POST-GRADUATE DEPARTMENT OF PSYCHOLOGY

UNIVERSITY OF JAMMU

INTERNSHIP FILE OF M.A PSYCHOLOGY

Name: Anjali Parihar

Semester: 4th
Session: 2024
Batch: February
CASE 1

CASE HISTORY

Socio demographic profile

• Name: Ms. P
• Age: 13
• Marital Status: Unmarried
• Gender: Female
• Education: Secondary schooling
• Occupation: Student
• Socio Economic Status: Middle
• Domicile: Semi urban
• District: Jammu
• State: J&K

Informant
• Relationship of the informant to the patient: Mother
• Intimacy: Strong relationship
• Length of acquaintance with the patient: Lifetime
• Consistency of the Information: Reliable
• Adequacy of the information: adequate

Chief complaints
The client has been experiencing a range of concerning symptoms over the past year.
She has been consistently irritable, demonstrating mood disturbances for an extended
period. Additionally, impulsivity has become a part of her behavior over the same
timeframe. She been facing conflicts both with their parents and peers for about half a
year, indicating possible interpersonal difficulties. Physical symptoms such as frequent
headaches and back pain, lasting several months, suggest potential underlying health
issues or stressors. Moreover, she has noticed an increase in appetite, which could be
linked to either physiological changes or emotional distress. Overall, these symptoms
collectively paint a picture of a client dealing with both emotional and physical
challenges that warrant attention and support.

History of Present Illness

• Onset: Acute
• Precipitating Factors: Starting of the menstrual cycle and body aches
• Course of the Illness: Episodic

Over the past year, the client has experienced a range of concerning symptoms. Irritability
has been a prominent feature, persisting for the duration of the year. This could suggest
underlying emotional dysregulation or mood disturbance. The presence of impulsivity
alongside irritability may indicate difficulties in emotional control and decision-making
 processes, which could significantly impact daily functioning and interpersonal
relationships.

The client has also reported conflicts with both parents and peers over the past six to seven
months. These disagreements may further exacerbate the client's emotional distress and
contribute to feelings of frustration or isolation. Living in a semi-urban area may add
additional stressors, such as social pressures or limited access to resources, which could
potentially exacerbate these conflicts.

Physical symptoms, including frequent headaches and back pain, have been present for
five to seven months. These somatic complaints may be manifestations of underlying
psychological distress or could exacerbate existing emotional symptoms, creating a cycle
of physical and emotional discomfort. The increase in appetite is another noteworthy
symptom, potentially indicating changes in eating patterns or coping mechanisms in
response to stress or emotional turmoil.

The onset of symptoms appears to have been acute, coinciding with the commencement
of the menstrual cycle and the onset of body aches. This suggests a potential hormonal
or physiological trigger. The client's symptoms have followed an episodic course,
indicating periods of exacerbation and remission.

It's important to note the client's familial context, including the presence of two younger
siblings aged six and nine. Living with younger siblings could contribute to increased
responsibilities and stressors within the household, potentially impacting the client's
emotional well-being and ability to cope with their symptoms effectively.

Overall, the history of the present illness highlights a complex interplay of emotional,
physical, and environmental factors contributing to the client's current presentation.

Negative history
No history of trauma, fever, vomiting, disorientation, memory, diabetes, hypertension,
substance abuse etc.

Family history
A. Father
• Education: Sr Secondary
 • Occupation: Central Govt Employee
• History of illness: N/A

B. Mother
• Education: Sr Secondary
• Occupation: Housewife
• History of present illness: N/A

Personal history
1. Birth & Early development:
• Full term delivery
• Hospital birth
• No complications during delivery
• Jaundice in post-natal period
• Mile stones were normal

2. Behavior during Childhood

• Sleep Disturbances: N/A

• Conduct Disturbances: N/A
• Truancy and gang activities: N/A
• Relationship with parents, siblings and peers: Very close relationship
• Thumb sucking: N/A
• Nail Biting: N/A
• Temper Tantrums: For a short frequency after the birth of younger sibling
• Bedwetting: N/A
• Stammering: N/A

3.Physical Illness During Childhood

• Jaundice

4.School:
• Age of beginning and finishing school: 4 years- ongoing
• Type of school attended: Central govt school; CBSE
• Scholastic Performance: Very good
• Attitude towards peers and teachers: Very respectful and sociable
• Competence and future Ambitions: Wants to start a successful business

5.occupation
• Age of starting work: N/A
• Jobs held: N/A
• Work Satisfaction; N/A
6.Menstrual History:
• Age of Menarche: 12.5 years
• Reaction to Menarche: Confusion and frustration
 •Regularity of Periods: Irregular
•Dysmenorrhea: Fatigue and nausea
•Menorrhagia: Present in the starting few cycles
•Oligomenorrhoea: N/A
•Emotional Disturbances in relation to Menstrual Cycle: Irritable mood along with
anger, frustration which sometimes results into crying and verbal spats with other
family members.
7.Sexual history

• Has knowledge about sex from school and other family members; no masturbatory
practices or engagement in any sexual activity with a partner

8.Marital history
• Unmarried

9.Use and abuse of alcohol, tobacco and drugs: N/A

Premorbid Personality
1. Attitudes to others in social, family and sexual relationships

The client exhibits a secure and confident demeanor in their social, family, and sexual
relationships. They possess a natural inclination to trust others and actively engage in
sustaining these relationships. With a leadership orientation, they take on responsibilities
willingly and have a strong capacity for decision-making. Their dominant personality trait is
balanced by a friendly demeanor, devoid of jealousy or guardedness. Additionally, they
demonstrate no difficulty in role-taking across various domains such as gender, sexuality,
family, parenthood, or work, indicating a versatile and adaptable nature.

2. Attitude to self:
The client demonstrates a generally positive attitude towards themselves, as evidenced by their
satisfaction with their work. While they harbor mild concerns regarding their health and bodily
functions, their overall attitude remains constructive, indicating a capacity for introspection
and proactive engagement with their well-being. Moreover, the client maintains a positive
outlook on past achievements and failures, viewing them as opportunities for growth rather
than setbacks.

3.Moral and religious attitudes and standards:

The client exhibits a complex set of moral and religious attitudes and standards. They
demonstrate rigidity in their beliefs, adhering firmly to their moral principles and values.
However, this rigidity is accompanied by an over-conscientiousness, suggesting a heightened
sense of responsibility and accountability in their moral conduct. Despite this
conscientiousness, the client also displays tendencies towards rebellion, indicating a
willingness to challenge societal norms or established authority when it conflicts with their
personal convictions. Their religious beliefs are characterized by a deep and unwavering
commitment, reflecting a strong connection to spiritual values and practices.

4.Mood:
The client's emotional landscape is characterized by a mix of mood swings, encompassing
feelings of anxiety, irritability, worry, and tension. These fluctuations may contribute to a
varied demeanor, oscillating between moments of warmth and gloominess depending on the
circumstances. While the client experiences a range of emotions, they sometimes struggle to
express these feelings effectively, particularly when it comes to anger, anxiety, or sadness.

