FINAL INTERNSHIP REPORT

FINAL INTERNSHIP REPORT

Case 1 Social Anxiety Disorder

Case 2 OCD
Session: MSc Applied Psychology (4th Semester)
Supervisor: Ms Amina Haider
Student Name: AbdulSalam
Roll Number: MC200400304
Clients: HC & AM
Submission Date: 28th August 2022

Virtual University of Pakistan

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Dedication
With the feeling of my heart, soul and spirit, I bow my heart before ALLAH and
ALMIGHTY who bestowed me the ability of reading and writing.. I would also like
to thanks my instructor who enables me to make this report effective, she guides
me well. Thanks for her cooperation And My Friend who always ready to help me.

Acknowledgement
I would like to take this opportunity to acknowledge & respect the contribution of
my supervisors specially Mr Naveed Sultan & his team for providing complete
guidance, information & knowledge that helped me gain valuable learning during
my internship.
Their guidance in these two cases provided me with practical experience &
introduced me with the latest field knowledge. I also acknowledge my course
instructor Miss Amna Hayder .because with the help of her i is able to complete
my Internship and Assessment report. As she helps me out throughout my report.
I am fortunate to have such a Great instructor and I am proud of her to be a part
of my study thank you. I would thank my instructor Miss AmNA Hayder who
deserves my deepest gratitude. As the completion of this case study and intership
report it gaves me immense pleasure and knowledge with great unconditional
help of my instructor

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Executive Summary
Summary Case 1 SAD
My client is 27 years old H.C. She is working as a project manager in a private
management firm. She stated that she has anxiety due to office environment.
After proper assessment, she was diagnosed with social anxiety disorder. With
proper treatment plan, we were able to facilitate her in overcoming her anxiety..
She was appointed as the project manager in a private software house. She was
perfectly fine in her JD at that time. After three months; she started suffering
through office politics & leg-pulling culture due to exceptional performance in her
work. Her colleagues tried to derail her projects due to jealousy factors. From
May 2021, the situation gets worse & things got much out of her hands. She tried
everything in this duration but all in vain. From May 2021 till now, she has tried to
relax by going on vacations & trying to build better relationships with her
colleagues but all in vain. During this duration, her family tried to support her by
giving her their best time & doing things that she always loves to do. They
arranged a gathering of client’s friend at home but it didn’t help that much.

Summary Case 2 OCD

AM is a news anchor working in a private news channel in Lahore. He face Some
obsession issues somehow, He is very good in his hygiene and organization. Most
of the time when he left home and close the door he check door again and again
and make it sure that it is lock or not ? But its not like an disorder but problem
start one year before when He first felt these symptoms when one of his uncles
died due to covid-19. This caused AM to think that he will die to due to the covid
19. This risk factor triggered a chain of actions by AM. He started a different
behavior with everyone. He started keeping distance from people even his family.
He reported the obsession of washing his hand again & again to avoid being
contaminated. His family & friends thought that I am being obsessed with this so I

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cut of myself from my life. He only started going to studio & spend rest of his time
in his room due to my thoughts about germs. Later He started being worried
about doors or closed windows & things keep getting complicated for him.

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Table of Content
 Background Information
 Main reason for referral
 Presenting complain
 History of presenting illness
 Predisposing factors
 Precipitating factors
 Family history
 Father
 Mother
 Sibling
 Personal history
 Marital history
 Occupational history
 Premorbid personality
 Mental status examination
 Sitting posture
 Facial Features
 Hair color Texture
 Styling and grooming
 Height
 Weight
 Body Shape
 Cleanliness
 Neatness
 Clothing/Dressing
 Level of Eye Contact
 Eye Movement
 Degree of friendliness
 Apparent Age
 Mannerism
 Speech (Form and Content)
 Volume of Speech
 Stammering/stuttering
 Mood
 Thoughts

