Brief Overview of the Organization

Calcutta National Medical College (CNMC) is called Chittaranjan Hospital, has its origin

in the "National Medical Institute" on 14 April 1921, founded as a product of the

Non-cooperation movement. It was inaugurated by Netaji Subhas Chandra Bose. Established in

1948, the institute was nationalized and taken under the Ministry of Health & Family Welfare

(West Bengal) in 1967. The college is accredited by the National Medical Commission (NMC).

It is currently affiliated to the West Bengal University of Health Sciences (WBUHS). The

founder principal of the college was Dr Sundari Mohan Das.

The psychiatry department is located on CNMC's second campus, which was originally

known as Calcutta Pavlov Hospital. This is at Gobra Road, Beniapukur, Kolkata, West Bengal

700014. With a rich history, it provides comprehensive services including inpatient and

outpatient care, emergency services, and specialized clinics for disorders such as mood and

anxiety disorders, psychosis, substance use, and child and adolescent psychiatry. Utilizing a

multidisciplinary approach, treatment plans involve psychiatrists, psychologists, social workers,

occupational therapists, and nurses.

The department is pivotal in training medical students, psychiatric residents, and other

mental health professionals, offering postgraduate courses in psychiatry (MD, DPM) in

affiliation with academic institutions. Active in research, it advances understanding and

treatment of mental disorders through clinical trials and epidemiological studies. The department

also engages in community outreach and awareness programs to reduce stigma and improve

mental health literacy. Equipped with necessary facilities, it emphasizes patient-centric care

through individualized treatment plans incorporating both pharmacological and

psychotherapeutic interventions.
 Nature of Internship

During my one-month internship at Pavlov Hospital under the Department of Psychiatry,

I was actively involved in a variety of clinical and observational activities. The primary objective

of my internship was to gain hands-on experience in the field of clinical psychology and

understand the complexity of psychiatric practice. Initially, the first week was dedicated to

observing the clinical setting and understanding the processes within the psychiatric facility.

Following this one week period, I took on several primary responsibilities:

● Case Histories and Mental Status Examination: I recorded detailed patient case

histories and conducted Mental Status Examinations (MSE), which provided essential

information for diagnosis and treatment planning.

● Psychological Assessments: A significant portion of my work involved understanding

administering psychological assessments. I interacted with patient with different

disorders ranging from mood and anxiety disorder to psychotic disorder, with majority of

children with intellectual diasabilties. I learned to administer the following tools -

- Vineland Social Maturity Scale (VSMS)

- Binet-Kamat Test (BKT)

- Brief Psychiatric Rating Scale (BPRS)

- Indian Scale for Assessment of Autism (ISAA)

- Children's Yale-Brown Obsessive Compulsive Scale (CY-BOCS)

- Yale-Brown Obsessive Compulsive Scale (Y-BOCS)

- Hamilton Depression Rating Scale (HAM-A)

- Hamilton Anxiety Rating Scale. (HAM-D)

 ● Psychodiagnostic Formulation and Provisional Diagnosis: I actively participated in

psychodiagnostic formulation and coming up with provisional diagnosis, contributing

significantly to the comprehensive treatment planning process.

● Therapeutic Interventions: As part of Cognitive Behavioral Therapy (CBT), I taught

relaxation techniques to patients, such as deep breathing, grounding techniques, mindful

meditation and how to journal our emotions, enhancing their coping mechanisms and

overall well-being.

● Observation and Counseling: I observed cases and counseling sessions conducted by

professionals, gaining valuable insights from their professional expertise about ongoing

patient care and therapeutic processes.

In the department, initially all the patient consult a psychiatrist who administers medications.

Clinical psychologists intervene only when referred by the psychiatrist. This structured approach

ensured a thorough and multi-disciplinary evaluation and treatment process.

Overall, this internship provided me with practical, hands-on experience and a deeper

understanding of clinical psychology applications in a real-world clinical setting. It shaped my

skills in rapport building, patient assessment, diagnosis, and therapeutic interventions, above all

increased my empathy and patience for dealing with patients and thus preparing me for future

professional roles in the field of mental health care.

 Week wise Description of the Work Done

Week 1: Orientation and Clinical Observation

During the initial week, I underwent orientation sessions that introduced me with the

department's organizational structure, including the functioning of the Outpatient Department

(OPD) and the assignment of units. As part of the internship protocol, I was assigned to work

under five different supervisors throughout the week.

My primary activities involved observing professional supervisors interacting with

patients. I witnessed firsthand how they conducted comprehensive case histories, administered

Mental State Examinations (MSE), and performed psychological assessments. For sensitive

cases, supervisors directly handled the assessments, while I closely observed experienced senior

interns who were also involved in assessment procedures.

Following the assessments, senior interns reported their findings to the supervisors.

