COUNSELLING CASE 1

(Aggressive Behaviour)

Socio-demographic data

Intake information:

Name : Client
Age : 16 years
Gender : Male
Educational qualification : 10+2
Occupation : Not Working
Income : NA
Marital status : Unmarried
Language : Telugu

Whether client stays with parents: Yes

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

Chief Complaints:
Presenting problem:
“I get angry very soon, I cannot continue my study with this mind-set. My father is not
supporting me. I am very upset because nobody understands me and my problems which
I am facing here. I never want to go to that college. I want to become a movie actor and
I could not get a chance”
Precipitating Factors if any:

● Comparing with friends, parent’s attitude and could not get a movie chance

● Feeling shame with friends

Duration of problem: 6 months

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Behaviour)
Any counselling taken: No
How intense is the problem and how does it affect the client?
● Aggressive behaviour
● Not taking food and sleeping on time, shouting on all
● Arguing with parents and rejecting marriage proposals
● Watching movies and imitating heroes
According to the Informant:
Interview with family members/spouse/the concerned person
Name: Mother of Client
Age: 40
Sex: Female
Relationship: Mother
The view point of her mother in regard to all the above
His mother said in the interview that her son (client) is very shy and softly spoken. He is a
very good student and has no bad habits in school and college. He was not happy with his
father's decision but after joining 10+2 he left college because he was not interested in
science groups but his father forcefully joined the science group. We faced a lot of problems
and after settling everything became normal. but recently by watching movies he influenced
by hero actions and then joined film institutes, he tried one movie chance but he could not
get, now his behaviour completely changed
Her mother said that I am concerned about my son's feelings and career so I encouraged him
to take counselling.
Relationship:
If unmarried:
Patient’s relationship with family members:
● With mother: His mother is very supportive, she is concerned about her son’s feelings
and career.
● Father: His father is strict
● Brothers: His brother is also very supportive and loves him a lot.
● Sisters: NA
Any other relative staying with patient: No
With friends: Good
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How many friends does the patient have? How does the patient relate to them? NA
With neighbours: Good
With classmates: Good
With the teachers in college: Good
With other authority figures: NA
With playmates: Good
In the games field: Good

Educational history:
● In school / college:
He was a good in studies in school and college
● How is the client in studies and academic performance?
His academic performance according to his report card of his school was good and he
was a rank holder in 10+2
● Does the client come up to the expectations of parents and teachers?
Yes
● Have they received any complaints from the school authorities regarding the client
performances?
No, they never received any complaint regarding this.
● When did they decide to consult a counsellor?
When the client was upset and fed-up with achievement in not getting movie chance and
changed his mind set and hesitating others, developed low confidence ie., says I cannot
do anything
Work history:
On and Off working in own business, supporting his father
If Married: NA (not married)

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 MSE
Appearance:
● Age: 16 years
● Sex: Male
● Hygienic: Yes

Movement and Behaviour:

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

Mood: Nervous and anxious

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

Thought Content:
After establishing the rapport and observing the client’s appearance and all, I assess that the
client’s behaviour is an aggressive behaviour and aggressive thought reactions

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

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Brief background & client’s assessment data:
Client came to me with his mother, started talking about his problem and said sir, “I get
angry very soon”
He was very much interested in overcoming this. His habit of getting angry very soon often
made him upset. He was concerned about it and opened up to discuss the whole thing.
Through the session it was observed that this behaviour of his interfered with his daily
routine and some contemporary ambitions like imitating movie heroes and becoming like
them.
Client is a 10+2 student and he is the eldest child of his parents. His father is a cloth business
shop owner and his mother is a housewife. He watched few movies and influenced, wanted
to become an actor

SESSION 1
Duration: 20-30 minutes
Medium of conversation: Telugu and English
Place: Counsellor’s Room

Objectives:
1. To establish rapport with the client.
2. To help client to open up and express his feelings without any hesitation and come
out from his problem.
3. To gather relevant information about the client and his background.

The verbatim conversation with client as follows:

Interpretation Introspections
Counsellor’s Charts Dialogue Skills Alternate
Response
CO: client entered; I greeted and asked him to have
a seat. I further enquired him about any difficulty
he might face in finding the place. I offered him a
glass of water. I decided to make sure that the client
is comfortable and told him that he can make
himself at home here and whatever he would tell, I

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will be kept completely confidential. A formal oath
of confidentiality was taken by me so that the client
becomes comfortable in sharing the problem and all
the things related to the problem. What is it that you
want to discuss?

CL: Sir, I lose my temper very often. I am totally

upset with this behaviour of mine. Sir, please tell
me what to do?

CO: Tell me, what are the situations and times

when you become angry?

CL: When my mother irritates me by telling me

this or that study and then comparing me with other
children especially either my relative’s children or
with my younger brother.

CO: So you get angry at home with your parents,

when they tell you to study or compare you with
Paraphrasing and
other children or your younger brother. What about
reflection skills
getting angry in school?

CL: Yes, sir

CO: Ok then tell me about your family.

Probing
CL: Sir, in my family I have a mother, father,
younger brother and our maid.

CO: Do you help your mother?

Oh! head nods,
CL: Yes, whenever my mother asks for it.
reflection of
CO: What about your maid?
feelings

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 CL: Our maid is good but my mother has a bad
habit of scolding me in front of her
The rest of the session went off in knowing about her background and general information.

My Observation:
The client was motivated enough to come alone without any situation. The initial rapport
building took no time and he verbalized his problem to the counsellor. The client was very
quick to open up and came up very easily with his problem. Paraphrasing and reflection
skills used by the counsellor helped to convey to the client that her problem had been
understood. The issue was more home oriented.

Plan of Action:
I had told him that we will meet tomorrow. He said he would come by 2PM, I said ok. I
planned to work on this problem and to find out what are the situations at the client's home
that make him angry. I would ask him to relate the same incidents which make her angry.

SESSION 2
Duration: 30 – 40mins
Venue: Counsellor’s Room

Objectives:
1. To find out the different situations in which the client gets angry.
2. To know about the client’s concern in detail in order to find out causes under the
concern.

The verbatim conversation with client is as follows:

Interpretation Introspections
Counsellor’s Charts Dialogue Skills Alternate
Response
CL: May I come in sir?

CO: Yes, please, how are you?

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CL: I am fine sir (seated comfortably).

CO: So in the previous session we were

Recap and
talking about you getting angry very
probing
soon. Can you mention some incidents
which make you angry?

CL: Sir I get mostly angry on holidays

when mummy keeps telling me to study
while watching movies.
CO: What is your behavioural reaction?
Probing
CL: Sir, what do I do? I just keep books
in front of me, but I am not able to
concentrate but just to avoid scolding I
do this.

CO: What other situations make you

angry?

CL: When my mother compares me with

other children. Why do not they
understand that every human being is
different or when my mother does not
like my movie interests

CO: Any other situation makes you

angry? Probing

CL: Yes, when I get back from the

tuitions, nobody even gives a glass of
water and on the other hand my mother
says go and drink, she is tired
Oh! empathy

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 CO: So what do you do?

CL: Nothing sir, just throw my bag on

Probing
the bed and get water for myself.

CO: Tell me some incidents which

make you feel angry.
CL: I feel upset when my parents do not
allow me to go with friends to party as
they do not take us out for movies,
picnics, etc. very often and they don’t
encourage me to do arts like dance, Approval and
action because I want to become an reassuring
actor.

CO: So I understand that situations at

home make you angry as you have
mentioned that most of the time the Paraphrasing and
attitude of your parents is the main cause. assurance
So now I want you to make an inventory
1 to 5 as “I get angry because
–––––.” Write 5 different reasons on a
piece of paper and mark them in order
of priority. So when we meet next time
we will discuss it. I will meet you the
day after tomorrow.
My Observation:
Information regarding his problem was revealed in this session. As I was able to express
interest in the client’s problem, this made him talk about himself. I was able to elicit
situations which he said made him angry. The college environment was not the cause but
parental pressure to do what they wanted made him react in this way. The case was clear
and easily understood. He was made to understand that we all get angry at one or other times

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but have to learn to manage situations and our anger to prevent our image, relationship as
well as to live happy life.

Plan of Action:
It was planned that now through a very interesting story I would ask him a few questions
and make him understand that anger is self-destructive and leads to no betterment.

............................. Regular sessions were followed continuously .............................

SESSION 12
Duration: 40 – 60mins
Venue: Counsellor’s Room

Objectives:
1. Conducting the session using storytelling and asking a few questions to make him realize
side effects of anger.
2. To understand what makes him angry.
3. Telling interesting story

The session to be conducted in a story strategy and by asking questions at the end of story
leading to self-understanding.
Very interesting story- Board and Pins: There was a little boy called Rama who did not
have any friends and nobody liked to play with him. His teachers also did not be with him
much and her parents were unhappy with him. Do you know why? (Pause) It was because
he was very short tempered and used to argue, use abusive language and get into fights with
everyone. One day her mother gave him a board and some drawing pins, she told him that
every time he lost his temper and abused or fought with someone, he was to go to his room
and put a pin on the board. At the end of month, now the board was full of pins. Rama’s
mother asked him to remove the pins from the board. He did so. His mother told him very
gently to see how many holes that he had made on the board by sticking the pins. Each hole
on the board represents someone you have hurt. You have made many holes in their heart
by your behaviour. Do you think you can repair all the hurt you've caused to so many people?
Rama realized how much damage he has done to his friends, family and teachers even to
strangers and he resolved to change himself. Now I asked the client few questions.

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 The verbatim conversation with client is as follows:
Interpretation Introspections
Counsellor’s charts Dialogue Skills Alternate
Response

CO: What did you learn from the story? Challenging

CL: That anger hurts the other person.

Sometimes the damage caused by our anger
may not be repaired.

CO: Let’s revise what makes you angry?

Paraphrasing
CL: When my parents do not let me do
something which I want to do, when I do not
get what I want, when my mother shouts at me
unnecessarily, when I am forced to do what I
do not want to do as they are always telling me
to study and work

CO: Do you want to know the ways to manage

anger?

CL: Yes, sir.

Intervention
CO: Deep breathing, counting till ten
positive thinking, using humour these are
many other ways of managing our emotions
e.g. exercising, walking away from the

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 situation that makes us angry etc. Expressing
our emotions in an appropriate, socially and
legally accepted manner. Separating our
feelings from reactions e.g. anger need not
lead to hitting, name calling and other
negative behaviour. Now I want you to
imagine and write the story where the client
instead of getting angry, using the various tips
Session ending
we discussed to manage his anger. You can be
as creative as you want.
CL: Ok sir.
(He made up a story using the anger
management tip)

My Observation:
All of us experience anger, In fact even the most tolerable person will get angry if pushed
beyond a point. The difference between a short tempered and a calm person is in the level
of tolerance and the way they express their anger.
I told him that there are three main approaches to anger management:
1. Expressing.
2. Suppressing.
3. Calming.
I also discussed that anger could be managed through the following:
1. Deep breathing.
2. Change the way you think.
3. Problem solving.
4. Better communication.
5. Using humour.
6. Avoidance.

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I tried using storytelling. I found this very effective and very innovative story on anger
management to manage this anger. I handed a leaflet to him and encouraged him to put it at
a place where he could see it daily and manage her anger.

LEAFLET HANDED OVER TO CLIENT:

Strategies to manage the anger:
1. Taking a deep breath.
2. Leaving the place/situation.
3. Talking about your feelings with someone else who is not involved.
4. Listening to music/dance.
5. Writing a letter to the person and then destroying it or writing a diary.
6. Helping someone else.
7. Watching a funny movie.
8. Spending time on your favourite hobby.
9. Doing something creative.
10. Spending time with a pet.
11. Doing something that makes you laugh.
12. Drinking water.
13. Meditation.
14. Ignoring the situation.
15. Talking with a pillow on your face and screaming.
16. Remind yourself of good jokes.
17. Playing a game of interest.
18. Watching T.V.
19. Telling and explaining the anger is useless.
Conclusion:
During initial sessions had little bit rapport problem due to his aggressiveness and then
slowly well rapport has been established, session went smoothly, observed improvement
and good feedback from their parents while leaving the counselling centre
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Finally, today's session was able to achieve the purpose with which it started.