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 Stream of Thought
 Thought Content
 Delusions
 Hallucinations
 Orientation:
 Orientation (Time)
 Orientation (Place)
 Orientation (Person)
 Memory
 Recent past memory
 Recent memory
 General information/intelligence
 General knowledge questions
 Insight
 Summary of Informal and Formal Psychological Assessment
 Informal Assessment includes
 Clinical Interview
 Mental Status Examination Formal Assessment includes
 Diagnostic Assessment Test
 Personality Assessment Test
 Diagnosis
 Prognosis
 Management and Treatment
 Family Counseling
 Psychological psychotherapy
 Follow up Plans Any Suggestions/Recommendations
 Case Formulation
 Appendances.

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Case 1
Demographics

Name HC
Gender Female
Age 27
Education Graduation (BA)
Birth Order 4th
No of Siblings 5
Marital Status Single
Number of Children N/A
Occupation Private Job
Date of Admission 29th June 2022
Informal Self

Reason for Referral

Client was referred to AbdulSalam by Happy Life Psychologist Services for Psychological
Assessment & Management of Problem.

Presenting Complaints

Presenting Complaints Duration

Muje Gathering main jany se khoof atta 1 Year
hai
Muje parties main jany se khoof atta ahi 1 Year
Main apni Boy friend k sath date nahi kar 1 Year
paati
Interview dany se khoof atta hai 8-9 Months
Jahan zzayada loog huu waha jany se 1 year
ghabratta huu , bboht ghabrahat hoti hai .
Naye kapray pehn kar be sharminda rehti 1 Year
huu logo ka samna nahi kar patti
Muje aysey lagta hai loog muje judge kar
rey hain .
Thanday paseeeny atty hain , dil ki dharkan 6-7 Months
bhar jati hai . muscles tension hoti hai .
Naye dost nahi bana patti , unka samna 1 Year
karny se ek ajeeb sa khoof rehta hai .

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History of Present Illness

Predisposing factors
Her life before the emergence of symptoms was very linear. Her home environment was
friendly and caring. Whole family used to do activities together. However, in office, her
colleagues acted as the triggering factor for her anxiety. Every time she met her, she feels
insecure and stressed. Now she avoids people in her office & personal life too. She doesn’t
attend any event as she feels anxiety among people & try to be in solitude. She skips
professional as well as family events & try to make as minimum contact with people around
her.
Precipitating Factors
HC professional career started at the age of 23. Recently she joined his new office in December
2020. She was appointed as the project manager in a private software house. She was perfectly
fine in her JD at that time. After three months; she started suffering through office politics &
leg-pulling culture due to exceptional performance in her work. Her colleagues tried to derail
her projects due to jealousy factors. They used to call her ugly, taunt her for her outfits & often
laugh at her. She was reported negatively to the higher management. This behavior of
colleagues made her emotionally broke. She started avoiding them, left social events, skipped
office meetings. It’s about one years before one day she is sitting on cafeteria for lunch then
some of her coworkers start bullying, teasing, rejection & humiliation .this act led to decreased
office productivity resulting in overthinking and social anxiety. It’s difficult for her to face people
and coworkers .From May 2021, the situation gets worse & things got much out of her hands.
She tried everything in this duration but all in vain. From May 2021 till now, she has tried to
relax by going on vacations & trying to build better relationships with her colleagues but all in
vain. During this duration, her family tried to support her by giving her their best time & doing
things that she always loves to do. They arranged a gathering of client’s friend at home but it
didn’t help that much.
Family History
Father:
Father of client is alive & currently working as an engineer in Faisalabad Industrial Complex. He
is physically healthy & has no psychological illness. He is very caring & responsible about his
family.
Mother:
Mother of the client is a housewife. She passed her intermediate & got married after that. She
is physically healthy. Client reported no psychological illness of her mother.
Siblings:

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Client is at number 4th in her siblings. They are total of 5 siblings. She has 2 brothers & 2 sisters.
They are physically healthy & no psychological condition was reported by the client.