Based on their evaluations and judgments, diagnostic formulations and treatment plans were

developed. Throughout the week, I had the opportunity to observe assessments conducted on

children presenting with intellectual disabilities and neurodevelopmental disorders.

Specific assessments that I observed in this week included the Vineland Social Maturity

Scale (VSMS) for intellectual disabilities, the ISAA for autistic children, the Binet Kamat Test

(BKT) for IQ assessment, and the Seguin Form Board Test (SFBT) used in cases where children

were uncooperative during BKT assessments. Additionally, I observed the use of the Conners

Abbreviated Rating Scale for ADHD evaluations.

Moreover, drawing from my previous experience in community service, where I had

gained experience in taking case histories and MSEs, I had the opportunity to actively participate
in these tasks. This hands-on experience allowed me to apply my skills directly under the

supervision of senior clinicians.

This week provided a foundational understanding of clinical procedures and assessment

techniques in child psychology and psychiatry. It enhanced my observational skills and deepened

my appreciation for the diagnostic process in clinical settings.

Week 2: Psychological Assessment and Case Management

During my second week, I worked on a variety of tough and interesting cases

that extended my understanding of psychiatric diseases and assessment methodologies. I began

by taking a thorough case history, performing a Mental Status Examination (MSE), and

administering the Vineland Social Maturity Scale (VSMS) to a patient with developmental

impairments. This individual complained primarily of verbal hostility, temper issues, and a

compulsive cleaning habit. Despite keeping eye contact and an appropriate appearance, their

understanding of their condition was restricted. The VSMS resulted in a Social Quotient (SQ) of

61, indicating minor impairment in social functioning.

In another case, I witnessed a schizophrenic patient who was paranoid and suspicious

of her spouse, believing he was having an affair and holding concerns of danger from others. In

this context, I learned how to administer the Brief Psychiatric Rating Scale (BPRS), which

provided insight into assessing paranoid ideation and delusional ideas.

In addition, I observed a patient who experienced anxiety symptoms such as headaches,

tremors, and difficulties concentrating, as well as neurological abnormalities. The psychiatrist

prescribed medicine and set up follow-up sessions to check her improvement.

Later that week, I administered both the VSMS and the Binet-Kamat Test (BKT) to
another patient, a 15-year-old with intellectual disabilities. Despite difficulty with fundamental

cognitive activities such as flower identification, the patient was able to reply to simple inquiries

regarding colors or numbers. The VSMS revealed a mild SQ of 61, and the BKT results

suggested a developmental age range of 5 to 8 years.

These experiences emphasized the importance of thorough assessment and personalized

care in psychiatric practice, as well as the wide range of mental health presentations and the

complex process of evaluating and supporting individuals with varying degrees of cognitive and

emotional challenges.

During this week of my internship, I watched and participated in the evaluation and

treatment of multiple individuals with various psychiatric disorders. One prominent example was

a patient with Obsessive-obsessive Disorder (OCD) who had no obsessive behaviors but a

continuous concern with physical fitness. This fixation greatly reduced his ability to concentrate

on other tasks. I conducted and graded the Leyton Obsessional Inventory (LOI) to determine the

severity of his obsessive thoughts.

In another case, I administered the Vineland Social Maturity Scale (VSMS) to a

patient who had already been diagnosed with autism, resulting in a Social Quotient (SQ) of 38,

which indicated moderate social impairment. I also saw a patient with anxiety and depression

symptoms who was excessively worried and tense, especially following criticism. I administered

the Hamilton Anxiety Rating Scale (HAM-A) and the Hamilton Depression Rating Scale

(HAM-D), yielding scores of 24 (moderate anxiety) and 19 (mild depression), respectively.

In addition, I took a full case history and performed an MSE on a patient who had

intellectual deficiencies caused by problems during her mother's pregnancy and her fragile
physical state from birth. Her mother confirmed her incapacity to read and write. The VSMS

revealed a SQ of 73, indicating borderline intellectual functioning.

Finally, I gathered a case history from another patient who was experiencing

depression symptoms. Despite being a good student, her academic performance has recently

dipped. She stated that she had trouble sleeping and was anxious. This week's experiences

highlighted the complexity and variety of psychiatric diseases, as well as the significance of

rigorous assessments and individualized interventions in patient care.

Another case involved a schizophrenic patient who was belligerent, angry, and had

paranoid thoughts that everyone was talking about her. She also engaged in self-talk and had no

understanding of her predicament. Because of her reluctance to seek help, as described by the

informant, she was given medication and requested to return for follow-up.

I also saw a case in which the main symptoms were anger difficulties, interrupted sleep

and food, and a need for isolation. This patient had previously had treatment and medicine, but it

had been withdrawn prematurely. As a result, medicine was restored to alleviate her problems.

In a follow-up case, I asked about the patient's improvement. She reported feeling

better and displaying progress in her anxious behavior, but she continued to battle with

overthinking. She was given medication again and instructed to continue with follow-up visits.