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 COUNSELLING CASE 2
(Internet Addiction)
Socio-geographic data
Intake information:
Name : Client
Age : 22 years
Gender : Male
Educational qualification : Graduate
Occupation : Not Working
Income : NA
Marital status : Unmarried
Language : Telugu, Hindi

Whether client stays with parents: Yes

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

Chief Complaints:
Presenting problem:
“I use the internet for long hours and now I have become habitual. But due to this habit it
was diagnosed as migraine.”
Precipitating Factors if any:
● Using Internet for long hours
● Duration of problem: 1 Year
● Any counselling taken: No
How intense is the problem and how does it affect the client?
● Has to take leave from work place : Yes
● Cannot carry not even the routine work in time : No
● Arguing with parents and rejecting tasks : Yes
● Does not want to do anything : Yes

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 According to the Informant:
Interview with family members/spouse/the concerned person
Name: Mother of Client
Age: 47
Sex: Female
Relationship: Mother
The view point of her mother in regard to all the above
His mother said in the interview that her son(client) always uses a smartphone, does not
want to work and arguing for small issues, he got a job but due this he left the job. He is the
eldest son in our family and it became a prestige issue for us, because when relatives come
to our house they say “why is your son not doing any job? why always with a phone?”
He fought for the iPhone because all his other friends are using it, when we told “it was very
costly” he replied “what do you do with all this money and property? I want iPhone that’s
all”
His mother said that I am concerned about my son's feelings and career so I encouraged him
to take counselling.
Relationship:
If unmarried:
Patient’s relationship with family members:
● With mother: His mother is very supportive. She is concerned about her son’s feelings
and career.
● Father: His father is good and supportive
● Brothers: NA
● Sisters: NA

Any other relative staying with patient: No

With friends:
How many friends does the patient have? How does the patient relate to them?NA
With neighbours: Good
With classmates: NA
With the teachers in college: Good
With other authority figures: NA
With playmates: Good
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 In the games field: Good
Educational history:
● In school / college:
He does most of his work with the help of internet e
● How is the client in studies and academic performance?
Average academic performance
Does the client come up to the expectations of parents and teachers?
No
● Have they received any complaints from the school authorities regarding the client
performances?
Yes, he always wants to use a smartphone, even though smartphones are not allowed.
● When did they decide to consult a counsellor?
when the client was spending hours together with smartphone and internet, he is not caring
other activities, also gets irritated for small things
Work history:
Joined part time work and left, as computer operator
If Married: NA (not married)

MSE
Appearance:
Age: 22 years
Sex: Male
Hygienic: Yes
Movement and Behavior:
● Client’s gait : Normal
● Posture : He sat down and was rubbing his hands as he was anxious
● Eye Contact : Makes eye contact and stable
Facial expression: Calm
Mood: Nervous, anxious

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Addiction)
 Speech:
● The volume of the person’s voice : Average
● The rate or speed of speech : Slow
● The length of answers to questions : Keeping short
● The appropriateness of the answers : Appropriately answered
● Clarity of the answers and similar characteristics: Clear

Thought Content:
After establishing the rapport and observing the client’s appearance and all, I assess that the
client is disturbed to think about the problem of migraine with effect of internet usage
Cognition:
a. Orientation: Intact with respect to time, date, place and person.
b. Attention/ Concentration: ok
c. Memory: NA
Intelligence: Adequate (as per educational background)
Judgment:
Social: NA
On test: NA
Insight: NA
Brief background & client’s assessment data:
He came to me and seemed pretty sure of his problem and was very much interested in
overcoming this. His habit of using the internet for long hours and he was concerned about
it and opened up to discuss the whole thing. Through the session it was observed that this
behavior of his interfered with his daily routine
Client is a graduate student and he is the eldest child of his parents. He is a graduate and he
addicted to internet and spends long hours with PC or smartphone, sleeps late night gets up
in the noon hours
On asking him his aim in life he just smiled but no response after that he does not have
proper sleep and looks active, observed power bank along with smartphone and this shows
how lengthy hours he uses smartphone as he is using power bank along with him

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Addiction)
He likes to browse the internet, play games, and also collect subject related things when any
information is needed for his studies, but this is good, other activities like games and social
media browsing dominated this knowledge base search so he developed internet addiction .
About Internet addiction:
Professionals that do recognize internet addiction tend to classify it as either an obsessive-
compulsive disorder or an impulse control disorder to aid treatment. Internet addiction is
also called compulsive computer use, pathological internet use, and internet dependence
In the past few years’ internet addiction (IA) and internet gaming disorder (IGD) have
become very frequent, leading to many personality and psychiatric disorders including low
self-esteem, impulsivity, poor sleep quality, mood disorder, and suicide

SESSION 1
Duration: 40-60 minutes
Medium of conversation: Telugu and English
Place: Counsellor’s Room

Objectives:
To make sensible picture of the client’s problem
The verbatim conversation with client as follows:

The Client entered; I greeted and asked him to have a seat. I further enquired him about any
difficulty he might face in finding the place. I offered him a glass of water.
I decided to make sure that the client is comfortable and told him that he can make himself
at home here and whatever he would tell, I will be kept completely confidential. A formal
oath of confidentiality was taken by me so that the client becomes comfortable in sharing
the problem and all the things related to the problem.
Then Client started sharing about the problem he was facing in his life.
Client shared that he uses the internet almost the whole day. He downloaded files, movies,
software for him as well as for his friends and also used emails, watching videos on you
tube, net surfing, searching not regarding assignments gradually. The use of the internet
gradually increased. According to the client “why there is sleep and people should not
sleep”. Client 2 sleeps around 3am, wakes up around 7:30am then goes to the college and
after returning from college, again starts spending time on the internet.

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Addiction)
How much time do you spend on the internet on an average? (Probing)
“I spend 8-9 hours daily, sometimes I spend 12 hours continuously on the internet for
different projects and assignments.”
In this way client, shared his problem and entire session went on addiction related and other
information
My Observation:
Point of view is, it’s a Process Addiction
He addicted to internet and that affected his personality and behaviour, also decided to
conduct IAT [Internet Addiction Test], given by Dr. Kimberly S. young, to know his level
of addiction
Internet Addiction Test (Dr. Kimberly S. young)
I decided to conduct Internet addiction test to know the score using Internet Addiction scale

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Addiction)
He took around 30 mins to complete this test and scored 80+, so considered he is a severe
dependence upon the internet
Plan of Action:
I informed the client and his mother about the score and don’t worry, we help you to come
out of the problem, but be confident because every problem has its own solution, so it felt
easy to come for the session and fix the time.
............................. Regular sessions were followed continuously .............................

SESSION 10
Duration: 20-30 minutes
Place: Counsellor’s Room

Objectives:
1. To help the client to come out of the problem
The verbatim conversation with client as follows:
The client entered; I greeted and asked him to have a seat. I further enquired him about any
difficulty he might face in finding the place. I offered him a glass of water.
In this session, we’ll discuss the strategic solution. According to Psychological Research,
spending more than 4 hours on the internet is considered an addiction and it is worldwide.
It was explained to the client that it is not a substance but it is a process addiction, sometimes
also addicts you. The process you are using, you get some thrill from them and also you are
curious to know the things so it’s an addiction to you. Now-a-days it is a lifestyle disease.
Client if you are aware about our brain system, it has different parts and each part has its
different function. Brain needs varieties for better processing. For your problem, we have to
see the criteria of addiction, whether it affects our daily life or not.
According to psychological research, the process of addiction can be de-addicted by time
management. For this, you have to set your priorities to adhere to the time. One who can’t
adhere to the time, he has to finish that work first which seems very important.
For explaining the flexibility of time and role of priorities I share an example
Explained JUG example for flexibility
Once I showed my students a jug and put big stones in the jug and asked students,
“Is it completely filled?”
Students replied, “Yes,
But I put small stones again and then asked students, “Is it filled now?”

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Addiction)
Students replied “Yes”
But this time I put sand in it and again asked the same question. Students were now confused
and then I poured honey and then flowers in the jug. So, client time is like this jug which is
flexible. It depends on us how we can manage things for doing our important work first and
then finish small work according to priorities. (Self-disclosure)

For relief in migraine, some activities were suggested which include meditation, walk,
exercise, sleep. Client has to fix his time for different works. He should shift his sleeping
time from 3am to 9PM or 10PM, going to bed
Client was interested in the gym so he was suggested to join the gym. Through this the time
which was only devoted to cognitive activities, now it will be engaged in non-cognitive
activities and in the meantime you can use the internet like before going to the gym, after
coming from gym, before going college. Except this, make a routine for doing Yoga for 15
minutes daily. As the process takes time, so for de-addiction the habit, things should be
connected with time. You can do meditation, walk, and exercise for getting relief from
migraine.
So I ended the interview in the following manner:
Client, we have discussed your problem which you are facing for a long time. Hope you
have found the solutions for your problems.
My Observation:
When the client left I found that he was looking relaxed and was happy that his problem
could be put across by him clearly to the counsellor. Now he was able to choose the right
solution to solve the issue.

Also referred following book-let

● Emotional Health Linking to Addiction
● Turn Off Notifications
● Account Management and unsubscribing
● Make a Plan
● Healthy Distractions
● New Hobbies
● Support Group

Conclusion:

22 MPCE 025, Interns Report : Enrolment No.2101329657 : Case 2 (Internet

Addiction)
Client was not comfortable before the Internet Addiction Test, after that when explaining
score and interpretation, he cooperated and he wanted to come out of the problem and finally
with today’s session was able to achieve the purpose with which it started.

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Addiction)
 COUNSELLING CASE 3
(General Anxiety Disorder)

Socio-demographic data
Intake information:
Name : Client
Age : 17 years
Gender : Female
Educational qualification : 10+2
Occupation : Student
Father occupation : Sales person
Mother’s occupation : Housewife
Income : NA
Marital status : Unmarried
Language : Telugu

Whether client stays with parents: Yes

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

Chief Complaints:
Presenting problem:
“She stopped going out of home. She fluctuates in her thinking. She gets up in between a
talk and starts walking around. She gets angry when we ask her to something”
Precipitating Factors if any: NA
Duration of problem: 1 Year
Any counselling taken: No

24 MPCE 025, Interns Report : Enrolment No.2101329657 : Case 3 (General Anxiety

Disorder)
How intense is the problem and how does it affect the client?
● Has to take leave from work place : Yes
● Cannot carry on even the routine work in time: No
● Arguing with parents and rejecting tasks : Yes
● Does not want to do anything : Yes

According to the Informant:

Interview with family members/spouse/the concerned person
Name: Mother of Client
Age: 40
Sex: Female
Relationship: mother
The view point of her mother in regard to all the above
As told by her parents, she is not able to sit peacefully and talk properly. She is not able to
take any decision. She remains stressed, restless and frustrated. She doesn't do physical
activities nowadays. She stopped going out of home. She fluctuates in her thinking. She gets
up late in the morning and she gets angry if we say something

Her mother said that I am concerned about my daughter's feelings and career so I encouraged
her to take counselling.
Relationship:
If unmarried:
Patient’s relationship with family members:
● With mother: Her mother is very supportive.
● Father: Her father is good and supportive
● Brothers: NA
● Sisters: Good

Any other relative staying with patient: No

With friends:
How many friends does the patient have? How does the patient relate to them? NA
With neighbours: Not good
With classmates: Good
With the teachers in college: Good

25 MPCE 025, Interns Report : Enrolment No.2101329657 : Case 3 (General Anxiety

Disorder)
With other authority figures: NA
With playmates: NA
In the games field: NA
Educational history:
● In school / college:
Good student
● How is the client in studies and academic performance?
Good
Does the client come up to the expectations of parents and teachers?
No
● Have they received any complaints from the school authorities regarding the client
performances?
Yes, she became weak in academics
● When did they decide to consult a counsellor?
suddenly lost her attention in studies and became weak in academics. Her attendance
also decreased at that time.

Work history:
NA
If Married: NA (not married)

MSE
Appearance:
● Age: 17 years
● Sex: Female
● Hygienic: Yes

Movement and Behaviour:

● Client’s gait : Normal
● Posture : Feeling uneasy in sitting
● Eye Contact : Makes eye contact and stable
● Facial expression: Not calm

Mood: Anxious

26 MPCE 025, Interns Report : Enrolment No.2101329657 : Case 3 (General Anxiety

Disorder)
Speech:
● The volume of the person’s voice : Average
● The rate or speed of speech : Slow
● The length of answers to questions : Keeping short
● The appropriateness of the answers : Appropriately answered
● Clarity of the answers and similar characteristics: Clear

Thought Content:
After establishing the rapport and observing the client’s appearance and all, I assess that the
client has general anxiety disorder
Cognition:
a. Orientation: Intact with respect to time, date, place and person.

b. Attention/ Concentration: ok
c. Memory: NA
Intelligence: Adequate (as per educational background, told 1st division)
Judgement:
Social: NA
On test: NA
Insight: NA
Brief background & client’s Assessment Data:
Client passed 10th from a private school nearby her house. Mostly she has been either first
or second in her class. She was a bright student and was loved by all school teachers. She
got many prizes in singing and other stage performances. She never received any complaint
from her school side. Then she got admission in a high ranked college and started 10+1 in
Physics, chemistry and maths. She was happy till mid of 10+2 and suddenly lost her attention
in studies and became weak in academics. Her attendance also decreased at that time.
As told by her parents, she is not able to sit peacefully and talk properly. She is not able to
take any decision. She remains stressed, restless and frustrated. She doesn’t do much
physical activity nowadays. She stopped going out of home. She fluctuates in her thinking.
She was looking very tired and upset. Her clothes were not neat and her hair was undone.
She looked very gloomy and didn’t respond to my greetings. She seemed unwilling to talk.