Educational History
Client Studied in District Girls Hight School till intermediate, Client mentioned that he had
healthy relations with all her class fellows & teachers though there were few people who used
to tease her. Her academic performance was 75% on average throughout her academic career.
However, some of her fellows always bully her for being a book lover.
Personal History
The client reported that she had birth by Normal Delivery & No physical, intellectual or
developmental Disability. Her first cry reported to be immediate. No History of any major illness
& no neurotic traits were reported.
Traumatic Experience: Suffered trauma while being victimized by colleagues many times in the
past 1 year.
Occupational History
Client started working at the age of 23. She first joined a study consultants as front desk officer
in Lahore. She got a better opportunity three later & moved to a new Software company named
Yoddo Softwares this year. She is currently managing PR of Yoddo Softwares.

Premorbid Personality
HC had an extroverted nature & she was very good at making new friends & attending events.
She creates strong social relationships & carries a high standard of values & discipline. The
following aspects of her personality are as follows.
Social Interests: Tourism, hiking.
Social Relationships: Extroverted Nature So had a good number of friends.
Mood: Positive & Welcoming.
Moral & Religious Values: Modern Muslim Carrying both east & Western Culture with balance.
Habits: Internet Surfing, Outing.
Reaction to Stress: High Blood Pressure, breathing difficulty. Start crying (low Emotional
intelligence).
Smoking/Addiction: N/A

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Assessment
Informal Assessment include Baseline chart and Subjective Rating Scale
Formal Assessment include Mental Status examination, Diagnostic test and personality test .

1-Informal Assessment
1.1-Baseline Chart

Activating Point Belief Consequence Consequence Results

Feeling Behaviour
One of my If I don’t go, she will Fear, I went & took I felt that they are
Colleagues rudely taunt me that I just Inferiority water for her misbehaving with me
asked me to go to show off to be Complex from the office & they laughed at me
the kitchen & bring helping but I am not. kitchen. when I entered in
water for her room with a water
bottle.
Once, they reported She asked me about Nervous, I told the whole They made fun later &
supervisor that I had a good color for fearful story to the taunted me for my
taunted her for her lipstick & I suggested supervisor but lipstick color.
looks while I didn’t. light red instead of they all stood at
dark red as per her one point & I
face texture & dress. was given a
warning.
Once I was I felt like they will Stress, I left the event I felt that I shouldn’t
attending a not like me & make anxiety midway & took go to public
marriage event, I me feel worse about uber back gatherings to avoid
met some myself. home. this anxiety.
unfamiliar faces
there & I wanted to
escape from there.
Once I got call for an I feel that I am not Severe I just decide not I felt that facing new
interview and after good enough to face anxiety to go for an people is irritate me a
attending call I feel people . an intense interview . lot and I feel fear
anxiety that how to fear to face people about it .
face people during
new interview and
new place

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Summary of base line chart

Base line chart reveal about the triggers of anxiety .Different event cause trigger for her
anxiety. Baseline chart reveals all trigger point which made my client more sad and push
towards Anxiety. My client share Her event that push her to anxiety.

Subjective Rating Scale

Event Intensity Off Anxiety ( 0 T0 10 )

When was your Colleagues rudely asked 9
you to go to the kitchen & bring water for
her then how you rate your anxiety at that
time
When you was attending a marriage 8
event, and you met some unfamiliar faces
there & you wanted to escape from there
because of social anxiety , what intensity
of anxiety you were faced .
When you decided not to go for interview 10
due to fear and anxiety to face people ,
share your intensity of anxiety at that
particular moments

1.2- Summary Subjective Rating

She Rate her anxiety as 8 , 9 , 10 In different event shared above .she used the 9 Points rating
scale (following) for my client for a subjective rating in the situation. H.C termed 8 out of 10
whiles being an intense situation.
Rating scale show the accurate progressivity of anxiety .Subjective chart, rating scale reveal the
intensity of particular event , like in this chart my client show Her rating scale according to
intensity .and this show us clear image and idea about the intensity of that particular event ,

