PSYCHOLOGICAL ASSESSMENT REPORT

Submitted to: Mam Zunaira Arshad

Submitted by: Amtul Musawer

Subject: Psychological Assessment

Department: BS Psychology (6-B Morning)

Department of Applied Psychology

National University of Modern Languages Islamabad

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Contents
Introduction.................................................................................................................................................3
Demographic Data.......................................................................................................................................3
Context and Reasons for Referral................................................................................................................4
The Assessment Process..............................................................................................................................4
Behavior and Appearance (MSE)...............................................................................................................................4
Presenting Complaints................................................................................................................................................4
Risk Assessment.........................................................................................................................................................5
Background History....................................................................................................................................5
Birth and Developmental History...............................................................................................................................5
Family History............................................................................................................................................................6
Educational History....................................................................................................................................................7
Professional History...................................................................................................................................................7
Social /Behavioral History.........................................................................................................................................7
Relationship History...................................................................................................................................................7
Medical History..........................................................................................................................................................8
Psychiatric/Drug History............................................................................................................................................8
Test Setting..................................................................................................................................................9
The Assessment Process..............................................................................................................................9
RISB (Rotter Incomplete Sentence Blank).................................................................................................................9
Analysis.............................................................................................................................................10
HTP (House Tree Person)........................................................................................................................................11
HOUSE..............................................................................................................................................11
TREE.................................................................................................................................................11
PERSON............................................................................................................................................12
Beck Anxiety Inventory...........................................................................................................................................12
Analysis.............................................................................................................................................13
Beck Depression Inventory......................................................................................................................................13
Analysis.............................................................................................................................................13
Bender Gestalt Test..................................................................................................................................................13
Errors and interpretation....................................................................................................................14
DASS........................................................................................................................................................................14
Interpretation.....................................................................................................................................14
DAST........................................................................................................................................................................15

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 Interpretation.....................................................................................................................................15
Thematic Apperception Test (TAT).........................................................................................................................15
Story 01.............................................................................................................................................15
Story 02.............................................................................................................................................16
Proposed Treatment...................................................................................................................................16
Long Term Goals......................................................................................................................................................16
Short Term Goals.....................................................................................................................................................17
Conclusion.................................................................................................................................................17

Introduction
This report is about Sufyan Butt. He is 22 years old who was contacted for the
purpose of my psychological assessment report. The report includes the
comprehensive history of the person including his family history, early learning,
educational history, psychiatric history, drug history. The report includes
psychological assessment of Sufyan based on following tests; Thematic
Apperception Test (TAT), House Tree Person (HTP), RISB, and The Mental
Status Examination (MSE), BGT (Bender Gestalt 1,2), BAI (Beck Anxiety
Inventory), BDI (Bender Depression Inventory), DAST 10, DASS-21 . The report
also proposes a preliminary treatment plan.

Demographic Data
My client name is Sufyan Butt and he is 22 years old. She has 1 brothers and 1
sister. He is the youngest one in the family. His father is a businessman and owns
factories in Islamabad and his mother is a housewife. Sufyan lives with her family
in Islamabad. He is currently in Islamabad Rehab Clinic (IRC).

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Context and Reasons for Referral
IRC Director was contacted for report on the bases of his willingness to let their
patient participate in project under my psychological assessment course. The
subject was basically observed and inquired for assessment purpose by me.

The Assessment Process

Behavior and Appearance (MSE)

Mr. Sufyan was wearing green T-shirt and black pent he had well groomed hair.
Mr. Sufyan had a height of 5.10 feet and was a smart man. Mr. Sufyan was
behaving normally throughout the interview; he had manners how to act. He’s
expressions were consistent with the situations he was discussing. Throughout the
interview the client had the eye contact and was confident. On observing the
attitude, the client was very cooperative and open. He shared everything easily and
was seen excited for the interview. The level of consciousness of Mr. Sufyan was
vigilant. The client was fully aware of his orientation, he's volume and tone was
normal and clear. On inquiring client’s mood he reported that he was feeling very
happy and excited. His thought content was linear and goal directed. No suicidal
thoughts were shared by the client, but he has a history of suicidal attempts several
times. In addition to this the client attention and concentration was good, client was
very talkative and enthusiastic but was lacking a little bit in writing skills.

Presenting Complaints
There were no presenting complaints or suicidal thoughts as stated by the client
and on observing as well.