This week, I encountered a rather unusual case involving a man with several personalities.

This patient had a distinct presentation of dissociative identity disorder, as he spoke in multiple

voices and shifted between Hindi and Bengali. He also demonstrated thought broadcasting, the

assumption that others can hear one's thoughts, and severe forgetfulness. Despite these

symptoms, he had no awareness of his condition, stating that he was OK and did not disturb

anyone. Because he came alone, my supervisor requested that he return with an informant for a
more thorough assessment. This case highlighted the difficulty of diagnosing and managing

dissociative identity disorder, as well as the significance of gathering full background

information from reputable sources to understand better and treat the patient's condition.

Another case featured a patient with drug addiction concerns who had been hooked to

cocaine, marijuana, and alcohol since the age of sixteen. He got psychoeducation on the

consequences of substance usage, was given medicine, and was scheduled for follow-ups.

Week 3: Psychological Assessment and Case Management

This week, my internship included several thorough and interesting situations. Initially, I

obtained a detailed case history and performed a Mental Status Examination (MSE) on a

22-year-old female who had angry outbursts, poor sleep, and violent behavior toward her

children that began six years after her marriage. She also had a history of suicide ideation but

displayed little awareness of her illness. I reported this instance to my supervisor, who taught me

particular signs to look for in suicidal patients and recommended an adjustment issue. I watched

as my supervisor psychoeducated the patient, using effective communication and intervention

approaches.

I then watched a case involving a child suffering from psychosis. The youngster

engaged in self-laughing, self-talking, self-harm, and fantasies of being damaged by others,

causing great terror. She also suffered from auditory and visual hallucinations, had hygiene

concerns, and had a history of sexual abuse. She avoided eye contact and had no idea about her

situation. The psychiatrist prescribed medicine and set up follow-up sessions to check her

Improvement.

Another case I saw featured a patient with Obsessive-Compulsive Disorder (OCD),which

is distinguished by excessive hand washing and frequent bathing. My supervisor informed the

patient that showering once a day is plenty for hygiene and made additional advice to improve

his condition. These included avoiding tea and caffeine after 7 p.m., limiting phone use at night,

walking before bedtime, and taking a bath before sleeping.

This week, my internship gave me insightful experiences. First, I followed up

with an OCD patient who had mild obsessions and compulsions. He was given psychoeducation

on his thoughts and told to write down the thoughts that led to his obsessive behaviors before

returning for a follow-up.

The following day, I observed two counseling sessions. The first case was a school

student who had regular checking concerns and thought he was forgetting things. After taking his

case history and doing an MSE, the Yale-Brown Obsessive Compulsive Scale for Children

(Y-BOCS C) was administered. My supervisor then led a brief therapy session, discussing OCD

symptoms, intrusive thoughts, safety precautions, and treatment options. The student was

encouraged to make a nightly to-do list to note how many items he neglected and to graph his

progress. He was booked for follow-up appointments.

The second example was a follow-up with a young woman who had improved but

remained concerned about her job. Despite being a bright student, she had failed the NEET exam

twice, which put a lot of pressure on her family. My supervisor met with her family, telling them

not to put pressure on her and recommending she enroll in college as a backup while studying for

one more NEET attempt. Despite her improved anger management, she continued to show

demanding behavior. She was urged to continue taking her medicine and attending follow-up

appointments. The next day, I conducted a thorough case history on another OCD patient who

likewise suffered from extreme anxiety. She believed she could die at any time and demonstrated
cleaning and checking behaviors with no awareness of her situation. I used the Hamilton Anxiety

Rating Scale (HAM-A), which scored 31 (showing severe anxiety), and the Y-BOCS, which

showed mild OCD symptoms. She was given medicine and instructed to return for follow-up

consultations. These experiences enriched my understanding of OCD, anxiety disorders, and the

significance of family involvement and psychoeducation in inpatient treatment.

This week, I experienced a wide range of scenarios that gave me good learning

opportunities. First, I worked on a renewal case for a high-functioning autistic patient. My

supervisor instructed me to administer the Vineland Social Maturity Scale (VSMS), which

yielded an average result. The patient was instructed to return the following week for the Indian

Scale for Assessment of Autism (ISAA) and Binet-Kamat Test (BKT).

The next day, I took a full case history and administered a Mental Status Examination

(MSE) to a 27-year-old female suffering from anxiety and depression. She had trouble sleeping

and was concerned about maintaining her household alone while her husband worked away from

home. She enjoyed seclusion and avoided interacting with others. I used the Hamilton Anxiety

Rating Scale (HAM-A) and Hamilton Depression Rating Scale (HAM-D), which showed

considerable anxiety and severe depression.

