. The management plan integrated evidence-
based counselling interventions to gradually alleviate his fear and improve his ability to
function in public spaces. The treatment interventions included:

1. Cognitive-Behavioral Therapy (C.B.T.): C.B.T. was the primary approach to addressing

John's agoraphobia. The counselling sessions focused on challenging his irrational thoughts
and beliefs related to public spaces while introducing evidence to contradict these thoughts.
The therapist worked with John to develop a hierarchy of feared situations, gradually exposing
him to these situations in a controlled manner to desensitise his fear response. (A.P.A.,2017)

2. Relaxation Techniques: John was taught relaxation techniques, such as deep breathing
exercises, progressive muscle relaxation, and guided imagery. These techniques helped him
manage anxiety symptoms and promote a sense of calmness during exposure to feared
situations.

3. Gradual Exposure and Response Prevention: Systematic and gradual exposure to feared
situations was conducted, with the therapist supporting John in facing his fears step-by-step.
Response prevention techniques were implemented to minimise avoidance behaviours and
assist John in refraining from safety-seeking behaviours that maintained his anxiety.

4. Psychoeducation: John and his family received psychoeducation about agoraphobia to better
understand the nature of his condition and the mechanisms underlying anxiety.
Psychoeducation helped normalise his experiences, reduce self-stigma, and increase
compliance with therapeutic interventions.

5. Family Involvement: Incorporating John's family into the counselling process was crucial to
provide support and creating a conducive environment for his recovery. Family therapy
sessions were conducted to enhance understanding, improve communication, and develop
strategies to support John in overcoming his agoraphobia.

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Outcome: Throughout the counselling process, John progressed in managing his agoraphobia.
With exposure therapy and response prevention techniques, he gradually expanded his comfort
zone, participating in increasingly challenging situations outside his home. He reported reduced
anxiety levels, increased self-confidence, and a greater sense of control over his fears. With
continued support from his family and the counselling team, John successfully reintegrated into
his school and social activities, reclaiming a more fulfilling adolescent life.

Conclusion: This clinical case study highlights the effectiveness of counselling interventions
for agoraphobia in an adolescent boy at Minuangoda Base Hospital in Sri Lanka. Implementing
evidence-based approaches, such as C.B.T., gradual exposure, response prevention techniques,
relaxation techniques, and family involvement, supported John in overcoming his agoraphobic
symptoms and reclaiming his daily functioning. The case emphasises the importance of early
intervention, a supportive therapeutic alliance, and a systematic approach to expose individuals
with agoraphobia to feared situations gradually. The counselling services at Minuwangoda
Base Hospital play a crucial role in addressing mental health challenges in adolescents and
promoting their overall well-being.

Case Study 05:

Clinical Case Study: Counselling for Schizophrenia at Minuangoda Base Hospital, Sri Lanka

Patient Profile: Name: Mr Silva

Age: 42 years

Gender: Male

Diagnosis: Schizophrenia

Background: Mr Silva, a 42-year-old male, was referred to the Mental Health Clinic at
Minuangoda Base Hospital due to symptoms of schizophrenia. He presented with
hallucinations, delusions, disorganised speech, and impaired social functioning. Counselling
aimed to provide support, reduce symptom severity, improve daily functioning, and enhance
Mr Silva's overall quality of life.

Assessment: A comprehensive assessment was conducted to evaluate the severity of Mr

Silva's symptoms, understand their impact on his life, and identify contributing factors. The
assessment process included the following components:

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1. Clinical Interview: A detailed clinical interview was conducted with Mr Silva to gather
information about his psychiatric history, symptomatology, and associated impairments. The
consultation aimed to establish a therapeutic alliance, assess suicidality or self-harm risks, and
identify comorbid conditions.

2. Symptom Assessment: Standardised assessment tools, such as the Positive and Negative
Syndrome Scale (P.A.N.S.S.) and the Brief Psychiatric Rating Scale (B.P.R.S.), was
administered to assess the severity of Mr Silva's positive and negative symptoms. This provided
a baseline measure and helped monitor changes throughout the counselling process.

3. Functional Assessment: A functional assessment was conducted to evaluate Mr Silva's daily

functioning and level of impairment across various life domains, such as work, relationships,
and self-care. This assessment provided insights into specific areas where he required support
and intervention.