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Risk Assessment
On inquiring about risks of self-harm, harm to others or harm from others; the
client reported that he has attempted suicide 3 to 4 times in 2018 and 2019. The
reasons behind these attempts are that Sufyan’s parents didn’t listen to him, so he
tried to attempt suicide. There were also cut marks on Mr. Sufyan’s arm, on
enquiring about them he said that he cut himself because this self-harm attempts
relaxed him, gave him some sort of peace. Mr. Sufyan also added that when he was
in effect of drugs he had done this self-harm (cut his arm with blade) many times
and it gave him a pleasure every time.

Background History

Birth and Developmental History

Before starting the interview Mr. Sufyan seemed calm, relax and was excited. On
inquiring about his birth and developmental history, Mr. Sufyan reported that he
was born on 16th December 1999 in Karachi, Pakistan. As the client reported the
birth was normal there were no complications during birth or before. He was the
middle child of his family so was very close to his family members especially his
mother. He belongs to a very rich family, and having a very strong financial
background. The client had spent his early childhood in Karachi. After 5 years of
age they’ve moved to Islamabad. Mr. Sufyan added that he was very naughty from
the start and was scolded by his parent several times. He loved to play cricket.
Apart from this Mr. Sufyan added that he was very intelligent from childhood but
he has lack of interest in his studies and has started smoking in the age of 9 years
and later on Weed in the age of 11 years, his interest totally vanished and he left
his studies after completing ICS. Mr. Sufyan added that as he was financially very
strong he used to have very lewd gatherings with his friends and peers plus had a

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gun every time with him and that's why he's friends approached him very much.
They used to attend parties in clubs. That was the point he started taking different
drugs.

Family History
Mr. Sufyan lives with his parents and siblings in a neutral family. Mr. Sufyan has
two siblings which include one brothers and one sister. His sister is youngest. The
detail relationship is mentioned below:

Mr. Sufyan reported that he loves his mother very much; he has very good
relationship with his mother as his mother cares for him so much and loves her.
Mr. Sufyan further added that her mother used to scold him very much whenever
he knew about his drug gatherings. Apart from this Mr. Sufyan reported that he can
bear everything whatever his mother do or say to him but when she gets upset and
doesn't talk to him that’s totally un-bearable for him.

On inquiring about the relationship of Mr. Sufyan and his father, the client added
that his relationship with his father is very exceptional. The client said that most
fathers are very strict to their sons and their sons are not able to share everything
with father but he was very frank with his father and shares everything easily with
him. His father loved him very much and fulfills his wishes. Mr. Sufyan further
added that when his father says NO to Mr. Sufyan on anything it is very disturbing
for him. He also said that his father is his ideal and was very attached with him.

Mr. Sufyan had quite good relationship with his siblings. He added that his eldest
brother runs business with his father and is also somehow related with political
side. Mr. Sufyan added that he is mainly attached with his youngest sister as she is
the one who loves him the most and cares for Mr. Sufyan. He also added that he
teases his sister and they have a very good bond. Mr. Sufyan said that the

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relationship with elder brother is respectful and reserved as he respects his brother
a lot because he is the one who supports him very much and the one who always
guide him in a good way and always wants better for him.

Educational History
On inquiring about the educational history Mr. Sufyan reported that his educational
career started in Karachi. He started going to school in the age of 5. He was
average student in his class. He further added that his interest in studies vanished
before matric and he skipped 8th grade and left his studies after ICS from Roots
International. Mr. Sufyan said that his is because of his friend’s lewd gathering and
he started smoking and taking different drugs that was the main reason that he left
his studies. Apart from this Mr. Sufyan added that his favorite subject was math.

Professional History
On inquiring about profession and career the client reported he used to take care of
his father’s factory in Islamabad. He further added that he has a great interest in
setting up a business on his own.

Social /Behavioral History

On inquiring about the social history Mr. Sufyan reported that as he was
financially very strong so that's why many of his friends approached him. The
client further added that he had a very strong relationship with his friends even
they were the major reason behind his drug abuse. Furthermore Mr. Sufyan’s
family has very bad relationship with some of their relatives too. And these issues
with relative are a bit disturbing for the client because it had affected his love life.

Relationship History
On inquiring about the relationship history Mr. Sufyan added that he has been into
1 relationship for 3 years which is not existed now. This relationship of client was

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with his cousin. The client reported that she left him because of his drug addiction
then Mr. Sufyan realized about his dark future and tried to quit drugs; but when his
cousin got married he again started doing drugs. Apart from this Mr. Sufyan
further added that he has been in an intimate relationship with someone but he
refused to tell more details about that.

