PRACTICUM

(MPCE 024)

Name of the Learner

VB Somasekhar

Name of the Programme

MAPC (Second Year, Jan 2022)

Enrolment Number: 2101329657

Year: 2021-2022

Address
3-6-648/101, Vyshnavi Villa, Street No.10, HimayathNagar

Hyderabad-500029

Ph: 9848573851, 9182094694

Regional Centre
IGNOU, 1st Floor M-5 Block Manoranjan Complex,

M.J Rd, Nampally, Hyderabad-500001

Discipline of psychology

School of social sciences

Indira Gandhi National Open University

Maidan Garhi, New Delhi-110068

 Table of Contents

Practical Practical Name Page No

No.

Practical 1 Big Five Personality Test 1

Practical 2 Internet Addiction 7

Practical 3 DSM IV vs DSM 5 13

Practical 4 Case History on COVID crisis 19

Practical 5 Counselling and Guidance 25

 Practical 1
(Big Five Personality Test)
Aim: To conduct the Big Five Factor Personality Test

Client information:

Name : Client
Age : 22 years
Gender : Male
Educational qualification : B.Tech
Occupation : Not Working
Income : NA
Marital status : Unmarried
Language : Telugu, Hindi, English

Whether client stays with parents: Yes

Whether client stays with spouse: NA
Whether have any siblings, if so how many: 1 Brother
What is the position of the client in the family: Elder
Anyone in the family having conflicts: No
Anyone in the family is suffering/has suffered from any physical disorders: No

Case or Presented problem:

“Client is aggressive, most of the time he is with friends, always talking and telling some
ideas, wants to be social always and things to be organised, if not gets irritated, also
sometimes he is impulsive in nature and very organized at his activities”

Relationship:
If unmarried:
Patient’s relationship with family members:
● With mother: His mother is very supportive; she is concerned about her son’s
feelings and career.
● Father: His father also supportive
● Brothers: His brother is also very supportive and loves him a lot.
● Sisters: NA

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Any other relative staying with patient: No
With friends: Good
How many friends does the patient have? How does the patient relate to them? NA
With neighbours: Good
With classmates: Good
With the teachers in college: Good
With other authority figures: NA
With playmates: Good
In the games field: Good

Educational history:
● In school / college:
He was a good in studies in school and college
● How is the client in studies and academic performance?
His academic performance according to his report card of his school was good and he
was a rank holder in 10+2 and Degree
● Does the client come up to the expectations of parents and teachers?
Yes
● Have they received any complaints from the school authorities regarding the
client performances?
No, they never received any complaint regarding this.
Work and marriage history: NA

Case analysis:
Client completed the Degree and looking for job opportunities. He was looking bright
student as per his academics as he got distinction, but he is more anxious and aggressive,
arguing with his friends and family members with his ideas and opinions, so his parents
joined him for personality development sessions to learn and build up the things as per
environment demands, but he could not opt the things as expected fashion. He attended few
interviews but failed with unknown reasons
Observed self-absorption, his focus is almost entirely on himself and personal fables, he sees
himself as unique and special, thinking others are focused on him, noting everything about
him including what he says and what he does.
Came to me for counselling to know the weak and strong areas of his personality.

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 So after analysing the case, I suggested a Big Five personality test and the client agreed for
the same to take the test.
Rationale of the test:
OCEAN Model is a self-report test measures the five key dimensions of our personality
using IPIP Big-Five Factor Markers
This assessment helps to identify the skill set of an individual in terms of personality
characteristics like openness, reserved, introvert and extrovert etc., also helps if there are
any mental health issues present, and to determine a diagnosis and treatment accordingly.

Description of the test:

This test has the five key personality dimensions:

Openness (O): sometimes called "Intellect" or "Imagination," this measures your level
of creativity , and your desire for knowledge and new experiences. Openness to Experience
is the personality trait of seeking new experience and intellectual pursuits. High scores may
day dream a lot. Low scorers may be very down to earth.
Conscientiousness(C): this looks at the level of care that you take in your life and work. If
you score highly in conscientiousness , you'll likely be organized and thorough, and know
how to make plans and follow them through. If you score low, you'll likely be lax and
disorganized. Conscientiousness is the personality trait of being honest and hardworking.
High scorers tend to follow rules and prefer clean homes. Low scorers may be messy and
cheat others.
Extraversion/Introversion: this dimension measures your level of sociability. Are you
outgoing or quiet , for instance? Do you draw energy from a crowd, or do you find it difficult
to work and communicate with other people?
Extroversion (E) is the personality trait of seeking fulfillment from sources outside the self
or in community. High scorers tend to be very social while low scorers prefer to work on
their projects alone.
Agreeableness: this dimension measures how well you get on with other people. Are you
considerate, helpful and willing to compromise? Or do you tend to put your needs before
others'? Agreeableness reflects how many individuals adjust their behaviour to suit others.
High scorers are typically polite and like people. Low scorers tend to 'tell it like it is'.
Neuroticism/Natural Reactions: also called "Emotional Stability," or "Neuroticism," this
dimension measures emotional reactions. Do you react negatively or calmly to bad news?

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 Do you worry obsessively about small details, or are you relaxed in stressful situations?
Neuroticism is the personality trait of being emotional.

Background of the test

The big five personality traits are the best accepted and most commonly used model of
personality in academic psychology. The big five come from the statistical study of responses
to personality items, using a technique called factor analysis. This test uses the Big-Five Factor
Markers from the International Personality Item Pool, developed by Goldberg (1992).
Procedure of the test
The test consists of fifty items that you must rate on how true they are about you on a five-
point scale where 1=Disagree, 3=Neutral and 5=Agree.
It takes most people 3-8 minutes to complete.
Once test is completed, there are few more optional questions for research purpose
So, that is your wish to take it and select appropriate answers accordingly Yes or No
Test Results:

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 Discussion:
How the test is scored will depend on which you take. If you take the one suggested above,
it will give you a score for each of the five personality traits, and will let you know if you
scored higher or lower than others who have taken the test.
score that is a series of letters and numbers – for example, O93-C74-E31-A96-N50. The
letters stand for each dimension, and the numbers are the percentage of people who scored
lower than you for each of these.
So a score of O93 would mean that 93 percent of people who took the test scored lower than
you in openness. This means that you're more creative and open to new experiences than 93
percent of the people who took the test. To be more precise 92 people have less openness
trait dimension than you and 7 people have more openness trait dimension than you
A score of C74 would mean that 74 percent of people who took the test scored lower than
you in conscientiousness. This means that you'll likely be more organized and self-
disciplined than 73 percent of the people who took the test
Interpretation:
For + keyed items, the response
"Very Inaccurate" is assigned a value of 1,
"Moderately Inaccurate" a value of 2,
"Neither Inaccurate nor Accurate" a 3,
"Moderately Accurate" a 4, and
"Very Accurate" a value of 5.

