Khansa Case Reports

INTERNSHIP CASE REPORTS
Session
2020-2024
Submitted by
Bibi Khansa
Roll No.
PSY-17
Department
Psychology
Submitted to
Dr. Rabia amjad
Department Of Psychology
Women University Mardan
1
Submitted by
Bibi Khansa
Roll No.
PSY-17
Approved by
Supervisor
Committee Members
Head Of Department
Department Of Psychology
Women University Mardan
2
Content
Case study -1………………….………………………Major depressive Disorder
Case study -2……………………………………….……… Generalized Anxiety Disorder
Case study -3………………………………...….…… ……… Conversion Disorder
Case study -4……………………….………...…….……… Major depressive Disorder
Case study -5……………………………………………….Generalized Anxiety Disorder
3
Submitted by
Bibi Khansa
Registration No.
2020/WUM/BS-PSY-17
BS 7th Psychology
2020-2024
Submitted to
Dr. Rabia Amjad
Signature
Internship committee members reviews
1.
Signature
2.
Signature
3.
Signature
4
Acknowledgments
I would like to express my gratitude and appreciation to each and every one who played an
important role in my academic accomplishments.
First of all, I am thankful to the almighty of ALLAH who is most merciful, grateful, and
powerful for the completion of my internship process.
Secondly and most specially I owe my greatest gratitude to my supervisor and most
honorable, diligent, most respected and responsible Dr. Rabia Amjad, who gave us warm
encouragement, knowledge and support and guided me with great patience.
Thirdly I would like to thank my institute that gave me the opportunity and platform for
exploring my abilities.
Last but not the least, Family and friends, who provided persistent advice and guidance
throughout the internship process, without their encouragement this internship was
incredibly complicated.
Thank you all for all the strong and encourage support.
5
CASE REPORT 01:
Major depressive disorder296.24
6
Demographics:
Name: ABC
Gender: Female
Age: 35
Birth Order: 4
Religion By Birth: Islam
Education: No
Siblings: 5
Mother Dead or Alive: Dead
Father Dead or Alive: Dead
Father Education: No
Mother Education: No
Father Occupation: Businessman
Marital Status: Married
Preferred By: Husband
Case Study Assigment Date: 22/11/23
7
Presenting Complaints:
It been four years but my headaches are not recovering. everytime my heart is very sad. I
don’t like to talk the people. my sleep pattern is disturbed. I want to kill myself or kill other
people. Because my headache intensity is very severe. in this condition I want to live in alone.
during interview she was mostly crying and her behavior was very aggressive.
Clinical Symptoms:
1. Severe Headache
2. Depressed mood
3. Loss of interest or pleasure
4. Severe aggression
5. Suicidal thoughts
6. Sleeping difficulty
Family History:
The client is the resident of Mardan. she was married female. She has a nuclear family
system. Her husband’s name is Saqib and she has 2 sons and 2 daughters. her son was a heart
patient. According to her husband before 4,5 years began my son heart problem so after that
condition of my wife was started, she taking severe stress in my son so after my son problem she
suffering from the problem of headache and severe aggression from 4 years. in this condition her
relationship was very bad with family members.
Personal History:
Client was very aggressive and introvert person. She wants to live in alone. she says my
heart is sad most of the time and I want to killed myself.
Behaviour Observation:
The client was in a simple dressing, she was very sad. and during interview she was
mostly crying and her behavior was very aggressive.
History Of Presenting Illness:
8
Premorbid Personality:
The client had clear change on personality changes after onset of symptoms. she
developed non-normative behavior his health went on weakening week to week, she lost weight.
Her relationship was bad with family members.
Onset Of Illness:
The problem arised after 4 years and the intensity of the symptoms were severe from past
2 weeks.
Informal Assessment:
During the time of questioning answering the client was crying and her behavior was so
aggressive.
Formal Assessment:
To assess the client for her mental dysfunctions BDI and HTP were administered.
BDI: (BECK DEPRESSION INVENTORY)
Interpretations:
Item O1: Sadness:
I Am Sad All the Time.
Item 04: Loss Of Pleasure:
I Can’t Get Any Pleasure from The Things I Used to Enjoy.
Item 06: Punishment Feelings:
I Feel I Am Being Punished.
Item 07: Self Dislike:
I Am Disappointed in Myself.
Item 09: Suicidal Thoughts or Wishes:
9
I Would Kill Myself If I Had the Chance.
Item 10: Crying:
I Feel Like Crying but I Can’t.
Item 17: Irritability: I Am Irritable All the Time.