I then saw an OCD patient who was very mindful of his body image, caressing his

face and looking in the mirror around 20 times per day. After reviewing his case history with my

supervisor, I administered the Yale-Brown Obsessive Compulsive Scale (Y-BOCS), which

revealed significant OCD. He was given medication and instructed to return for follow-ups. My

supervisor observed that he had strong OCD symptoms.

Another case had a schizophrenic patient who had auditory hallucinations, heard two

female voices, and engaged in self-laughing and self-talk. She had difficulty sleeping, gaining
energy, and maintaining an appetite. I used the Brief Psychiatric Rating Scale (BPRS), which

proved psychosis symptoms.

Finally, I took the case history of a depressed patient. Her main concerns were a lack of

interest in others, low confidence, recurrent feelings of depression, and suicidal thinking. She

was quite apprehensive and nervous throughout the interview. I gave the HAM-D, which

indicated mild depression. She was given medicine and scheduled for follow-up visits.

The next day, First, I observed a follow-up instance in which the patient showed improvement in

stress and sleep but remained concerned about her spouse and children. She loves cleaning and

organizing her house. She was instructed to continue her treatment and return for additional

Follow-ups.

Next, I evaluated an 11-year-old male youngster whose parents reported attention

troubles, aggression issues, and anxiety about his education. He was anxious about his tests,

preferring isolation, and relied largely on his parents to handle his difficulties. I administered the

Beck Depression Inventory-II (BDI-II), which showed mild depression. He was given

medication, and my supervisor urged his parents to let him face and handle his issues.

Another follow-up example was an OCD patient who had reduced her frequency of house

cleaning but continued to bathe and change bedsheets regularly. She was urged to stay active at

work. Her sleep and appetite remained disturbed.

I also followed up on a patient who had improved speech and erectile problems. His

wife had abandoned him, generating concern, but his condition had improved marginally. He was

encouraged to continue taking medication and return with his wife since he felt responsible for

their problems. My boss convinced him that his difficulties were solved.
 Finally, I met a patient who was concerned about her capacity to maintain sexual

relationships, assuming that this was why she had no children. She reported physical abuse by

her first spouse and was currently with her second husband. She was crying and felt helpless. My

supervisor recommended she return with her spouse for the next appointment to receive adequate

therapy.

Week 4: Psychological Assessment and Case Management

This week, I began with an old case that required the renewal of a disability certificate. I

administered the Indian Scale for Assessment of Autism (ISAA) and the Binet-Kamat Test

(BKT) to the patient, who was diagnosed with mild autism. The BKT took longer to administer,

but I completed the evaluation, submitted the report, and received approval from my supervisor. I

also saw a depressed patient who was quite stubborn and refused to answer any questions. As a

result, she was given medication and sent home.

The next day, I show the case of sleeplessness. The patient, who had been battling with

sleep for 5-6 years, stated that he could sleep with medicine but struggled to fall and stay asleep

without it. In addition, he had been using narcotics for a month and had premature ejaculation,

which he blamed for his insomnia. He also had suicidal ideas. He was scheduled for motivational

improvement therapy in a month.

Another case featured a 35-year-old female who suffered from depression and attempted

suicide. Her informant reported that she also exhibited hypomanic symptoms. I administered the

Hamilton Anxiety Rating Scale (HAM-A) and the Hamilton Depression Rating Scale (HAM-D),

which both revealed moderate levels of anxiety and depression. The Young Mania Rating Scale
(YMRS) was also administered, which showed mild hypomania. My supervisor ordered

medication and requested her to come for a follow-up.

The next day began with a case involving a child who had anger difficulties and

developmental delays that had started a year ago. I administered the Vineland Social Maturity

Scale (VSMS), and the results were borderline. However, my supervisor pointed out that this

score reflected the child's premorbid phase. For another patient, I used the Indian Disability

Evaluation and Assessment Scale (IDEAS), which revealed a moderate disability. Medication

was ordered, and a follow-up appointment was set.

I then saw a 19-year-old female undergoing Cognitive Behavioral Therapy (CBT) from

my supervisor. When the patient failed to reach her academic goals, she became anxious. My

supervisor gently helped her through identifying her triggers, allocating time for pending work,

developing a daily routine, and self-evaluation. She was asked to come for follow-ups.

The next day, I saw my first patient with Obsessive-Compulsive Disorder (OCD). With

my supervisor's guidance, I began to participate more actively, asking the patients questions. This

particular patient, a follow-up instance, had been given homework. She claimed improvement,

although she still cleansed her hands regularly when they came into touch with non-vegetarian

foods. I administered the Yale-Brown Obsessive Compulsive Scale (YBOCS), which revealed

moderate severity. She was instructed to limit her handwashing to twice a day and had more

follow-up appointments scheduled.