5.Leisure Activities and Interests:

The client's leisure activities and interests span a diverse range, reflecting a rich and varied
engagement with life. They derive enjoyment and fulfillment from activities such as reading,
music, prayer, learning religious hymns, painting, and dancing. Their creativity shines through
in their pursuits, with a propensity for imaginative expression and innovation evident in their
engagement with various art forms. Despite the depth of their interests, the client maintains a
social circle comprising approximately 5-6 friends, indicating a balanced lifestyle that values
both solitary pursuits and social connections

6. Fantasy Life:
• Amount of time spent in day dreaming: Around 30-40 mins

7.Reaction Pattern to Stress

The client's reaction pattern to stress appears generally resilient, with an intact ability to tolerate
frustrations, losses, disappointments, and circumstances that may evoke anger, anxiety, or
depression for the majority of the time. There is an indication of a specific defense mechanism
being utilized, namely rationalization, which may suggest a tendency to intellectually justify
or explain away difficult emotions or situations as a means of managing stress.

8.Habits:
• Eating, sleeping and excretory functions: Increased appetite

SESSION I

Objective: rapport building and History Taking

The client is a 13-year-old individual, who has a history of Irritable mood and
impulsivity from past 1 year and disagreement with parents and peers from past 6-7
months. The client was in a happy mood when called for counselling session. The client
was made to sit comfortably and the counselling session began with building the rapport
and then asking about the client’s history.
 Sample Of Talk

• How are you feeling today?

I am feeling good today.
• Would you like to tell us about your interests?
Yes, sure. I like to read books. I also like to paint and dance. I have participated in
various painting and dance competitions in my school also. I also like to meditate and
learn religious hymns and stories.
• Could you describe about your relationship with your family members?
I feel like these days my mother does not pay any attention to me. All she wants is to
pamper my younger siblings…..etc.,etc.,
• Can you tell me more about how you feel you mother does not pay any attention to
you?
She never talks to me. All she ever wants to do is talk to my younger siblings
spending time with them. She has even stopped checking my homework for school
daily…... etc. etc.

SESSION II

Objective: Progress and Exploration

It was established in the first session that the client has a case of impulsive behaviour,
irritability and disagreements with parents and peers, which coincided with the onset of
puberty. Since the first session, the client has become less irritable and gotten comfortable with
parents and peers.
In this session, we went over the story of client again found that most of the issues of the client
coincided with the onset of puberty. The onset of puberty has caused the client to stress, which
has led her to have irritable mood and temper. The client feels lack of affection and attention
from the parents which is causing the client to last out and have disagreements and verbal spats
with the parents.
The client was told to have open hearted conversations with their parents and peers and also
try to journal daily about the feelings experienced in a day. The client was also asked to try
indulging into various hobbies.

SESSION III

Objective: Progress and Continued support

In second session, we had already established that the undesirable behaviour of the client was
an unhealthy way of coping with the various changes they were going through the adolescence
period. Parental counselling was also done in this session.
In this session the mother of the client was also made aware of the ongoing situation. The
mother was advised to engage in open dialogue with her daughter. The mother was also
encouraged to spend one on one time with the client to help with feelings of lack of attention
and affection the client has been feeling.
The client seemed more happier about the fact that her mother was ready to engage in one-on-
one time with the client. Along with the previous advice of engaging in hobbies and journalling,
the client seems to be on a progressive path.
CASE HISTORY 2

Socio demographic profile

• Name: Mr. R
• Age: 17
• Marital Status: Unmarried
• Gender: Male
• Education: High school
• Occupation: Student
• Socio Economic Status: Lower-middle class
• Domicile: Semi-Urban
• City: Jammu
• State: J&K
Informant
• Relationship of the informant to the patient: Older Sister
• Intimacy: Close relationship
• Length of acquaintance with the patient: Lifetime
• Consistency of the Information: Reliable
• Adequacy of the information: Adequate

Chief complaints

Over the past year, the client has experienced a combination of various concerning symptoms
that have significantly impacted various aspects of their life. Persistent irritability and anger
outbursts have characterized their emotional landscape, suggesting underlying difficulties in
emotional regulation and management. These emotional challenges have been accompanied by
a decline in academic performance over the course of six to seven months, indicating potential
impairment in their ability to concentrate and engage effectively in their studies.
Concurrently, the client has exhibited signs of social withdrawal, distancing themselves from
interpersonal interactions and potentially isolating themselves from support networks. Physical
manifestations of distress have also emerged, with changes in eating habits occurring over a
five-month period, potentially reflecting disruptions in their routine or coping mechanisms.
Additionally, the loss of interest in previously enjoyed activities underscores a broader sense
of apathy or disengagement with life, further highlighting the pervasive impact of these
symptoms on their overall well-being. These symptoms collectively point towards a significant
disturbance in the client's emotional, social, and academic functioning, warranting thorough
assessment and intervention to address their needs effectively.

History of Present Illness

• Onset: Gradual
• Precipitating Factors: Family conflict, academic stress
• Course of the Illness: Persistent
 Over the past year, the client has grappled with a range of distressing manifestations,
including chronic irritability and frequent anger outbursts, which may reflect
underlying difficulties in emotional regulation exacerbated by their environment. These
emotional struggles have been accompanied by a noticeable decline in academic
performance over the past six to seven months, indicating the profound impact of their
mental health on their scholastic endeavors.
Concurrently, social withdrawal has emerged as a coping mechanism, potentially
isolating the client from vital sources of support and exacerbating their sense of distress.
The emergence of changes in eating habits over the past five months suggests a further
deterioration in their overall well-being, while the loss of interest in previously enjoyed
activities underscores a pervasive sense of apathy and disengagement from life.

The client's experience with their mental health challenges presents a complex picture
marked by a gradual onset and persistent course of illness. The precipitating factors of
family conflict and academic stress have likely contributed to the development and
perpetuation of their symptoms.

It's noteworthy that the client resides in a semi-urban area, potentially exacerbating their
stressors through factors such as limited resources or increased social pressures.
However, amidst these challenges, the client's older sister serves as a significant
informant and source of support, indicating a strong and nurturing relationship that has
offered a valuable source of resilience and guidance in navigating their mental health
journey.

Negative history
• No history of trauma, fever, substance abuse, or chronic medical conditions.