For - keyed items, the response

"Very Inaccurate" is assigned a value of 5,
"Moderately Inaccurate" a value of 4,
"Neither Inaccurate nor Accurate" a 3,
"Moderately Accurate" a 2, and
"Very Accurate" a value of 1.

Reference Table:

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 As I explained in the discussion, client has got the score as following
O70-C93-E96-A30-N78
A score of O70 would mean that 70 percent of people who took the test scored lower than
you in openness. This means that you're more creative and open to new experiences than 70
percent of the people who took the test. To be more precise 69 people have less openness
trait dimension than you and 30 people have more openness trait dimension than you

A score of C93 would mean that 93 percent of people who took the test scored lower than
you in conscientiousness. This means that you'll likely be more organized and self-
disciplined than 93 percent of the people who took the test, 7 percent of people higher than
you, to be more precise, 92 people scored lower than you and 7 people scored higher
than you

A score of E96 would mean that 96 percent of people who took the test scored lower than
you in extroversion. This means that you'll likely be very social than 96 percent of the people
who took the test, similarly you got 30% in Agreeableness and 78% in Neuroticism
Conclusion:
Conducted the Big Five personality test and observed client is an extrovert in social
relationships and more conscientiousness in organising the things, my client is
Very High in Extroversion and Conscientiousness
High in Openness and Neuroticism
Low in Agreeableness
Recommendations:
Suggested to his parents, continue the personality development sessions and focus on other
personality dimensions like emotional stability, agreeableness and openness to change,
especially on anger management, explained in brief following for anger management
1. Deep breathing.
2. Change the way you think.
3. Problem solving.
4. Better communication.
5. Using humour.
6. Avoidance.

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 Practical 2
(Mobile Internet Addiction and Internet Addiction)
Aim: To watch the videos and discuss about Internet and mobile addiction,
types, causes and preventions

Visited and watched following YouTube videos asked in IGNOU practicum MPCE024 and
these were prepared by NIMHANS, Bangalore

● Mobile internet addiction

Link https://www.youtube.com/watch?v=idvdtvmvH1w

● Internet Addiction Disorder By Dr Bharath Holla

Link https://www.youtube.com/watch?v=dX_6WWWH8cw

After watching videos my answers are as following for the given questions

Q (a): Is Internet disorder identified as a separate disorder?

Excessive Internet use has not been recognised as a disorder by the DSM-5 (Diagnostic and
Statistical Manual of Mental Disorders by APA, or the ICD-11 (International Classification of
Diseases by WHO).

Professionals that do recognize internet addiction tend to classify it as either an obsessive-

compulsive disorder or an impulse control disorder to aid treatment. Internet addiction is also
called compulsive computer use, pathological internet use, and internet dependence
In the past few years’ internet addiction (IA) and internet gaming disorder (IGD) have become
very frequent, leading to many personalities and psychiatric disorders including low
self-esteem, impulsivity, poor sleep quality, mood disorder, and suicide

NIHMANS current study aimed to examine the prevalence rates of internet addiction and
specific uses of the internet among a help-seeking, psychiatric population in Bangalore, India.
Almost half of the patient sample scored above the cut-of Internet Addiction Test indicating
severe dependence. This prevalence is markedly higher than that found previously in a
psychiatric sample in India. One preference with this previous study was that it included
patients with less common disorders, such as schizophrenia and disorder Although these
disorders were not examined in isolation, internet addiction may be lower in prevalence in
these groups, therefore attenuating the overall prevalence. One possibility is that disordered
thought and deficits in cognitive functioning that are characteristic of these disorders might
inhibit the sustained engagement in internet-related behaviours.

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Broadly in three domains Internet addiction have been identified:
1. Entertainment [ Video game addiction and social media]
2. Cybersex or online sex addiction, and
3. Online gambling addiction.
Increasingly, addiction to mobile devices, such as cell phones and smartphones, and addiction
to social networking sites, such as Facebook, are being investigated. There may be overlaps
between each of these subtypes. For example, online gambling involves online games, and
online games may have elements of pornography.
Sexting, or sending sexually explicit texts, has landed many people in trouble. Some have been
teens who have found themselves in hot water with child pornography charges if they are
underage.
Treatment for Internet addiction is available, but only a few specialized Internet addiction
services exist. However, a psychologist with knowledge of addiction treatment will probably
be able to help.

Q (b): What are the different names given to internet addiction?

Internet addiction is a behavioural addiction. Also known as “cyber addiction,
“Internet addiction refers to excessive and compulsive engagement with the online world.
In the scientific community, internet addiction disorder (IAD) is sometimes called:
● compulsive internet use (CIU)
● problematic internet use (PIU)
● iDisorder
Dr. Kimberly S. Young Internet Addiction Test can be used to know the level of addiction
0 – 30 – Normal
31 -49 – Mild
50 – 79 – Moderate
80 – 100 - Severe
While there is yet no officially accepted criteria to diagnose an internet addiction, researchers
have identified 5 subcategories of specific types of computer and internet addictions.
● Cybersex Addiction
A cybersex addiction is one of the more self-explanatory internet addictions. It involves online
pornography, adult websites, sexual fantasy/adult chat rooms, and XXX webcam services. An
obsession with any of these services can be harmful to one’s ability to form real-world sexual,
romantic, or intimate relationships. Treatment options are available for those with cybersex