27 MPCE 025, Interns Report : Enrolment No.2101329657 : Case 3 (General Anxiety

Disorder)
After listening to her parents and observing her, she seems to be suffering from GAD
(General Anxiety Disorder) and Depression.
SESSION 1

Duration: 20-30 minutes

Medium of conversation: Telugu and English
Place: Counsellor’s Room

Objectives:
1. To establish rapport with the client.
2. To help client to open up and express his feelings without any hesitation and come
out with his problem.
3. To gather relevant information about the client and his background.
The verbatim conversation with client as follows:
She came into the room with her parents. I greeted them and offered them seats.
I decided to make sure that the client is comfortable and told her that she can make herself
at home here and whatever she would tell, I will be kept completely confidential. A formal
oath of confidentiality was taken by me so that the client becomes comfortable in sharing
the problem and all the things related to the problem.
Her parents told me, “She is not able to take any decision. She remains stressed, restless and
frustrated. She doesn't do too many physical activities nowadays ....” I listened to them
calmly and then asked if they let the client be alone with me. They agreed and sat outside
the room.
Then I asked her, “How can I help you?” She told me that she doesn’t need any help. I
decided not to touch the problem part right then. So I started with her plans of education.
She told me, “I want to become a fashion designer and search for a good institute to take
admission.” After saying it she stood up and started walking in the room. I softly tell her to
sit and relax. Then I said, “I used to do singing and also painting, but now I don’t find them
interesting, “Suddenly she stood up again and told me, “I think I should do some animation
course. I heard that it has good scope. Isn’t it…No…? I think I should learn embroidery and
open a boutique.”

28 MPCE 025, Interns Report : Enrolment No.2101329657 : Case 3 (General Anxiety

Disorder)
I noticed that she was anxious about her studies and lacking decision talking. She was
vacillating in confusion. The problem told by the parents was confirmed. I noticed she was
in a hurry to go back and was not in the mood to talk. I called her parents in and told them
to come again to work further.
My Observation:
In this session the client’s parents expressed their worry over the depressing condition of
their daughter. The client turned depressed and anxious but she didn’t disclose the problem.
Her studies also got affected and she merely passed her exams while earlier she used to be
first in her class. She was asked her plans of study and she could not show any consolidated
decision. She was confused and frustrated. She showed symptoms of GAD and Depression.
She was not dressed properly and looked shabby. Her movements were lethargic. She was
stressed and anxious. She was unwilling to talk as she was struggling with something in her
mind and was unable to discuss it with anyone. She was standing up and walking again and
again while talking. She was not able to take any decision and looked frustrated.
Plan of Action:
Client showed all the symptoms told by her parents. She was anxious and depressed. She
didn’t open up and didn’t share any problems either. When she was asked about her plans
of study she was confused among several options. She revealed her hobbies of painting and
singing. But now she has lost her interest in almost every activity. With I ended the session
and asked to come for next session

SESSION 2

Duration: 40-60 minutes

Place: Counsellor’s Room

Objectives:
1. To explore the level of anxiety and depression of the client.
2. To help client to open up and express his feelings without any hesitation and come out
with her problem.

The verbatim conversation with client as follows:

Today she came with her mother. She was dressed in the same fashion as in the previous
session. But she was not as reluctant as before. I started with her relations with parents and
29 MPCE 025, Interns Report : Enrolment No.2101329657 : Case 3 (General Anxiety
Disorder)
she told me, “They are very kind. They care for both of us a lot. Whatever I demand, they
fulfil as much as possible. I know these days they are tense because of me. But I love them.
my sister is also very close to me.
I said, “That means you know that they are tense because of you.” She said, “But I don’t
have any problem.” I told her very calmly while reflecting her sentiments, “Client! We all
are human beings and it is natural to have problems. Having problems is not bad but
suppressing them is worse. Problems are part of our life; they can be solved only when
shared.”
She stood up again and I warmly requested her to sit. I again started, “Believe me every
problem has solutions. Honestly, we shall find solutions together. Whatever you are going
to tell me will not be shared with anyone until you agree. It will be kept completely
confidential. You can share anything that you can’t share with your parents.”
She broke down and started, “I had been a top student …. not only in academics but also in
extracurricular activities. But it happened to me…. Why did it happen to me? I am shattered
now…everything was fine till I participated in the annual function. I was singing the song
on stage and some boys started hooting and shouting at me. They didn’t like the song and
made fun of me in front of the whole school. Everyone was laughing at me…. I was badly
insulted. I had never faced such an incident before…now I can’t face any crowd; especially
boys. I didn’t know that I was such a useless, disgusting person. I could not say anything to
those fellows. I was humiliated. My parents are very proud of me. How can I tell them that
I am not worthy of that? I am the reason for their insult also. What would they think of me?
I don’t want to go anywhere to face anyone.”
As she became silent and calm, I told her, “You are absolutely fine and as respectful as were
before. No such an incident can sweep your pride from you or your parents. Don’t worry
once you shared your bitter experience, now we will together fight with this feeling,”
This time she didn’t stand up even once and after the catharsis she was peaceful and calm.
I took help of Beck's Depression Scale to know the level of problem. She was willing to
take the scale, she answered the Depression Scale statements
The test showed that she had ‘moderate’ depression. I interpreted this result to her and she
needs not to worry as it was not a severe depression and she would be better soon. I asked
her, “Things that happened in the past doesn’t mean life is finished. Tremendous
opportunities will be coming in the future. We can repair the damage once we make the right
choice in the present and direct our future. Even with me it also happened when I was in

30 MPCE 025, Interns Report : Enrolment No.2101329657 : Case 3 (General Anxiety

Disorder)
school. I fell down while dancing on the stage. Everyone laughed at me but I got up and
completed my dance. even after that I performed many times. Nothing could stop me, “Do
you ever feel shame for that?”
I said, “Why should I feel shame? Every human learns by committing mistakes only and
amends himself further.” (self-disclosure)
She realized that and expressed her wish to move on. I engaged her in this encouragement
by asking her career plans, like this session went on smoothly as expected
Later on I taught her various techniques to counter anxiety and depression. She attentively
listened and when I started discussing yoga and meditation, she told me that she had already
been exercising yoga and meditation as she learnt them in summer camp. Additionally, I
taught relaxation techniques also.
My Observation:
In this session catharsis was done and the client's problem was evident. She was insulted by
some boys in front of the whole school. She could not eat it and lost her confidence and self-
esteem. She is now anxious about facing boys and crowds. After catharsis, I assured her she
will be better soon. She needs to continue counselling. Though she was anxious and stressed,
she was established. She was not very complicated to open up; it shows a lot of scope of
intervention. After catharsis she was calm and relaxed. She felt light and promptly agreed to
come for the next session.
Plan of Action:
The actual cause of the problem was identified. She faced a humiliating incident. She thinks
she is the cause of her family’s insult. She lost her self-confidence and got anxious in the
crowd. However, she was more relaxed and calmed after the catharsis was done. As the
problem is evident in the next session

31 MPCE 025, Interns Report : Enrolment No.2101329657 : Case 3 (General Anxiety

Disorder)
 ............................. Regular sessions were followed continuously .............................

SESSION 13

Duration: 30-40 minutes

Place: Counsellor’s Room

Objectives:
1. To explore career choice and further improvement in the client’s behaviour.
2. 7 column thought record

The verbatim conversation with client as follows:

She came into the room in a bright T-shirt and a pair of jeans. Her hair was nicely tugged
and she was looking bright and self-caring this time. She greeted me before I did. I asked
her about her health and her routine. She said, “I feel healthier. Now I wake up early and
go for a walk with my mother. Earlier I felt it tough but now I find this work quite enjoyable.
Then I help my mother with house chores. I continued exercises and techniques told by you.
Now things seemed to be changing slowly! .and yes! I made my choice of career. I decided
to go into fashion designing. I realized this is something I always dreamt of and I have good
scope in Hyderabad. Is it okay?”
Counsellor: oh! Very good and keep it up, 100% you will be successful and then explained
7 column thought record

7 Column Thought Record

How Much
What Do You Still
Identify evidence do What Other What evidence Believe Your
Identify your automatic you have to Perspective do you have to Initial
Event mood (%) thoughts or support this You support this Thoughts?
images thought? Can Take On alternative ? (%)
This?

I feel that Once I was That was I heard

90% going to be travelling in happened everybody will
Going in an accident car met an going with not drive 45%

32 MPCE 025, Interns Report : Enrolment No.2101329657 : Case 3 (General Anxiety

Disorder)
Car accident reckless high recklessly
speed 140kmph

LEAFLET HANDED OVER TO THE CLIENT:

1) Regular Yoga
2) Meditation and Relaxation practice
3) Engaging in creative work
4) Keeping oneself Happy
5) Focus toward Career Goals
6) Keeping Company of Like-Minded People and Well-wishers.

Conclusion:
Client did not cooperate in 1st session and had no rapport, then later session rapport was
established and she wanted to come out of the problem and finally with today’s session was
able to achieve the purpose with which it started.

33 MPCE 025, Interns Report : Enrolment No.2101329657 : Case 3 (General Anxiety

Disorder)
 COUNSELLING CASE 4
(Career Confusion)

Socio-demographic data
Intake information:
Name : Client
Age : 16 years
Gender : Male
Educational qualification : 10+2
Occupation : Student
Father occupation : Business
Mother’s occupation : Housewife
Income : NA
Marital status : Unmarried
Language : Telugu, Hindi, English

Whether client stays with parents: Yes

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

Chief Complaints:
Presenting problem:
“Inability to decide a career after 10+2. He does have a few options such as computer
programming, B. Com etc. but is unable to decide on what to choose finally”
Precipitating Factors if any: NA

Duration of problem: NA
Any counselling taken: No
How intense is the problem and how does it affect the client?
● Has to take leave from work place : No

34 MPCE 025, Interns Report : Enrolment No.2101329657 : Case 4 (Career

Confusion)
 ● Cannot carry on even the routine work in time : No
● Arguing with parents and rejecting tasks : No
● Does not want to do anything : No
According to the Informant:
Interview with family members/spouse/the concerned person
Name: Father of Client
Age: 42
Sex: Male
Relationship: Father
The view point of his Father in regard to all the above
The problem as stated by his father, is his inability to decide a career after 10+2. He does
have a few options such as computer programming, B.Com etc. but is unable to decide on
what to choose finally
His father said that I am concerned about my son’s career so I encouraged him to take
counselling.
Relationship:
If unmarried:
Patient’s relationship with family members:
● With mother: His mother is very supportive.
● Father: His father is good and supportive
● Brothers: NA
● Sisters: NA

Any other relative staying with patient: No

With friends:
How many friends does the patient have? How does the patient relate to them? NA
With neighbours: Good
With classmates: Good
With the teachers in college: Good
With other authority figures: NA
With playmates: Good
In the games field: NA

35 MPCE 025, Interns Report : Enrolment No.2101329657 : Case 4 (Career

Confusion)
Educational history:
● In school / college:
Good student
● How is the client in studies and academic performance?
Good
Does the client come up to the expectations of parents and teachers?
No
● Have they received any complaints from the school authorities regarding the client
performances?
No
● When did they decide to consult a counsellor?
When there was confusion in selecting career after completing the 10+2 whether to go
for computers or B.com degree etc.,

Work history:
NA
If Married: NA (not married)

MSE
Appearance:
● Age: 16 years
● Sex: Male
● Hygienic: Yes

Movement and Behaviour:

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

Mood: Calm and attentive

36 MPCE 025, Interns Report : Enrolment No.2101329657 : Case 4 (Career

Confusion)
 Speech:
● The volume of the person’s voice : Soft
● The rate or speed of speech : Normal
● The length of answers to questions : Appropriate
● The appropriateness of the answers : Appropriately answered
● Clarity of the answers and similar characteristics: Clear

Thought Content:
After establish rapport and observing the client’s appearance and all, I assess that the client
has career confusion after 10+2
Cognition:
a. Orientation: Intact with respect to time, date, place and person.

b. Attention/ Concentration: ok
c. Memory: NA
Intelligence: Adequate (as per educational background, told 1st division)
Judgement:
Social: NA
On test: NA
Insight: NA

Background information:
Client is a sixteen years old boy, and is a student of 10+2. He voluntarily sought help from a
counsellor, with the problem that he cannot decide on a career after 10+2. Client’s father runs
their own property business and mother is a simple housewife. His family consists of his
parents and himself. He has a good relationship with his parents and friends. He is very good
in fine arts but did not opt it as a subject in 12th. Client’s past academic achievement revealed
him to be a low performer. He scored 42% in the 11th.
The problem is inability to decide on a career after 10+2. He does have a few options such as
computer programming, B.com(pass) etc. but is unable to decide on what to choose finally

37 MPCE 025, Interns Report : Enrolment No.2101329657 : Case 4 (Career

Confusion)
 SESSION 1

Duration: 40-60 minutes

Medium of conversation: Telugu and English
Place: Counsellor’s Room

Objectives:
1. To build rapport with the clients by creating an environment of warmth, acceptance,
trust so that the client feels free to discuss his problem.
2. To gather basic information about the client to understand his problem in the context
of his career and education
Verbatim conversation with the client as follow:
Counsellor: The Client entered; I greeted and asked him to have a seat. I further enquired
him about any difficulty he might face in finding the place. I offered him a glass of water.
I decided to make sure that the client is comfortable and told him that he can make himself
at home here and whatever he would tell, I will be kept completely confidential. A formal
oath of confidentiality was taken by me so that client becomes comfortable in sharing the
problem and all the things related to problem, then started the session
Please tell me how I can help?
Client: I don’t know what to do after my 12th class. I just do not know what to say.
Counsellor: oh, you are finding it difficult to make a decision about your future career.
(paraphrasing)
Client: Yes, Sir.
Counsellor: Client I would like to understand your difficulty. Tell me, what you have
studied in class 11th (Reflection of feelings)
Client: I was interested in opting science but due to low scores in the class 10th I got
commerce stream with maths(pause).
Counsellor: can I see……. What was your performance in the 11th?
Client: I got umm….62% Sir, but 39% in math’s and 42% in science.