Later, I took a full case history and administered a Mental Status Examination (MSE)

to another patient, as well as the Hamilton Anxiety Rating Scale (HAM-A). The patient felt

anxious about minor social contacts and became angry if her requests were not met. Her HAM-A

score was moderate. She was then asked to come for follow-ups.
 The final instance of the day was another OCD patient who was disinterested in taking

medication or receiving therapy. My supervisor explained to her family that treatment or

counseling could only be beneficial if the patient wanted to get better. They were instructed to

bring her back when she was ready to seek assistance. The following example for counseling

involves a patient with a hoarding condition who would pick up papers from the road and keep

them. He also had symptoms of worry and depression. I used the Hamilton Anxiety Rating Scale

(HAM-A) and the Hamilton Depression Rating Scale (HAM-D), which both showed low

severity. He was instructed to come the next day for counseling. When he returned, he was

psycho-educated about anxiety and overthinking and encouraged to engage in enjoyable

activities. He was also instructed to identify anxiety triggers, practice 10 minutes of breathing

exercises, and keep a journal of his task ratings, which included one enjoyable and one

achievement task, out of ten.

The second instance concerned a person with intellectual disability and Down

syndrome who requested a disability certificate report. I administered the Vineland Social

Maturity Scale (VSMS), which yielded a score of 51, indicating substantial impairment. I created

the report accordingly.

The next day, I saw a psychotic patient who had disrupted sleep, visual hallucinations of

a female, self-talking, and self-laughing, worry about being murdered, self-isolation, and hand

tremors. She was given medicine and booked for follow-up appointments.

Another case involved an autistic patient with hyperactive traits who was destructive,

restless, ess and had mannerisms. I administered the VSMS and the Indian Scale for Assessment

of Autism (ISAA), which yielded scores of 57 for VSMS (mild) and 141 for ISAA (moderate

autism). Accordingly, I made the report and asked them to get the certificate.
 Later, I noticed a patient with Obsessive-Compulsive Disorder (OCD) who engaged in

regular checking and cleaning habits. The informant stated that these practices consumed so

much time that the patient neglected critical tasks and struggled to sleep and eat properly. I

administered the Yale-Brown Obsessive Compulsive Scale (Y-BOCS), which revealed a

moderate level of OCD. The patient was given medicine and instructed to return for follow-up

Visits.

Week 5: Psychological Assessment and Case Management

This week, I first obtained a full case history and performed a Mental Status Examination

(MSE) on an OCD patient who expressed anxiety, stress, guilt over little concerns, and phone

addiction. He demonstrated frequent checking, cleaning, and hoarding behaviors, as well as a

ten-year history of masturbation. I administered the Yale-Brown Obsessive Compulsive Scale

(Y-BOCS), which revealed moderate obsession and compulsion symptoms. I taught him

Relaxation and breathing techniques and my supervisor set up a follow-up consultation.

The following cases involved a 15-year-old male with developmental delays and

intellectual difficulties. I administered the Vineland Social Maturity Scale (VSMS) and had

moderate findings. I created a report proposing the issue of a disability certificate.

Later, I took a detailed case history of a depressed patient with poor eye contact and no

insight. She favored isolation and demonstrated difficult behavior, as well as suicidal ideation.

Her Hamilton Depression Rating Scale (HAMD) score was moderate. My supervisor warned her

parents not to leave her alone, prescribed medication, and set up a follow-up.

On the final day, I assessed an autistic patient for the renewal of his disability certificate.

I administered the Indian Scale for Assessment of Autism (ISAA), which resulted in a moderate
score of 80% autism. The patient was recommended to acquire a disability certificate.

The next case included a 23-year-old boy with phone addiction and substance abuse

difficulties, including nicotine, cannabis, and heroin, which hampered his studies and caused

behavioral disorders. He lacked awareness and struggled with wrath. My supervisor urged his

father to cease giving him money and phone recharges and to schedule follow-up sessions for

medication. Finally, my supervisor offered suggestions for growth in areas such as clinical

judgment and competence.

 Reflective Report

Student’s View of Themselves as an Upcoming Clinical Psychologist:

Before embarking on my internship, I envisioned myself as someone deeply committed

to making a positive impact through clinical psychology. I had a solid foundation in

psychological theories and felt confident in my ability to empathize and listen attentively to

others' concerns. However, I recognized the limitations of my theoretical knowledge without

extensive practical experience. This lack of hands-on experience often led me to doubt my ability

to make sound clinical judgments and manage my emotions effectively, especially in challenging

situations such as conducting assessments that could profoundly influence individuals' lives, like

determining eligibility for disability support.

Despite these uncertainties, I approached my internship with eagerness and

determination. I viewed it as a pivotal opportunity to bridge the gap between theory and practice,

to learn from seasoned professionals, and to cultivate both personal and professional growth. My

primary aspiration was to emerge from this experience not only more knowledgeable but also

more skilled and confident in my capacity to assist others as a clinical psychologist.