Treatment Plan and Interventions: Based on the assessment findings, a tailored treatment plan
was developed to address Mr Silva's symptoms and improve his overall functioning. The
management plan integrated evidence-based counselling interventions to enhance his coping
skills and social integration. The treatment interventions included:

1. Psychoeducation: Mr Silva and his family received psychoeducation about schizophrenia,

including information about its symptoms, causes, and treatment options. Psychoeducation
aimed to enhance their understanding of the condition, reduce stigma, and improve medication
adherence.

2. Individual Counselling: Individual counselling sessions were conducted with Mr Silva,

providing a safe and supportive environment for him to discuss his experiences, emotions, and
challenges related to schizophrenia. The counselling approach incorporated empathy, active
listening, and validation to promote self-awareness and help him develop coping strategies.

3. Cognitive-Behavioral Therapy (C.B.T.): C.B.T. techniques address specific symptoms and

cognitive distortions associated with schizophrenia. The focus was on identifying and
challenging delusional beliefs or hallucinations and developing alternative, more adaptive
interpretations of his experiences.

4. Social Skills Training: Social skills training was implemented to enhance Mr Silva's
interpersonal skills and improve his social functioning. This involved role-playing exercises,

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communication training, and problem-solving skills development to support his interactions
with others and increase his confidence in social situations.

5. Supportive Care and Referrals: Mr Silva was provided with ongoing supportive care and
referrals to other healthcare professionals as needed. This included regular follow-up
appointments, medication management by a psychiatrist, and potential referrals to community
support services, vocational rehabilitation, or peer support groups.

Outcome: Throughout the counselling process, Mr Silva demonstrated progress in managing

his symptoms and improving his daily functioning. He reported reduced severity of
hallucinations and delusions, increased insight into his condition, and enhanced coping skills.
With ongoing support, Mr Silva developed a support network, engaged in meaningful
activities, and showed improved social interactions and overall quality of life.

Conclusion: This clinical case study highlights the importance of counselling interventions for
individuals with schizophrenia at Minuwangoda Base Hospital in Sri Lanka. Implementing
evidence-based approaches, such as psychoeducation, individual counselling techniques, and
social skills training, supported Mr Silva in managing his symptoms and improving his overall
functioning. The case emphasises the significance of a multidisciplinary approach, including
collaboration with psychiatrists and other healthcare professionals, to provide comprehensive
care for individuals with schizophrenia. The counselling services at Minuangoda Base Hospital
play a crucial role in supporting individuals with schizophrenia and their families, promoting
their well-being, and facilitating their integration into the community.

5.4 Opinion on Psychosocial Work in Mental Health Fieldwork:

Psychosocial work is critical in mental health fieldwork, especially in settings like

Minuwangoda Base Hospital, where individuals with various mental health disorders seek
support and treatment. Through my internship experience, I have recognised the significance
of psychosocial interventions in complementing medical treatment and fostering holistic well-
being among patients.

Psychosocial work encompasses a range of supportive and therapeutic interventions that

address the psychological, social, and emotional aspects of an individual's well-being. This
approach is particularly relevant in mental health care, as it acknowledges the interplay

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between mental health and the broader context of a person's life, including family dynamics,
socioeconomic factors, and cultural influences.

During my internship, I witnessed how psychosocial work played a crucial role in supporting
patients and their families. The counselling and therapeutic services provided helped
individuals cope with the challenges of mental health disorders, build resilience, and improve
their quality of life. Psychosocial interventions, such as individual counselling, group therapy,
and family support, offered a safe space for patients to express their emotions, develop coping
strategies, and work towards recovery.

Suggestions for Further Improvement:

Enhanced Psychosocial Assessment: Strengthening the psychosocial assessment process can

provide a more comprehensive understanding of patients' needs and challenges. Implementing
standardised assessment tools and incorporating a biopsychosocial approach in the evaluation
process would aid in identifying underlying psychosocial stressors and designing tailored
interventions.

Interdisciplinary Collaboration: Encouraging greater collaboration among healthcare

professionals, including psychiatrists, psychologists, social workers, and counsellors, would
optimise patient care. Regular case conferences and joint treatment planning would facilitate a
holistic and cohesive approach to addressing patients' psychosocial needs.