38 MPCE 025, Interns Report : Enrolment No.2101329657 : Case 4 (Career

Confusion)
Counsellor: Did you expect to score higher? What was the reason for getting 62%?
Client: I am an average student but it was due to my carelessness and low concentration.
Counsellor: So you never aimed very high in life but wanted to do well in board exams but
due to lack of confidence did not do well (paraphrasing,)
Client: Yes, Sir (visibly relaxed and relieved that) the counsellor has been able to understand
his inability to get good marks.
Counsellor: How was your performance in class 11th?
Client: Sir, So So-43% the same due to lack of concentration.
Counsellor: Have you ever tried to increase concentration?
Client: No, Sir but it troubles me.
Counsellor: We will discuss this too--- but what about your career? Have you got
preferences, a few options? that you may have considered for a career.
Client: Oh, well, I often think of computers as one possibility or hotel management as 2 nd
possibility.
Counsellor: Did you do anything about computer programming or hotel management?
Client: Not much Sir. (Nodded)
Counsellor: Hum…. Well Client, for a career in computers it will be preferred if you have
done Math’s in higher secondary. But you say you are doing commerce without
Maths, which are the subjects you like?
Client: I have Math’s as an additional subject.
Counsellor: So you also opted Math’s as an additional subject.
Client: Yes, Sir. ok
Counsellor: Are you preparing it well for exams?
Client: Till date, No Sir.
Counsellor: Have you discussed your future plans with your parents?
Client: Yes, Sir but they say in a hurry, a decision can be made after I do my 12th class.
Counsellor: Client, do you want them to take this decision for you?
Client: (thinking for some time) I may do whatever, they ask me Sir I told you, I am finding
it difficult to concentrate on my studies.
Counsellor: For that I would like to know how you study, the time you spend on studying.
Do you plan beforehand for the day i.e. what you are going to study?
Client: I only decide the time of studying.

39 MPCE 025, Interns Report : Enrolment No.2101329657 : Case 4 (Career

Confusion)
Counsellor: I hope you can make a plan of study which you will be able to follow, for how
long can you study at a stretch?
Client: Maybe an hour, after that I want to get up for at least 15 minutes.
Counsellor: So Client, initially you can keep a study period of an hour each with 15 minutes
break. Think of that 15 minute’s break whenever your mind starts to wander. It may
help to concentrate just imagine how happy you will be after half an hour’s
concentrated study.
Client: Yes. Sir, even now when I think of it, it makes me feel very happy.
Counsellor: So you can reward yourself in those 15 minutes by engaging yourself in an
activity that you really want to do or doing anything of your choice.
Client: I will try this Sir.
Counsellor: After you have tried this for ten days, tell me whether it is helping to
concentrate or not?
Client: Yes, Sir.
Counsellor: Next time when you will come, we will discuss your qualities and related career
possibilities for you.
Client: o.k. Bye Sir, I will definitely come.
My Observation:
This session mainly aims to gain trust and confidence of the client and gather information
about his academic performance. She was able to bring out some of the client’s weak points,
inability to perform well due to poor concentration, unsystematic plan of study etc.
Plan of action:
Need few more sessions to understand more about her confusion and make her to take
decision her own way, fixed the time and scheduled the next session

............................. Regular sessions were followed continuously .............................

SESSION 12
Duration: 40-60 minutes
Place: Counsellor’s Room

Objectives:

40 MPCE 025, Interns Report : Enrolment No.2101329657 : Case 4 (Career

Confusion)
 1. To know further about the client’s interest and to give him necessary information
about the related careers.
2. To provide the client information on the nature of work, the skill required for
degree courses, engineering courses and opportunities.

The verbatim conversation with the client is as follow:

Counsellor: Hello Client, come in, come in, how are you?
Client: Quiet well Sir.
Counsellor: So did you do something of your interest this week. You said computer’s
interest you. Have you ever tried working on a computer?
Client: No, Sir, not yet.
Counsellor: Suppose you join a very expensive computer course and Later-on find out
that you are not so interested in it or you do not enjoy working on the computer as
much as you had imagined it, then what do you think you would do?
Client: Perhaps I may have to leave the course.
Counsellor: O.k. It seems to me that the idea of thinking up a computer has appealed to you
a lot but you don’t know that to have a full-fledged career in computers, you need
science and maths as well as must have certain abilities such as analytical, numerical
and abstract thinking.
Client: Sir, definitely I update myself, please tell me about different career options after
my 10+2
Counsellor: Ok, sure, please listen carefully and be attentive after 10+2 you can enter into
1. Degree Courses [ B. Com, B.A, B.Sc.,]
2. Engineering Course [ B.Tech, IIT, IIIT ]
Degree courses:
Science and Arts are people who do the methodical investigation of the design and conduct of
the physical, social, and characteristic universes through perception and experimentation. It’s
critical to development, worldwide seriousness, and human progression. It’s significant that
the world keeps on propelling the field of science, regardless of whether it’s discovering new
solutions for malignant growth and different sicknesses or distinguishing and investigating new
41 MPCE 025, Interns Report : Enrolment No.2101329657 : Case 4 (Career
Confusion)
galaxies, also to become a Lecturer, get a Ph.D., in various research areas, and great
contribution in Defence/Civil Services.

Although both BSc and B.Com provide enough job opportunities, if you want to earn a bit
more, B.Com is a more preferable option. With B.Sc you get the scope in teaching jobs,
laboratories, small level management jobs and government jobs. With B.Com you get entry in
the corporate sector, private organisation and government job as well.

B.Sc is a basic course though B.Com provides you with more options. In comparison to B.Sc,
B.Com has more opportunities for professional courses. There are more professional courses
linked with B.Com. Though a B.Sc graduate can also join the banking and management, B.Com
graduates get some special offers.

Engineering:

Engineers are people who solve problems and focus on making things work more efficiently
and effectively. They apply the theories and principles of science and mathematics to research
and develop economical solutions to technical problems. They are often the ones who are
overburdened with their assignments, everyone is competing in the race of securing the highest
grade points and even a percent matters, to become an entrepreneur or planning to do research
or to get a high-class job.

Choosing CSE will lead you towards software companies which will definitely provide you a
better pay package than a core ECE company will provide to an average student.

To be precise, you may get a PRIVATE job with a high salary structure.

On the other hand, ECE, being a core branch, has a good scope for GOVERNMENT jobs too.

For example, you can appear for competitive examinations such as IES with ECE as your
subject.

And the best part is, you can still apply for software jobs if you are confident with your coding.

you will have to be exceptionally good at coding (if you choose ECE) to compete with a CSE
guy as far as "PACKAGE" is concerned.

So according to me, conclusion is (Assuming you are not biased for a particular branch):-

1. If you are seeking a high package - Go for CSE!!

2. If you want a broader range of opportunities - Go for ECE.

42 MPCE 025, Interns Report : Enrolment No.2101329657 : Case 4 (Career

Confusion)
Also suggested to the client, try to find out in which other areas your interest and aptitudes lie.
you go for psychological tests
Life career assessment (LCA) for choosing a future career for oneself.
Career psychologists have suggested a variety of ways of organizing the life career themselves,
in this case a popular framework presented by J.L. Holland (1979) was used to categories the
life career themselves emerging from the L.C.A. The framework provides following
classifying themes

Following information is provided in the form of brochure

Artistic: Dislikes routine, supervision is expressive, original, Adventurous, impulsive,

spontaneous, abstracts, Thinks like novelty, change, varieties.
Social: Adaptable, interested, co-operative kind, friendly, Insight fell, generous, sociable,
understanding, Guiding, popular, idealistic, adventurous, energetic, ambitions, Independent,
sociable, persuasive, assertive, optimistic, self-confident, dislike routine, supervision, seeks
reward recognition etc.
Conventional: Careful, persistent, systematic, structured, Efficient, confirming, practical,
conservative, inhibited conscientious, likes details, complete tasks etc.
Related: Systematic, structured, efficient confirming, practical, works with tools machines,
conformists, precise, Methodical materialistic, frank, honest, humble Natural, persistent,
modest, shy, stable, thrifty.
Investigative: Analytical, efficient, cautious, like to investigate, methodical, tries to
understand, tries to solve problems, work with precision, Independent, modest organized,
reserved etc.
My Observation:
This is a typical case of a youngster who is not able to make a decision because of lack of self-
knowledge about the world of work. Youngsters are often pressured by family members to
choose a career based on their own preferences which may not prove a suitable career.
Interview with the client indicated that he was interested in a career in computers. However,
his choice was based on information provided by other people.
Conclusion:
Counsellor was successful in opening up various other possible occupational avenues by
providing information about other career possibilities. Further sources of information helped
the client explore some other alternative areas. Thus created a sense of self confidence in the
43 MPCE 025, Interns Report : Enrolment No.2101329657 : Case 4 (Career
Confusion)
client and now he was prepared to make a sensible and a choice full decision for pursuing his
career.

44 MPCE 025, Interns Report : Enrolment No.2101329657 : Case 4 (Career

Confusion)
 COUNSELLING CASE 5
(Behavioural problem under pressure)

Socio-demographic data
Intake information:
Name : Client
Age : 11 years
Gender : Male
Educational qualification : 6th class
Occupation : Student
Father occupation : Business
Mother’s occupation : Housewife
Income : NA
Marital status : NA
Language : Telugu, Hindi, English

Whether client stays with parents: Yes

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

Chief Complaints:
Presenting problem:
“Client remains restless in the class. Keep destroying things like breaking pens, pencils,
spoiling desks, his own uniform, never completing his work on time, even spoiling books
and notebooks of others and taking their things without asking them. Sometimes he sings
songs in a very low pitch when the teacher is writing on the blackboard. Although Client is
a very intelligent boy”
Precipitating Factors if any: NA

Any counselling taken: No

45 MPCE 025, Interns Report : Enrolment No.2101329657 : Case 5 (Behavioural

Problem )
How intense is the problem and how does it affect the client?
● Has to take leave from work place : No
● Cannot carry on even the routine work in time : No
● Arguing with parents and rejecting tasks : No
● Does not want to do anything : No
According to the Informant:
Interview with family members/spouse/the concerned person
Name: Father of Client
Age: 42
Sex: Male
Relationship: Father
The view point of his Father in regard to all the above
“Client feels difficulty in participating in activities which he likes due to hesitation
His father said that I am concerned about my son’s career so I encouraged him to take
counselling”
Relationship:
If unmarried:
Patient’s relationship with family members:
● With mother: His mother is very supportive.
● Father: His father is goo, but strict in study
● Brothers: NA
● Sisters: NA

Any other relative staying with patient: No

With friends:
How many friends does the patient have? How does the patient relate to them? NA
With neighbours: Good
With classmates: Good
With the teachers in college:NA
With other authority figures: NA
With playmates: Not good
In the games field: Not good

46 MPCE 025, Interns Report : Enrolment No.2101329657 : Case 5 (Behavioural

Problem )
Educational history:
● In school / college?
Not good and hesitates to participate in activities
● How is the client in studies and academic performance?
Good
Does the client come up to the expectations of parents and teachers?
No
● Have they received any complaints from the school authorities regarding the client
performances?
Yes
● When did they decide to consult a counsellor?
Client was not listening to his school teacher and hesitates to study and does not do
homework etc.,

Work history:
NA
If Married: NA

MSE
Appearance:
● Age : 11 years
● Sex : Male
● Hygienic: Yes

Movement and Behaviour:

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

Mood: Little bit anxious but attentive

47 MPCE 025, Interns Report : Enrolment No.2101329657 : Case 5 (Behavioural

Problem )
Speech:
● The volume of the person’s voice : Soft
● The rate or speed of speech : Normal
● The length of answers to questions : Appropriate
● The appropriateness of the answers : Appropriately answered
● Clarity of the answers and similar characteristics: Clear

Thought Content:
After establishing rapport and observing the client’s appearance and all, I assess that the
client feels difficulty in participating in activities which he likes due to hesitation which he
has developed due to his father’s restrictions.

Cognition:
a. Orientation: Intact with respect to time, date, place and person.

b. Attention/ Concentration: ok
c. Memory: NA
Intelligence: Adequate (as per educational background)
Judgement:
Social: NA
On test: NA
Insight: NA
Background Information:
Problem explained by teacher, Client has behaviour related problem and he is a 6 th class
student and he is the eldest child in the family and his father does a part time business and
he is very particular about his son’s study and to prove his son is very talented and intelligent
by producing highest marks in class as an evidence, he forces him to study for long hours
and do not allow him to play at all. As a result, he has a habit of staying in a room and using
his energy in spoiling things. He wanted to participate in games and extra-curricular
activities but his father strictly told him not to participate otherwise he beat him badly. From
the student information blanks it was gathered that now the client feels difficulty in

48 MPCE 025, Interns Report : Enrolment No.2101329657 : Case 5 (Behavioural

Problem )
participating in activities which he likes due to hesitation which he has developed due to his
father’s restrictions.

SESSION 1

Duration: 20-30 minutes

Medium of conversation: Telugu and English
Place: Counsellor’s Room

Objectives:
To establish rapport with the client so that he is able to express his problem.
The verbatim conversation with the client is as follows:
Introspections
Counsellor’s Charts Dialogue Interpretation Alternate
Skills Response

CO: Client entered with his father; I greeted and

asked them to have a seat. I further enquired him
about any difficulty he might face in finding the
place. I offered him a glass of water.