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2-Formal Assessment
2.1-Mental State Examination
2.2-Psychological Assessment
2.3-Personality Assessment
Mental Status Examination
Clients was a Looking Good, Hygienic, blackhair, well-groomed. Height is about to 5 feet as an
average . Physically look week look .she wears neat and clean dress, and wear A black sandals.
Eye contact is Strong, a bit friendly in nature .Sitting position is in comfortable Her facial
expression is Open to read Volume of Speech is low mood is bit low.

Delusions
‫کیا آپ کو اس بات کا یقین ہے کہ کوئی دو لوگ آپ کے خالف بات کر رہے ہیں؟‬
NO
‫کیا آپ کو ایسا محسوس ہوتا ہے کہ ا پ کے قریبی رشتے دار آپ کے خالف ہیں؟۔‬
‫نہیں‬
‫کیا آپ کو ایسا لگتا ہے کہ آپ کا تعلق کسی عظیم ہستی سے ہے؟‬
‫جی ہاں‬
Hallucinations:
‫کیا آپ کو ایسی آوازیں سنائی دیتی ہیں جو دوسروں کو دکھائی نہیں دیتی؟‬
‫نہیں‬
‫کیا آپ کو ایسی شکلیں دکھائی دیتی ہیں جو دوسروں کو نظر نہیں آتیں؟۔‬
‫نہیں‬
Orientation:
Orientation (Time):
‫آج کیا تاریخ ہے؟‬
29
‫یہ کونسا مہینہ ہے؟‬
‫ج ون‬
Orientation (Place):
‫یہ کونسی جگہ ہے؟‬
‫کونسلنگ ٓافس‬
‫یہ کونسا شہر ہے؟‬
‫اسالم ٓاباد‬
Orientation (Person):

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‫میرا نام کیا ہے؟‬

‫میرا نام ریا ہے‬
Memory:
Remote memory:
‫آپ کہاں پیدا ہوئے؟‬
‫الہور میں‬
Recent Past Memory:
‫آپ نے کل ٹی وی پر کونسا پروگرام دیکھا؟‬
‫سنگ ماہ‬
Recent Memory:
‫ان الفاظ کو اسی ترتیب سے دہرائیں۔ کرسی۔ میز۔ الماری۔‬
‫ترتیب درست تھی‬
‫کرسی۔ میز۔ الماری‬
General information/intelligence:
General knowledge questions
‫ کتنے ہوتے ہیں؟‬۲ ‫ جمع‬۵
۹
Insight:
‫آپ کی بیماری کس نوعیت کی ہے؟‬
‫فسیاتی ۔‬

Diagnostic Assessment
Back Anxiety Inventory
Score 22 -35 ( Moderate anxiety)

Personality Assessment HTP

The House-Tree-Person (HTP) test in clinical psychology is part of the series of a group of
projective tests which help in the assessment of personality traits. The HTP test is also
administered to identify mental disorders like schizophrenia. Get to know how this test
is interpreted

House interpretation:
House drawing show more hidden parts of my client as, my client have drawn a house
with closed doors along with a lock and closed windows (two). She has drawn a big
house, which means that she may be overwhelmed by her family life. The roof
symbolizes the fantasy life, and my client has paid extra attention to it which indicates
her extra attention to fantasy and ideation. My client have drawn closed windows and
locked doors, she emphasized on locks, which may indicate that he did not want anyone

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to enter to see in her mind. She is not interested to interact with others. The strength
and the security of depicted walls of the house are directly related to the degree of ego-
strength in the personality.

Tree Interpetation

My client Sketch a tree sketched branches of tree which showing cohesiveness. And
social bounding as he live in joint family system. Type of tree is Wind blow that shows
environmental pressure and also make cotton wrap style tree which means guilt. Shape
like clouds showing fantasy .Ground of tree shows depression and insecurity. He makes
no leave that indicate feeling of barren.