Family history
A. Father
• Education: High school
• Occupation: Blue-collar worker
• History of illness: Hypertension
B. Mother
• Education: High school
• Occupation: Housewife
• History of illness: Diabetes
Personal history
• Birth & Early development:
• Full term delivery
• Hospital birth
• No complications during delivery
• Milestones were normal

Behaviour during Childhood

• Sleep Disturbances: N/A
• Conduct Disturbances: N/A
• Truancy and gang activities: N/A
 • Relationship with parents, siblings, and peers: Strained relationship with parents,
close relationship with siblings
• Thumb sucking: N/A
• Nail Biting: N/A
• Temper Tantrums: Occasionally during childhood
• Bedwetting: N/A
• Stammering: N/A
Physical Illness During Childhood
• Asthma

School:
• Age of beginning and finishing school: 5 years-ongoing
• Type of school attended: Govt school, State board curriculum
• Scholastic Performance: Declined recently
• Attitude towards peers and teachers: Withdrawn and indifferent
• Competence and future Ambitions: Unsure about future plans
Occupation
• Age of starting work: N/A
• Jobs held: N/A
• Work Satisfaction; N/A
Sexual history
• No sexual activity
Marital history
• Unmarried
Use and abuse of alcohol, tobacco, and drugs: N/A

Premorbid Personality

Attitudes to others in social, family, and sexual relationships

The client demonstrates a generally positive attitude towards others in their social,
family, and sexual relationships, characterized by a fundamental trust in others and an
ability to sustain meaningful connections. While they may experience occasional bouts
of anxiety, their relationships are mostly secure, fostering a sense of emotional stability
and support. In social dynamics, they tend to take on a follower role rather than
asserting dominance, participating actively and responsibly while remaining friendly
and approachable. Their capacity to make decisions remains intact, contributing to their
active engagement in interpersonal interactions. While they lean towards a submissive
demeanor, they maintain a friendly and emotionally warm disposition, devoid of
jealousy, suspiciousness, or guardedness. Furthermore, they exhibit no notable
difficulties in role-taking across various spheres of life, suggesting adaptability and
comfort in their identity and responsibilities within familial, social, and professional
contexts.

Attitude to self:
The client's attitude towards themselves is characterized by a generally positive outlook,
particularly concerning their health and bodily functions. They exhibit a favorable disposition
towards maintaining their well-being, reflecting a proactive approach to self-care. However,
their satisfaction or dissatisfaction with work is not applicable, suggesting that this aspect may
not significantly influence their self-perception at present. Regarding their attitudes towards
past achievements and failures and their outlook on the future, the client experiences mixed
feelings about what will happen in the future. While they may harbor some optimism about
certain aspects of the future, there is also a sense of uncertainty or ambivalence, indicating a
complex emotional landscape shaped by past experiences and future aspirations. Overall, the
client's attitude towards themselves reflects a nuanced blend of positivity, self-awareness, and
a degree of apprehension about what the future may hold.

Moral and religious attitudes and standards:

The client's moral and religious attitudes and standards are characterized by a balance between
compliance and a degree of conscientiousness. They generally adhere to established moral and
religious principles, demonstrating a willingness to abide by societal norms and ethical
standards. However, their conscientious nature may sometimes manifest as an inclination
towards overthinking or placing excessive importance on moral considerations. Despite this,
the client also exhibits mild tendencies towards rebellion, suggesting a willingness to challenge
certain conventions or norms within the bounds of their moral and religious framework. Their
religious beliefs are moderate in intensity, indicating a sincere commitment to spiritual values
and practices without veering into extremes. Overall, the client's moral and religious attitudes
reflect a nuanced approach, combining adherence to tradition with a degree of individual
autonomy and critical thinking.
Mood:
The client's mood exhibits a predominantly irritable tone, marked by frequent fluctuations
between feelings of tension, anxiety, and irritability. While they may experience moments of
positivity, their overall demeanor tends towards gloominess, reflecting a pervasive sense of
sadness or despondency. Additionally, the client struggles with expressing their emotions
effectively, particularly when it comes to feelings of anger, anxiety, or sadness. This difficulty
in emotional expression may contribute to internalized distress and challenges in interpersonal
communication, potentially exacerbating their emotional struggles.

Leisure Activities and Interests:

The client's leisure activities and interests encompass a variety of engaging pursuits, reflecting
a diverse range of interests. They find enjoyment in reading, video games, and drawing,
demonstrating a multifaceted approach to leisure. While their creativity is described as
moderately creative, they nonetheless engage in activities that allow for self-expression and
imaginative exploration. In terms of social connections, the client maintains a small but close-
knit group of friends, suggesting a preference for meaningful and intimate relationships over a
larger social circle. Overall, their leisure activities and social interactions contribute to a
balanced and fulfilling lifestyle, providing opportunities for both personal enjoyment and
meaningful connections with others.

Fantasy Life:
• Amount of time spent in daydreaming: Minimal
Reaction Pattern to Stress
The client demonstrates a moderate level of tolerance towards frustrations, losses,
disappointments, and circumstances that may evoke anger, anxiety, or depression. While they
exhibit a capacity to endure and cope with these stressors to some extent, their tolerance is not
without limits. Additionally, the client tends to employ avoidance as a defense mechanism,
potentially utilizing this strategy excessively as a means of managing stress and discomfort.
This avoidance behavior may manifest as a tendency to withdraw from or avoid confronting
challenging situations or emotions, which could ultimately impact their ability to effectively
address underlying issues and cope with stress in a healthy manner. Understanding these
patterns in their reaction to stress can inform targeted interventions aimed at enhancing their
coping strategies and resilience.

Eating, sleeping, and excretory functions:

Changes in eating habits, irregular sleep patterns

SESSION I

Objective: rapport building and History Taking

• The client, a 17-year-old male has a history of irritability, anger outbursts, and social
withdrawal over the past year. The initial session focused on establishing rapport and gathering
information about the client's history and current concerns. The client seemed hesitant but
cooperative during the session.

Sample Of Talk
• How have you been feeling lately?
I've been feeling pretty frustrated and down lately.
• Would you like to tell us about your interests?
I am very interested in video games and e-sports, and lately have gained a lot of
knowledge about them also. etc., etc.….
• Would you like to tell me more about what has been causing you to be pretty down
and frustrated lately?
It is mostly my parents…They are…constantly screaming and fighting and lashing
out and just…idk. I feel like I cannot survive in this house. The only sane person is
my sister…. Etc. etc..

SESSION II

Objective: Progress and Exploration

In subsequent sessions, it was revealed that the client's behaviour changes were linked to
familial conflicts and academic stress. The client expressed a desire to improve but struggled
with communicating his feelings effectively. Strategies were discussed to cope with stress
and enhance communication skills. The client was advised to talk to his siblings about his
day-to-day life and enquire about them also. The client was encouraged to have conversations
with his parents as well as his friends also.