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addictions, typically in the form of intervention followed by ongoing inpatient or outpatient
therapy.
● Net Compulsions
Net compulsions concern interactive activities online that can be extremely harmful, such as
online gambling, trading stocks, online auctions (such as eBay), and compulsive online
shopping. These habits can have a detrimental impact on one’s financial stability and disrupt
job-related duties. Spending or losing excessive amounts of money can also cause stress in
one’s relationships. With instant and easy access to online casinos and stores, it is easy for
those who are already susceptible to a gambling or spending addiction to get hooked online.
● Cyber (Online) Relationship Addiction
Cyber or online relationship addicts are deeply involved with finding and maintaining
relationships online, often forgetting and neglecting real-life family and friends. Typically,
online relationships are formed in chat rooms or different social networking sites but can occur
anywhere one can interact with people online. Often people who pursue online relationships
do so while concealing their real identity and appearance; this modern phenomenon led to the
creation of the term “catfish.”
After being consumed by an online social life and personal life, a person may be left with
limited social skills and unrealistic expectations concerning in-person interactions. Many
times, this leads to an inability to make real-world connections, in turn making the individual
more dependent on their cyber relationships. Counselling or therapy is typically required to
treat this addiction and ensure lasting behavioural changes.
● Compulsive Information Seeking
The internet provides users with a wealth of data and knowledge. For some, the opportunity to
find information so easily has turned into an uncontrollable urge to gather and organize data.
In some cases, information-seeking is a manifestation of pre-existing, obsessive-compulsive
tendencies. Compulsive information-seeking can also reduce work productivity and potentially
lead to job termination. Depending on the severity of the addiction, treatment options can range
from different therapy modalities — which target changing compulsive behaviour and
developing coping strategies — to medication.
● Computer Or Gaming Addiction
Computer addiction, sometimes referred to as computer gaming addiction, involves online and
offline activities that can be done with a computer. As computers became more widely
available, games such as Solitaire, Tetris, and Minesweeper were programmed into their
software. Researchers quickly found that obsessive computer game playing was becoming a
9 MPCE 024, Enrolment No. 2101329657 : Practical 2 ( Internet Addiction)
problem in certain settings. Office employees would spend excessive amounts of time playing
these games, causing a notable decrease in productivity. Not only are these classic games still
available today but so are thousands of new ones, and the condition of computer gaming
addiction is as prevalent and harmful as ever.

Q(c): Identify the probable causes of such behavioural addictions.

Some of the causes of this addiction can include using the internet too much as a kid and not
having a parent watch online use. People with a recent traumatic event, high stress levels or a
substance use disorder all face a high risk of having this type of addiction. Other risk
factors are:
● Having a mental health condition
● Having poor moods
● Having limited offline social time
● Family conflict
● genetics
● environmental factors
● playing games, shopping or gambling and it provides rewards.
● using social media because have many friends for talking to chatting
Whenever Internet addicts feel overwhelmed, stressed, depressed, lonely or anxious, they use
the Internet to seek solace and escape. Studies from the University of Iowa show that Internet
addiction is quite common among males ages 20 to 30 years old who are suffering
from depression.
Certain people are predisposed to having a computer or Internet addiction, such as those who
suffer from anxiety and depression. Their lack of emotional support means they turn to the
Internet to fill this need. There are also those who have a history of other types of addiction,
such as addictions to alcohol, drugs, sex and gambling. Even being stressed and unhappy can
contribute greatly to the development of a computer or Internet addiction. People who are
overly shy and cannot easily relate to their peers are also at a higher risk of developing a
computer or Internet addiction.

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Q(d): If you are placed as a School Counsellor, devise a plan for the parents of school
children, especially from Class I to V, to handle the issue of mobile/internet addiction.
Time management is one of the best ways to come out the internet addition so I explain one
example for flexibility of time and role of priorities with verbatim fashion
JUG example for flexibility:
Once I showed my students a jug and put big stones in the jug and asked students,
“Is it completely filled?”
Students replied, “Yes,
But I put small stones again and then asked students, “Is it filled now?”
Students replied “Yes”
But this time I put sand in it and again asked the same question. Students were now confused
and then I poured honey and then flowers in the jug. So, client time is like this jug which is
flexible. It depends on us how we can manage things for doing our important work first and
then finish small work according to priorities.
Tips to prevent from Internet Addiction:
1. Time Management ie., Agree the hours of use of the computer (no more than 1.5 - 2 hours
daily, with the exception of weekends), unsubscribe the sites, disable the notification in mobile
2. Place the computer in a common site in the home, like the living room.
3. Promote social activities.
4. Encourage interests like sports, reading, or the cinema.
5. Encourage communication and dialogue in the family.
Counselling to parents:
In a two-parent household, it is critical that both parents present a united front. As parents, each
must take the issue seriously and agree on common goals. Discuss the situation together and,
if necessary, compromise on desired goals so that when you approach your child, you will be
coming from the same page. If you do not, your child will appeal to the more sceptical parent
and effectively create division between you.
In a single-parent household, the parent needs to take some time to think about what needs to
be said and to prepare for the likely emotional response from the child. A child who is addicted
to the internet or becoming addicted to it will feel threatened at the very idea of curbing
computer or screen time. A single parent needs to be prepared for an emotional outburst laden
with accusatory phrases designed to make the parent feel guilty or inadequate. It is important
not to respond to the emotion— or worse: get side-tracked with a lecture on disrespect.
Acknowledge feelings but stay focused on the topic of his or her internet use.

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Show your care:
It will help to begin your discussion by reminding your child that you love them and that you
care about their happiness and well-being. Children and teens Often Interpret questions about
their behaviour as blame and criticism. You need to reassure your child that you are not
condemning them. Rather, tell your child you are concerned about some of the changes you
have seen in their behaviour and refer to those changes in specific terms: fatigue, declining
grades; giving up hobbies, social withdrawal, etc. Assign an internet time log—tell your child
that you would like to see an account of just how much time they spend online each day and
which internet activities they engage in.
Remind them that, with television, you can monitor viewing habits more easily, but with the
internet, you need their help and cooperation to become appropriately involved. Put them on
the honour system to keep the log themselves for a week or two to build trust between you. If
they balk at this idea or clearly lie in their log, you are likely dealing with their denial of
addiction.
Become more computer-savvy:
Checking history folders and interne 'log earning about parental monitoring software, and
installing filters all require a degree of computer savvy. It is important for every parent to learn
the terminology (both technical and popular) and be comfortable with the computer, at least
enough to know what your child is doing online. Take an active interest in the internet and
learn about where your child goes online.
Set reasonable rules and boundaries:
Many parents get angry when they see the signs of internet addiction in their child and take the
computer away as a form of punishment, Others become frightened and force their child to
quit cold Turkey, believing that is the only way of the problem. Both approaches invite trouble
—your child will internalize the message that they are bad; they will look at you as the enemy
instead of an ally; and they will suffer veal withdrawal symptoms of nervousness, anger, and
irritability. Instead, work with your child to establish clear boundaries for limited internet
usage. Allow perhaps an hour per night after homework, with extra weekend hours. Stick to
your rules and remember that you're not trying to control your child or change who they are—
you are working to help them free themselves from a psychological perspective. Finally, make
the computer visible. Create a rule that non-homework-related computer usage should only
happen in more public areas of the home, where your child is more likely to interact with you
or other members of the household.