I decided to make sure that the client is

comfortable and told him that he can make
himself at home here and whatever he would tell,
I will be kept completely confidential. A formal
oath of confidentiality was taken by me so that
client becomes comfortable in sharing the
problem and all the things related to problem

Paraphrasing
CO: Client, your teacher told me that you are a
very good singer.

CL: No no sir.

49 MPCE 025, Interns Report : Enrolment No.2101329657 : Case 5 (Behavioural

Problem )
CO: Why do you sing when other students are Challenging
doing work?

CL: I don’t like to study.

CO: Why?

CL: I study at home all the time

CO: Ok tell me your routine. Probing
CL: My father wakes me up at 5:30 am then after
the toilet and bath etc. I study till the breakfast is
ready then I go to school. Here all the students
participate in games of their choice but my father
does not allow me to do so. If the teacher insists
then my father argues and even fights with them.

Probing
CO: Which game do you like to play?

CL: Football.

CO: Would you like to play a game with me

also?

CL: No. I don’t like to play indoor games.

CO: Why? Probing

CL: I do not want to stay at one place.

CO: Ok then stand up, use this pen as a mic and
speak 5 lines to your family. (client did it very Silence
well.)

CO: Very good. Can you mimic any one you Assurance
like?

CL: Yes, sir.

(He did the task very nicely.)

50 MPCE 025, Interns Report : Enrolment No.2101329657 : Case 5 (Behavioural

Problem )
 The rest of the session went in collecting
background information and other general
information about the client.

My Observation:
The client was motivated to open up and come alone without any hesitation. The initial
support building took no time and the child told his problem to the counsellor. The client
was able to express, when the play way method was used.
Plan of Action:
I had told him to come tomorrow during the last period of the activity. In the meantime, I
planned to work on this problem to find out what are the causes/reasons which are
responsible for his behaviour
............................. Regular sessions were followed continuously .............................

SESSION 13
Duration: 20-30 minutes
Place: Counsellor’s Room

Objectives:
1. To find out various causes/factors which are responsible for Client ’s behaviour.
2. To find a way to help the client to gain confidence and to sort out his problem.
The verbatim conversation with the client is as follows:
Interpretation Introspections
Counsellor’s Charts Dialogue Skills Alternate
Response
Before this session I spoke to his father and
took the information and suggested few
things to resolve his son’s behaviour

CL: May I come in sir?

51 MPCE 025, Interns Report : Enrolment No.2101329657 : Case 5 (Behavioural

Problem )
 CO: Yes, please. (client is a little uneasy to Paraphrasing and
see his father) Please sit down. I had a assurance
detailed conversation with your father about
your problem and he agreed to give you
permission to play football.

CL: In between really papa thank you papa.

CO: Client but one promises you have to
Challenging
make that you will study properly and
sincerely at home and in school.

CL: But papa, you also promise me that you

will not scold me if I miss one or two
questions in an exam.

PAPA: Ok I will not but you will put sincere

effort in your studies.

CL: Yes, papa I will.

CO: Ok Client, I am giving you a time table

to follow for next two weeks then I will ask
you and your teacher about your performance
and then we’ll decide the next step.

CL: Ok Bye-Bye Sir

PAPA: Thanks sir for giving me

Session termination
information about my son's problem and
helping in resolving it.

My Observation:
Information regarding Client ’s problem was revealed during the sessions by using play way
method and reflection method, also when I spoke to the client's father and class teacher
Conclusion:
52 MPCE 025, Interns Report : Enrolment No.2101329657 : Case 5 (Behavioural
Problem )
During the session, able the understand the problem for client’s behaviour and suggested
father to encourage him in playing games and other., so his father was happy for identifying
the problem and he went with happy face with his son, finally achieved to what the sessions
were initiated.

53 MPCE 025, Interns Report : Enrolment No.2101329657 : Case 5 (Behavioural

Problem )
 COUNSELLING CASE 6
(Adaption and Adjustment Problem)

Socio-demographic data
Intake information:
Name : Client
Age : 18 years
Gender : Female
Educational qualification : B.A (1st year)
Occupation : Student
Father occupation : Business
Mother’s occupation : Housewife
Income : NA
Marital status : Unmarried
Language : Telugu, Hindi, English

Whether client stays with parents: Yes

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

Chief Complaints:
Presenting problem:
“I have gone into high anxiety. I have no interest in studies and I don’t want to go to college.
My principle is not ready to give me migration”
Precipitating Factors if any: NA
Duration of problem: 3-4 months
Any counselling taken: No
How intense is the problem and how does it affect the client?
● Has to take leave from work place : No
● Cannot carry on even the routine work in time: No
● Arguing with parents and rejecting tasks : No

54 MPCE 025, Interns Report : Enrolment No.2101329657 : Case 6 (Adjustment

Problem )
 ● Does not want to do anything : Yes

According to the Informant:

Interview with family members/spouse/the concerned person
Name: Father of Client
Age: 42
Sex: Male
Relationship: Father
The view point of his Father in regard to all the above
With Father: I took the interview of her father. After asking he explained that from the last
3-4 months she is getting tensed that she doesn’t want to go to college. She wanted to be
admitted to a different college but her principal is not ready to give migration.
His father said that I am concerned about my daughter’s career so I encouraged him to take
counselling.
Relationship:
If unmarried:
Patient’s relationship with family members:
● With mother: her mother is very supportive.
● Father: her father is good and supportive
● Brothers: NA
● Sisters: NA

Any other relative staying with patient: No

With friends:
How many friends does the patient have? How does the patient relate to them? NA
With neighbours: Good
With classmates: Good
With the teachers in college: Good
With other authority figures: Good
With playmates: Good
In the games field: Good
Educational history:
● In school / college:

55 MPCE 025, Interns Report : Enrolment No.2101329657 : Case 6 (Adjustment

Problem )
● She scored a good percentage (94.6%) in class 12 but she didn’t get her choice of college
so she doesn’t want to go that college

● How is the client in studies and academic performance?

Good
● Does the client come up to the expectations of parents and teachers?
No
● Have they received any complaints from the school authorities regarding the client
performances?
No
● When did they decide to consult a counsellor?
She is getting tensed that she doesn’t want to go to college. She wanted to admit in a
different college but her principal is not ready to give migration
her father said that I am concerned about my daughter’s carrier so I encouraged him to take
counselling
Work history:
NA
If Married: NA
MSE
Appearance:
● Age : 18 years
● Sex : Female
● Hygienic: Yes

Movement and Behavior:

● Client’s gait : Normal
● Posture : Moving hands while talking
● Eye Contact : Makes eye contact and stable
● Facial expression: Angry and sad

Mood: Sad and anxious

Speech:
● The volume of the person’s voice : Normal
● The rate or speed of speech : Normal

56 MPCE 025, Interns Report : Enrolment No.2101329657 : Case 6 (Adjustment

Problem )
● The length of answers to questions : According to question
● The appropriateness of the answers : Appropriately answered
● Clarity of the answers and similar characteristics: Clarity of answer

Thought Content:
After establishing rapport and observing the client’s appearance and all, I assess that the
client was angry and also sad.
Cognition:
a. Orientation: Intact with respect to time, date, place and person.

b. Attention/ Concentration: ok
c. Memory: NA
Intelligence: Adequate (as per educational background, told 1st division)
Judgment:
Social: NA
On test: NA
Insight: NA

Background information:
For 3-4 months she is getting tensed that she doesn’t want to go to college. She wanted to
be admitted to a different college but her principal is not ready to give migration. She is
unable to understand their lectures

SESSION 1

Duration: 20-30 minutes

Medium of conversation: Telugu and English
Place: Counsellor’s Room

Objectives:
To make sensible picture of the client’s problem

The verbatim conversation with client as follows:

57 MPCE 025, Interns Report : Enrolment No.2101329657 : Case 6 (Adjustment

Problem )
The client entered; I greeted and asked her to have a seat. I further enquired her about any
difficulty she might face in finding the place. I offered her a glass of water.
I decided to make sure that the client is comfortable and told her that she can make himself
at home here and whatever she would tell, I will be kept completely confidential. A formal
oath of confidentiality was taken by me so that the client becomes comfortable in sharing
the problem and all the things related to the problem.
Then the client started sharing about the problem she was facing in her life.
In the first session the client's father started to share the problem that the client has gone into
high anxiety. Now she is not interested in continuing her studies.
Counsellor: What do you mean by high anxiety? (Leading)
Client: “I don’t like my college so I don’t want to go to that college` I scored well and I still
got such a college.” It creates tension for her.
Counsellor: Why don’t you like your college? (Leading)
According to client no co-curricular activities are there and the college is single sex college.
She added that the faculty is also not good and she is unable to understand their lectures.
Client: How much time do you spend in college? (Probing)
Client: There is a long gap between the classes, I have to stay there till evening. Sometimes
it happens that one class is in morning time and another class will be held after 2-3 hours.
So, it seems like a waste of time.
She applied for the migration and the colleges in which the client wants to take admission
are ready but the principal of the studying college is not ready to give N.O.C. All the things
were shared by the client.
Counsellor: I will repeat the things that I understood as you said that you are not interested
in studies due to your choice of college and its faculty members. You are worried due to
single sex college as well as no co-curricular activities in your college. You feel that your
time is wasted due to large gaps between the classes and after having so many problems
your college principal is not ready to give N.O.C. to you. (Paraphrasing),
Like this session went assessing the client’s difficulties to create a picture to help her to
arrive at right solution
My Observation:
In this session the client’s parents expressed their worry about their daughter. Adjustment
problem in college, she doesn't like her college and does not want to go to that college
so client has the adjustment problem to the environment and new places

58 MPCE 025, Interns Report : Enrolment No.2101329657 : Case 6 (Adjustment

Problem )
Plan of Action:
Need few more sessions to assess the problem in detail, so for the next session I asked the
client, can we fix it next Monday? The client responded that she would like to come next
week at the specified time, ok, agreed and fixed the time for next session
............................. Regular sessions were followed continuously .............................

SESSION 10
Duration: 20-30 minutes
Place: Counsellor’s Room
Objectives:
To analyse client’s problem in deep and making client choose right solution
The verbatim conversation with client as follows:
Done the recap of the last session and then started the session.
It was told to the client your score in 12th class (94.6%) was very respectable and good. But
according to xx University 94.6% is not a very high score, and see how many students lie
between 94.6% and 100%. If you would see before 94.6% also there is a large population
who didn’t get admission anywhere. As there is high competition, students like you, even
after having a good percentage, aren't able to get college according to their choice.
Counsellor: What is your aim, Client.? (Probing)
Client: “I WANT TO BECOME ENGLISH LECTURER”
Counsellor: You have three years which can become preparation time for your career. It’s
good if you study in single sex college as your career won’t distract. I believe that co-ed
schools and colleges help in personality formation but you have to see personality vs.
academics.
As you shared that your faculty is poor. Poor faculty is a world-wide issue. Scarcity of good
teaching faculty is a problem for almost every college student because teaching is an art.
But in the present scenario you have so many other resources like multimedia books, library,
videos available on the internet which helps in conceptual learning. You can use the library
and through this you can use your time which you get between the classes. And according
to Research, if purpose is important for any person then other things should not be important.
If you go anywhere, you won’t get any option which is free from any issue or problems.
“Distractions are everywhere”
Client: I was one of the famous in my school and college, performed very well in co-
curricular activities

59 MPCE 025, Interns Report : Enrolment No.2101329657 : Case 6 (Adjustment

Problem )
Counsellor: Ok, but focus on the main purpose, if something you missing the you learn
many new things, the beauty of life, when there is no scope, there is a high probability of
getting the shine and fame. My known, there was an uncle who lived in a village. He was
the only person in that village who bought a car and he was famous in that village. After
some years he shifted to posh areas of a metropolitan city but there he saw that every person
had their own vehicle and in a single house, there was more than one vehicle. her fame
faded. So. one needs darkness to shine, in your college you can shine by taking other
initiatives (Self-Disclosure)
Told Eagle Story... Changes for Survival....
EAGLE can live up to 70 years, but to reach this age, the eagle must make a hard decision
in its' 40's, its' long & flexible talons can no longer grab prey which serves as food, Its' long
& sharp beak becomes bent. Its' old-aged & heavy wings, due to their thick feathers, become
stuck to its' chest & make it difficult to fly. Then the eagle is left with only 2 options: die
or go through a painful process of change which lasts 150 days.
The process requires that eagle fly to a mountain & the eagle knocks its' beak against a rock
until it plucks it out
After this, the eagle will wait for a new beak to grow back. When its' new talons grow back,
the eagle starts plucking its' old-aged feathers & after 5 months, eagle can take its' flight of
rebirth & lives for 30 more years
Moral of the Story...
Many times, in order to survive, we have to start a change process. We sometimes need to
get rid of Old memories, habits & other past traditions. Only freed from past Burdens, we
can take advantage of the present.
I have seen confidence level in client's face, and then I told
Overall, you have to change your perception by linking things with your career. After three
years you are to go for Post-graduation so you need fewer distractions. spend this phase
keeping in mind your career. God has given you an opportunity that you can shine and make
your career.
So I ended the interview here in the following manner:
Today we have discussed your problems you are facing all over and we also have tried out
in finding the alternatives to solve it. Hopefully now you are able to reach your solution and
you are well known about what is right and what is wrong.
My Observation:

60 MPCE 025, Interns Report : Enrolment No.2101329657 : Case 6 (Adjustment

Problem )
When the client left I found that she was looking relaxed and confident about her goals and
decisions. Now she is able to choose the right solution to solve the issue.
Conclusion:
Dealt sensitively and helped client in selecting solution in her own way and
was able to achieve the purpose with which it started.