Medical History
There were no medical issues as reported by the client. And there is no medical
history of the client.

Psychiatric/Drug History
On inquiring about the drug history Mr. Sufyan reported that he started smoking at
school level due to his gathering of friends. Apart from this the client added that in
2011 one of his friends introduced him to weed and marijuana which gradually
became part of his life and he became habitual to it. Mr. S added that he used to
take different drugs secretly in bars and cafes without letting his parents know but
as they came to know they scolded him several times even his elder brother talked
with him about this addiction, eventually then they send him to the rehabilitation
center. Mr. Sufyan further reported that he came to rehab 3 rd time, he tried to quit
drugs but due to several reasons he again started taking drugs. He reported that he
has no withdrawal effects.

Based on the subject’s detailed family background and history it seems that Mr.
Sufyan is having no such specific psychological disorder. However Mr. Sufyan has
some intense anger issues and overthinks about everything but the symptoms don't
cover fully on any disorder mentioned in the DSM.

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Test Setting
The interview including the tests was taken at Islamabad Rehab Clinic in one
session on 30th May 2022. Tot time for the session was almost 3 hours. At the time
of interview only the client and two interviewers were present during the setting.
The environment was calm, comfortable and no such disturbance was noted.

The Assessment Process

The assessment process for Mr. Sufyan included an open structured interview
which was almost of 3 hours with some tests. The tests include

 MSE
 RISB
 DASS
 DAST
 BDI
 BGT
 HTP
 TAT
 BAI

RISB (Rotter Incomplete Sentence Blank)

Mr. Sufyan Completed the RISB form in 10 minutes. The client orally answered
the items answers as he asked for this. Mr. Sufyan interest was consistent
throughout the session. Mr. Sufyan scored 131 which mean that he is adjusted in
his environment. The scoring is given below:

Response Category Correspondent Score Obtained Score

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Positive Response
P3 0 0x2=0
P2 1 2 x1 = 2
P1 2 2 x 12 = 24
Neutral
N 3 3 x 11 = 33

Conflict Response
C1 4 4 x 5 = 20
C2 5 5 x 8 = 40
C3 6 6 x 2 =12

Analysis
Mr. Sufyan provides a picture of good relationship with his parents (item to 11 and
35) as he is showing a positive and warm attitude towards his parents. Talking
about the social attitudes item 9, 10 depicts how he is satisfied with the people who
are the part of his life. Generally Mr. Sufyan is showing bad nature and a harsh
attitude toward people (item 19). Apart from this a negative view can be seen
towards female (item 40) this could be possibly linked with his own experiences
reported by the client. The client seems to be very upset on his past behavior
especially on why he started taking drugs (item 5 and 21).The subject can be
characterized as a man who is adjusted and satisfied with his parented relationship
but is lacking somehow in showing warm attitude toward his friends. He has a
positive view regarding his future and has the potential and willpower to overcome
his faults. Another indication can be of his behaviors which might be possibly
disturbing for his parents. A little bit lacking area can be seen in controlling his
anger issues and nerves.

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HTP (House Tree Person)
For the administration the client was given a paper, a pencil and eraser. While
during drawing it was observed as the client seemed to be in hurry or want to end
the test as soon as possible. The time duration was of three minutes. The client
have used eraser many times. No additional information was added by the client.
The detailed analysis is given below:

HOUSE
Mr. S has drawn ‘a roof’ which indicates the sensitive interaction with the
environment. The wall was also drawn which is an indicator of ego. The house
drawn is kind of small, and well-drawn which indicates feelings of great
inadequacy that the environment is hostile and is opposing, a similar response can
also be seen in the RISB ( go to page # 9). A door can also be seen which indicates
the direct contact with environment. As the client shaded the roof indicates the
anxiety in fantasy level. Windows are drawn shows media contract with
environment. The wall is overemphasized shows the effort to maintain control. The
door is drawn shows direct contact with environment, but the door is high beyond
baseline shows that the person is inaccessible. Door knob is drawn indicates orality
and dependency, Higher the door is beyond baseline, the greater the degree of
unwillingness to get in contact.