Person interpretation:
Person drawing reveals more about the hidden part of personality of client as my client my
client has drawn Same sex. A Girl is simply standing with open hands which show
willingness to engage. Legs and feet are also like roots of trees, and representing grounding
and power too, feet can indicate a need for security. The neck separates the head from the
body. Here the closed tight mouth of the drawn person indicates the denial of needs or
some passive aggression. Facial features of the drawn person are large eyes, tightly open
lips, a nose. Look anxious and look to show active and alertness.

Summary of Informal and Formal Psychological Assessment

Informal assessment Base line chart reveal about the triggers of anxiety .Different event cause
trigger for her anxiety. Baseline chart reveals all trigger point which made my client more sad
and push towards Anxiety. And subjective rating scale shown the intensity of anxiety at
particular moments as My client share Her event that push her to anxiety shown She Rate her
anxiety as 8 , 9 , 10 In different event shared above .she used the 9 Points rating scale
(following) for my client for a subjective rating in the situation. H.C termed 8 out of 10 whiles
being an intense situation.

Diagnosis
According to DSM my client is Suffering from Social Anxiety Disorder (Social Phobia) 300.23
(F40.10)
Prognosis

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Prognosis is satisfactory , my client engage herself with proper therapeutic session ,

psychotherapy and well manage his disorder . People with social anxiety disorder display a
combination of physical and behavioral symptoms. The physical symptoms include trembling,
sweating, nausea and stammering when trying to speak. These symptoms make the person
more self-conscious because they believe that people around have noticed, leading to a deep
sense of humiliation and embarrassment for the sufferer. As a result, their behavior may
change in the following ways:
They try to avoid situations where they might have to speak

They withdraw from their personal and professional relationships

They usually avoid eye contact in social settings

These symptoms can be very distressing for the person, and they may have trouble coping with
daily life. If you have noticed these symptoms in someone you know, try and talk to them about
consulting a mental health professional.

Management & Treatment

After completing initial assessment & diagnosis, Client went through a proper counseling &

psychotherapy channel for five weeks. Following therapeutic interventions were used.

1. MBSR (Mindful based Stress Reduction Techniques)

Mindful based stress reduction techniques enable the person to be mindful and relaxed at the

situations where he normally gets stressed. This technique involves learning to focus on breath,

being more self-centered and increase the awareness about the positive part of environment.

This technique helped clients in managing his stress at social situations.

2. CBT (Cognitive Behavioral Therapy)

CBT enables a person to remove his unrealistic thought patterns. In CBT, the thought pattern of

client is challenged to change his perception and behaviour ultimately. Through CBT, we helped

the client in understanding the irrational part of her thinking which helped her understand the

situation in a better manner.

3. Exposure Therapy

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In exposure therapy, client is exposed to similar situation in which he get stressed in a

controlled environment. This help client in dealing practically with the situation and get the

most out of it. In exposure therapy, client was asked to interact with the group of interns which

were very humble and polite. This helped client gain confidence that he can manage social

situations in a better fashion.

4. Talk Therapy/ Psychotherapy

Talk therapy is the most common way of discussing the ideas that the client possess. In talk

therapy, we discussed the client’s problems and solution which helped her in getting relaxed

and being more composed.

Case Formulation:

After review all symptoms and case history this case is related to cognitive School of thoughts

because The anxiety of client was due to the rude behavior of her colleagues & due to over

thinking habit. This case is viewed within the frame of Cognitive Behavioral Perspective. As in

cognitive behavioral school of thought, there is the acceptance of two influences on an

individual’s cognition, emotions, affect and behavior. These are:

 Cognition

 Environment

Hence this case belongs to Cognitive behavioral Paradigm.