Outreach and Community Programs: Expanding psychosocial services beyond the hospital
setting could increase access to mental health support for individuals who may not seek
hospital-based care. Implementing outreach and community-based programs would help reach
underserved populations and raise awareness about mental health issues.

Cultural Competence and Sensitivity: Providing training on cultural competence and sensitivity
to psychosocial workers would ensure that interventions are tailored to patients' diverse cultural
backgrounds. Understanding cultural beliefs and practices can improve the effectiveness of
psychosocial support and avoid potential stigmatisation.

Strengthening Family Support: Engaging family members in treatment is vital for patients'
recovery. Implementing family therapy programs and support groups would empower families
to actively participate in healing and foster a supportive environment for patients.

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Integration of Technology: Utilising telepsychiatry and Tele counselling can facilitate access
to psychosocial services for patients in remote areas or those facing mobility challenges.
Integrating technology would enhance the reach and effectiveness of psychosocial
interventions.

Long-term Follow-up: Incorporating long-term follow-up and aftercare support for patients
who have completed their treatment is crucial in preventing relapse and promoting sustained
recovery. Regular check-ins and support groups can provide ongoing psychosocial support.

In conclusion, psychosocial work is an essential component of mental health fieldwork,

contributing significantly to the well-being of patients at Minuwangoda Base Hospital.
Psychosocial interventions complement medical treatment and foster holistic recovery by
addressing the psychological and social aspects of mental health. By implementing suggested
improvements such as enhanced psychosocial assessment, interdisciplinary collaboration,
community programs, cultural competence, family support, technology integration, and long-
term follow-up, Minuangoda Base Hospital can further strengthen its psychosocial services
and provide comprehensive and effective care to individuals with mental health disorders.

6.0 Reflection of the case studies and skills learned.

Reflecting on the clinical case studies and internships at Minuangoda Base Hospital in Sri
Lanka, several essential skills can be developed as a trainee counsellor. These skills contribute
to personal and professional development and are valuable for future medical practice. Here
are some important skills that can be acquired:

1. Clinical Skills: Working with patients and actively participating in their care allows
counsellors to develop and refine their counselling and psychosocial supportive skills. These
skills include history taking, mental state examination, diagnostic reasoning, treatment
planning, and administration of specific psychological assessment tools. The hands-on
experience gained during internships helps counsellors become competent in delivering
evidence-based and patient-centred care in future as carrier counsellors.

2. Communication and Interpersonal Skills: Interacting with patients, families, and the
healthcare team requires effective communication and interpersonal skills. Internships provide
opportunities to enhance verbal and non-verbal communication, active listening, empathy, and
cultural sensitivity. These skills are essential for building solid counsellor-patient relationships,
understanding patients' needs, and collaborating with colleagues from diverse backgrounds.

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3. Teamwork and Collaboration: Internships emphasise the importance of teamwork and
interdisciplinary collaboration in healthcare settings. Working alongside other healthcare
professionals fosters skills in effective teamwork, mutual respect, and collaboration. Learning
to contribute to a multidisciplinary team and communicate efficiently enhances patient care
outcomes and promotes a collaborative approach to counselling and psychosocial supportive
care delivery.

4. Problem-Solving and Critical Thinking: Dealing with complex medical cases and clinical
challenges during internships cultivates problem-solving and critical thinking skills.
Counsellors learn to analyse information, synthesise knowledge, and make evidence-based
decisions. These skills are crucial for accurate diagnosis, appropriate treatment planning, and
adapting to rapidly changing clinical situations.

5. Professionalism and Ethical Practice: Internships provide opportunities to develop

professionalism and ethical practice. Counsellors learn to maintain patient confidentiality,
uphold ethical standards, and demonstrate integrity when interacting with patients and
colleagues. They also build self-reflection, self-assessment, and lifelong learning skills,
contributing to ongoing professional growth as a counsellor.

6. Research and Evidence-Based Practice: Engaging in projects, research activities, and

literature reviews during internships promotes skills in research methodology, critical appraisal
of scientific literature, and evidence-based practice. Counsellors learn to evaluate and apply
the latest research findings to inform their clinical decision-making and contribute to advancing
counselling and psychosocial supportive care knowledge.