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 Practical 3
(DSM IV vs DSM 5)
Aim: To discuss the significant changes from DSM IV to DSM 5

Question 3:
You are aware that mental disorders are diagnosed with the help of DSM and ICD
criteria. DSM-IV- TR is also mentioned in your self-learning material. DSM-5 was
published by the American Psychiatric Association 2013. Now with the help of online or
offline resources, discuss and figure out the key changes that have been made in DSM-5.
The content should be coherently organized and not to be copied from any source

What is DSM?
The Diagnostic and Statistical Manual of Mental Disorders (DSM) is the handbook used by
healthcare professionals in the United States and much of the world as the authoritative guide
to the diagnosis of mental disorders. DSM contains descriptions, symptoms and other criteria
for diagnosing mental disorders
It provides a common language for clinicians to communicate about their patients and
establishes consistent and reliable diagnoses that can be used in research on mental disorders.
It also provides a common language for researchers to study the criteria for potential future
revisions and to aid in the development of medications and other interventions.

DSM-IV to DSM-5 Changes

The American Psychiatric Association (APA) published the DSM-5 in 2013. This latest
revision takes a lifespan perspective recognizing the importance of age and development on
the onset, manifestation, and treatment of mental disorders. Other changes in the Diagnostic
and Statistical Manual of Mental Disorders, 5th ed. (DSM-5) include eliminating the multi-
axial system; removing the Global Assessment of Functioning (GAF score); reorganizing the
classification of the disorders; and changing how disorders that result from a general medical
condition are conceptualized.

() Elimination of the Multi-Axial System and GAF Score

One of the key changes from DSM-IV to DSM-5 is the elimination of the multi-axial system.
There were five different axes.

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Axis I consisted of mental health and substance use disorders (SUDs);

Axis II was reserved for personality disorders and mental retardation;

Axis III was used for coding general medical conditions;

Axis IV was to note psychosocial and environmental problems (e.g., housing, employment);

Axis V was an assessment of overall functioning known as the GAF.

The GAF scale was dropped from the DSM-5 because of its conceptual lack of clarity (i.e.,
including symptoms, suicide risk, and disabilities in the descriptors) and questionable
psychometric properties (American Psychiatric Association, 2013b).

() Clubbing of Disorders or Disorder Reclassification

categorize disorders into “classes” with the intent of grouping similar disorders (particularly
those that are suspected to share etiological mechanisms or have similar symptoms) to help
clinician and researchers use the manual.
In DSM-5, six classes were added and four were removed. As a result of these changes in the
overall classification system, numerous individual disorders were reclassified from one class
to another (e.g., from “mood disorders” to “bipolar and related disorders” or “depressive
disorders”). The reclassification of disorder classes will not have a direct effect on any SED
estimation; however, it does warrant consideration when documenting disorders that may
have changed classes.
1. Autism and Asperger were different
*Now it is called ASD [ autism spectrum disorder]
2. Schizophrenia types
* Now schizophrenia Spectrum Disorder
3. learning disorders like dyslexia, dysgraphia, dyscalculia etc.,
* Specific learning Disorder
4. Mental retardation ( based on IQ)
Now Intellectual Development Disorder (based on level of support required)
5. Psychological aspects, neuro biological orientation -dementia and amnestic disorder
*Now neurocognitive disorder
6. Cultural consideration ( like autism eye contact)
7. Objectivity to subjectivity (Flexibility)
8. ADHD is now AD/HD
9. children -bipolar disorder *Now DMDD Disruptive Mood Dysregulation Disorder

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 DSM-5 (2013)
The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM), the
DSM-5, was approved by the Board of Trustees of the APA on December 1, 2012.
Published on May 18, 2013, the DSM-5 contains extensively revised diagnoses and, in some
cases, broadens diagnostic definitions while narrowing definitions in other cases.
The DSM-5 is the first major edition of the manual in 20 years. DSM-5, and the abbreviations
for all previous editions, are registered trademarks owned by the American Psychiatric
Association.
A significant change in the fifth edition is the deletion of the subtypes of schizophrenia:
paranoid, disorganized, catatonic, undifferentiated, and residual. The deletion of the subsets of
autistic spectrum disorder—namely, Asperger's syndrome, classic autism, Rett syndrome,
childhood disintegrative disorder and pervasive developmental disorder not otherwise
specified—was also implemented, with specifiers regarding intensity: mild, moderate, and
severe.
DSM-5-TR (2022)
A revision of DSM-5, titled DSM-5-TR, was published in March 2022, updating diagnostic
criteria and ICD-10-CM codes. The diagnostic criteria for avoidant/restrictive food intake
disorder were changed, along with adding entries for prolonged grief disorder, unspecified
mood disorder and stimulant-induced mild neurocognitive disorder. Prolonged grief disorder,
which had been present in the ICD-11, had criteria agreed upon by consensus in a one day in-
person workshop sponsored by the APA. A 2022 study found that higher rates of diagnosis of
prolonged grief disorder in the ICD-11 could be explained by the DSM-5-TR criteria requiring
symptoms to persist for 12 months, and the ICD-11 requiring only 6 months.