SESSION III

Objective: Progress and Continued support

During the third session, family counselling was also done. The client's sister was
involved in the therapeutic process to provide additional support. The client showed
gradual improvement in managing his emotions and engaging in open discussions
with family members. Continued support and coping strategies were reinforced. The
sister of the client was also advised about how to help the client navigate through the
various communication issues he is facing at home.
CASE HISTORY 3

Socio demographic profile

• Name: Mr. A
• Age: 25
• Marital Status: Unmarried
• Gender: Male
• Education: Bachelor's degree
• Occupation: Software Engineer
• Socio Economic Status: Upper-middle class
• Domicile: Urban
• City: Jammu
• State: J&K

Informant
• Relationship of the informant to the patient: Best friend
• Intimacy: Close relationship
• Length of acquaintance with the patient: 10 years
• Consistency of the Information: Reliable
• Adequacy of the information: Adequate

Chief complaints
The client's experience with depression has been profound and enduring, spanning a period of
two years. They have grappled with a persistent depressed mood, characterized by feelings of
sadness, hopelessness, and despair, which have significantly colored their outlook on life. This
emotional struggle has been compounded by a profound loss of interest in previously enjoyed
activities, robbing them of pleasure and motivation.
Physical manifestations of their depression, such as fatigue and low energy, have persisted for
approximately one and a half years, further contributing to their sense of lethargy and
withdrawal from daily life. Feelings of worthlessness have plagued the client for a year, eroding
their self-esteem and sense of value.
Additionally, they have encountered difficulties concentrating for a similar duration, impairing
their ability to focus and engage in tasks effectively. Perhaps most concerning is the presence
of suicidal ideation, highlighting the severity of their emotional distress and the urgent need
for intervention and support. Collectively, these symptoms paint a picture of profound
emotional suffering and functional impairment, underscoring the importance of comprehensive
assessment and targeted treatment to address the client's complex mental health needs.

History of Present Illness

• Onset: Gradual
• Precipitating Factors: Work-related stress, relationship issues
• Course of the Illness: Chronic

The client's experience with depression has been characterized by a gradual onset and a chronic
course, with symptoms persisting over the past two years. Work-related stress and relationship
issues have served as significant precipitating factors, contributing to the development and
perpetuation of their emotional struggles. Throughout this period, he has endured a pervasive
and enduring depressed mood, marked by feelings of sadness, hopelessness, and despair that
have colored their daily experiences. Concomitantly, he has experienced a profound loss of
interest in activities that once brought him joy and fulfillment, indicating a significant
impairment in their ability to derive pleasure from life. Physical manifestations of his
depression, such as fatigue and low energy levels, have been a constant companion for
approximately one and a half years, further complicating their ability to function optimally in
daily life.
Feelings of worthlessness have plagued the client for a year, eroding their self-esteem and
sense of value. Moreover, he has grappled with difficulty concentrating for a similar duration,
impairing his cognitive functioning and contributing to feelings of frustration and inadequacy.
The presence of suicidal ideation underscores the severity of his emotional distress and the
urgent need for intervention and support. The client is currently seeking help from a clinical
psychologist.

Negative history
No history of substance abuse, trauma, or chronic medical conditions.

Family history

A. Father
• Education: Master's degree
• Occupation: Businessman
• History of illness: Alcohol use disorder

B. Mother
• Education: Bachelor's degree
• Occupation: Housewife
• History of illness: Thyroid issues, PCOD

Personal history
1. Birth & Early development:
• Full term delivery
• Hospital birth
• No complications during delivery
• Milestones were normal

2. Behaviour during Childhood

• Sleep Disturbances: N/A

• Conduct Disturbances: N/A
• Truancy and gang activities: N/A
• Relationship with parents, siblings, and peers: Close relationship with parents,
few close friends
• Thumb sucking: N/A
• Nail Biting: N/A
• Temper Tantrums: Rare during childhood
• Bedwetting: N/A
• Stammering: N/A
 3. Physical Illness During Childhood
• Recurrent respiratory infections

4. School:
• Age of beginning and finishing school: 5 years-18 years
• Type of school attended: Private school, CBSE curriculum
• Scholastic Performance: Excellent
• Attitude towards peers and teachers: Sociable, well-liked
• Competence and future Ambitions: Ambitious, desired a successful career

5. Occupation
• Age of starting work: 22
• Jobs held: Software Engineer
• Work Satisfaction; Initially satisfied, decreased over time

6. Sexual history
• Heterosexual, 1 long term partner

7. Marital history
• Unmarried

8. Use and abuse of alcohol, tobacco, and drugs: Occasional alcohol use, no history of
substance abuse

Premorbid Personality
1. Attitudes to others in social, family, and sexual relationships
In their interactions within social, family, and sexual relationships, the client exhibits a
generally positive attitude, marked by a fundamental trust in others and a commitment
to sustaining meaningful connections. He feels mostly secure in these relationships,
demonstrating an ability to navigate interpersonal dynamics with confidence and ease.
Taking on a leadership role, he actively participates and takes responsibility for his
actions, displaying a capacity to make decisions autonomously. His dominant demeanor
suggests assertiveness and a willingness to take charge, while maintaining a friendly
and approachable demeanor. However, occasional bouts of jealousy may arise,
indicating a vulnerability in managing feelings of insecurity. Overall, the client's
attitude towards others reflects a balance between assertiveness and warmth,
underpinned by a foundation of trust and active engagement in their relationships.

2. Attitude to self:
In reflecting on his attitude towards himself, the client initially experienced satisfaction
with his work, but over time, this sentiment shifted towards dissatisfaction. Despite this,
he maintains a generally positive outlook on his health and bodily functions, suggesting
a proactive approach to self-care. However, when considering his past achievements
and failures, he harbors mixed feelings, indicating a complex relationship with his
personal history. Additionally, he feels uncertain about the future, highlighting a degree
of apprehension or ambiguity regarding what lies ahead. These nuanced attitudes
towards various aspects of himself reflect a journey of introspection and self-awareness,
 underscoring the importance of ongoing reflection and support in navigating his
evolving sense of self.

3. Moral and religious attitudes and standards:

The client's moral and religious attitudes and standards are characterized by a blend of
compliance and a tendency towards over conscientiousness. He generally adheres to
established moral and religious principles, demonstrating a willingness to abide by societal
norms and ethical standards. However, his conscientious nature may sometimes manifest as an
inclination towards overthinking or placing excessive importance on moral considerations.
Despite this adherence, the client also exhibits mild tendencies towards rebellion, suggesting a
willingness to challenge certain conventions or norms within the bounds of his moral and
religious framework. His religious beliefs are moderate in intensity, indicating a sincere
commitment to spiritual values and practices without veering into extremes. Overall, the
client's moral and religious attitudes reflect a nuanced approach, combining adherence to
tradition with a degree of individual autonomy and critical thinking.

4. Mood:
The client exhibits a predominantly stable mood, with occasional fluctuations but generally
maintains emotional equilibrium. He tends to be generally cheerful, suggesting a positive
outlook on life despite occasional challenges. Additionally, he demonstrates an ability to
express and control feelings of anger, anxiety, or sadness effectively, indicating a healthy level
of emotional awareness and regulation. Overall, his mood profile suggests a resilient and
emotionally balanced demeanor, with a capacity to navigate various emotional states with ease
and composure.

5. Leisure Activities and Interests:

The client engages in a variety of leisure activities and interests, demonstrating a diverse range
of pursuits. His interests include sports, traveling, and music, indicating an active and
adventurous lifestyle. While his creativity is described as moderately creative, he nonetheless
finds enjoyment in activities that allow for self-expression and exploration. In terms of social
connections, he maintains a small circle of close friends, emphasizing quality over quantity in
his social interactions. Overall, his leisure activities and social engagements contribute to a
fulfilling and balanced lifestyle, providing opportunities for both personal growth and
meaningful connections with others.