61 MPCE 025, Interns Report : Enrolment No.2101329657 : Case 6 (Adjustment

Problem )
 COUNSELLING CASE 7
(Family Counselling)

Socio-demographic data
Intake information:
Name : Client
Age : 18 years
Gender : Female
Educational qualification : 10+2 pass
Occupation : Student
Father occupation : Business
Mother’s occupation : Housewife
Income : NA
Marital status : Unmarried
Language : Telugu, Hindi, English

Whether client stays with parents: Yes

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

Chief Complaints:
Presenting problem:
“She completed her 12th class with 48% marks and before passing 10th class, she failed two
times. She is interested in learning parlor related work. But father wants her to complete
graduation, quarrel between parents”
Precipitating Factors if any: NA

Duration of problem: 3-4 months

Any counselling taken: No

62 MPCE 025, Interns Report : Enrolment No.2101329657 : Case 7 (Family

Counselling)
 How intense is the problem and how does it affect the client?
● Has to take leave from work place : No
● Cannot carry on even the routine work in time : No
● Arguing with parents and rejecting tasks : No
● Does not want to do anything : Yes
According to the Informant:
Interview with family members/spouse/the concerned person
Name: Father of Client
Age: 42
Sex: Male
Relationship: Father
The view point of her Father in regard to all the above
With Father: I want my daughter to do graduation and then to do any job but my wife wants
my daughter to do a course related to beauty parlours. And due to this, there is rift between
us”
His father said that I am concerned about my daughter’s career so I encouraged her to take
counselling.
Relationship:
If unmarried:
Patient’s relationship with family members:
● With mother: His mother is very supportive.
● Father: His father is good and supportive
● Brothers: NA
● Sisters: NA

Any other relative staying with patient: No

With friends:
How many friends does the patient have? How does the patient relate to them? NA
With neighbours: Good
With classmates: Good
With the teachers in college: Good
With other authority figures: Good
With playmates: Good
In the games field: Good

63 MPCE 025, Interns Report : Enrolment No.2101329657 : Case 7 (Family

Counselling)
Educational history:
● In school / college?
He is falling behind in his studies in the school
● How is the client in studies and academic performance?
Below Average
● Does the client come up to the expectations of parents and teachers?
No
● Have they received any complaints from the school authorities regarding the client
performances?
No
● When did they decide to consult a counsellor?
Family problem
Work history:
NA
If Married: NA (not married)
MSE
Appearance:
● Age: 18 years
● Sex: Female
● Hygienic: Yes

Movement and Behaviour:

● Client’s gait : Normal
● Posture : She sat down and crossed her hands
● Eye Contact : Not making eye contact
● Facial expression: Confused

Mood: Sad
Speech:
● The volume of the person’s voice : Normal
● The rate or speed of speech : Normal
● The length of answers to questions : Keeping short
● The appropriateness of the answers : Lack

64 MPCE 025, Interns Report : Enrolment No.2101329657 : Case 7 (Family

Counselling)
 ● Clarity of the answers and similar characteristics: Not so clear

Thought Content:
After establishing rapport and observing the client’s appearance and all, I assess that the
client was angry and also sad.
Cognition:
a. Orientation: Intact with respect to time, date, place and person.

b. Attention/ Concentration: ok
c. Memory: NA
Intelligence: Not so (as per educational background)
Judgment:
Social: NA
On test: NA
Insight: NA
Background information:
She completed her 12th class with 48% marks and before passing 10th class, she failed two
times. She is interested in learning parlour related work. But father wants her to complete
graduation, quarrel between parents”
Her father said, I want my daughter to do graduation and then to do any job but my wife
wants my daughter to do a course related to beauty parlours. '' And due to this, there is rift
between us”

SESSION 1
Duration: 40-60 minutes
Medium of conversation: Telugu and English
Place: Counsellor’s Room

Objectives:
1. To establish rapport with the client.
2. To help client to open up and express her feelings without any hesitation and come out with
her problem.
3. To gather relevant information about the client and her background.

The verbatim conversation with client as follows:

65 MPCE 025, Interns Report : Enrolment No.2101329657 : Case 7 (Family

Counselling)
The client entered with her family; I greeted them and asked them to have a seat. I further
enquired them about any difficulty they might face in finding the place. I offered them a
glass of water. As the issue was related to the whole family, so family counselling was
preferred.
I decided to make sure that the client is comfortable and told him that she can make herself
at home here and whatever she would tell, I will be kept completely confidential. A formal
oath of confidentiality was taken by me so that the client becomes comfortable in sharing
the problem and all the things related to the problem.
Client started sharing about the problem she was facing in her life.
Client shared that she completed her 12th class with 48% marks and before passing 10th class,
she failed two times. Client is interested in learning parlour related work. Client mother has
her own parlour and this is one of the reasons behind her low score.
Client shared that as her mother spent all her time in the parlour and many times, Client also
went to the parlour to help her mother. “I lost interest in studies. Now client interest was
developed towards Parlour related work.
Client Mother: shared that the client should join a Beauty Culture Course in an institution
at Hyderabad. This course duration is one year and fees for the course is 1,25,000Rs. for
one year. She will provide the fee for my daughter. She added that after doing this course,
she and her daughter together can spread their work. Now-a-days the monthly earning from
a good parlour is 40-45,000 Rs.
Counsellor: What does your father want you to do? (Probing)
Client Father: “I want my daughter to complete her graduation and then find a job at a good
place”. Her mother is doing work with a parlour but is not able to earn enough money. I
don’t want my daughter to work at such a place where there is no recognition of such a job.
The family members shared their views one-by-one, i shown attention towards them while
telling their versions, thought one story and that may help them and relate to their problem
Told ONE HAPPY FAMILY birds story
In a forest there lived a family of birds with father, mother, and a baby bird. The baby is
loved by both the parents very much. They were living very happily. As days went by father
and mother birds started fighting for simple reasons. The fighting kept on going for days
and even for months. Baby bird was so sad to see her parents fighting. She begged both of
them not to fight and be happy, but they did not listen to her words. It made her very sad.
The baby bird consoles her mother whenever the fighting is over. For the sake of the baby
66 MPCE 025, Interns Report : Enrolment No.2101329657 : Case 7 (Family
Counselling)
bird mother also gets convinced and returns to normal. When years passed by the mother
could not cooperate with the father bird for a long time. So she decided to leave him, but
thinking of the baby she stays back always.
One day the father bird went out in search of prey. At that time the mother bird flew away
with her baby bird from the nest to another place. When the father bird returned, he could
not find his family. He felt so bad and realized his mistake. He told himself “if I would have
listened to my baby, it could not happen”
He searched for them here and there. After searching for months, he found them in a deep
forest living alone in a small nest. He went near the mother bird and apologized for his
mistake. He also apologized to the baby bird for the happenings. By the time the mother
bird also felt like leaving the father bird alone, she also said sorry in return. Thereafter,
without blaming each other and fighting they lived with their baby bird happily.
Moral: Live your life happily; do not blame others for your mistakes
I ended the session by telling above story and moral, let's continue in next session
My observation:
Miscommunication between family members.
Plan of action:
Time is a big medicine for anything in this world, told them think about the story and
planning for next session
............................. Regular sessions were followed continuously .............................

SESSION 11
Duration: 20-30 minutes
Place: Counsellor’s Room
Objectives:
1. To help the client to come out the problem

The verbatim conversation with client as follows:

Done the recap of last session and about story for happy family, then
It was told to the client and her mother that it’s your father’s dream for her daughter to
complete graduation and it is her aspiration to see your future in a better way. You both
should also understand her point of view.
I said to the client's father that it is good that you want your daughter to complete graduation
but as you also know her percentage in class 12th is very low. So, it’s very difficult to get
admission in any college. Another thing is that after completing graduation, she won't be

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Counselling)
able to get a job as no skills are taught in B.A. So, if a client is interested in taking admission
for a Beauty Culture Course, it is also a good option. After one year she would be able to
start her own parlour or can help her mother.
Client now you have an option that you can do both the things together. From the Open
Learning System, you can complete your graduation. In Open Colleges you just have to go
once a year to take exams. Rest of the time, you can do your Beauty Culture Course side-
by-side. After one year, you will be able to earn money and in your spare time you can also
prepare for your studies.

So with that I ended the session by saying,

Client, I think today we’ve discussed your problem you are facing all over and we also have
tried out to find the alternatives to solve it. Hopefully, now you as well as your parents are
able to choose the right career option for you.

My observation:
When the family was leaving I found that they were looking relaxed and confident.

Conclusion:
Various conflicts that she has expressed and during session also listened parent’s version of
interests that she is facing from a long time, finally achieved to what the sessions were
initiated.

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Counselling)
 COUNSELLING CASE 8
(Depression due to Disability)

Socio-geographic data
Intake information:
Name : Client
Age : 34 years
Gender : Male
Educational qualification : M.Com, B.Ed., CTET
Occupation : Teaching
Income : NA
Marital status : Divorced
Language : Telugu, English, Hindi

Whether client stays with parents: Yes

Whether client stays with spouse: No
Whether have any siblings, if so how many: 1 brother
What is the position of the client in the family: Elder
Anyone in the family having conflicts: Yes, between client and father
Anyone in the family is suffering/has suffered from any physical disorders: Yes
Client (50% disabled) & his brother (70% disabled)

Chief Complaints:
Presenting problem:
“I am very unhappy with my life and also don’t like my father. I am scared of everything.”
Precipitating Factors if any: NA
Duration of problem: 1 Year
Any counselling taken: No
How intense is the problem and how does it affect the client?
● Has to take leave from work place : No
● Cannot carry on even the routine work in time : No
● Arguing with parents : Yes
● Does not want to do anything : Yes

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According to the Informant:
Interview with family members/spouse/the concerned person: No
Relationship:
Married: Yes
Relationship with spouse in terms of
● Day to day dealings - Not living with spouse (divorced)
● Sex life - Was not good (remained good till few months)
● Work relationship - Nil
● Relationship with children - Nil
● Decision making - Spouse
● Sharing of work at home - No

Patient’s relationship with family members:

● With mother: His mother is very supportive. she is concerned about her son’s feelings
● Father: His father strict not understanding nature
● Brothers: NA
● Sisters: NA

Any other relative staying with patient: No

With friends:
How many friends does the patient have? How does the patient relate to them? NA
With neighbours: Good
With classmates: NA
With the teachers in college: Good
With other authority figures: NA
With playmates: Good
In the games field: Good

Educational history:
● In school / college?
Good
● How is the client in studies and academic performance?
Good
Does the client come up to the expectations of parents and teachers?
Mixed inputs

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● Have they received any complaints from the school authorities regarding the client
performances?
No
● When did they decide to consult a counsellor?
Feeling depression and tried with self-awareness but could not come out the problem so
decided to consult a counsellor
Work History:
● What occupation is the client involved in?
The Client was working as a teacher in a NGO but now the client is jobless from last
few months
● How regular is the client for work?
When he worked in the NGO, he worked well and regularly.
● Has the client been complaining about the workplace? If so, what?
The client complained about the salary he got after having good qualification

MSE
Appearance:
● Age: 34 years
● Sex: Male
● Hygienic: Yes

Movement and Behaviour:

● Client’s gait : Normal
● Posture : Uneasy
● Eye Contact : Continuously moving his eyeballs, was not able to make eye contact
● Facial expression: Tensed, fearful

Mood: Nervous, anxious

Speech:
● The volume of the person’s voice : High
● The rate or speed of speech : Fast
● The length of answers to questions : 3-4 sentences
● The appropriateness of the answers : Appropriately answered

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 ● Clarity of the answers and similar characteristics: Clear

Thought Content:
After establish rapport and observing the client’s appearance and all, I assess that the client
is facing self-conscious, weak will power, depression symptoms
Cognition:
a. Orientation: Intact with respect to time, date, place and person.

b. Attention/ Concentration: ok
c. Memory: NA
Intelligence: Adequate (as per educational background)
Judgment:
Social: NA
On test: NA
Insight: NA

SESSION 1
Duration: 40-60 minutes
Medium of conversation: Telugu, English and Hindi
Place: Counsellor’s Room

Objectives:
1. To establish rapport with the client and to make sensible picture of the client’s problem
2. To help client to open up and express his feelings without any hesitation and come out
with his problem.
3. To gather relevant information about the client and his background.
The verbatim conversation with client as follows:
Client entered; I greeted and asked him to have a seat. I further enquired him about any
difficulty he might face in finding the place. I offered him a glass of water.
I decided to make sure that the client is comfortable and told her that he can make himself
at home here and whatever he would tell, I will be kept completely confidential. A formal
oath of confidentiality was taken by me so that the client becomes comfortable in sharing
the problem and all the things related to the problem.
Client started sharing about the problem he was facing in his life.