Three review groups for sex and gender, culture and suicide, along with an "ethnocidal equity
and inclusion work group" were involved in the creation of the DSM-5-TR which led to
additional sections for each mental disorder discussing sex and gender, racial and cultural
variations, and adding diagnostic codes for specifying levels of suicidality and no suicidal self-
injury for mental disorders.
Other changed mental disorders included:
Autism spectrum disorder
Bipolar I disorder, Bipolar II disorder, and related bipolar disorders
Obsessive-compulsive personality disorder in the alternative DSM-5 model for personality
disorders

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Depressive episodes with short-duration hypomania
Intellectual developmental disorder
Delusional disorder
Disruptive mood dysregulation disorder
Brief psychotic disorder
American Psychiatric Association issued the fifth edition of the Diagnostic and Statistical
Manual of Mental Disorders (DSM–5). Although there is considerable overlap between DSM–
5 and DSM–IV, the prior edition, there are several important differences:
Changes Disorder Terminology
DSM–IV described two distinct disorders, alcohol abuse and alcohol dependence, with specific
criteria for each.
DSM–5 integrates the two DSM–IV disorders, alcohol abuse and alcohol dependence, into a
single disorder called alcohol use disorder (AUD) with mild, moderate, and severe sub-
classifications.
Changes Diagnostic Thresholds
Under DSM–IV, the diagnostic criteria for abuse and dependence were distinct: anyone
meeting one or more of the “abuse” criteria (see items 1 through 4 below) within a 12-month
period would receive the “abuse” diagnosis. Anyone with three or more of the “dependence”
criteria (see items 5 through 11 below) during the same 12-month period would receive a
“dependence” diagnosis.
Under DSM–5, anyone meeting any 2 of the 11 criteria during the same 12-month period would
receive a diagnosis of AUD. The severity of AUD—mild, moderate, or severe—is based on
the number of criteria met.

Removes Criterion
DSM–5 eliminates legal problems as a criterion.
Adds Criterion
DSM–5 adds craving as a criterion for an AUD diagnosis. It was not included in DSM–IV.
Revises Some Descriptions
DSM–5 modifies some of the criteria descriptions with updated language.

There are changes are made different disorders, one of the key changes in DSM 5 in contrast
with DSM IV regarding alcohol abuse, as shown below

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 DSM–IV
In counselling, asking subject, as following if one matches then that’s an Alcohol abuse
In the past year, have you:
Any 1 = ALCOHOL ABUSE
● Found that drinking—or being sick from drinking—often interfered with taking care of
your home or family? Or caused job troubles? Or school problems?
● More than once gotten into situations while or after drinking that increased your
chances of getting hurt (such as driving, swimming, using machinery, walking in a
dangerous area, or having unsafe sex)
● More than once gotten arrested, been held at a police station, or had other legal
problems because of your drinking?
**This is not included in DSM–5**
● Continued to drink even though it was causing trouble with your family or friends?

DSM–5
In counselling, asking subject, as following if 2 matches then that’s an AUD
In the past year, have you:
The presence of at least 2 of these symptoms indicates Alcohol Use Disorder (AUD)
The severity of the AUD is defined as:
Mild: The presence of 2 to 3 symptoms
Moderate: The presence of 4 to 5 symptoms
Severe: The presence of 6 or more symptoms

● Had times when you ended up drinking more, or longer, than you intended?

● More than once wanted to cut down or stop drinking, or tried to, but couldn’t?

● Spent a lot of time drinking? Or being sick or getting over other aftereffects?

● Wanted a drink so badly you couldn’t think of anything else?

**This is new to DSM–5**

● Found that drinking—or being sick from drinking—often interfered with taking care
of your home or family? Or caused job troubles? Or school problems?

● Continued to drink even though it was causing trouble with your family or friends?

17 MPCE 024, Enrolment No. 2101329657 : Practical 3 ( DSM IV vs DSM 5)

 ● Given up or cut back on activities that were important or interesting to you, or gave
you pleasure, in order to drink?

● More than once gotten into situations while or after drinking that increased your
chances of getting hurt (such as driving, swimming, using machinery, walking in a
dangerous area, or having unsafe sex)?

● Continued to drink even though it was making you feel depressed or anxious or adding
to another health problem? Or after having had a memory blackout?

● Had to drink much more than you once did to get the effect you want? Or found that
your usual number of drinks had much less effect than before?

● Found that when the effects of alcohol were wearing off, you had withdrawal
symptoms, such as trouble sleeping, shakiness, restlessness, nausea, sweating, a racing
heart, or a seizure? Or sensed things that were not there?

On to bipolar disorder I may have heard of this before in terms of manic depression that's
an old term for it it’s been divided into bipolar 1 and bipolar 2. now the differences between
bipolar 1 and bipolar 2 you'll see this here you see the terms manic hypomanic and depressed

Depressive disorders and probably the most famous one that people know is major
depressive disorder you can have a single episode you can have a recurrent episode there is
no minor depressive it's just major depressive you see a couple other things you may have
heard premenstrual dysmorphic disorder

Obsessive compulsive disorder was grouped under anxiety disorders now there’s a whole
section of obsessive-compulsive related disorders

Asperger’s has been rolled into autism so Asperger’s as kind of a freestanding diagnosis
doesn't really exist and that’s become an area of controversy attention deficit hyperactivity
disorder add is sort of another term that's put into the public slang but the actual disorder is
known as ADHD.

18 MPCE 024, Enrolment No. 2101329657 : Practical 3 ( DSM IV vs DSM 5)

 Practical 4
(Case History on COVID crisis)
Aim : To take the case history of psychological problem during COVID19

Question 4: Case History: This activity will be conducted in the format mentioned in
the Handbook of Practical. Refer to Page. No. 10 of the Handbook for the Case History
format. You may take Case History information from any of your acquaintances/
family members, who have faced any psychological problems during the present
COVID crisis. Record the information of the Case History in your File.