Throughout the internship, I confronted these initial insecurities head-on. I immersed

myself in diverse clinical scenarios, gaining invaluable hands-on experience that challenged and

expanded my understanding of psychological principles in real-world contexts. This practical

exposure enabled me to refine my clinical judgment, sharpen my assessment skills, and develop

effective strategies for managing complex emotional dynamics within therapeutic settings.
 Moreover, the guidance and mentorship I received from experienced clinicians were

instrumental in shaping my professional identity. Their insights, feedback, and support nurtured

my confidence and resilience, equipping me with the tools to navigate the complexities of

clinical practice with greater assurance and empathy.

Looking ahead, I see myself as an upcoming clinical psychologist who values continuous

learning and growth. I am committed to honing my therapeutic techniques, integrating

evidence-based practices, and maintaining a steadfast dedication to ethical care and patient

advocacy. My journey has reinforced my passion for helping others navigate their mental health

journeys with compassion, integrity, and a deep-seated belief in the transformative power of

psychological support.
 Reflective Report

First week:

The first week of my internship at Pavlov Hospital's Department of Psychiatry was an

emotional journey mix of excitement, fear, and growth. Interacting with different clients and

observing various cases offered a profound understanding of the emotional demands in clinical

settings.

Initially, asking questions during case histories was intimidating. However, as the week

progressed, my confidence grew. Each interaction with patients allowed me to refine my

questioning techniques and develop a deeper appreciation for the individuality of each case. This

gradual increase in confidence was immensely rewarding, transforming my initial nervousness

into a more assured approach to patient care.

Conducting Mental Status Examinations (MSEs) and taking case histories was

nerve-wracking. The fear of making mistakes loomed large, causing considerable anxiety.

However, my supervisor's supportive presence and constructive feedback played a crucial role in

alleviating my fears. Her reassurance and validation of my diagnostic accuracy transformed my

nervousness into a growing sense of confidence and competence.

My initial exposure to patients with Obsessive-Compulsive Disorder (OCD) was both

fascinating and overwhelming. The depth and complexity of their backgrounds elicited a sense of

awe, yet the challenge of aligning their symptoms with textbook knowledge caused considerable

anxiety. The unpredictability of real-life cases made me question my diagnostic abilities, but it

also sparked a determination to enhance my understanding and skills.

 The realization that real-life clinical situations often diverge from theoretical knowledge

was a significant source of apprehension. Encountering patients whose symptoms did not neatly

fit into textbook descriptions made me feel uneasy and uncertain. This discrepancy underscored

the complexity of mental health conditions and the importance of practical experience, leaving

me feeling both challenged and motivated.

A particularly memorable case involved a young patient exhibiting inappropriate

behavior towards his mother. My initial reaction was one of surprise and mild amusement, shared

by my fellow interns. However, my supervisor's immediate intervention and serious explanation

reframed my understanding of the situation. This emotional shift from surprise to a deeper

comprehension of the behavioral issues was a significant learning experience, highlighting the

importance of empathy and professionalism.

Being present during sensitive assessments handled directly by supervisors was

emotionally intense. These cases, often involving severe mental health conditions, were sobering

and emphasized the gravity of psychiatric care. The emotional weight of these sessions was

significant, but they also underscored the critical importance of accuracy and sensitivity in

clinical practice.

This week has reinforced the importance of empathy, adaptability, and continuous

learning in the field of mental health, and has laid a strong emotional foundation for my future

endeavors in clinical psychology.

Second week:

During my second week of internship at Pavlov Hospital's Department of Psychiatry, I

encountered a range of emotionally charged cases that significantly impacted my understanding

and empathy towards patients. This week deepened my emotional resilience and highlighted the

importance of balancing empathy and objectivity in clinical practice.

Handling cases involving Bengali-speaking patients from lower socio-economic

backgrounds presented a new set of challenges. Effective communication was often difficult, and

the language barrier heightened my anxiety. This experience underscored the need for cultural

sensitivity and adaptability in clinical practice, evoking a mixture of frustration and

determination to improve my communication skills.

Encountering a suicidal patient triggered a strong sense of responsibility and the urgent

need for effective care. The intensity of the patient's emotions and their focus on their own

despair were overwhelming. This case highlighted the critical importance of timely intervention

and empathetic support, leaving me feeling both deeply saddened and motivated to enhance my

skills in crisis management.

My initial interactions with a psychotic patient were marked by nervousness and

misconceptions about their potential for violence. Struggling to understand her communication

was frustrating, and my anxiety was palpable. However, my supervisor’s guidance helped correct

these misconceptions, transforming my fear into a more informed and compassionate approach.

The increased workload, including administering assessments like the Vineland Social

Maturity Scale (VSMS) and the Indian Scale for Assessment of Autism (ISAA) for the first time,
was overwhelming. My initial uncertainty about the accuracy of my assessments added to my

anxiety. Despite these challenges, my supervisor’s encouraging feedback highlighted areas for

improvement, boosting my confidence and perseverance.