These acquired skills are closely related to the academic background of a counsellor. The
academic curriculum of counselling and psychological education provides a theoretical
foundation, while internships and clinical case studies offer practical application and
experiential learning. Integrating academic knowledge with hands-on experience allows
counsellors to develop a comprehensive skill set essential for personal and professional
development.

These skills are crucial for the future practice of counselling and psychosocial support. They
enable counsellors to deliver high-quality patient care, adapt to advancements in counselling
and psychological knowledge and technology, and navigate complex healthcare systems.
Effective communication and teamwork skills facilitate collaborative patient management,
improved patient outcomes, and enhanced patient satisfaction. Critical thinking, problem-
26
solving, and evidence-based practice skills enable doctors to provide accurate diagnoses,
develop optimal treatment plans, and contribute to advancing counselling and psychological
knowledge through research.

Moreover, developing these skills contributes to the personal growth of counsellors. They
foster empathy, resilience, and adaptability, enabling counsellors to handle challenging
situations and provide compassionate care effectively. These skills also support self-reflection
and continuous professional development, allowing do to stay updated with the latest
counselling and psychological advancements and provide the best po care to their patients.

In conclusion, the internships and clinical case studies at Minuwangoda Base Hospital provide
valuable opportunities for trainee counsellors to develop various skills. These encompass
clinical expertise, effective communication, teamwork, critical thinking, professionalism,
research, and evidence-based practice. Acquiring these skills d internships enhances personal
and professional growth, supports lifelong learning, and prepares counsellors for the challenges
and demands of future counselling and psychosocial supportive care practice.

7.0 Conclusion

In conclusion, the internship program at Minuangoda Base Hospital has been a transformative
experience, providing valuable opportunities for personal and professional growth. The report
highlights key aspects of the Internship, including the purpose, background information about
the hospital and Hope Centre("Balaporoththuwe Niwahana"), tasks and responsibilities as a
counsellor, accomplishments, and shall overcome.

The Internship allowed me to develop essential skills such as clinical expertise, effective
communication, teamwork, critical thinking, professionalism, research, and evidence-based
practice. These skills are crucial for delivering high-quality patient care as a counsellor,
fostering interdisciplinary collaboration, and adapting to the evolving counselling and
psychosocial support field. Moreover, the Internship provided a platform for personal growth,
promoting empathy, resilience, and adaptability.

The experience at Minuwangoda Base Hospital has not only contributed to acquiring new skills
but also reinforced the importance of patient-centred cultural sensitivity and the significance
of holistic approaches to counselling and psychosocial support. Exposure to diverse patient
populations and challenging clinical cases has broadened my perspectives and enriched my
understanding of various psychiatric conditions.

27
Furthermore, the internship experience fostered a sense of professionalism, instilled ethical
values, and emphasised the importance of continuous learning and professional development.
Engaging in research projects and contributing to advancing counselling and psychosocial
knowledge has reinforced my commitment to evidence-based practice.

Overall, the Internship at Minuwangoda Base Hospital has provided invaluable practising
experiences, mentoring, and opportunities to integrate academic knowledge with world patient
care in counselling and psychosocial support. The skills and insights gained during this
Internship will be a solid foundation for future counselling, psychosocial supportive care
practice, and further professional endeavours.

In conclusion, the internship program as a trainee counsellor at Minuwangoda Base Hospital

has been an advantageous and enriching experience, shaping professional competence,
fostering personal growth, and a commitment to compassionate, patient-centred care. The value
of the Internship extends beyond the acquisition of clinical skills, as it has instilled a deep
appreciation for the holistic nature of counselling and psychosocial supportive care,
interdisciplinary collaboration, and ongoing professional development. The experiences
gained, and the lessons learned will undoubtedly have a lasting impact on my journey as a
healthcare professional, reinforcing the importance of providing the highest standard of care
and continuously striving for excellence in counselling and psychosocial support.

8.0 Internship Reflection Report

The internship training at Minuwangoda Base Hospital has been a valuable transformative
experience that has profoundly shaped my perspective on mental health, available services in
Sri Lanka, and my understanding of the meaning of life. This reflection report aims to capture
the essence of my internship training, including the experiences gained, changes in perspective,
and observations about the services provided by Minuwangoda Base Hospital.