TREE
Focusing on the tree drawn by Mr. Sufyan it is 2 dimensional which means it's a
normal tree and indicates the basic self portrait of Mr. Sufyan. The trunk drawn
indicates the basic power and ones ego strength. The trunk line is drawn somehow
heavily with symbolizes the anxiety of Mr. Sufyan. Mr. Sufyan said it is a fruit tree
which shows that he is a dependent child. But opposite response can be observed in
BAI. The trunk is drawn heavily and overly large which is the indicator of Mr.

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Sufyan’s anxiety and their aggressive reaction in fantasy or in actuality. Roots
drawn shows ungratified needs. Leaves are drawn which indicates satisfaction and
fulfillment but the leaves are not drawn well are crude show less intelligence of the
client.

PERSON
The person drawn by Mr. Sufyan doesn't seem a normal as distorted parts can be
seen, the client has omitted the areas associated with sexual parts. The head is
drawn which indicates the self-concept of Mr. Sufyan. Lack of Hair can be seen
which symbolizes the feeling of impotence or lack of virility. The eyes drawn are
but pupils are missing which represents that the subject is expressing guilt in
relation to voyeuristic tendencies. Nose is drawn hooked and flared represents that
the client is expressing rejection and contempt. Mouth is drawn which suggest oral
adjustment, but the client has drawn one line mouth indicates oral resistance or
denial of Mr. Sufyan. Large trunk is drawn shows unsatisfied needs which client is
not aware of. The ears can be seen underemphasized which indicates the sensitivity
to criticism. The body drawn is long which indicates the un- satisfied needs of the
client. The shoulders drawn are in square form which represent the over defensive
attitude of the client. The arms are one dimensional which indicates gross
inadequacy feeling of regression. The hands are drawn which indicates the hostility
or hostile feelings. The feet drawn are in form of bars with symbolizes the form of
defiance.

Beck Anxiety Inventory

For the administration of back anxiety inventory the client has given the scale and
told to answer all questions. The client scored 11 on the Beck anxiety inventory.

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Analysis
As the client has scored 11 it basically indicates very low anxiety that is usually a
good thing. The client seems to have low anxiety as well if we focus on the
detailed history of the client no such anxiety is observed. Apart from this too little
anxiety can also indicate that the client is detached from himself, others or the
environment. The client rated himself on mainly some physical symptoms, which
seems that the client may face more on physical issues and this could probably be
related to little bit anxiety. In addition to this, overall the client seemed very
confident and fearless which also indicates that Mr. Sufyan has low anxiety level.

Beck Depression Inventory

The back depression inventory was administered for evaluating the severity of
depression. The client scored 05 on Beck depression inventory which indicates that
the client has some ups and downs which are considered to be normal.

Analysis
The client seems to be fed up and wants to go home as per the detailed history
given by the client. Apart from this the client has not reported any physical
complaints which show the client is not depressed. Apart from this the client
reported about feeling guilty and ashamed of his past life that why he used to take
drugs. These all could be some possible reasons which are contributing in these
ups and downs.

Bender Gestalt Test

The Bender Gestalt test was administered to evaluate visual-motor functioning,
visual perceptual skills and emotional disturbances among the client.

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Errors and interpretation
The client generally made three errors in total which indicates an absence of visual
constructive defects and brain impairment. The client simplification error was
more. The client seemed to simplify every single figure that could be possible
possibly due to the lack of motivation and hurry to complete the test as it seemed
like that. Apart from this the client’s eye motor coordination was good. It means
that the clients non- verbal skills are also well. In short there's no evidence of any
brain impairment.

DASS
The DASS was administered in order to assess the subjective depressive, anxiety
and stress complaints in client. The items were told orally to the client.

Interpretation
Based on the scoring the analysis for the client is given below;

 Depression

The client scored ‘3’ on depression items which indicate that it's in normal range
and no such depressive symptoms are present in client. In contrast to these results
were reported by the client on Beck depression inventory the client has no
depression.

 Stress

The client has scored ‘8’ on stress items which indicate that it is normal and no
such stress is present in client. The client is satisfied and has no stress.

 Anxiety

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The client scored ‘9’ on the Anxiety items which indicates that the client is having
mild anxiety which the client reported earlier that it is due to living in center and
being detached from outer world. Similar results were reported by the client on
Beck anxiety inventory too.

DAST
The following test was administer for the information about the client’s possible
involvement with drugs not including alcoholic beverages during the past 12
months.