6. Fantasy Life:
Amount of time spent in daydreaming: Moderate

7. Reaction Pattern to Stress

The client demonstrates a moderate level of tolerance towards frustrations, losses,
disappointments, and circumstances that may evoke anger, anxiety, or depression. While he
possesses a capacity to endure and cope with these stressors to a reasonable extent, his tolerance
has its limits. Additionally, he tends to utilize rationalization as a defense mechanism,
potentially employing this strategy excessively as a means of managing stress and discomfort.
Rationalization may serve as a way for him to justify or explain away challenging situations or
emotions, providing a temporary buffer against distress. However, it's essential to ensure that
this defense mechanism does not hinder his ability to confront and address underlying issues
effectively.

8. Habits:
• Eating, sleeping, and excretory functions: Changes in appetite and sleep patterns

SESSION I

Objective: rapport building and History Taking

• The client, a 25-year-old male, presented with symptoms of depression including
depressed mood, loss of interest, and suicidal ideation. The initial session focused on
establishing rapport and gathering information about the client's history and current
symptoms. The client appeared distressed but willing to engage in therapy.

Sample Of Talk

• How have you been coping with your feelings lately?

Honestly, it's been really tough. I've been feeling so down and I don't know how to shake it
off.
• How frequently you socialize with your friends?
Lately I have not been feeling like meeting anyone. So, I have been skipping most of the
hangouts and gatherings organized by friends since a year. Except for my best friend and
girlfriend I do not engage in frequent conversations with anyone…..etc.,etc..

SESSION II

Objective: Progress and Exploration

In subsequent sessions, the client explored the underlying factors contributing to his
depression, including work-related stress and relationship issues. Mindfulness
techniques, Cognitive-behavioral techniques and relaxing techniques were introduced
to challenge negative thought patterns and improve coping skills of the client.
The client was also encouraged to have a conversation with at least one person a week
except his best friend and girlfriend.

SESSION III

Objective: Progress and Continued support

During the third session, the client showed improvement in mood and reported decreased
suicidal ideation. The client was encouraged to keep seeking help from the clinical psychologist
he is currently seeking treatment from. Continued support was provided, and strategies for
managing stress and enhancing self-esteem were reinforced. Referral to a psychiatrist for
medication evaluation was also discussed as part of the comprehensive treatment plan. The
client was psycho-educated about how constant stressors like work related issues and
relationship issues can play a role exacerbating his health conditions.
Mindfulness techniques involve practices that cultivate present moment awareness and
nonjudgmental acceptance of thoughts, feelings, and sensations. These techniques can be
effective in reducing stress, enhancing emotional regulation, and promoting overall well-being.

These techniques can be particularly beneficial in helping to alleviate symptoms and improve
coping skills of the client. Recommended techniques may include mindfulness meditation,
which involves focusing attention on the breath or bodily sensations to cultivate awareness and
presence. Additionally, body scan exercises can help individuals connect with their physical
sensations and release tension held in the body. Mindful walking or mindful movement
practices, such as yoga can also promote relaxation and enhance mind-body connection.
Finally, incorporating mindfulness into daily activities, such as eating or showering, can help
client bring greater awareness and intentionality to their experiences, fostering a sense of
groundedness and presence in the moment.

Relaxation techniques encompass a variety of practices designed to induce a state of calmness,

reduce stress, and promote physical and mental relaxation. These techniques can be valuable
tools for managing symptoms of depression and improving overall well-being.

For the client relaxation techniques can serve as effective coping strategies to alleviate distress
and enhance emotional resilience. Recommended techniques may include progressive muscle
relaxation, which involves systematically tensing and relaxing different muscle groups to
release physical tension and promote relaxation. Deep breathing exercises, such as
diaphragmatic breathing or belly breathing, can help individuals activate the body's relaxation
response and reduce symptoms of anxiety and depression.

Mindfulness-based relaxation techniques, such as mindfulness meditation or body scan

exercises, can also be beneficial by fostering present moment awareness and acceptance of
difficult emotions.

Incorporating relaxation techniques into daily routines, such as practicing yoga or tai chi, taking
warm baths, or listening to calming music, can also promote relaxation and reduce symptoms
of depression over time. Overall, relaxation techniques offer a holistic approach to managing
depression symptoms and promoting emotional well-being.
CASE HISTORY 4

Socio demographic profile

• Name: Ms. S
• Age: 35
• Marital Status: Married
• Gender: Female
• Education: Master's degree
• Occupation: Marketing Manager
• Socio Economic Status: Upper class
• Domicile: Urban
• City: Jammu
• State: J&K

Informant
• Relationship of the informant to the patient: Husband
• Intimacy: Close relationship
• Length of acquaintance with the patient: 12 years
• Consistency of the Information: Reliable
• Adequacy of the information: Adequate

Chief complaints
The client presents with a constellation of symptoms that have significantly impacted her daily
functioning and overall well-being. Over the past year, she has reported experiencing an
anxious mood characterized by persistent feelings of worry and apprehension. Additionally,
she has been struggling with panic attacks for the past six months, experiencing sudden and
intense episodes of fear accompanied by physical symptoms such as rapid heartbeat and
shortness of breath. These panic attacks have further exacerbated her symptoms of insomnia,
contributing to disrupted sleep patterns and fatigue. Alongside these physical manifestations,
the patient reports difficulty concentrating, which may be attributed to the cognitive effects of
chronic anxiety and sleep disturbances. Furthermore, she describes experiencing feelings of
dread and impending doom, indicative of the pervasive nature of her anxiety. Collectively,
these chief complaints paint a picture of a female patient grappling with significant
psychological distress and functional impairment.

History of Present Illness

• Onset: Gradual
• Precipitating Factors: Work-related stress, family conflict
• Course of the Illness: Chronic

The client's journey with mental health challenges unfolds gradually, with symptoms
persisting over time and indicating a chronic course of illness. Work-related stress and
family conflict emerge as significant precipitating factors, potentially contributing to
the onset and perpetuation of her symptoms.
Over the past year, she has grappled with an anxious mood, marked by persistent
feelings of worry and tension that have colored her daily experiences.
 Additionally, she has been troubled by panic attacks for the past six months,
characterized by sudden and intense episodes of fear accompanied by physical
symptoms such as rapid heartbeat and shortness of breath. These panic attacks have
further compounded her struggles with insomnia, leading to disrupted sleep patterns
and persistent fatigue.
Alongside these physical manifestations, the client reports difficulty concentrating,
potentially impairing her cognitive functioning and contributing to feelings of
overwhelm. Furthermore, she describes experiencing feelings of dread and impending
doom, indicative of the pervasive nature of her anxiety and the emotional toll it has
taken on her.
Overall, these chief complaints paint a complex and challenging picture of a female
client grappling with significant psychological distress and functional impairment,
underscoring the importance of comprehensive assessment and targeted intervention to
address her mental health needs effectively.