Appendices:

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2nd Case
Demographics

Name AM
Gender Male
Age 25
Education MS (Continue)
Birth Order 3rd
No. of Siblings 4
Marital Status Single
Number of children N/A
Date of Admission 12ND July 2022
Occupation Media Industry Job
Informant Self

Reason for Referral

ARK was referred to AbdulSalam by Happy Life Psychologist Services for Psychological
Assessment & Management of Problem.
Presenting Complaints

Presenting Complaints Duration

Main Jab be bath leta huu muje aysey lagta 1 Year
hai k main ny theek se bath nahi liya hai , so
main baar baar nahata rehta huu
Main jab be door lock karta huu main baar 1 Year
baar check karta huuk theek se lock howa
ha k ahi ?
Muje jab ghussa atta hai tab main baad 1 Year
baar baar hath dhoota huu , aur masalsal
dhoota rehta hu.
Main kissi se hand shake nahi karta , muje 1 Year
aysey lagta hai k handshake karny se mery
hath ganddday ho jaen gy aur muje re wash
karna pary gy .
Ghar main bikhri howi chezoon ki wajah se 1 Year
muje bechani hoti hai aur main set karny
lagta huu .
Apna karma saaf rakhta huu , koi agar mery 1 Year
room main aha jae tuu main dobara se
apna room re clean karta huu

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History of Present Illness

Predisposing Factors
AM had very good relation with his family from start. They had a close relationship. His life
before the death of his uncle was very linear and composed. He used to go to office daily and
was getting good feedback on his performance. After the triggering event, his life changed. His
family supported him in best possible manner by giving him space & convinced him for
counseling.
Precipitating Factors
problem start one year before when He first felt these symptoms when one of his uncles died
due to covid-19. This caused AM to think that he will die to due to the covid 19. This risk factor
triggered a chain of actions by AM. He started a different behavior with everyone. He started
keeping distance from people even his family. He reported the obsession of washing his hand
again & again to avoid being contaminated. His family & friends thought that I am being
obsessed with this so I cut of myself from my life. He only started going to studio & spend rest
of his time in his room due to my thoughts about germs. Later He started being worried about
doors or closed windows & things keep getting complicated for him.
AM had very good relation with his family from start. They had a close relationship. His life
before the death of his uncle was very linear and composed. He used to go to office daily and
was getting good feedback on his performance. After the triggering event, his life changed. His
family supported him in best possible manner by giving him space & convinced him for
counseling.

Family History
Father
His father is a retired professor & HEC faculty member. He is living a healthy life & no
psychological or psychiatry issues are reported.
Mother:
His mother is a housewife & client didn’t report any clinical disease in her.
Siblings:
AM has 2 brothers & 3 sisters. They always share a good bond but in last one year, AM try to
avoid them due to possible contamination

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.
Personal History
AM Had Birth by Normal Delivery & No physical, intellectual or developmental Disability was

reported.

Traumatic Experience: AM was very close to his uncle who died due to covid-19. His death
caused him so much pain.
Educational History
ARK Studied in Kasoor Hight School, Client mentioned that he had healthy relations with all her
class fellows & teachers due to his good academic record. Her academic performance was 90%
on average throughout her academic career. He was an ambivert & use to socialize for fun.
Occupational History
AM started working 2 years back as a digital news reporter for a webtv. He later joined a main
stream news channel as a broadcaster reporter in same company. He is working in a same
organization for 2 years & had a good interaction with his colleagues in 1 st year of his career.
However, after his uncle’s death, he started maintaining a distance with his friends &
colleagues.