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Client started sharing his problem that he is a 50% disabled person. He has done B.com,
M.com, and B.Ed. Cleared CIET exam and presently working in an NGO in Hyderabad and
earning 40000. He is unhappy with his father and fed up from his life.
Counsellor: What do you mean by fed up? (Probing)
Client: “Fed up means I don’t like anything, I get afraid of things and events, and feel
confused”. Client is unhappy because he is physically disabled and he feels his energy level
becomes down.
Counsellor: You said you are afraid from things and events; from what kind of things you
feel fear? (Probing)
Client: “I live in a SBH colony and whenever I listen to the sound of waves, I get afraid
from the thought of Tsunami as I can`t run.”
Also told that he is scared from things and feels disturbed. Most of the time just thinks about
his problems and life.
Counsellor: Where does your wife live? Does she live in her home town or with you?
(Probing)
His wife doesn’t live with him. She has left him. His wife is not disabled and belongs to a
poor family from Vijayawada. They lived together for only 8 months. She was happy in the
first month.
Client doesn’t earn enough so that he can keep his wife along with him. One more reason
for leaving the client was that his wife had an extra affair with the client's father’s friend and
this is the reason Client don’t like his father and remains unhappy with his father. Because
then client told his father about this relation, his father said “his friend not that kind of
person”
Client also added that he is jobless now and feels insecure. He has no hope for further life.
Counsellor: What do you want now? (Probing)
Client: “Suggest me something in which I can suppress my fear and conquer it and my life
become good again”.
All these things were shared by the client in the first session. I repeated what I understood
as a client. You shared your problem that you are a physically disabled person and due to
this you feel fearful, scared and fed up from your life. (Paraphrasing)
Now you need motivation and suggestions to improve things in your life, we discuss those
things in coming sessions and ended the session

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My Observation:
It is the case of depression and under-achievement.
The client was very quick to open up and came up very easily with his problem. Paraphrasing
and reflection skills used by the counsellor helped to convey to the client that his problem
had been understood.
Plan of Action:
I had told him that we will meet tomorrow. I planned to work on this problem and to find
out what are the things at the client that make him upset. I would ask him to relate the same
incidents which make him depressed and have low confidence with fear

............................. Regular sessions were followed continuously .............................

SESSION 13
Duration: 40-60 minutes
Place: Counsellor’s Room

Objectives:
1. To help client to come out with his problem by making him to select best solution
himself
2. To help telling moral story and relate
The verbatim conversation with client as follows:
Done the recap of last session and start focussing the clients problem with questions with
probing and empathy
CO: Client as you mentioned that your body is 50% disabled which is now a reality and a
part of your life and our body is like hardware and our mind is like software. If the problem
is in hardware (due to body), then you have to use your mind. The capacity of your mind
becomes weak because you feel weakness in terms of your body. But when you accept
reality and emphasize the mind's ability then your mind will work effectively.
you are still jobless; you should focus on teaching for your career intervention. Thus you
would be financially independent. According to Psychological Research, when you become
financially independent, your self-confidence will become high. You have to learn different
skills to compensate for your disability.
According to you, what should be the priorities for you now?
Client: First of all I need a good job.

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Counsellor: You have to work on different skills, improve your interview skills,
communication skills, create humour in you so that you can clear interviews and get a job.
Told an inspirational story about Stephen Hawking
When you talk about men of science, you cannot leave Stephen Hawking out of the picture.
Hawking was diagnosed with ALS when he was only 21 and needed a wheelchair and a
voice synthesizer to enable him to speak and go about his daily life. This did not stop him
from becoming one of history’s most brilliant theoretical physicists, astrophysicists, and
cosmologists, similar to Einstein, Stephen Hawking had an estimated IQ of 160
Here are 8 lessons from his extraordinary life and achievements that can inspire us.
1. He has used technology to overcome his disability. ...
2. He refused to let his disability halt his research. ...
3. He is always curious. ...
4. He has never lost his sense of humour. ...
5. He stands by his principles. ...
6. He never gives up.
7. He values time as a precious resource
8. He shares his knowledge
I have seen changes on his face, gaining confidence, then I switched to current topic and
started, your wife has gone and she will not come back. Now, there is no use to continue
your conflicts with your father, especially when you both live together, under the same roof.
Talk to your father and he will also help you in getting a job. Once you will get a job, your
fear will go far away and financially also you will be strong. So with this I ended the
interview in the following manner
I think today we have discussed your problems you were facing and we also tried to find
various alternatives to solve it. Hopefully now you are able to reach your solution.
My Observation:
When the client left I found that he was looking relaxed and was happy, now he was able to
go with confidence and achieve the things, also suggested an optional session if required
with his father, to clear the misunderstandings between them.
Conclusion:
Many disabled persons are not mentally strong and cannot be motivated easily, but in this
case, he easily came up with motivational stories, felt good, shown symptoms to move

75 MPCE 025, Interns Report : Enrolment No.2101329657 : Case 8 (Depression due to

Disability)
positive side of the life and finally with today’s session was able to achieve the purpose with
which it started.

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 COUNSELLING CASE 9
(Low Self-Esteem)

Socio-demographic data

Intake information:
Name : Client
Age : 21 years
Gender : Female
Educational qualification : Graduate (B.Sc)
Occupation : Not Working
Income : NA
Marital status : Unmarried
Language : Telugu, Hindi, English

Whether client stays with parents: Yes

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

Chief Complaints:
Presenting problem:
Client is 21 years of age and has a very poor self-esteem; in fact she hates the way she looks.
As a result, Client has such low self-esteem that it prevents her from looking for work.
Precipitating Factors if any:

● Looking Fat

● Break-up Love relationship

Duration of problem: From Childhood
Any counselling taken: Yes

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How intense is the problem and how does it affect the client?
● Aggressive behaviour
● Not taking food and sleeping on time
● Blaming herself

According to the Informant:

Interview with family members/spouse/the concerned person:
Name: Mother of Client
Age: 48
Sex: Female
Relationship: Mother
The view point of her mother in regard to all the above
She blames herself for the break-up and believes that her boyfriend ended the relationship
because she's fat. However, when questioned further about this Client could not recall a time
when boyfriend had ever criticised her appearance, in fact he seemed to be very supportive.
At the moment she has such low self-esteem that she doesn't even want to try to find a job,
she thinks "who is ever going to hire me". also described how her friends have stopped
calling her because they say she is constantly criticising them. Client stays at home all day
and every time she looks in the mirror she thinks how ugly she is.
Her mother said that I am concerned about my daughter condition and career so I encouraged
her to take counselling, went to many and this is a one of them, expecting she can come out
from the problem
Relationship:
If unmarried:
Patient’s relationship with family members:
● With mother: His mother is very supportive. She is concerned about her daughter’s
feelings and career.
● Father: Not supportive
● Brothers: Good
● Sisters: NA

Any other relative staying with patient: No

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With friends: Not Good
How many friends does the patient have? How does the patient relate to them? NA
With neighbours: Good
With classmates: NA
With the teachers in college: Not Good
With other authority figures: NA
With playmates: NA
In the games field: NA

Educational history:
● In school / college?
He was good in studies in school and college
● How is the client in studies and academic performance?
Average performance
● Does the client come up to the expectations of parents and teachers?
No
● Have they received any complaints from the school authorities regarding the client
performances?
No, they never received any complaint regarding this.
● When did they decide to consult a counsellor?
when the client was feeling low self-esteem that it prevents her from work,

struggled with her weight all her life, breakup with boyfriend, and her life
became miserable

Work history:
Joined but due to her low self-esteem, she could not do for long time, left the job and now
at home
If Married: NA (not married)

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Esteem)
 MSE
Appearance:
● Age: 21 years
● Sex: Female
● Hygienic: Yes

Movement and Behaviour:

● Client’s gait : Not comfortable
● Posture : Uneasy
● Eye Contact : No eye contact and talking by seeing walls and posters
● Facial expression: Sad and tension

Mood: Nervous and anxious

Speech:
● The volume of the person’s voice : Soft
● The rate or speed of speech : Slow
● The length of answers to questions : 1-2 sentences
● The appropriateness of the answers : Appropriately answered

Thought Content:
After establishing rapport and observing the client’s appearance and all, I assess that the
client has low self-esteem and blaming herself for any outcome
Cognition:

a. Orientation: Intact with respect to time, date, place and person.

b. Attention/ Concentration: ok
c. Memory: NA
Intelligence: Adequate (as per educational background)
Judgement:
Social: NA
On test: NA
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Esteem)
Insight: NA

Background info and client’s assessment data according to client and her mother:
Client is 21 years of age and has struggled with her weight all her life. She remembers back
in primary school how the kids used to call her "fatty" and would not want to play with her.
The taunting continued throughout high school however it was subtler. She found it difficult
to make friends and often found herself excluded from social events. Although the client's
mother is very supportive, the put downs continued at home. Client's father would say things
like "why don't you go on a diet" or "what are you eating for it's only going to make you
fatter". Her elder brother was embarrassed to be seen with her and to make things worse, he
was quite athletic. A few months back, things were starting to turn around for the client. She
began a relationship with a man (x), started exercising and lost about 10 kilograms. Slowly
she started feeling better about herself, however the relationship didn't last and consequently
Client's self-esteem is now at its lowest.

SESSION 1
Duration: 40-60 minutes
Medium of conversation: Telugu and English
Place: Counsellor’s Room

Objectives:
1. To establish rapport with the client.
2. To help client to open up and express his feelings without any hesitation and come out
with his problem.
3. To gather relevant information about the client and his background.

The verbatim conversation with client as follows:

Client entered; I greeted and asked him to have a seat. I further enquired him about any
difficulty she might face in finding the place. I offered her a glass of water.

I decided to make sure that the client is comfortable and told her that she can make herself
at home here and whatever he would tell, I will be kept completely confidential. A formal
oath of confidentiality was taken by me so that client becomes comfortable in sharing the
problem and all the things related to problem

81 MPCE 025, Interns Report : Enrolment No.2101329657 : Case 9 (Low Self-

Esteem)
She blames herself for the break-up and believes that her boyfriend ended the relationship
because she's fat. However, when questioned further about this Client could not recall a time
when boyfriend(x) had ever criticised her appearance, in fact he seemed to be very
supportive. At the moment the client has such low self-esteem that she doesn't even want to
try to find a job, she thinks "who is ever going to hire me". Client also described how her
friends have stopped calling her because they say she is constantly criticising them. Client
stays at home all day and every time she looks in the mirror she thinks how ugly she is. It is
important to note that Client is currently within the healthy weight range for her age and
height. It is obvious that the foundations for Client's low self-esteem were laid down early
in life, however as an adult it is important for Client to now recognise that she is in control
of her self-esteem and hence has the power to change it, like this session went on to build
rapport and collecting the information
My Observation:
client was an extremely shy and softly spoken person, she did not open up as expected,
has low self-esteem due to criticism.
Plan of Action:
To discuss more about personal issues and conflicts with near and dear that made her to
development low self-esteem, fixed the time and planned for next session

SESSION 2
Duration: 30-40 minutes
Medium of conversation: Telugu and English
Place: Counsellor’s Room

Objectives:
1. To help client to open up and express his feelings without any hesitation and come out
with his problem.
2. To improve her low self-esteem.
The verbatim conversation with client as follows:
I discussed the issues of personal control and how it would benefit the client if she took
responsibility for her self-esteem regardless of the influence that others may have had.
I established a client's commitment to improve her self-image and stressed that it was not
constructive to "blame" others, then discussed with Client the importance of setting her own

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standards and not listening to those people who tell her what she "ought" to do or look like.
client's father was the most obvious culprit
However, I stressed that social standards also have a big influence on young people,
especially women today. The ideal woman is portrayed in magazines and on television to
be extremely thin and therefore the average person who compares themselves to these
models is going to feel overweight. Client revealed that she does read a lot of popular
magazines in her spare time and often feels saddened afterwards; she agreed to stop this for
a while. Finally, I asked the client exactly what aspects of herself she would like to change
in order to enhance her self-esteem. The client's response was to lose weight, get more
confidence so she could find a job and hang out with her friends more.

My Observation:
client is mainly concerned about her weight and through that only she was criticised and
developed low self-esteem
Plan of Action:
To discuss more about low self-esteem and to improve her confidence need some more time
so fixed the time and scheduled the next session

............................. Regular sessions were followed continuously .............................