Negative history
No history of substance abuse, trauma, or chronic medical conditions.

Family history
• Three Generations Genogram
• Symbols used in drawing Genogram

A. Father
• Education: Bachelor's degree
• Occupation: Retired
• History of illness: Hypertension

B. Mother
• Education: Master's degree
• Occupation: Homemaker
• History of illness: Cancer

Personal history
1. Birth & Early development:
• Full term delivery
• Hospital birth
• No complications during delivery
• Milestones were normal

2. Behaviour during Childhood

• Sleep Disturbances: N/A

• Conduct Disturbances: N/A
• Truancy and gang activities: N/A
• Relationship with parents, siblings, and peers: Close relationship with parents,
few close friends
• Thumb sucking: N/A
• Nail Biting: N/A
 • Temper Tantrums: Occasionally during childhood
• Bedwetting: N/A
• Stammering: N/A

3. Physical Illness During Childhood

• Frequent stomach aches

4. School:
• Age of beginning and finishing school: 5 years-18 years
• Type of school attended: Private school, CBSE
• Scholastic Performance: Excellent
• Attitude towards peers and teachers: Sociable, well-liked
• Competence and future Ambitions: Ambitious, desired a successful career

5. Occupation
• Age of starting work: 23
• Jobs held: Marketing Manager
• Work Satisfaction; Initially satisfied, later decreased

6. Sexual history
• Heterosexual, stable relationship with husband

7. Marital history
• Married

8. Use and abuse of alcohol, tobacco, and drugs: No history of substance abuse

Premorbid Personality

1. Attitudes to others in social, family, and sexual relationships

The client demonstrates a positive attitude towards others across various relationship dynamics.
She exhibits a fundamental trust in others and is able to sustain relationships effectively.
Feeling mostly secure in her interactions, she exhibits leadership qualities rather than adopting
a follower role, actively participating in social interactions and taking responsibility for her
actions. Her capacity to make decisions remains intact, indicating a sense of autonomy and
self-assurance. Furthermore, she tends to assert dominance in her relationships, while
maintaining a friendly and approachable demeanor. However, occasional bouts of jealousy may
arise, suggesting a vulnerability in managing feelings of insecurity. Overall, the she displays a
balanced approach to social and interpersonal interactions, characterized by trust,
assertiveness, and warmth, with occasional challenges in managing jealousy.

2. Attitude to self:
The client’s attitude towards herself reflects a complex interplay of experiences and emotions.
Initially satisfied with her work, she later experiences feelings of dissatisfaction, indicating a
shift in her professional fulfillment over time. However, her attitudes towards health and bodily
functions remain generally positive, suggesting a proactive approach to self-care and well-
being. When considering past achievements and failures, she experiences mixed feelings,
perhaps reflecting a nuanced perspective on her personal history and accomplishments.
Additionally, she feels uncertain about the future, highlighting a sense of ambiguity or
apprehension regarding what lies ahead. These nuanced attitudes towards various aspects of
herself underscore the importance of self-reflection and adaptability in navigating life's
challenges and transitions.

3. Moral and religious attitudes and standards:

The moral and religious attitudes and standards of the client demonstrate a blend of adherence
and autonomy. She tends towards compliance with established moral and religious norms,
suggesting a respect for tradition and authority. However, she also exhibits a tendency towards
over conscientiousness, indicating a meticulous and careful approach to ethical considerations.
Additionally, she displays mild rebellious tendencies, suggesting a willingness to challenge
certain conventions or norms within the bounds of her moral and religious framework. Despite
this, her religious beliefs are moderate in intensity, reflecting a sincere commitment to spiritual
values and practices without veering into extremes. Overall, her moral and religious attitudes
reflect a balanced combination of tradition, conscientiousness, and individual autonomy.

4. Mood:
The client maintains a predominantly stable mood, with occasional fluctuations but generally
exhibits emotional equilibrium. She tends to be generally cheerful, indicating a positive outlook
on life despite occasional challenges. Furthermore, she demonstrates an ability to express and
control feelings of anger, anxiety, or sadness effectively, suggesting a healthy level of
emotional awareness and regulation. Overall, her mood profile suggests a resilient and
emotionally balanced demeanor, with a capacity to navigate various emotional states with ease
and composure.

5. Leisure Activities and Interests:

The client engages in a variety of leisure activities and interests, reflecting a diverse range of
pursuits. She finds enjoyment in reading, traveling, and practicing yoga, indicating an
appreciation for both intellectual stimulation and physical well-being. While her creativity is
described as moderately creative, she nonetheless incorporates imaginative and expressive
elements into her leisure pursuits. In terms of social connections, she maintains a small circle
of close friends, suggesting a preference for meaningful and intimate relationships over a larger
social circle. Overall, her leisure activities and social engagements contribute to a balanced and
fulfilling lifestyle, providing opportunities for both personal growth and meaningful
connections with others.
6. Fantasy Life:
• Amount of time spent in daydreaming: Moderate

7. Reaction Pattern to Stress

In response to stress, the client demonstrates a moderate level of tolerance towards frustrations,
losses, disappointments, and circumstances that may evoke anger, anxiety, or depression.
While she possesses a capacity to endure and cope with these stressors to a reasonable extent,
her tolerance has its limits. Additionally, she tends to utilize rationalization as a defense
mechanism, potentially employing this strategy excessively as a means of managing stress and
discomfort. Rationalization may serve as a way for her to justify or explain away challenging
situations or emotions, providing a temporary buffer against distress. However, it's essential to
ensure that this defense mechanism does not hinder her ability to confront and address
underlying issues effectively.

8. Habits:
• Eating, sleeping, and excretory functions: Changes in appetite and sleep patterns

SESSION I

Objective: rapport building and History Taking

The client, a 35-year-old female, presented with symptoms of anxiety including anxious
mood, panic attacks, and insomnia. The initial session focused on establishing rapport and
gathering information about the client's history and current symptoms. The client appeared
anxious but willing to engage in therapy.

Sample Of Talk

• How have you been coping with your feelings lately?

I've been feeling overwhelmed and constantly on edge. It's been really hard to relax or
sleep
• Do you feel a change in your routine patterns?
Yes, I often find myself worried about something wrong is going to happen and I am
not able to sleep as well in the night…etc., etc.…
• Can you recall since when you are experiencing these feelings?
It has been almost an year now…About six months ago I even started having panic
attacks….That was the scariest part for me…For a minute I felt like I was dying.

SESSION II

Objective: Progress and Exploration

In subsequent sessions, the client explored the underlying factors contributing to her anxiety,
including work-related stress and family conflict. Another factor that also came to surface was
that, client is almost at the same age when her mother was diagnosed with cancer and has a
fear of having cancer herself. This fear is responsible majorly for her anxiety provoking
thoughts and behaviors. Client was encouraged to visit an oncologist which can help her in
managing the anxiety provoking thoughts. The client was also seeking help from a psychologist
at that time which was further encouraged.

Behavioral techniques like Progressive muscle relaxation and Mindfulness therapy were
introduced to challenge negative thought patterns and improve coping skills.