Socio-demographic data
Intake information:

Name : Client
Age : 14 years
Gender : Female
Educational qualification : 9th class
Occupation : NA
Income : NA
Marital status : Unmarried
Language : Telugu

Whether client stays with parents: Yes

Whether client stays with spouse: NA
Whether have any siblings, if so how many: NA
What is the position of the client in the family: Only child
Anyone in the family having conflicts: No
Anyone in the family is suffering/has suffered from any physical disorders: No

Chief Complaints:
Psychological faced Problems during COVID19: Stress, anxiety and depression etc.,
“Unbearable Stress and Anxiety due to parents lost their income sources and couldn’t afford
education; client was forced into working to support her family incomes. During these
unprecedented times where basic livelihoods and lives were at stake, education took a back
seat, client suffered with COVID and went depression for few days”

19 MPCE 024, Enrolment No. 2101329657 : Practical 4 ( Case History on COVID crisis)
Precipitating Factors if any:

● COVID19

● Unemployment, force to leave the jobs

Duration of problem: 1 year
Any counselling taken: No
How intense is the problem and how does it affect the client?
● Client could not attend the school
● Too much worry and doesn’t know “what is happening
● Affected with COVID once and recovered
● Faced hard time to adapt the situations

According to the Informant:

Interview with family members/spouse/the concerned person
Name: Mother of Client
Age: 40
Sex: Female
Relationship: Mother
The view point of her mother in regard to all the above
Her mother said, “we are a small family with only a daughter and we work in construction
works, so we earn day-to-day for livelihood, we don’t have big properties. We came to
Hyderabad from a remote village to work and get education for our daughter. Life was ok till
COVID19, after the life became miserable and lost jobs then went back to native village but
there was no work and suffered with many psychological issues like stress, anxiety and
depression, also more concerned about our daughter career and health because she was affected
with COVID once and recovered with God’s grace, after 2 years, now we are ok and life is
going smoothly”
Relationship:
If unmarried:
Patient’s relationship with family members:
● With mother: Her mother is very supportive
● Father: Her father is also very supportive
● Brothers: NA
● Sisters: NA

20 MPCE 024, Enrolment No. 2101329657 : Practical 4 ( Case History on COVID crisis)
Any other relative staying with patient: No
With friends: Good
How many friends does the patient have? How does the patient relate to them? NA
With neighbours: Good
With classmates: Good
With the teachers in college: Good
With other authority figures: NA
With playmates: Good
In the games field: Good

Educational history:
● In school / college:
She was a good in studies in school
● How is the client in studies and academic performance?
Her academic performance according to her report card of her school was good and he
was a first-class student
● Does the client come up to the expectations of parents and teachers?
Yes
● Have they received any complaints from the school authorities regarding the client
performances?
No, they never received any complaint regarding this.
● When did they decide to consult a counsellor? NA
Work history:
Works with her parents during holidays, and supports her mother in home activities
If Married: NA (not married)

21 MPCE 024, Enrolment No. 2101329657 : Practical 4 ( Case History on COVID crisis)
 MSE
(While discussing, her problems during COVID19)
Appearance:
● Age: 14 years
● Sex: Female
● Hygienic: Yes

Movement and Behaviour:

● Client’s gait : Normal
● Posture : Uneasy
● Eye Contact : Makes eye contact and stable
● Facial expression: Tensed and fearful

Mood: Nervous and anxious

Speech:
● The volume of the person’s voice : Normal
● The rate or speed of speech : Normal
● The length of answers to questions : 2-3 sentences
● The appropriateness of the answers : Appropriately answered

Thought Content:
After establishing the rapport and observing the client’s appearance and all, I assess that the
client’s behaviour resembled that she faced problems like Stress and worry, anxiety, fear and
nervousness etc., during COVID19

Cognition:
● Orientation: Intact with respect to time, date, place and person.
● Attention/ Concentration: ok
● Memory: NA
Intelligence: Adequate (as per educational background, told 1st division)
Judgement:
Social: NA
On test: NA
Insight: NA

22 MPCE 024, Enrolment No. 2101329657 : Practical 4 ( Case History on COVID crisis)
Case analysis:
Client was one of the most enthusiastic students in Grade 9 of a Private School, Hyderabad. In
spite of her parents being construction workers, she loved learning and always had her hand up
eagerly in class.

In March 2020 when the Covid-19 lockdown was announced, none of the school staff could
get in touch with her.

Her parents lost employment i.e., got no work from construction industry so they migrated to
their native village, they started stress and worry about income and their daughter
After a few months of trying, she was finally able to attend her new, virtual classroom.
However, the device she could access was 4 km away from her home, also started stressful life,
developed anxiety about her education and parents’ situations

Countless are the stories of children all over the country today who are doing all they can to
access devices. Right from shared tabs and phones and taking on more responsibilities at home,
students from low-income backgrounds have been impacted the most by the shutdowns.

With no public transport and very little resources to take private transport, she used to walk.
Though she was technically attending virtual classes, they meant a 4km walk every day.

As some of the mass migration to villages has been permanent, students have been disenrolled
out of their city schools completely. Some parents said they would be readmitted to schools in
their native villages, but there was no guarantee.

As parents lost their jobs and couldn’t afford further education, some students were forced into
working to support familial incomes. During these unprecedented times where basic
livelihoods and lives were at stake, education took a back seat.

The various government solutions didn’t see too many results. Few govt TV channels
broadcasted subject lessons. But they weren’t very effective in keeping children engaged to
continue learning.

Virtual classrooms have opened up new avenues. The access to resources to make learning
more interactive and interesting has helped tremendously and students have been more
enthusiastic. Concepts are now explained through videos and games.

23 MPCE 024, Enrolment No. 2101329657 : Practical 4 ( Case History on COVID crisis)
The flexibility in timings of online classes has also been a major advantage. Classes are held
at times that are most convenient for students, and we now build better interpersonal
relationships with students and parents.

Tools like Google Classroom, Edmodo, etc have been very helpful in simulating the in-
classroom experience, at home.

Schools reopening with strict guidelines

Through this gradual shift, human interaction as we know it has changed. Initially, it was hard
to monitor students’ moods, track their phone activity, and how involved they are with learning.
Keeping up with their submissions, ensuring the authenticity of work and assessments now
needed an added lens and more time. It was imperative for us as teachers to keep students
engaged while being mindful of daily screen time.

After nearly 6-7 months of the academic year being lost, schools had slowly started operating
with strict guidelines from regional governments. While private schools have been conducting
online classes right from June 2020, government-run and low-income private schools didn’t
have the resources and infrastructure to replicate that model.

A hybrid of Blended Learning for the future is now becoming more and more evident. A
solution where some students can learn from home while the other half attends school, ensures
large groups are avoided. Well-defined, efficient structures for Blended Learning can do
wonders for the education sector.