SESSION 11

Duration: 40-60 minutes

Medium of conversation: Telugu and English
Place: Counsellor’s Room

Objectives:
1. To help client to come out of the problem
2. CBT and inspirational story to build confidence
The verbatim conversation with client as follows:
I recapped the last session and made her comfortable to then start telling motivational story
to build confidence and determination
Determination: Sparrow, her eggs and Ocean Story

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As for determination, one should follow the example of the sparrow who lost her eggs in the
waves of the ocean. A sparrow laid her eggs on the shore of the ocean, but the big ocean
carried away the eggs on its waves. The sparrow became very upset and asked the ocean to
return her eggs. The ocean did not even consider her appeal. So the sparrow decided to dry
up the ocean. She began to pick out the water in her small beak, and everyone laughed at
her for her impossible determination. The news of her activity spread, and at last Garuḍa,
the gigantic bird carrier of Lord Viṣhṇu, heard it. He became compassionate toward his
small sister bird, and so he came to see the sparrow. Garuḍa was very pleased by the
determination of the small sparrow, and he promised to help. Thus Garuḍa at once asked the
ocean to return her eggs lest he himself take up the work of the sparrow. The ocean was
frightened at this, and returned the eggs. Thus the sparrow became happy by the grace of
Garuḍa.
I saw the facial expression while telling story and bit-by-bit building confidence, because as
a bird it took such determination why should I not take inspiration from it and implement it
I explained more about the story and then I started introducing the principles of Cognitive
Behavioural Therapy in order to modify Client's negative thinking. I explained how
constantly telling herself that she was ugly and overweight was only reinforcing her negative
body image and low self-esteem. Therefore, Client needed to recognise and combat
inappropriate negative thinking in order to enhance her self-image. Therefore, I suggested
Client use a strategy called Thought Stopping and explained to her how it works and
explained that, as an example, when a client looks in the mirror and thinks how ugly and
overweight she is she needs to identify this as a negative thought and get herself to stop. I
also described how even saying STOP out loud will help her become more aware of negative
thinking.
I explained how the use of positive affirmations would help her replace negative thoughts.
For example, whenever a negative thought about her appearance did pop into her mind,
client needed to replace it with affirmations such as "I'm a fit and healthy person" and/or "
I'm honest and friendly".
I explained further that it would help to get the focus off her physical appearance and affirm
her personal qualities. The client agreed with me that she would try and implement these
techniques.
All of us experience low self-esteem, it matters how we come out it, explained to client in
various techniques and exploring options then ended the session

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 LEAFLET HANDED OVER TO CLIENT:
Low self-esteem quotes
1. "You yourself, as much as anybody in the entire universe, deserve your love and
affection." -- Buddha
2. "Self-care is never a selfish act--it is simply good stewardship of the only gift I have,
the gift I was put on earth to offer to others." -- Parker Palmer
3. "Why should we worry about what others think of us, do we have more confidence in
their opinions than we do our own?" -- Brigham Young
4. "Love yourself first and everything else falls into line. You really have to love yourself
to get anything done in this world." -- Lucille Ball
5. "Remember always that you not only have the right to be an individual, you have an
obligation to be one." -- Eleanor Roosevelt
6. "If you could only sense how important you are to the lives of those you meet; how
important you can be to people you may never even dream of. There is something of
yourself that you leave at every meeting with another person." -- Fred Rogers (Mr.
Rogers)
7. "What lies behind us and what lies before us are tiny matters compared to what lies
within us." -- Ralph Waldo Emerson
8. "A healthy self-love means we have no compulsion to justify to ourselves or others why
we take vacations, why we sleep late, why we buy new shoes, why we spoil ourselves
from time to time. We feel comfortable doing things which add quality and beauty to
life." -- Andrew Matthews

Conclusion:
During initial sessions had little bit rapport problem due to her shy and softness then slowly
well rapport has been established, session went smoothly, observed improvement and good
feedback from both client and her mother, with today’s session was able to achieve the
purpose with which it started.

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Esteem)
 COUNSELLING CASE 10
(Social Anxiety)
Socio-demographic data
Intake information:
Name : Client
Age : 60 years
Gender : Female
Educational qualification : B.Ed
Occupation : Teacher
Father occupation : NA
Mother’s occupation : House Wife
Income : NA
Marital status : Married
Language : Telugu, Hindi, English

Whether client stays with parents: Yes

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

Chief Complaints:
Presenting problem:
● An extreme fear of situations where she may have to meet new people or be scrutinized
by others.
● Social situations were either experienced with intense anxiety or avoided altogether.
● When she did face these situations, she experienced physical symptoms such as
sweating, shaking, tension, shaky voice, dry mouth and a pounding heart.
Precipitating Factors if any: NA

Duration of problem: NA
Any counselling taken: No

86 MPCE 025, Interns Report : Enrolment No.2101329657 : Case 10 (Social Anxiety)

How intense is the problem and how does it affect the client?
● Has to take leave from work place : No
● Cannot carry on even the routine work in time: No
● Arguing with parents and rejecting tasks : No
● Does not want to do anything : No

According to the Informant:

Interview with family members/spouse/the concerned person: NA

Relationship:
If unmarried:
Patient’s relationship with family members:
● With mother: His mother is very supportive.
● Father: NA [ Lost in young age ]
● Brothers: Good
● Sisters: NA

Any other relative staying with patient: No

With friends:
How many friends does the patient have? How does the patient relate to them? No
With neighbours: Good
With classmates: Good
With the teachers in college: Good
With other authority figures: Good
With playmates: NA
In the games field: NA
Educational history:
● In school / college?
Good
● How is the client in studies and academic performance?
Good
● Does the client come up to the expectations of parents and teachers?
Yes

87 MPCE 025, Interns Report : Enrolment No.2101329657 : Case 10 (Social Anxiety)

 ● Have they received any complaints from the school authorities regarding the
client performances?
No
● When did they decide to consult a counsellor?
Suffering from Social Anxiety

Work history: NA
If Married: Married
MSE
Appearance:
● Age: 60 years
● Sex: Female
● Hygienic: Yes

Movement and Behaviour:

● Client’s gait : Normal
● Posture : Normal
● Eye Contact : Making eye contact
● Facial expression: Tension

Mood: Anxious
Speech:
● The volume of the person’s voice : Soft
● The rate or speed of speech : Normal
● The length of answers to questions : Keeping short
● The appropriateness of the answers : Appropriately

Thought Content:
After establish rapport and observing the client’s appearance and all, I assess that the client
has social anxiety

Cognition:
a. Orientation: Intact with respect to time, date, place and person.

b. Attention/ Concentration: ok
c. Memory: NA

88 MPCE 025, Interns Report : Enrolment No.2101329657 : Case 10 (Social Anxiety)

Intelligence: Adequate (as per educational background)
Judgement:
Social: NA
On test: NA
Insight: NA
Background information and case assessment:
Client was an unplanned baby, born after her older brother. Her parents did not want a
second child but when they realised another was on the way, they hoped for another
boy. As a child client remembers always being in the background and her brother and
father being the 'important' ones.
Client reported a vivid memory of coming home from school one day and finding no-
one home and sat on the front porch and cried until her mother eventually came home
and told her to stop being so silly. She described her mother as being more concerned
with the state of the house than with her young daughter.

Client's father died when she was very young, and she remembers her mother not coping
well for a long time. During this time, she (but not her brother) was often sent to her
grandparents' farm to give her mother a break. Here client spent most days on her own.
However, she remembers these visits fondly, like 'a lull in the storm'.
When her mother died, she left everything to the client's brother, who was by then a
well- paid solicitor with a young family. Client also had a young family but did not
question her mother's decision as she had been conditioned from childhood to believe
males were more important.
Client has recently retired from a career in teaching. Working for many years in a secondary
school environment, she was confident, motivated and dedicated to her work, but at the same
time looking forward to retirement so she and her husband could travel and spend more time
with their adult children who lived nearby.

89 MPCE 025, Interns Report : Enrolment No.2101329657 : Case 10 (Social Anxiety)

 SESSION 1
Duration: 40-60 minutes
Medium of conversation: Telugu, English and Hindi
Place: Counsellor’s Room
Objectives:
1. To establish rapport with the client.
2. To help client to open up and express his feelings without any hesitation and come out
with his problem.
3. To gather relevant information about the client and his background.

The verbatim conversation with client as follows:

The Client entered; I greeted and asked him to have a seat. I further enquired him about any
difficulty he might face in finding the place. I offered him a glass of water. I decided to
make sure that the client is comfortable and told him that he can make himself at home here
and whatever he would tell, I will be kept completely confidential. A formal oath of
confidentiality was taken by me so that the client becomes comfortable in sharing the
problem and all the things related to the problem.

Client described her current physical symptoms and her feelings of hopelessness that
she would never have the lifestyle she had dreamed of having in retirement. She was
very tearful and her voice was quite high and shaky. She stuttered occasionally and her
hands moved constantly, tearing the tissue she was holding to pieces.
She described trying to sew curtains and being overtaken by an uncontrollable fit of
crying. She could not explain why this had made her so upset. She had also avoided
inviting former work colleagues to her house for fear it would not be 'good enough'. Her
main concern was her daughter's wedding, coming up in three months. She became
more tearful talking about this, saying she did not know how the bride's mother was
supposed to look or act.
However, upon finishing work, she found herself experiencing severe anxiety, particularly
when around other people, and began not wanting to leave the house or invite people into
the house. She also experienced bouts of crying when attempting to complete tasks such as
housework and using the sewing machine. She found her symptoms eased when she and her
husband went on camping trips in national parks where they often did not see other people
for days and like this session went on smoothly as expected with client

90 MPCE 025, Interns Report : Enrolment No.2101329657 : Case 10 (Social Anxiety)

 My Observation:
The client was motivated enough to come alone without any situation. The initial rapport
building took no time and he verbalized his problem to the counsellor. The client was very
quick to open up and came up very easily with his problem. Paraphrasing and reflection
skills used by the counsellor helped to convey to the client that her problem had been
understood.
Issues identified:
Cline’s symptoms appeared to be those of social anxiety disorder. They included:
1. An extreme fear of situations where she may have to meet new people or be scrutinized by
others.
2. Social situations were either experienced with intense anxiety or avoided altogether.
3. When she did face these situations, she experienced physical symptoms such as sweating,
shaking, tension, shaky voice, dry mouth and a pounding heart.

The main symptom of this disorder involves feeling extreme anxiety in the presence of
others. Sufferers often believe other people are very confident in public and that they
are the only ones who aren't. Almost everyone experiences some social anxiety now and
then; however social anxiety disorder severely limits the lifestyle of the sufferer, causing
them to avoid making friends or miss important opportunities at work.
Plan of Action:
According to the symptoms adopting strategies from Cognitive Behavioural Therapy in
order to address any irrational thoughts and behaviours which may be maintaining client's
anxiety, and to complete any unfinished business which may have led to the development
of her anxieties in the first place

91 MPCE 025, Interns Report : Enrolment No.2101329657 : Case 10 (Social Anxiety)

 ............................. Regular sessions were followed continuously .............................

SESSION 10
Duration: 40-60 minutes
Place: Counsellor’s Room
Objectives:
1. To help client to open up and express his feelings without any hesitation and come out
with his problem.
2. CBT process and techniques to come out the problem

The verbatim conversation with client as follows:

Client was so sensitive and understood the process and concepts, it became easy to go
with main techniques without going through multiple sessions
Cognitive restructuring
Challenging and modifying a client's faulty thought processes is the basis of Cognitive
Behavioural Therapy (CBT). After Sasha had outlined several situations that were
causing her anxiety, C helped her identify her beliefs about these situations. Sasha was
shown that it was her beliefs about these situations which led to her bad feelings, and
was encouraged to find more realistic alternative beliefs. Some of these processes
included:
Activating event (A) = sewing
Belief (B) = I can't do it well enough, I might as well give up
Consequence (C) = crying, giving up, bored and depressed
Dispute (D) = I'll do my best and focus on enjoying myself rather than focusing on the
outcome
A = husband's family staying.
B = they'll see the state of my house and be horrified.
C = panic.
D = I've got better things to do than clean the house and if they don't like it, it doesn't
mean I'm a bad wife.
A = attending daughter's wedding.
B = I'll let her down and embarrass the whole family by saying or doing something
wrong.
C = panic.
D = people will be focusing on the bride, not me, so I'll focus on her too.
92 MPCE 025, Interns Report : Enrolment No.2101329657 : Case 10 (Social Anxiety)
Explained CBT process by using diagrams

CBT technique, asked the client to look for disconfirming evidence for the belief that
she was inadequate. She was able to find many examples of this, chiefly in her work
and as a mother to her own children. She was asked to continue noticing examples like
this on a daily basis. She was also asked to be aware of herself in the present moment
as much as possible, rather than focusing on the past or the future. This allowed her to
enjoy what she was doing, rather than focusing on previous failures and criticisms, or
future 'what ifs'.
Client's experiments reinforced the fact that her thoughts were producing her anxiety,
not other people. She realised that when she wasn't focused on herself, her anxiety was

93 MPCE 025, Interns Report : Enrolment No.2101329657 : Case 10 (Social Anxiety)

no longer there. When she couldn't distract her thoughts, she learned to modify them to
something more realistic.
By challenging her irrational belief that if she wasn't perfect she was inadequate, she
began to enjoy everyday activities and became much more relaxed. This was noticeable
even in her voice, which lowered in tone, and in her generally more relaxed nonverbal
behaviour.
I ended the session by seeing positive symptoms towards problem resolution and
explained few tips as mentioned below

LEAFLET HANDED OVER TO THE CLIENT:

● Grieve the memory and Talk to somebody about it
● Avoid objects and places that trigger the memory.
● Focus on happier memories.
● Learn to be in the present
● Consider what you learned from the event
● Form happy new memories
● Have a busy life
● Avoid alcohol and drugs
● Make your health a priority

Conclusion:
As a result of implementing the CT strategy, client found it a lot easier to be around other
people. By learning to accept herself as she was, she no longer felt the need to guess what
other people wanted from her, and began to feel comfortable presenting her authentic self
to the world. and finally with today’s session I was able to achieve the purpose with which
it started.

94 MPCE 025, Interns Report : Enrolment No.2101329657 : Case 10 (Social Anxiety)