Psychoeducation refers to the process of providing individuals with information and

knowledge about mental health conditions, treatment options, coping strategies, and resources.
It aims to empower individuals to better understand their own mental health and equip them
with the tools they need to manage their symptoms and improve their overall well-being. The
client was also psychoeducated about how given the fact about her mother passing away from
cancer can have a huge impact on her mental and emotional state as she herself is nearing the
age where her mother passed away

Mindfulness techniques involve practices that cultivate present moment awareness and
nonjudgmental acceptance of thoughts, feelings, and sensations. These techniques can be
effective in reducing stress, enhancing emotional regulation, and promoting overall well-being.

These techniques can be particularly beneficial in helping to alleviate symptoms and improve
coping skills of the client. Recommended techniques may include mindfulness meditation,
which involves focusing attention on the breath or bodily sensations to cultivate awareness and
presence. Additionally, body scan exercises can help individuals connect with their physical
sensations and release tension held in the body. Mindful walking or mindful movement
practices, such as yoga can also promote relaxation and enhance mind-body connection.
Finally, incorporating mindfulness into daily activities, such as eating or showering, can help
client bring greater awareness and intentionality to their experiences, fostering a sense of
groundedness and presence in the moment.

Relaxation techniques encompass a variety of practices designed to induce a state of calmness,

reduce stress, and promote physical and mental relaxation. These techniques can be valuable
tools for managing symptoms of depression and improving overall well-being.

For the client relaxation techniques can serve as effective coping strategies to alleviate distress
and enhance emotional resilience. Recommended techniques may include progressive muscle
relaxation, which involves systematically tensing and relaxing different muscle groups to
release physical tension and promote relaxation. Deep breathing exercises, such as
diaphragmatic breathing or belly breathing, can help individuals activate the body's relaxation
response and reduce symptoms of anxiety and depression.

Mindfulness-based relaxation techniques, such as mindfulness meditation or body scan

exercises, can also be beneficial by fostering present moment awareness and acceptance of
difficult emotions.

Incorporating relaxation techniques into daily routines, such as practicing yoga or tai chi, taking
warm baths, or listening to calming music, can also promote relaxation and reduce symptoms
of depression over time. Overall, relaxation techniques offer a holistic approach to managing
depression symptoms and promoting emotional well-being.
SESSION III

Objective: Progress and Continued support

During the third session, the client showed improvement in managing her anxiety symptoms
and reported fewer panic attacks. The client also managed to get an appointment of a renowned
oncologist to get herself for any potential cancer threats. Continued support was provided, and
strategies for managing stress and enhancing relaxation were reinforced.
CASE 5

CASE HISTORY

Socio demographic profile

• Name: Ms. R
• Age: 15
• Marital Status: Unmarried
• Gender: Female
• Education: Secondary schooling
• Occupation: Student
• Socio Economic Status: Middle
• Domicile: Semi urban
• District: Jammu
• State: J&K

Informant
• Relationship of the informant to the patient: Self
• Length of acquaintance with the patient: Lifetime
• Consistency of the Information: Reliable
• Adequacy of the information: Adequate

Chief complaints
The client, a 10th-grade student, is experiencing significant stress and confusion about
choosing the right subjects for 11th grade. They're overwhelmed by indecision and mood
disturbances, which affect their concentration on studies. Impulsivity complicates their
decision-making, and conflicts with parents and peers add to their stress. Physical symptoms
like headaches and fatigue are likely due to academic-related anxiety. Additionally, they've lost
their appetite, indicating emotional distress. Overall, the client needs support to navigate this
challenging period and make informed decisions about their academic and career path.

History of Present Illness

• Onset: Insidious
• Precipitating Factors: Stress about choosing a particular stream of subjects after
completing 10th class
• Course of the Illness: Episodic
Over the past few months, the client has exhibited a range of concerning symptoms stemming
from extreme stress and anxiety regarding the selection of a specific academic stream after
completing 10th grade. Notably, irritability has been a persistent feature throughout this period,
suggesting underlying emotional dysregulation or mood disturbance exacerbated by the
decision-making process.

Coupled with irritability, the presence of impulsivity indicates challenges in emotional control
and decision-making, which can significantly impact daily functioning and interpersonal
relationships. Conflicts with both parents and peers have arisen over the past six to seven
months, likely intensifying the client's emotional distress and feelings of frustration or
isolation. Living in a semi-urban area may add further stressors, including social pressures or
limited access to resources, exacerbating these conflicts.

Physical symptoms, such as frequent headaches and back pain, have persisted for five to seven
months. These somatic complaints may stem from underlying psychological distress or
exacerbate existing emotional symptoms, creating a cycle of physical and emotional
discomfort. The increase in appetite is also noteworthy, potentially indicating changes in eating
patterns or coping mechanisms in response to heightened stress and emotional turmoil.

The onset of symptoms appears to have coincided with the decision-making period for
choosing an academic stream, further suggesting a potential trigger related to this stressor. The
client's symptoms have followed an episodic course, with periods of exacerbation and
remission linked to the intensity of the decision-making process.

Overall, the history of the present illness underscores the intricate interplay of emotional,
physical, and environmental factors influencing the client's current state, emphasizing the need
for support and guidance during this challenging decision-making period.

Negative history
No history of trauma, fever, vomiting, disorientation, memory, diabetes, hypertension,
substance abuse etc.

Family history
C. Father
• Education: Sr Secondary
• Occupation: Central Govt Employee
• History of illness: N/A

D. Mother
• Education: Sr Secondary
• Occupation: Housewife
• History of present illness: N/A
Personal history
1. Birth & Early development:
• Full term delivery
• Hospital birth
• No complications during delivery
• Mile stones were normal

2. Behavior during Childhood

• Sleep Disturbances: N/A

• Conduct Disturbances: N/A
• Truancy and gang activities: N/A
• Relationship with parents, siblings and peers: Very close relationship
• Thumb sucking: N/A
• Nail Biting: N/A
• Temper Tantrums: For a short frequency after the birth of younger sibling
• Bedwetting: N/A
• Stammering: N/A

3.Physical Illness During Childhood

• N/A

4.School:
• Age of beginning and finishing school: 4 years- ongoing
• Type of school attended: Central govt school; CBSE
• Scholastic Performance: Very good
• Attitude towards peers and teachers: Very respectful and sociable

5.Occupation
• Age of starting work: N/A
• Jobs held: N/A
• Work Satisfaction; N/A
6.Menstrual History:
• Age of Menarche: 12.5 years
• Reaction to Menarche: Confusion and frustration
• Regularity of Periods: Regular
• Dysmenorrhea: Fatigue and nausea
• Menorrhagia: Present in the starting few cycles
• Oligomenorrhoea: N/A
• Emotional Disturbances in relation to Menstrual Cycle: Irritable mood along with
frustration

• 7.Sexual history
 • Has knowledge about sex from school and other family members; no masturbatory
practices or engagement in any sexual activity with a partner

8.Marital history
• Unmarried

9.Use and abuse of alcohol, tobacco and drugs: N/A

Premorbid Personality
1. Attitudes to others in social, family and sexual relationships

The client exhibits a secure and confident demeanor in their social, family, and sexual
relationships. They possess a natural inclination to trust others and actively engage in
sustaining these relationships. With a leadership orientation, they take on responsibilities
willingly and have a strong capacity for decision-making. Their dominant personality trait is
balanced by a friendly demeanor, devoid of jealousy or guardedness. Additionally, they
demonstrate no difficulty in role-taking across various domains such as gender, sexuality,
family, parenthood, or work, indicating a versatile and adaptable nature.