One of the most significant impacts of the internship training was the shift in my perspective
on mental health. Witnessing firsthand the challenges individuals with mental health disorders
and their families faced, I gained a deeper appreciation for the importance of mental well-being.
This experience highlighted the need for increased awareness, destigmatisation of mental
illnesses, and improved access to mental health services in Sri Lanka. It became clear that
mental health is as important as physical health, and both should be prioritised to ensure
comprehensive and holistic healthcare for all individuals.

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The exposure to the available mental health services in Sri Lanka during the internship training
was eye-opening. Minuwangoda Base Hospital was pivotal in providing essential mental health
services to the local community. The dedication and expertise of the healthcare professionals
in the hospital were commendable, as they worked tirelessly to address the needs of patients
with mental health disorders. The services provided, including counselling, psychotherapy,
psychosocial support services, medication management, and rehabilitation, showcased the
hospital's commitment to delivering comprehensive mental healthcare.

However, during the Internship, I also identified areas for improvement within the mental
health services at Minuwangoda Base Hospital. One key area was the need for increased
resources and capacity to meet the growing demand for mental health services. The hospital
faced limitations regarding staff availability, infrastructure, and funding, impacting the timely
access and quality of patient care. Addressing these resource constraints and implementing
strategies for expansion would be crucial in ensuring optimal mental health services to the
community.

Moreover, the internship training profoundly influenced my understanding of the meaning of

life. Engaging with patients who were struggling with mental health disorders allowed me to
witness the resilience, strength, and potential for recovery within everyone.

Their stories and experiences taught me the importance of compassion, empathy, and human
connection in fostering healing and growth. This experience reinforced my belief that life's
meaning lies in making a positive difference in the lives of others and in contributing to the
well-being of society.

In conclusion, the internship training at Minuwangoda Base Hospital has been a transformative
and enlightening experience. It has changed my perspective on mental health, highlighted the
need for improved services in Sri Lanka, and deepened my understanding of the meaning of
life. The exposure to mental health services, the dedication of healthcare professionals, and the
challenges faced by patients have collectively shaped my commitment to advocating for mental
health awareness and equitable access to quality care. I am grateful for the opportunity to
participate in this Internship and for the invaluable lessons and experiences gained during this
transformative period. Moving forward, I am motivated to contribute to improving mental
health services and to work towards creating a society that embraces and supports the mental
well-being of all individuals.

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9.0 References:
• American Psychological Association (2017). What Is Cognitive Behavioral Therapy?
American Psychological Association. [online] Available at: https://www.apa.org/ptsd-
guideline/patients-and-families/cognitive-behavioral.
• Bandara, P., Page, A., Senarathna, L., Wijewardene, K., Silva, T., Gunnell, D., Knipe,
D. and Rajapakse, T. (2022). Clinical and psychosocial factors associated with
domestic violence among men and women in Kandy, Sri Lanka. P.L.O.S. Global
Public Health, 2(4), p.e0000129. doi: https://doi.org/10.1371/journal.pgph.0000129.
• Colombo Telegraph. (2012). P.T.S.D. Sri Lankan Experience. [online] Available at:
https://www.colombotelegraph.com/index.php/ptsd-sri-lankan-experience/ [Accessed
17 Jul. 2023].
• Dhar, M., Kapoor, N., Suastika, K., Khamseh, M.E., Selim, S., Kumar, V., Raza,
S.A., Azmat, U., Pathania, M., Rai Mahadeb, Y.P., Singhal, S., Naseri, M.W.,
Aryana, I.S., Thapa, S.D., Jacob, J., Somasundaram, N., Latheef, A., Dhakal, G.P. and
Kalra, S. (2022). South Asian Working Action Group on SARCOpenia (SWAG-
SARCO) – A consensus document. Osteoporosis and Sarcopenia, 8(2), pp.35–57. doi:
https://doi.org/10.1016/j.afos.2022.04.001.
• Hapangama, A., Mendis, J. and Kuruppuarachchi, K.A.L.A. (2022). Why are we still
living in the past? Sri Lanka needs urgent and timely reforms of its archaic mental
health laws. BJPsych International, pp.1–3. doi: https://doi.org/10.1192/bji.2022.26.
• Health.gov.lk. (2017). Ministry Of Health - HOME. [online] Available at:
http://www.health.gov.lk/moh_final/english/.
• Mettananda, S., Peiris, R., Pathiraja, H., Chandradasa, M., Bandara, D., de Silva, U.,
Mettananda, C. and Premawardhena, A. (2020). Psychological morbidity among
children with transfusion-dependent β-thalassaemia and their parents in Sri Lanka.
PLOS ONE, 15(2), p.e0228733. doi; https://doi.org/10.1371/journal.pone.0228733.
• Rasalingam, G., Rajalingam, A., Chandradasa, M. and Nath, M. (2022). Assessment
of mental health problems among adolescents in Sri Lanka: Findings from the cross‐
sectional Global School‐based Health Survey. Health Science Reports, 5(6). doi:
https://doi.org/10.1002/hsr2.886.
• Samaraweera, S., Sumathipala, A., Siribaddana, S., Sivayogan, S. and Bhugra, D.
(2008). Completed Suicide among Sinhalese in Sri Lanka: A Psychological Autopsy