These responses show that the client is sad and irritated all of the time. The client is fed up all the
people around her and lost complete interest in the people around her. As reported by her
husband she doesn’t even take care of herself.
The client total score 48 on BDI. this suggest that the client is suffering from severe depression.
HTP (HOUSE TREE PERSON):
Along BDI HTP was also administered on the subject and following interpretation.
House
The subject draw details material of the house which shows overwhelmed personality.
The house with heavy lines on roof which indicates tendency of regression and dependency.
Shading represents anxiety and depression. Door is drawn to express a strong need to receive
warmth from without.
Tree
The tree with small trunk indicates the limited ego. Small branches which represent
limited skills and inferiority complex of the subject. The tree has no roots show the client is
insecure.
Person
The subject draws the head of a person which represent the area of intelligence and
empathy. Clear head indicate feeling of anxiety. Small feet indicate inadequate base need of
security. Closed tight mouth indicates denial of needs or some passive aggression. Narrow neck
show depression. Arms closed to the body show tension. long fingers show regression. Shoe
shows insecurity.
10
Case Formulation:
The ABC was the married women. she was 35-year-old. She belongs to a middle-class
family. She was born in resident Mardan. She has a nuclear family system. Her husband’s name
is Saqib and she has 2 sons and 2 daughters. Her husband was a farmer. Only husband in the
family was the earner. She says that it been four years but my headaches are not recovering. She
was very sad during interview client mostly crying and her behavior was very aggressive. She
says most of the time I want to killed myself or killed other people. Because my headache was
very severe in this condition I want to live in alone. History of the problem is that ‘’her son was a
heart patient. According to her husband before 4,5 years began my son heart problem so after
that condition of my wife was started, she taking severe stress in my son so after my son problem
she suffering from the problem of headache and severe aggression from 4 years. ‘’ after that I
apply the BDI and HTP test over the client from which I find the conclusion because the score
obtain from the BDI is 48 which fall in the category of severe depression.
Differential diagnosis:
1. Post-traumatic Stress Disorder (PTSD).
2. Acute Stress Disorder (ASD).
3. Bipolar Disorder.
4. Personality Disorders.
Tentative Diagnosis:
296.24 MAJOR DEPRESSIVE DISORDERS.
Therapeutic Recommendation:
11
Cbt:( cognitive behaviour thearapy)
CBT is a type of psychotherapy that helps individuals identify and change negative
thought patterns and behaviors. CBT is useful for clients having disrupted cognitive functioning
and mal- behavioral disorders.
Gradual Exposure:
Gradual exposure to anxiety-provoking situations, guided by a therapist, can help
individuals build tolerance and reduce avoidance behaviors.
Prognosis:
The client prognosis will be more favorable if the therapy is continued for long time until
the symptoms become much lesser.
Timely Intervention:
Seeking help early and receiving timely intervention increases the likelihood of
positive outcomes. Early identification and treatment can prevent the worsening of
symptoms.
Individual Response to Treatment:
Responses to therapy, whether through psychotherapy, medication, or a combination
of both, can vary. Some individuals may experience significant relief from symptoms,
12
while others may require ongoing support.
Personal Insight and Awareness:
Developing insight into one's thought patterns and increasing awareness of triggers
can empower individuals to manage anxiety more effectively.
Continued Monitoring:
Regular check-ins Contribute to client positive health outcomes.
13
REFERENCES
Diagnosis and statistical manual of mental disorders, (2013). Washington, D,C: American
Psychiatric Association.
Clark, D.A. (2018). Conginitive Therapy of Anxiety. In R.L. Leahy (Ed), Science and practice in
Cognitive therapy: foundations, mechanisims, and applications (pp. 317-334).
Abela, J. R. Z., & D’Allesandro, D . U. (2002). Beck’s cognitive theory of depression: The
diathesis- stress and casual mediation components. British Journal of clinical psychology, 41,
111-128
14
CASE REPORT 02:
Generalized Anxiety disorder 300.02(F41.1)
15
Demographics:
Name: XYZ
Gender: Female
Age: 19
Birth Order: 4
Education: Matric
Siblings: 4
Mother Dead or Alive: Alive
Father Occupation: Farmer
Marital Status: Single