Premorbid Personality
AM was good in socializing & making friends. He likes to party & travel with his friends with
keen interests in cultural events & tourism journalism.
Social Interests: Cultural events
Social Relationships: Healthy
Mood: Neutral (Inclined toward positivity)
Moral & Religious Values: Like to read spirituality & mysticism
Habits: High Interests in spiritualism, mysticism & comparative religious studies.
Reaction to Stress: Cut off from the scenario & try to deal on its own.
Smoking/Addiction: N/A
Assessment
1-Informal Assessment

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1.1-Baseline Chart:

Summary of Base line chart

Baseline chart reveals that client have Facing Obsession at many time , and he do compulsion
on obsessions . Every night he check the door frequently aggain and again at same time . He
washed his hands frequently several time a day , he use his arm instead of hand for hand
shaking.

Subjective rating Scale .

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Summary of Subjective Rating Scale

Client rate his obsessions in several events as 9 , 9 8 , 9 which show intense and moderate level
of obsessions . As above client share his life events and rate particular level of obsession
accordingly.

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Summary of Informal and Formal Psychological Assessment

A. Presence of Obsessions, Compulsions or both Present

B. Obsessions are time Consuming Present
C. No Other Physiological condition or substance Use Present
D. Not Explained by any other mental condition Present

2-Formal Assessment
2 Mental State Examinations
2.2-Psychological Assessment
2.3-Personality Assessmen

Mental Status Examination

Clients a Looking Good, Hygienic, Big brown hair, have brown shade of fashion, shiny hair with
well-groomed. Height is about to 5 feet. Physically look healthy and graceful beautiful look. He
wears neat and clean dress, Sea green kurta and black skinny trouser. Eye contact is Strong, a
bit friendly in nature .Sitting position is in comfortable Her facial expression is Open to
read .Volume of Speech is loud mood is bit nervous. Fluctuation in thoughts pattern, No clarity
of thoughts, flights of ideas and clients not willing to open sharing. Client focus on positive
thoughts.

Delusions
‫کیا آپ کو اس بات کا یقین ہے کہ کوئی دو لوگ آپ کے خالف بات کر رہے ہیں؟‬
‫نہیں‬
‫کیا آپ کو ایسا محسوس ہوتا ہے کہ ا پ کے قریبی رشتے دار آپ کے خالف ہیں؟۔‬
‫نہیں‬
‫کیا آپ کو ایسا لگتا ہے کہ آپ کا تعلق کسی عظیم ہستی سے ہے؟‬
‫نہیں‬
Hallucinations:
‫کیا آپ کو ایسی آوازیں سنائی دیتی ہیں جو دوسروں کو دکھائی نہیں دیتی؟‬
‫نہیں‬
‫کیا آپ کو ایسی شکلیں دکھائی دیتی ہیں جو دوسروں کو نظر نہیں آتیں؟۔‬

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‫نہیں‬
‫‪Orientation‬‬
‫‪Time‬‬
‫آج کیا تاریخ ہے؟‬
‫دو‬
‫یہ کونسا مہینہ ہے؟‬
‫جوالئی‬

‫‪Place‬‬
‫یہ کونسی جگہ ہے؟‬
‫ٓافس‬
‫یہ کونسا شہر ہے؟‬
‫الہور‬
‫‪Person‬‬
‫میرا نام کیا ہے؟‬
‫اے ار کے‬
‫‪Memory‬‬
‫‪Remote memory:‬‬
‫آپ کہاں پیدا ہوئے؟‬
‫قصور‬
‫‪Recent Past Memory:‬‬
‫آپ نے کل ٹی وی پر کونسا پروگرام دیکھا؟‬
‫کوئی نہیں‬
‫‪Recent Memory:‬‬
‫ان الفاظ کو اسی ترتیب سے دہرائیں۔ کرسی۔ میز۔ الماری۔‬
‫ترتیب درست تھی‬
‫کرسی میز الماری‬
‫‪General information/intelligence‬‬
‫‪General knowledge questions‬‬
‫‪ ۵‬جمع ‪ ۲‬کتنے ہوتے ہیں؟‬
‫‪۹‬‬
‫‪Insight‬‬
‫آپ کی بیماری کس نوعیت کی ہے؟‬
‫ذہنی یا نفسیاتی‬