Interpretation
The client has scored ‘9’ in DAST which indicates severe level degree of problem
related to drugs. In drug history the client also reported that he has taken several
drugs to seek pleasure on extreme level. So, the test shows that the client has taken
every drug in full form in during past 12 months.

Thematic Apperception Test (TAT)

The client were shown 2 TAT cards one by one for few minutes and told all the
instructions to write the story. Then Mr. Sufyan was given a blank paper to write
the story. Overall interpretation is given below:

Story 01
This is the army of Hitler of Germany. These people are helping Hitler. His army
was really small so he introduced ice, methamphetamine to keep his soldier awake
and these soldiers were fighting for three or four days and awaken by taking drugs.
Now they're tired and having rest. They had a good experience using those drugs.
They have found ultimate comfort after using these drugs. They will take these
drugs in future also.

Interpretation

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This story shows the client’s addiction toward these drugs and his urge to take
these drugs again. Although the client regrets doing drugs but he is still having
cravings for them. As he clearly mentioned the names of drugs in the story show
his attraction toward drugs as he used word “ultimate comfort” and “good
experience”.

Story 02
This is a graveyard probably of Christians and there are many graves in the
graveyard and this is a ghost walking with tied hands and zombie is looking toward
the grave. This is the scene of a scary movie. The ghost is looking like a helpless
person whose hands are tied. It seems that he is searching someone’s grave or
maybe he is punished by someone. The expression shows sadness and helplessness
on ghost’s face and he has no energy left. He is waiting for a miracle.

Interpretation

The story written by Mr. Sufyan portrays himself as he used the words ‘helpless’
and ‘punished’. As he was in rehab and is unable to take drugs his hands are tied so
he feels himself helpless. And he is being punished by his parents for taking drugs
and being admitted in rehab clinic, he considers this a punishment for him. He is
waiting for a miracle to happen that he will be free again.

Proposed Treatment
The client is categorized as a normal functioning person. As the client face issues
regarding stress and some intense anger and mood issues. The recommended
treatment is given below for these domains:

Long Term Goals

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 As the client reported intense anger issues so progressive muscle relaxation
exercise would be recommended. This involves slowly tensing and then relaxing
each muscle group in body at a time this will help in keeping the client calm and
patient.

 For mood - Aerobic exercise would be recommended. The client should take part
in different sports like basketball, tennis. These exercises basically increase the
endorphins and helps in stabilizing the mood and anger issues.

Short Term Goals

 The client should follow the breath focus technique in which the client has to take
long, slow and deep breaths that would gently disengage mind from the
distracting thoughts and sensations and will ultimately lower the stress level.

 The client should also practice the mindfulness meditation technique by sitting
comfortably focusing on breathing and bringing minds attention to the present.
This will help in lowering stress and pain level.

Conclusion
Based on the client's thorough history, the client can be classified as a socially and
functionally stable individual. Throughout the discussion, Mr. Sufyan exuded
confidence and was very open and cooperative. The client knew what he was
saying, and while his speech skills were strong, he lacked writing abilities. Low
levels of anxiety, despair, and stress can also be identified in the client. Apart from
modest rage and mood issues, the client had no such concerns in general. The
client was able to regulate his emotions, which indicates that he has good

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emotional control and if continued, it would be a positive element in the future.
The client was socially adaptable, as evidenced by his positive relationships with
his family, friends, and peers, which is a good predictor of future social stability.
The client's minor tension was owing to the scenario, as he desired to return home.
Apart from that, the client friends and gatherings can be considered one of the most
significant threats to the client's returning point back to smoking and ice drug use.
It will be extremely advantageous to the client if he maintains detached from them
and forms good friendships with people who share his values. Such an
environment will be extremely beneficial to the mental and social wellness of the
clients. Furthermore, the client would benefit from a healthy and fresh
environment. The client should devote the most of his time to his education, which
is also a good proposal. Furthermore, if the client takes up intriguing hobbies that
keep him occupied in his spare time, this will result in a significant improvement in
the future. The aforementioned recommendations will be beneficial to the client.
Mr. Sufyan was sorry for his previous actions now that he had a complete
understanding of drug addiction. According to the client He was responsible for the
harm he had caused himself. Mr. Sufyan was optimistic that he could improve and
feel better. He aspires to be a gentleman. He was certain that he would make a
difference in his life. He'd learned a lot while being away from home, and he'd like
to return. He aspires to return home and never return here, and he would never use
drugs to achieve this goal. His self-assured facial and body expressions revealed
his ability to alter.

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