Preferred By: Mother
16
It Been two years but my headaches are not recovering. and sometime the vomiting was
also occurred. I am scared in every time. When I feel the headache my heart racing starting and I
felt difficulty of breathing.
Clinical Symptoms:
1. Headache
2. Heart pounding
3. Muscle stretches
4. Difficulty of breathing
Family History:
The client XYZ is from Mardan. She was 19-year-old. She is a single girl. and her
qualification is matric. Her father’s name is Mumtaz and mother name is Gulnar. She was one
brother and three female sisters. Her birth order number is four. A nuclear family system. Her
father and brother were dead in two years ago. The two sister was married and now just mother
and client XYZ are live in the home.
Personal History:
The client belonged in a middle-class family. The client lives in Mardan with her mother.
She was very closed to her mother. she says I am scared. she felt severe headache.
Behavioral Observation:
The client was in a simple dressing. She was looking shy, and she was nervous during
session.
The client says my problem starting was 2 years ago. Because 2 years ago my brother
was dead. After 2 week my father was dead. The client mentioned that he is never happy in their
environment. she says I am scared in every time. and during the headache my heart racing
17
starting and I felt difficulty of breathing. she says Only Her mother is live with XYZ in their
home.
Client has good relationship with their mother. Her academic performance went very low.
Onset Of Illness:
The problem arised after 2 years and the intensity of headache were severe from past
week.
During the time of questioning and answering the client was nervous and she was looking
shy,
Formal Assessment:
To assess the client for her mental dysfunctions BAI and HTP were administered.
BAI: (BECK ANXIETY INVENTORY)
Interpretations:
Item 01: ‘’Numbness or tingling”
This suggest that the client has a severe rate of anxiety.
Item 04: “Unable to Relax”
This was noticed during the interview that the client couldn’t stop worrying about stuff.
Item 06: ‘’Dizzy’’
Item 07: “Heart Pounding”
This suggest that the client had an unhealthy physical state and followed Somatic symptoms as
well.
Item 09: “Terrified and Afraid”
18
The client was suffering from negative thoughts about the future that terrified him.
Item 10: “nervous”
The client has developed an unrealistic outcome of her situation and couldn’t think of the
reality.
Item 15: ‘’difficulty of breathing”
Item 17: “scared”
Item 18: “indigestion”
The client is physically suffering her nutritional needs are not welcoming her health.
Item 21: “Cold/Hot sweats”
The client is suffering from severe parasympathetic dysregulations.
HTP :(HOUSE TREE PERSON)
HTP was administered on the subject;
House:
lines and walls represent the strength of ego extra attention to roof interprets the extra
attention to fantasy ideation, open door shows lured one. Doors to see into the house so they
related to the openness.
Tree:
trunk shows egoistic characteristics, heavy lines or shading indicates anxiety. Leaves on
the tree shows that the effort to reach out a successful life. The tree has no roots to indicate the
client is insecure.
Person:
Client draws a small person that suggest that a person has a low self-esteem. Small head
indicate feeling of anxiety or inferiority relatives to body functions.
19
Case Formulation:
The client XYZ is from Mardan. She was 19-year-old. She was a single girl. and her
qualification is matric. She was one brother and three female sisters. Her father and brother were
dead in two years ago. The two sister was married and now just mother and client XYZ are live
in the home. She says that it been 2 years but my headaches are not recovering. and sometime
vomiting also occurs. The client says my problem starting was 2 years ago. Because 2 years ago
my brother was dead. After 2 week my father was dead. The client mentioned that he is never
happy in their environment. she says I am scared in every time. and during the headache my
heart racing starting and I felt difficulty of breathing. she says Only Her mother is live with XYZ
in their home.After that I apply the (BAI) and (HTP) test over the client from which I find the
conclusion because the scores obtain from (BAI) is 37 which fall in the category of severe
anxiety.
Differential diagnosis of persistent depressive disorder includes ruling out
medical/organic causes as well as screening for other DSM diagnosis,including:
➢ Major depression.
➢ Bipolar psychotic disorder.
➢ Substance-induced states.
➢ Adjustment disorders.
300.02(F41.1) ,Generalized Anxiety disorder.