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 Study. Suicide and Life-Threatening Behavior, 38(2), pp.221–228. doi
https://doi.org/10.1521/suli.2008.38.2.221.
• Siva, N. (2010). Sri Lanka struggles with mental health burden. The Lancet, [online]
375(9718), pp.880–881. doi: https://doi.org/10.1016/s0140-6736(10)60370-4.
• Sørensen, J.B., Rheinländer, T., Sørensen, B.R., Pearson, M., Agampodi, T.,
Siribaddana, S. and Konradsen, F. (2014). An investigation into the role of alcohol in
self-harm in rural Sri Lanka: a protocol for a multimethod, qualitative study. BMJ
Open, [online] 4(10), p.e005860. doi: https://doi.org/10.1136/bmjopen-2014-005860.

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10.0 Acknowledgments

I would like to express my sincere gratitude to all the individuals who have supported me
throughout this internship and fieldwork, making it possible for me to complete this report.
Their encouragement, guidance, and assistance have shaped my experiences and reflections
during this transformative journey.

First and foremost, I would like to extend my heartfelt appreciation to Dr. M.G.T. Fernando
and Dr. H.M.C.J. Herath, who have been an incredible source of support and inspiration
throughout my internship. Their mentorship, patience, and willingness to share their knowledge
have enhanced my clinical skills and understanding of mental health care.

I am deeply indebted to my family for their unwavering love and encouragement. Their
constant support and belief in my abilities have driven my pursuit of a career in counselling
and psychosocial support. Their understanding and sacrifices have allowed me to focus on my
internship, and I am forever grateful for their presence in my life.

I am immensely thankful to my senior counsellors, whose wisdom and expertise have shaped
my approach to counselling and psychosocial work. Their constructive feedback and guidance
have been crucial in honing my therapeutic skills and navigating the complexities of mental
health care.

I would also like to acknowledge the entire team at Minuwangoda Base Hospital, whose
dedication and commitment to patient care have been truly inspiring. Their collaborative spirit
and interdisciplinary approach have taught me the importance of teamwork and patient-centred
care in delivering comprehensive health services.

Lastly, I extend my thanks to all the patients and their families who participated in this
fieldwork. Their openness, trust, and resilience have allowed me to learn and grow as a
professional, emphasising the importance of empathy and compassion in providing holistic
care.

In conclusion, I am grateful to each person who has contributed to my internship and fieldwork
through direct mentorship, support, or understanding. Their belief in me and willingness to
invest in my growth have been invaluable. This report is a testament to the collective effort and
dedication of all those involved, and I am honoured to have had the opportunity to work with
such remarkable individuals.

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 11.0 Appendices

11.1 Appendix I – Letter issued to K.C.P. Perera – 2021/PgDCP/70 From the Faculty of
Graduate Studies University of Colombo

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11.2 Appendix II – Site Supervisor Evaluation Report of K.C.P. Perera - 2021/PgDCP/70

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11.3 Appendix III – Evaluation Form Used to Assess the Patients at Base Hospital
Minuwangoda

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11.4 Appendix IV - Photographic detail of family medical clinic and Shelter of Hope Centre
at base hospital Minuwangoda – The location of my Internship Program in Counselling and
Psychosocial Support

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