24 MPCE 024, Enrolment No. 2101329657 : Practical 4 ( Case History on COVID crisis)
 Practical 5
(Counselling and Guidance)
Aim: To provide counselling and guidance for a hypothetical case

Question 5 : Consider the following hypothetical case of Tanveer, a 17-year old boy. He was
brought to you (you as a counsellor) by his mother for counselling and guidance.
“Tanveer, is a 17-old year boy who completed his Class XII with average marks. He is an
intelligent and hard-working student, however, for the last two years he has become
disinterested in his studies. He is thoroughly dependent upon luck and fortune. Presently,
he has been following someone on social media and started to meditate for long hours
each day. The duration of meditation is somewhere between five-six hours everyday.
Though completely disinterested in studies, he has applied in various colleges and
University of his city for an undergraduate programme. He wants to pursue Journalism,
but his father wants him to pursue Law (father is a lawyer)”
a. How will you counsel and guide Tanveer?
b. What measures would you suggest for the family members?
**As mentioned, it is a hypothetical case, upon scope of counselling and guidance, counselling
will be done and it is only a short-term talking therapy so if personality tests and investigations
are required then case will be referred to a clinical psychologist or psychiatrist

The factors responsible for a child’s disinterest in studies need to be established and
understood, and only then can a course of action be taken. There is always a reason behind
the child not wanting to study —
Unable to understand the Subject
Unable to cope up with the pace at which topics are covered in school
Wrong signals home (may be doting grandparent interfering with the way the child's
being raised)
Slow learning tendency
Depression and other psychological problems (domestic violence and fights etc.)
Peer pressure and bad company
Lack of motivation (no praise from parents)
● Inattentive parents
● Abuse of some kind (even sexual by someone known to the family)
● Too much pressure and expectations to perform well

25 MPCE 024, Enrolment No. 2101329657 : Practical 5 ( Counselling and Guidance )

Q: How will you counsel and guide Tanveer?

I go with stage by stage to understand the problem of Tanveer

First step is, I build up a rapport so that can open-up and shares his interests and challenges
Without any hesitation and I use confidential statement to make confident that I will not share
any information about him or discussed with any one including his family members
I use following counselling stages skills
Stage 1: Attending client and building relationship
<Sub stages >
● Welcome and taking basic info
● Attending the client and make him comfortable
● Rapport build-up
● Confidential statement
<Skills >
● SHOVLER [Sit squarely, Head nods, Open posture, Verbal following, Lean to the
client,
● Eye contact and Relax
● Open Ended questions and closed ended questions
● Paraphrasing
● Reflection of feelings [Empathy]
● Non-judgmental
Stage 2 : Mental Status Examination and History Taking
<sub stages >
● MSE : General appearance and behaviour, Speech, Thought, Mood/Affect, Perception,
Cognition, Insight
● Taking Family / Childhood/Health/Mental /Life style history
<skills>
● Interpretation; new framing the situation/changing the perception by connecting dots
past [childhood] to present by psychoanalysis
● Silence: Allows client to speak more about issue without interruption or distraction
● Focusing: counsellor focuses on emotion behind the story, explore a feeling or
movement more deeply
● Unconditional + ve regard : Complete support and acceptance does not matter what
person says or does

26 MPCE 024, Enrolment No. 2101329657 : Practical 5 ( Counselling and Guidance )

Stage 3: Assessment of issue and insight
<Sub stages >
● Presenting the issue
● ABET [Activating situation, Behaviour, Emotion, Thought process]
● Initial key questions
Since how long are you facing this problem?
How frequently?
How does it affect you?
How do you cope up?
Scale the rating?
What made you get into this?
● Exploration
Confirming the issue by asking I think this is your issue?
Do you want to come out from this issue?
What are you expecting from me?
● Sharing responsibility ie., what is going to share you pains and sorrows ?
<Skills>
● Immediacy: Counsellor reveals how they themselves are feeling in response to the
client. or + -ve closeness among counsellor and client, present here and now
● Self-disclosure: Motivating the client by saying you are not alone having this kind of
issue, also I went through this but came out this, we help you so that you also come out
so don’t worry
● Approval and reassurance: client feels more comfortable and opens up
() client focused [in client perception]
() situation focused [yes, very difficult situation]
() focused on significant others [ yes, that very bad he should not behaved like that]
● Challenging/Confrontation: mixed responses/contradicting statement, I want to cross
river but my body should not get wet

27 MPCE 024, Enrolment No. 2101329657 : Practical 5 ( Counselling and Guidance )

Stage 4: GOAL setting and mental health
<sub stages >
● Therapeutic alliance: Working alliance, description of interaction between therapist
and client
● Goal setting: Reconfirming the issue with client before goal setting, like I think office
stress is your problem correct if am wrong, if I miss something please add so that it
makes easier to set goal collaborative process both sit together decide not one way from
counsellor then
motivate the client to reach the goal goals can be
● short-term or long-term goals
● therapy goals like 5 to 10, 20
● Avoidance goals or Approach goals
Every avoidance has hidden approach goals
Reducing/Decreasing [ avoidance goal] ex :Angry
Increasing [ approach goal] ex: Confidence
Mental Health Checklist: [general mental issues] yes or no, count the issues correct them
all are not issues
Functional [ nothing to do it] or
dysfunctional [disturbing to we have working on it]
<skills >
Summarizing: can be done at any time end of the session or between the sessions
summering the 2 or more client issues or thoughts, or connecting them
Guidance and information:
counselling is past problem, guidance is post problem [where when why what who how ]
we should have info about mental hospitals, rehabilitation centers lawyers, NGOs, website,
pamphlet, books etc.,

28 MPCE 024, Enrolment No. 2101329657 : Practical 5 ( Counselling and Guidance )

Stage 5: Interventions
<sub stages >
Educate the client, like neuroplasticity, anger
● Providing interventions
Story telling
Coping card
Reverse role play
Brainstorming
Psycho education
Stage 6: Follow up and Ending session
<sub stages >
● Follow up session
● Ending session:
● Conclude: treated or client is happy and fine
() referral: if not treatable or different, not under counselling then refer to other
() transfer: timing/language problem with language, not under can be transferred to other
counsellor within organization
() terminate: does not like, not happy or not comfortable each other, can not continue

Counsellors should respect their clients by listening to them and learning about them as people,
accepting and trusting them, showing compassion for them, and seeing them as capable of self-
management.
Clients may also contribute significantly to the working partnership. Probably the most critical
characteristic is the ability for trust, since there can be no good relationship without it, Clients
who are defensive or reluctant, or who lack the capacity to examine themselves and their
surroundings, will almost certainly struggle in the therapy relationship.
Clients who do not seem to be motivated to change are unlikely to benefit from therapy, while
therapists may take steps to assist clients in developing a drive for change, to summarise, the
therapeutic working alliance integrates client and clinician traits in order to facilitate
transformation.