20
CBT:(COGNITIVE BEHAVIORAL THERAPY)
Major techniques useful for the client:
1. Cognitive restructuring and re-framing.
2. Guided discovery.
3. Activity scheduling and behaviour recording.
4. Behavioral experiments.
5. Relaxation and stress reduction techniques.
6. Successive approximation techniques.
Prognosis:
1. Timely Intervention: Recognizing and addressing symptoms early on improves outcomes.

Seeking professional help promptly enhances effective management.
2. Treatment Compliance: Consistent adherence to treatment, be in therapy, medication, or a

combination, is vital for managing the disorder effectively.
3. Individual Response to Treatment: Individuals respond differently to treatments; finding the

most effective approach may involve trial and adjustments to the plan.
21
4. Social Support: A strong support system, comprising friends, family, or support groups, can
significantly influence the prognosis by aiding in the effective management of anxiety symptoms.
5. Coping Skills: Creating and using effective coping strategies for stress and anxiety is crucial.
Cognitive-behavioral therapy (CBT) teaches skills to manage and alter negative thought patterns.
22
REFERENCES
111-128
23
CASE REPORT 03:
MAJOR DEPRESSIVE DISORDER 296.24 (F43.8)
24
Demographics:
Name: ABC
Gender: Female
Age: 35
Birth Order: 4
Education: No
Siblings: 7
Mother Dead or Alive: Alive
Mother Education: no
Father Occupation: Driver
Preferred By: Mother
25
I am very upset in my life. I am every time anger and most of the time disturb. I lot of
headache problem. I felt severe headache. in this condition my mood was off every time. It’s
hard to get interested in anything.
Clinical Symptoms:
1. Headache.
2. Depressed mood.
3. Guilty feeling.
4. Fatigue.
Family History:
The client ABC is from Mardan. She belonged a middle-class family. She was 35-year-
old. She is a married female. She had two brother and five female sisters. Her birth order number
is four.
Personal History:
The ABC is the married women. She belongs to a middle-class family. She has a nuclear
family system. Her husband’s name is Naeem Jan and she has 1 son and 2 daughters. Her
husband is a farmer. Only husband in the family was the earner. She is very sad. she says MY
Husband is a bad nature person. she says His nature is very aggressive. I feel fear to his
aggression. The client mentioned that he is never happy with her Husband Because he is
providing tension. Client says when my husband comes her home my headache is starting.
The client was in a simple dressing, she answered very properly. She appeared to be
depressed and upset all the time during session. Rapport was easily built and maintain
throughout the sessions.
26
The client relationship with her husband was very bad. She takes stress about her
husband daily regression.
Onset Of Illness:
The problem arised after 2 years and the intensity of symptoms were severe from past
TWO week.
The rapport build with client is not difficult. Client was cooperative and motivated for a
session.
Formal Assessment:
Human figure drawing HFD, and BDI were administered on the client in order to make
evaluation about her symptoms.
Interpretations:
Item o1: Sadness:
I am sad all the time.
I Can’t Get Any Pleasure from The Things I Used To Enjoy.
Item 05: Guilty Feelings:
I Feel Quite Guilty Most of The Time.
Item 08: Self Criticalness:
I Criticize Myself for All of My Faults.
Item 10: Crying:
I Cry Over Every Little Thing.
27
Item 17: Irritability:
I Am Much More Irritable Than Usual. These Responses Show That the Client Is Sad
and Irritated All of The Time. The Client Is Fed Up All the People Around Her and Lost
Complete Interest in The People Around Her. The Client Total Score 30 On Bdi. This
Suggest That the Client Is Suffering from Severe Depression.
(HFD) HUMAN FIGURE DRWANIG TEST:
Hair was given much attention which showed narcissism, characteristics, head was
clearly indicated showing feelings of anxiety, full face view indicates social dependency and
social communication. Tiney eyes indicate strong visual curiosity. Long lashes show
seductiveness. Single lines show passive aggression. nose strong showed masculine assertions,
concave mouth showed dependency, narrow neck show depression. long legs show need for
autonomy.
Case Formulation:
THE client is from Mardan. The client was the married women. She belongs to a middle-
class family. She has a nuclear family system. Her husband’s name is Naeem Jan and she has 1
son and 2 daughters. Her husband is a farmer. Only husband in the family was the earner. She is
very sad. she says MY Husband is a bad nature person. she says His nature is very aggressive. I
am very scared to his aggression. The client mentioned that he is never happy with her Husband
Because he is providing tension. Client says when my husband comes her home my headache is
starting. The client relationship with her husband was very bad. She takes stress about her
husband daily regression. she says I am very upset in my life. and I am every time anger and
most of the time disturb. She says I felt severe headache. in this condition my mood is off every
time. It’s hard to get interested in anything. After that I apply the (BDI) and (HFD) test over the
client from which I find the conclusion because the scores obtain from (BDI) is 30 which fall in
the category of severe depression.
1. Post-traumatic Stress Disorder (PTSD).
28
2. Acute Stress Disorder (ASD).
3. Bipolar Disorder.
4. Personality Disorders.
296.24 (F43.8) MAJOR DEPRESSIVE DISORDERS.
CBT:(COGNITIVE BEHAVIORAL THERAPY)
Gradual Exposure:
Gradual exposure to anxiety-provoking situations, guided by a therapist, can help
individuals build tolerance and reduce avoidance behaviors.
Prognosis:
The client prognosis will be more favorable if the therapy is continued for long time until the
symptoms become much lesser.
1. Early interventions
2. Effective treatment
3. Peacefull environment
29
symptoms.
30
REFERENCES
111-128
31
CASE REPORT O4:
CONVERSION DISORDER F44.5
32
Demographics:
Name: XYZ
Gender: Female
Age: 38
Birth Order: 1st
Education: no
Siblings: 5
Father Education: 6 Class
Preferred By: Son
33
When I get a headache or I have these seizures, I don’t know what I’m doing, but my
family is telling me that when you have these seizures, you do these things. But during these
things I don’t have any awareness that what I’m actually doing. They also saying that I kept
talking to someone, they claimed that it’s a spirit that I’m talking to all the time when I had this
situation.
Clinical Symptoms:
1. Psychogenic non epileptic seizures