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Diagnostic Assessment
Yale-Brown Obsessive-Compulsive Scale (YBOCS)
Score 33 Severe

Personality Assessment
HTP
Assessment of HTP
The house-tree-person (HTP)projective technique developed by john buck was originally an
outgrowth of the good enough scale utilized to assess intellectual functioning .Buck felt artistic
creativity represented a stream of personality characteristic that flowed onto graphic art.He
believed that through drawing, subjects objectified unconscious difficulties by sketching the
inner image of primary process.
INTERPRETATION OF A PERSON:
He made a teen age girl picture which is standing in a stylish pose. Girl wore a hat on head
which means she has moral values. He made open arms of the girl that shows willing to
engage herself and as we mention above in his background history that she is a working
woman its indicate that she like to be busy and engage. He made the girls legs straight which
show her straight forwardness. He made her neck not separated from his head which means
her desires for aspirations. He made small mouth with smile that indicate she has the desire to
live happily and smiling the girl is wearing a modern stylish dress which shows client 'an
aesthetic sense.

INTERPRETAION OF A TREE:
The picture of tree drawn by the client is very meaningful .He made a tree with a broad trunk
with heavy lines or shading present in it which shows anxiety about him. The trunk is small
which means she has small ego strength. he made large branches with thick leaves which mean
he meets his needs and he has no financial problem. He made thick and heavy leaves which
mean he likes to effort in his life.
INTERPRETATION OF A HOUSE:

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He made windows which are closed and having no curtains indicate some unwillingness to
reveal much about him. The ground lines are so dark and bolt that means that inside the family
believe and thought are so congested. All the doors and windows are closed which means that
their home atmosphere is isolated and silent. His house drawing roof showed empty which
shows that the person is not like to gatherings around his house.

Diagnosis:

According to dsm v the client is suffering from 300.3 (f42) obsessive compulsive disorder .

Prognosis: Satisfactory as client is willing to overcome his OCD & want to move on. His family is
also worried about him & they want him to be happy as he was in the past.
Management and Treatment:
Client was involved in one-on-one counseling sessions. Following therapeutic techniques were
used to cope with OCD.
1-CBT
CBT enables a person to remove his unrealistic thought patterns. In CBT, the thought pattern of

client is challenged to change his perception and behaviour ultimately. Through CBT, we helped

the client in understanding the irrational part of her thinking which helped her understand the

situation in a better manner.

2-Exposure Therapy
In exposure therapy, client is exposed to similar situation in which he get obsessed in a

controlled environment. This help client in dealing practically with the situation and get the

most out of it. In exposure therapy, client was asked to write a activity note every time and

make a video of closing the door when he go for closing the door. In another activity, he was

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asked to wash his hand under my supervision once in an hour. This reduced his frequency of

washing hands from five to one.

3-Psychotherapy/Talk Therapy
Talk therapy is the most common way of discussing the ideas that the client possess. In talk

therapy, we discussed the client’s problems and solution which helped her in getting relaxed

and being more composed. Client was assisted in identifying the irrational part of her believes.

Our talk therapy consisted on one or two sessions as client already had a good idea about his

obsessions.

4-Hypnotherapy
In hypnotherapy, client went through a stage of hypnosis with the help of a hypnotherapist.
With the help of hypnotherapy, the irrational part of her believes were tried to replace with the
new ones. This therapy enabled him to be stronger in dealing with his obsessions.

Case Formulation:
The Obsessive thoughts of client was due to the death of his uncle due to covid 19. This led

client over think about everything resulting in obsession. This case is viewed within the frame of

Cognitive Behavioral Perspective. As in cognitive behavioral school of thought, there is the

acceptance of two influences on an individual’s cognition, emotions, affect and behavior. These

are:

 Cognition

 Environment

Hence this case belongs to Cognitive behavioral Paradigm.

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Appendances

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Thank You

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