2. Attitude to self:
The client demonstrates a generally positive attitude towards themselves, as evidenced by their
satisfaction with their work. While she does not harbor any serious concerns regarding her
health and bodily functions, her overall attitude remains constructive, indicating a capacity for
introspection and proactive engagement with their well-being. Moreover, the client maintains
a positive outlook on past achievements and failures, viewing them as opportunities for growth
rather than setbacks.

3.Moral and religious attitudes and standards:

The client exhibits a complex set of moral and religious attitudes and standards. She
demonstrates rigidity in their beliefs, adhering firmly to their moral principles and values.
However, this rigidity is accompanied by an over-conscientiousness, suggesting a heightened
sense of responsibility and accountability in their moral conduct. Despite this
conscientiousness, the client also displays tendencies towards rebellion, indicating a
willingness to challenge societal norms or established authority when it conflicts with her
personal convictions. Her religious beliefs are characterized by a deep and unwavering
commitment, reflecting a strong connection to spiritual values and practices.

4.Mood:
The client's emotional landscape is characterized by a mix of mood swings, encompassing
feelings of anxiety, irritability, worry, and tension. These fluctuations may contribute to a
varied demeanor, oscillating between moments of warmth and gloominess depending on the
circumstances. While the client experiences a range of emotions, they sometimes struggle to
express these feelings effectively, particularly when it comes to anger, anxiety, or sadness.
5.Leisure Activities and Interests:
The client's leisure activities and interests span a diverse range, reflecting a rich and varied
engagement with life. They derive enjoyment and fulfillment from activities such as reading,
listening to music, watching vlogs of various social media creators, painting, and dancing.
Their creativity shines through in their pursuits, with a propensity for imaginative expression
and innovation evident in their engagement with various art forms. Despite the depth of her
interests, the client maintains a social circle comprising approximately 7-8 friends, indicating
a balanced lifestyle that values both solitary pursuits and social connections

6. Fantasy Life:
• Amount of time spent in day dreaming: Around 30-40 mins

7.Reaction Pattern to Stress

The client's reaction pattern to stress appears generally resilient, with an intact ability to tolerate
frustrations, losses, disappointments, and circumstances that may evoke anger, anxiety, or
depression for the majority of the time. There is an indication of a specific defense mechanism
being utilized, namely rationalization, which may suggest a tendency to intellectually justify
or explain away difficult emotions or situations as a means of managing stress.

8.Habits:
• Eating, sleeping and excretory functions: Decreased appetite

SESSION I

Objective: rapport building and History Taking

The client, a 15-year-old individual, has a history of signification stress and confusion
from past few months. Despite these challenges, upon arrival for the counseling
session, the client exhibited a happy mood. To begin, the client was seated comfortably,
and the counseling session commenced by establishing rapport and then delving into
the client's personal history.

Sample Of Talk

• How are you feeling today?

I am feeling good today.
• Would you like to tell us about your interests?
Yes, sure. I like to read books. I also like to listen to music. I also like to watch daily
vlogs of my favourite social media creators.
• Could you describe about your relationship with your family members?
I have a very good relationship with
SESSION II

Objective: Progress and Exploration

It was established in the first session that the client has a case of signification stress, and
confusion and these issues were impacting her interpersonal relationships.
In this session, we went over the story of client again found that most of the issues of the
client were due the stress of choosing a particular stream of subjects after class 10. The client
had to be more aware about the various career options she could be interested which could
further aid in choosing the subjects she could opt for in class 11th.
To facilitate this Career Preference Questionnaire by Bhargava and Bhargava was
administered on the client.
It measures career choices in ten broad areas:
Mass Media and Journalism (MMJ)
Artistic and Designing (AD)
Science and Technology (ScT)
Agriculture and Horticulture (Ag)
Commerce and Management (M)
Medical Profession (M)
Defense (D)
Tourism and Hotel Management (TH)
Law and Order (Lo)
Educational Administration and Teaching (E)
These ten fields are distributed twice in the Career Preference Record from left to right and top
to bottom along with two options each. Thus, there are a total of 200 options for careers in the
Career Preference Record. And the student chooses the appropriate option. In their career
preferences students can take support of their peers, parents and teachers. By choosing the right
career, a student charges ahead in his/her life and can be successful. An individual's career
choice acts like a stimulus for a better result in the chosen field. Career Preference must be
flexible and within realistic zones of our life so that we can take effective decisions to promote
a satisfactory life.

The result of the client are as follows:

General Report:
● Main Career Preference Area: ScT
● Second Career Preference Area: AD
●Third Career Preference Area: MMJ
● Least Career Preference Area: D

Special Report:
● High Career Preference: NIL
● Career Preference above average: NIL
● Average Career Preference: MMj, AD, ScT, AG, CM, M, TH, Lo, E
● Career Preference below average: NIL
● Low career Preference: D

According to the results, the client was advised with three career preferences. The
preferences were as follows:
Science and Technology
Artistic and Designing
Mass Media and Journalling
Following are some of the career options that one can explore within these three career
preferences:
In the Science and Technology field, a person can opt for many options ranging from natural
sciences to social sciences. The options can include researching in natural sciences (atomic
scientist, microbiologist, etc.), various engineering fields (like chemical engineer, automobile
engineer, computer engineering, aeronautical engineering), social sciences (like
anthropologist, psychologist) and also some new emerging fields like food technology, bio-
chemistry etc.
In the artistic and design field, there are numerous career options, including graphic design,
interior design, fashion design, industrial design, web design, animation, illustration,
architecture, photography, and user experience (UX) design. Each of these fields requires a
unique set of skills, creativity, and often formal education or specialized training. It's essential
to explore different areas within art and design to find what aligns best with your interests and
talents. Additionally, freelance opportunities and entrepreneurship are common paths in this
field for those who prefer more flexibility and creative freedom.
In mass media and journalling field, the career options can have a wide range of career options
ranging from radio journalist to a camera man. Some other options include TV Journalist,
Script writer, photographer, commentator, sound technician. The options can include creative
roles like film direction or script writing, etc. or more technical roles like camera technician or
sound technician.
Based on the above preferred career choices the client was advised with following subjects that
she could opt for after class 10th, which can align more with her preferred career choices.
Physics, Chemistry, Computer Science, Psychology, Biology, Mathematics etc.
The client was also advised to further discuss their choices with their parents to get a better
understanding of their choices.