2. Weakness or paralysis
3. Abnormal movements
4. Headache
Family History:
The client XYZ is from Mardan. She belonged a middle-class family. She was 38-year-
old. She is a married female. Her father and mother were dead. She had two brother and three
female sisters. Her birth order number is 1st.
Personal History:
The client XYZ is a married woman. She belongs to a middle-class family. She has a
nuclear family system. Her husband was dead in recently. she says the husband death was the
most stressful or traumatic event. and she has 4 son and 1 daughter. She says after her husband
death her family is alone in their home.
The client was in simple dressing. Client seems to be very introvert person. She appeared
to be depressed and upset all the time during session. The rapport was not easily built. During the
first session she was silent but in the second and third session she answered all the question
properly.
History Of Present Illness:
34
The client had clear change on personality changes after onset of symptoms. she
developed non-normative behavior his health went on weakening week to week, she lost weight.
Her relationship is GOOD with children’s.
Onset Of Illness:
The problems arised after her husband death. Because she is thinking that all burden will
be on me. the intensity of symptoms was severe from past 6 months.
The rapport build with client was difficult. but after develop rapport building Client
shared all her thoughts clearly about her major problem.
Formal Assessment:
Human figure drawing HFD, and BDI were administered on the client in order to make
evaluation about her symptoms.
Interpretations:
Item O1: Sadness:
I Am Sad All the Time.
Item 03: Failure:
I Feel I Am a Total Failure as A Person.
35
I Can’t Get Any Pleasure from The Things I Used to Enjoy.
Item 05: Guilty Feelings:
I Feel Quite Guilty Most of The Time.
Item 08: Self Criticalness:
I Criticize Myself for All of My Faults.
Item 10: Crying:
I Cry Over Every Little Thing.
Item 17: Irritability:
I am much more irritable than usual. These responses show that the client is sad and irritated all
of the time. The client is fed up all the people around her and lost complete interest in the people
around her. The client total score 32 on BDI.
HFD (HUMAB FIGURE DRAWING) TEST.
The HFD was administered on the subject to evaluate her problem. In the figure subject
drawn hairs spares unpressed hair which show tendency inadequate virility. Large head show
tendency of paranoid+ Fantasy preoccupied. Eye a dot with pressure shows tendency of paranoid.
Trim eye brow shows disdain. Large nose show tendency of involutional patients. Single line
mouth show tendency of passive aggressive. Arms long week shows tendency of dependency.
Spear fingers show paranoid. Long legs show need for autonomy.
Case Formulation:
The client XYZ is a married woman. She is from Mardan. She was 38-year-old. Her birth
order number is first. She belongs to a middle-class family. She has a nuclear family system. Her
husband was dead in recently. she says the husband death was the most stressful or traumatic
event. and she has 4 son and 1 daughter. She says after her husband death her family is alone in
their home. The problems arised after her husband death. Because she is thinking that all burden
will be on me. the intensity of symptoms was severe from past 6 months. She says When I get a
36
headache or I have these seizures, I don’t know what I’m doing, but my family is telling me that
when you have these seizures, you do these things. But during these things I don’t have any
awareness that what I’m actually doing. They also saying that I am kept talking to someone, they
claimed that it’s a spirit that I’m talking to all the time when I had this situation. After that I
apply the (BDI) and (HFD) test over the client from which I find the conclusion because the
scores obtain from (BDI) is 32 which fall in the category of severe depression. According to her
son some time my mother body movements was not normal movements. Her hands were not
working. So, the client severe depression is converting body parts.
 Epilepsy
 Movement Disorders
 Multiple Sclerosis (MS)
 Somatization Disorder
 Factitious Disorder
 Malingering
F44.5 CONVERSION DISORDER.
Cbt:(cognitive behavioral therapy)
37
Medical Evaluation:
Conduct a thorough medical evaluation to rule out any underlying medical conditions that may
be contributing to the symptoms.
Collaborative Care:
Establish a collaborative care team, including neurologists, psychiatrists, psychologists, and

other healthcare professionals, to address both medical and psychological aspects of the disorder.
Psychoeducation:
Provide psychoeducation to the individual and their family about conversion disorder, its nature,
and the role of psychological factors in the development of symptoms.
Individual Psychotherapy:
Engage the individual in psychotherapy, with a focus on evidence-based approaches such as

cognitive-behavioral therapy (CBT) or psychodynamic therapy.
Addressing Underlying Stressors:
Explore and address underlying stressors, trauma, or psychosocial factors that may be
contributing to the symptoms.
Prognosis:
1. Early interventions
2. Effective treatment
3. Peacefull environment
Early Intervention: Timely recognition and appropriate intervention, including psychotherapy

and support, can positively impact the prognosis.
38
Treatment Adherence: Engaging in and adhering to treatment recommendations, including
psychotherapy and other therapeutic interventions, can contribute to a better prognosis.
Psychosocial Factors: The presence of supportive social networks, understanding family

members, and a stable psychosocial environment can positively influence the prognosis.
Underlying Stressors: Identifying and addressing underlying stressors or traumatic experiences