Many patients from lower socio-economic backgrounds struggled with mental health

awareness, making psychoeducation particularly challenging. Their impatience and desire for

quick fixes tested my ability to emphasize the importance of ongoing care and patience. This

experience was both frustrating and enlightening, highlighting the need for effective

communication and persistent support.

One of the most emotionally challenging experiences was counseling a suicidal teenager

who ultimately took her own life despite receiving support. This tragic outcome left me deeply

saddened and questioning my abilities as a future clinical psychologist. The emotional impact of

this loss was profound, underscoring the importance of resilience and the harsh realities of

mental health care.

During this tough time, the support and guidance from senior colleagues were invaluable.

They emphasized the importance of emotional resilience and maintaining focus after challenging

incidents. Their advice helped me develop better coping mechanisms and highlighted the need

for balance between empathy and objectivity in clinical practice.

This week reinforced the importance of continuous learning, emotional resilience, and

compassionate care in the field of mental health, shaping me into a more capable and empathetic

future clinical psychologist.

Third week:

During my third week of internship at Pavlov Hospital's Department of Psychiatry, I

experienced significant growth in confidence and professional competence. Overcoming initial

fears and challenges, I focused on deepening my understanding of patient care and honing my

assessment skills under the guidance of my supervisor.

Initially, discussing cases of premature ejaculation with male patients made me uneasy.

However, I quickly realized that my openness and non-judgmental approach fostered trust and

comfort among patients. This mutual trust significantly boosted my confidence in handling

sensitive topics and conducting thorough assessments.

Throughout the week, I noticed a marked improvement in my assessment skills. With

fewer errors in evaluations, I felt more assured in my ability to diagnose and treat patients

effectively. Regular feedback and encouragement from my supervisor were instrumental in my

professional growth, emphasizing the importance of meticulousness and thoroughness in patient

assessments.

One of the most challenging experiences was managing a session with a psychotic patient

who behaved inappropriately. This incident tested my professional demeanor and ability to

maintain composure under pressure. However, I successfully ensured the session proceeded

safely and professionally, reaffirming my commitment to delivering compassionate care while

prioritizing patient and personal safety.

Working closely with OCD patients presented unique challenges, particularly in

addressing their obsessive behaviors such as excessive hand washing and checking. These
behaviors significantly impacted their daily lives and relationships. Articulating these broader

impacts required patience, clear communication, and a tailored approach to each patient's

specific concerns. Balancing empathy with firm guidance was crucial in supporting these

individuals effectively.

Few of the lessons I learned the importance of delving deeper into each case for a

thorough understanding, rather than rushing through assessments. This approach not only

improved the accuracy of my evaluations but also enhanced my ability to empathize with

patient’s unique circumstances, additionally managing challenging patient behaviors reinforced

the importance of maintaining professionalism and ensuring both patient and personal safety

during clinical interactions. This experience highlighted the need for adaptability and quick

decision-making in unpredictable situations.

The third week of my internship marked a significant period of growth and learning.

Building confidence in handling sensitive issues, improving assessment accuracy, and navigating

challenging patient interactions were pivotal in shaping my development as a clinical

psychologist. These experiences reinforced my commitment to compassionate and competent

patient care, equipping me with invaluable skills for future clinical practice.
Fourth Week:

During the fourth week of my internship at Pavlov Hospital's Department of Psychiatry, I

delved into addiction cases that both ignited my passion and challenged my abilities. This week

was marked by encounters that tested my patience, clinical skills, and commitment to making a

meaningful impact in mental health care.

Working with addiction cases fueled my passion for making a positive impact on patient’s

lives. However, I also faced considerable frustration due to many patients lacking insight and

engagement in their treatment. This often left me feeling ineffective despite my efforts. Drawing

on my prior experience from a de-addiction center provided me with some confidence but

highlighted the ongoing challenges in managing addiction.

Despite moments of disheartenment when patients ignored advice or resisted treatment, I

remained composed and persistent in guiding them through their recovery journey. Asking

probing questions became crucial in encouraging reflection and fostering gradual change, even in

resistant cases.

Struggling with accurate diagnoses continued to be a significant hurdle during this week.

Despite weeks of practical experience, I encountered complexities that reminded me of the

continuous learning required in psychiatric assessments. Administering assessments like the

Binet Kamat Test (BKT) was particularly draining, compounded by interruptions from impatient

family members seeking immediate answers.

The week reinforced the importance of persistence and maintaining composure in the

face of clinical challenges, especially in addiction treatment where patient resistance is common.
 Additionally, the experience underscored the ongoing need for continuous learning and

adaptation in psychiatric practice, particularly in refining diagnostic skills and navigating

complex patient dynamics.

Week 4 of my internship at Pavlov Hospital was a pivotal period of personal and professional

growth. Navigating addiction cases with resilience enriched my clinical practice and reinforced

my commitment to pursuing excellence in mental health care. These experiences have equipped

me with invaluable insights and skills that will guide my journey toward becoming a proficient

and compassionate clinical psychologist.

Fifth Week:

As I entered the final week of my internship at Pavlov Hospital's Department of

Psychiatry, I experienced a mix of emotions, knowing that this valuable learning experience was

drawing to a close. Despite the bittersweet feelings, I remained dedicated to fulfilling my

professional responsibilities with diligence and compassion.

During my last few days, I encountered a patient who was profoundly isolated and lacked

social connections. This situation evoked a sense of empathy and sadness within me, knowing

the challenges the patient faced. However, in a surprising turn of events, the patient expressed

gratitude by saying, "Madam, you are my friend from now onward." This heartfelt

acknowledgment touched me deeply and served as a poignant reminder of the impact of genuine

empathy and professionalism in therapeutic relationships.

Throughout the week, I maintained a clear distinction between my personal emotions and

professional responsibilities. Despite feeling emotional about concluding this internship, I

ensured that my focus remained on providing quality care and support to each patient I

encountered.

Throughout my internship, my supervisor played a pivotal role in enhancing my

counseling skills and clinical judgment. Their mentorship and constructive feedback were

instrumental in my professional development, equipping me with the confidence and competence

necessary for effective practice in clinical psychology.

I am immensely grateful for my supervisor's unwavering support, encouragement, and

guidance throughout this internship journey. Their mentorship not only bolstered my clinical
skills but also nurtured my growth as a compassionate and competent future clinical

psychologist.

As I reflect on my final week at Pavlov Hospital, I am filled with a profound sense of

gratitude for the invaluable experiences and lessons learned during this internship. The patient's

unexpected gesture of friendship reinforced the importance of maintaining professionalism while

fostering genuine connections with those in need of support. Moving forward, I carry with me a

deepened commitment to ethical practice, continuous learning, and compassionate care in the

field of clinical psychology. This internship has been a transformative journey that has prepared

me for the challenges and rewards of serving individuals with diverse mental health needs in the

future.
 Overall Evaluation and Future Changes

Reflecting on my internship experience, I've undergone significant personal and

professional growth that has profoundly shaped my journey toward becoming a clinical

psychologist. One of the most notable transformations has been the development of confidence

in conducting tests and leading therapy sessions. Initially, I was uncertain and hesitant, but with

guidance and practice, I've gained the assurance needed to navigate client interactions with skill

and effectiveness. This newfound confidence not only improves my ability to connect with

clients but also instills trust and facilitates a more productive therapeutic process.

A crucial aspect of my growth has been learning to maintain professional boundaries and

manage emotional responses effectively. In the demanding and often emotionally charged

environment of clinical psychology, these skills are paramount. I've focused on adopting a softer

approach and maintaining a calm demeanor, which has proven beneficial in establishing rapport

and creating a supportive therapeutic atmosphere. This adjustment has not only enhanced my

ability to empathize with clients but also ensures that I can provide them with the stability and

guidance they need during challenging times.

Despite these strides, my internship experience has also underscored areas where

continued improvement is necessary. Enhancing my clinical judgment remains a priority as I

strive to deepen my understanding of diverse and complex cases. Each client presents unique

challenges, and honing my ability to assess and intervene effectively is essential for delivering

tailored and impactful treatment plans. This process involves ongoing learning, consultation with

experienced colleagues, and a commitment to staying abreast of the latest research and

therapeutic approaches.
 Looking ahead, my goals include further refining my therapeutic techniques to better

meet the needs of my clients. This includes not only adjusting treatment plans based on

individual circumstances but also integrating new methodologies and evidence-based practices

into my repertoire. Moreover, maintaining resilience in the face of challenges is crucial. I aim to

cultivate a mindset that embraces growth and learning from every client interaction, ensuring

continuous improvement in my practice.

In summary, my internship has been a pivotal experience that has equipped me with

foundational skills, confidence, and insights necessary for a successful career in clinical

psychology. By continuing to develop my clinical judgment, refine therapeutic techniques, and

maintain resilience, I am committed to providing compassionate, effective, and personalized care

to individuals seeking mental health support.

 Conclusion

In conclusion, my internship has been transformative, equipping me with foundational

skills, confidence, and insights essential for a successful career in clinical psychology. By

steadfastly refining my clinical judgment, enhancing therapeutic approaches, and nurturing

resilience, I am committed to delivering compassionate, effective, and personalized care to

individuals navigating mental health challenges. This journey marks just the beginning of my

dedication to making a positive impact in the field of clinical psychology, guided by a steadfast

commitment to growth, empathy, and professional excellence. I am grateful for the excellent

guidance and support I received during my internship, which has prepared me to embark on a

fulfilling career helping individuals navigate their mental health journeys successfully.
 References

CNMC Kolkata. (n.d.). https://www.cnmckolkata.com/