29 MPCE 024, Enrolment No. 2101329657 : Practical 5 ( Counselling and Guidance )

Q: What measures would you suggest for the family members?
Make no comparisons; your child is not the same as another’s, their capabilities and
circumstances are distinct, and you must recognise this. Have no expectations of your kid, but
be there to mould them in ways that will enable them to carve out a place for themselves. And
this can only be accomplished with the assistance and understanding of others. Nagging,
yelling, and reprimanding will not work. Avoid pressuring your kid, since this may cause them
to despise school and avoid study.
Create a healthy learning atmosphere. Eliminate distractions and establish a daily regimen that
includes time set out for academics an other-pursuits. You will need to strike a balance so that
the youngster does not spend all of his time studying and does not have time for pleasure and
hobbies.

Unconditional love:
Academic failure and lack of enthusiasm in academics should have no effect on the link and
relationship you enjoy with Your kid. Withhold love as a form of punishment for not studying
or receiving low marks. Refusing love makes the youngster feel guilty, unwelcome, and
fearful. You are Their support of your behaviour has a detrimental effect on the youngster.
Create an atmosphere of kindness, acceptance, encouragement, and support. Your kid should
understand that you are not abandoning him and that you will remain a 'friend, philosopher,
and leader' for him. A atmosphere that oozes acceptance, kindness, and confidence motivates
children to excel.

Human nature dictates that we live others' expectations and satisfy them. Appreciation and
belief serve as a motivator. Bear in mind that children, like adults, desire attention, praise, and
faith. Encourage your youngster by rewarding him when he deserves it, Recognize each
performance and achievement. Compliment the youngster on his development. This positive
reinforcement acts as a spark, causing the youngster to establish larger objectives and strive
for greater heights. This is a more effective strategy than scolding. Make no attempt to entice
the Youngster to study via the use of rewards. These approaches work briefly; for long-term
benefits, use all available forms of encouragement.

Contrast not:
Make no comparisons; this is the worst thing a parent can do for their child's self-esteem. When
you compare your kid to another child, you are being unjust. The comparison is skewed; you
have no idea about the context and compare just what you deem appropriate.

30 MPCE 024, Enrolment No. 2101329657 : Practical 5 ( Counselling and Guidance )

A balanced act is one in which you compare everything and then come to a decision, which is
not feasible in this circumstance. Your kid is a unique person with unique strengths, limitations,
and defects. Treat him as a person and work with him to overcome his weaknesses.
Your objective must be to stimulate your kid, to assist him in discovering his inner power, and
to assist him in developing fervour and drive. Comparisons simply serve to increase despair,
resentment, and a sense of worthlessness. On the other hand, motivation elicits passion. Rather
of lecturing and threatening your youngster, choose a 'let's do it together' approach. A little
amount of trust in the kid, a small amount of you can do it,' may go a long way toward a
youngster believing in himself. At times, all that is required is a pep talk.

Allow for liberty and choice:

You may establish guidelines for the youngster and create a schedule with designated study
and play times. Numerous parents use this as a means of control. You are communicating to
the youngster that you are the boss and that they must obey your commands. By appearing
authoritative, you create an imbalance.
A more effective strategy is to include the youngster in his growth. Allow the youngster to
speak. Establish fundamental parameters based on what the kid needs schoolwork, self-
study/revision/practice, and amusement and skill development. Determine the duration of each
activity and then let your kid choose when he wants to do What.
He may choose to do schoolwork after play and before supper. He may choose to spend an
hour studying prior to going to school. He may like to practise guitar lessons before retiring
for the night. What you're doing here is allowing the youngster to make his own decisions, but
only if he adheres to the plan.
Additionally, allow the youngster to study in his room or at the dining table. Allow him to pick
which topics and for how long he wants to review. Advise the youngster, however, that with
freedom comes responsibility.
Allowing children to make their choices teaches them responsibility. Ascertain that the
youngster is prepared for this job; speak with him and inform him that he has accepted the
obligation to do his work diligently and that you trust him

31 MPCE 024, Enrolment No. 2101329657 : Practical 5 ( Counselling and Guidance )

Participate from the side-lines:
Don't sit with your child with the purpose of making him learn things by hook or by crook.
You have to keep the fun element intact; Learning is more productive when it involves
discoveries. Trying to shovelling information into your child's brain often backfires. The better
way to do this is to let the child discover and learn.
He made a mistake in addition, channelizing his brain to think, maybe give him a few objects
and ask him to calculate how many pieces there are. Don't point out the mistake, but let him
discover it on his own. Let the Child discover and correct his mistakes, this also helps in brain
development.

Don't hold the child' hand. Allow him to learn and grow. Step in only when you notice the child
is unable to cope. Begin by explaining the error, and break it down so it’s easier to remember.
Follow it up by giving the child a few mor problems to solve. Applaud each successful attempt
and show patience when the attempts fail. Go back to the drawing board and start all over
again, until your child grasps the concept. The child shouldn't feel burdened and at the same
time, he must know that you ate there, to assist him.
Don't worry, you'll do a good job. Just let encouragement be a key ingredient in your parenting
skills. Everything else falls into place. Don't let your child's failures disappoint you. He is still
learning, be there to guide him, every step of the way. Show him how things are done, but at
the same time allow him to discover things. Go slow, keep pace with your child, an don't expect
him to keep pace with you. It pays to be patient.

32 MPCE 024, Enrolment No. 2101329657 : Practical 5 ( Counselling and Guidance )