that may have contributed to the development of conversion disorder is crucial for long-term
39
REFERENCES
111-128
40
CASE REPORT O5:
Generalized Anxiety disorder 300.02(F41.1)
41
Demographics:
Name: ABC
Gender: Female
Age: 45
Birth Order: 4
Education: no
Siblings: 6
Preferred By: Husband
42
From next 6 months when there is some one around me or some talk to me so the head
pain begins to start and after that medicine can’t over come the pain. My heart become restless
and breathing difficulty are also here and every time I am worried about my son’s future.
Clinical Symptoms:
1. Headache.
2. Difficulty breathing.
3. Heart pounding.
4. WORRY about son future.
Family History:
The client ABC is from Mardan. She was 45-year-old. Her father and mother were dead.
She had three brother and three female sisters. Her birth order number is four.
Personal History:
The client belonged to a middle-class family from Mardan. She was a married woman.
She was 45 years old. She lived with husband and 5 children’s. she has a nuclear family system.
She says before 1 year my son Do an accident and he lost his one hand and one foot in their
accident. But he has a live white this abnormality. So that’s why I’m very tense. She says Every
time I’m worried about my son future. She says it’s been 5 to 6 months but my headache is not
recovering not even with medicines, with that I have breathing difficulty.
The client was in a simple dressing. She was nervous during the session. But She
answered very properly. She was comfortable being interviewed.
Client has good relationship with their family. She takes fear about his son illness.
43
Onset Of Illness:
The problem arised after 6 months. And the intensity of symptoms was severe from past 2
weeks.
Informal Assessments:
During the time of questioning answering the client was relaxed in the environment. She
was sitting straight and trying to avoid looking ill and unhealthy. The rapport built with client
was not difficult.
Formal Assessment:
(BAI) AND (HTP) were administered on the client in order to make evaluation about her
symptoms.
BAI: (BECK ANXIETY INVENTORY)
Interpretations:
Item 04: “Unable to Relax”
This was noticed during the interview that the client couldn’t stop worrying about stuff.
Item 06: ‘’Dizzy’’
Item 07: “Heart Pounding”
This suggest that the client had an unhealthy physical state and followed Somatic symptoms as
well.
Item 09: “Terrified and Afraid”
The client was suffering from negative thoughts about the future that terrified him.
Item 10: “nervous”
The client has developed an unrealistic outcome of her situation and couldn’t think of the reality.
Item 15: ‘’difficulty of breathing”
44
The client is physically suffering her nutritional needs are not welcoming her health.
Item 21: “Cold/Hot sweats”
The client is suffering from severe parasympathetic dysregulations.
HTP :(HOUSE TREE PERSON)
HTP was administered on the subject;
House:
lines and walls represent the strength of ego extra attention to roof interprets the extra
attention to fantasy ideation, open door shows lured one. Doors to see into the house so they
related to the openness. Small windows indicate withdrawal. Draw the pathway of the house
shows that the subject is very friendly.
Tree:
trunk shows egoistic characteristics, heavy lines or shading indicates anxiety. Leaves on
the tree shows that the effort to reach out a successful life. The tree has no roots to indicate the
client is insecure. Shading strong lines indicate anxiety.
Person:
Client draws a small person that suggest that a person has a low self-esteem. Small head
indicate feeling of anxiety or inferiority relatives to body functions. Circle eye with no pupil
shows immaturity. Large nose show tendency of involutional patients. Single line mouth show
tendency of passive aggressive. Arms long week shows tendency of dependency. Spear fingers
show paranoid. Long legs show need for autonomy.
Case Formulation:
The client belonged to a middle-class family from Mardan. She was a married woman.
She was 45 years old. She lived with husband and 5 children’s. she has a nuclear family system.
She says before 1 year my son Do an accident and he lost his one hand and one foot in their
accident. But he has a live white this abnormality. So that’s why I’m very tense. She says Every
time I’m worried about my son future. She says it’s been 5 to 6 months but my headache is not
45
recovering not even with medicines, with that I have breathing difficulty. She says when there is
someone around me or some talk to me so the head pain begins to start and after that medicine
can’t overcome the pain. My heart becomes restless.
After that I apply the (BAI) and (HTP) test over the client from which I find the conclusion
because the scores obtain from (BAI) is 32 which fall in the category of severe anxiety.
Differential diagnosis of persistent depressive disorder includes ruling out
medical/organic causes as well as screening for other DSM diagnosis,including:
➢ Major depression.
➢ Bipolar psychotic disorder.
➢ Substance-induced states.
➢ Adjustment disorders.
300.02(F41.1)generalized Anxiety disorder.
CBT:(cognitive behavioral therapy)
Major techniques useful for the client:
7. Cognitive restructuring and re-framing.
8. Guided discovery.
9. Activity scheduling and behaviour recording.
46
10. Behavioral experiments.
11. Relaxation and stress reduction techniques.
12. Successive approximation techniques.
Prognosis:
The client prognosis will be more favorable if the therapy is continued for long time until the
symptoms become much lesser.
symptoms.
Personal Insight and Awareness:
Developing insight into one's thought patterns and increasing awareness of triggers
can empower individuals to manage anxiety more effectively.
Continued Monitoring:
47
Regular check-ins Contribute to client positive health outcomes.
48
49
REFERENCES
111-128
50

Khansa Case Reports

Uploaded by

Document Information

Original Description:

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

Khansa Case Reports

Uploaded by

Copyright:

Available Formats

INTERNSHIP CASE REPORTS

Internship committee members reviews

Major depressive disorder296.24

Religion By Birth: Islam

Mother Dead or Alive: Dead

Father Dead or Alive: Dead

Father Occupation: Businessman

Marital Status: Married

Preferred By: Husband

Case Study Assigment Date: 22/11/23

History Of Presenting Illness:

BDI: (BECK DEPRESSION INVENTORY)

Item O1: Sadness:

I Am Sad All the Time.

Item 04: Loss Of Pleasure:

I Can’t Get Any Pleasure from The Things I Used to Enjoy.

Item 06: Punishment Feelings:

I Feel I Am Being Punished.

Item 07: Self Dislike:

Item 09: Suicidal Thoughts or Wishes:

Item 10: Crying:

I Feel Like Crying but I Can’t.

Item 17: Irritability: I Am Irritable All the Time.

HTP (HOUSE TREE PERSON):

1. Post-traumatic Stress Disorder (PTSD).

2. Acute Stress Disorder (ASD).

296.24 MAJOR DEPRESSIVE DISORDERS.

Gradual exposure to anxiety-provoking situations, guided by a therapist, can help

individuals build tolerance and reduce avoidance behaviors.

Individual Response to Treatment:

Responses to therapy, whether through psychotherapy, medication, or a combination

Personal Insight and Awareness:

can empower individuals to manage anxiety more effectively.

Regular check-ins Contribute to client positive health outcomes.

Generalized Anxiety disorder 300.02(F41.1)

Religion By Birth: Islam

Mother Dead or Alive: Alive

Father Dead or Alive: Dead

Father Occupation: Farmer

Marital Status: Single

Preferred By: Mother

Case Study Assigment Date: 28/11/23

History Of Presenting Illness:

BAI: (BECK ANXIETY INVENTORY)

Item 01: ‘’Numbness or tingling”

This suggest that the client has a severe rate of anxiety.

Item 04: “Unable to Relax”

Item 06: ‘’Dizzy’’

Item 07: “Heart Pounding”

Item 09: “Terrified and Afraid”

Item 10: “nervous”

Item 15: ‘’difficulty of breathing”

Item 17: “scared”

Item 18: “indigestion”

Item 21: “Cold/Hot sweats”

The client is suffering from severe parasympathetic dysregulations.

HTP :(HOUSE TREE PERSON)

HTP was administered on the subject;

Differential diagnosis of persistent depressive disorder includes ruling out

medical/organic causes as well as screening for other DSM diagnosis,including:

➢ Bipolar psychotic disorder.

300.02(F41.1) ,Generalized Anxiety disorder.

Major techniques useful for the client: