Counselling Shry Final

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Government College University Faisalabad *

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Psychology

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Nov 24, 2024

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Counseling Psychology Counseling psychology is a psychological specialty that encompasses research and applied work in several broad domains: counseling process and outcome; supervision and training; career development and counseling; and prevention and health. Some unifying themes among counseling psychologists include a focus on assets and strengths, person–environment interactions, educational and career development, brief interactions, and a focus on intact personalities. What is counselling? Counselling at is the opportunity to discuss your thoughts and feelings about any issue that you face in every-day life that you may wish to explore and understand better, in a professional and confidential setting, with a qualified and competent counsellor, over a period of time. It is a collaborative process in which you as the expert in your life, gain greater awareness and find your own answers. The Importance Of Counselling Counselling may help those who are struggling in the world. They may help them to deal with personal issues such as loss of a job or a divorce. This can be a very stressful time for anyone. A counsellor can help the person to get back on their feet and feel empowered and stronger than ever. Counselling may help the person to let go of the past and start over without feeling guilty. The counsellor may help an addict or alcoholic to give up their drug of choice and their drinking in an effort to lead a normal life. They may help guide the person through the difficult transition of going from addict to functional person in society. Not all addicts or alcoholics are bad, many have had serious issues in getting to where they are at and just need a bit of encouragement and help to make it back up to the top. Areas of counselling The areas of counselling that we deal with include:  Abuse (Emotional, Mental, Physical, Sexual).  Addictions (Alcohol, Drugs, Exercise, Gambling, Shopping, Smoking, Sex, Work.  Anger management  Bereavement and loss  Depression  Eating Disorders (Anorexia, Binge Eating Disorder, Bulimia and Compulsive Overeating).  Low self esteem and confidence

 Relationships (Couple’s counselling, divorce counselling, issues around sex/intimacy, infidelity).  Stress (Money, health, relationships, work)  Trauma (Experiencing/witnessing accidents, attacks, abuse, violence, wars, natural disasters etc).  Post-traumatic Stress Disorder (PTSD).  Vocational Counselling

Bio Data Sheet Name: F. A Father name: Muhammad Ali Age: 8 years Gender: Female Education: Not School going Occupation: Student Marital status: Single Siblings: 3 Sister(s): 1 Brother(s): 2 Birth order: 4th Occupation father’s: Sales Man Present address: Jhang Permanent address: Jhang Socio-Economic status: Middle

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Reason for Referral The client was referred by the OPD for assessment and management of her problems such as Muscles problem, delayed milestones, Problem to remember and speech problem. Initial Observation The child was came with her mother. Both of the client and her mother was in neat dresses. Rapport was developed in first session with the client and her mother. The client could not walk because she has muscles problems from her birth. Her hands muscles were also weak. She did not even caught the pencil in her hands. And she has also stuttering problem in her speech. Eye contact was almost maintained with the client and her mother. Developmental History of the Problem The client’s problem was basically from her birth. Because she had Birth Asphyxia. She also has delayed milestones and speech problem too. Her mother told that her delivery was at home and she had lack of oxygen at the time of her birth. But she couldn’t taken to the hospital at time. And she did not cry at the time of her birth. And she could not walk because she has muscles problem in her hands, arms, and legs. She did not even go to school because of her walking problem. That’s why her mother brought her up in the room. Background Information Personal history The client was not a hesitant person. But she did not like to meet everyone or strangers. The client spent most of time with her mother. She liked to watch T.V. Her relations with her mother and other family members was very good. Family History The client lived in joint family. She had 3 siblings including 2 brothers and 1 sister. She was the youngest one in siblings. The client belonged to middle socio economic status. She belonged to Jhang city. But she lived in a small town of Jhang. Her father was sales man. Her younger

brother was 5 th class student. He was very brilliant student. He was unmarried and was doing nothing. Her other brother was working with her father at shop and he was of 15 years old. Her sister was at second last number. Her sister was also a student of 4 th class. And all his family members were physically healthy no family history found related to the problems of the client. The client had also loving relations with all family members. She has very loving relationship with her parents specially with her father. All her family members loved her. Her aunt uncle also has good relations with her. Educational History The client the client was not going to the school, when she came first time because she had muscles problem. She could not walk .So, she cannot go to school. When she came first time her mother brought her up with herself. She has also speech problem. when I asked to her mother about special school near their house she told that there is no school near our house. History of Psychiatric/Medical illness The client's mother reported that we have already treated our child from a hospital. But the medicines did not work. And a woman told us about Children Hospital. Because she had taken medicine from children hospital to her daughter and she had recovered. Assessment Assessment was carried out with the help of different assessment modalities. Following tools were used to get the in depth information about the client’s problem.  Behavior Observation  Clinical Interview  with the client  With the psychologist  PGEE ( portage guide early education ) Behavioral Observations

In order to assess the client more deeply, behavior observation was done in multi settings such as during session, during group activity and in common room. Clinical interview with the client Clinical interview was done with the client’s mother in order to get in-depth information about her daughter problem. Interview went very constructive as it revealed many factors about the client’s problem. The client had lack of social support and living (like neighbors and relatives) . But when she has given empathy and positive regard and appraise she became so happy. Clinical interview with the psychologist The client was referred by the psychologist therefore clinical interview was taken from the psychologist about the presenting complaints of the client and also to elicit her routine in the unit. The test applied checking for mental retardation. PGEE Portage guide early education is a test that was applied on the client for checking mental age ,self helping, motor area, speech and cognitive. Portage Table Areas Functional Age Cognition 2.5 Self-help 5.1 Language 3.6 Social Skills 5.6 Diagnosis  Birth Asphyxia  Delayed Milestones  Intellectual Disability  Muscles Problem

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Rapport maintaining The therapist tried to build and maintain rapport with the client in order to make her comfortable during sessions and to manage her problems. Initially rapport was not easily built but it was properly developed in third session. The client’s mother was an obstacle in maintaining rapport but assured of confidentiality was given to the client which facilitated in maintaining rapport in future sessions. Psycho education The client’s mother had insight regarding her illness but had not knowledge about the actual factors about her illness. So in order to educate her mother about client's problem psycho education was given initially in following dimensions. Activity scheduling The client was spending her all time while remaining alone as it was depicted from behavior observation as well as from interview also. So in order to made the client busy, an activity scheduling was used with the client. The mother of client was first asked to give detail of her daily routine which was not with any type of activity. After that activity schedule was made of the client with her to keep her busy most of time. It was started from small activities. So that it would be easy for her to follow. Daily scheduling chart was given to the client and to fill it on daily bases. Although the client showed interest in that activity but she did not follow activity schedule . She engaged in therapy after two sessions. Recommendations Following recommendations were suggested regarding this case of the client  The client was a motivated person in spite of chronic illness she was giving positive respond to therapeutic intervention. She should provided facility of trained clinical psychology especially for social skill training.  The client had almost good cognitive ability in spite of chronic illness. She should give social skill training for purpose of rehabilitation.

Bio Data Sheet Name: A. B Father’s name: B. M Age: 11 years Gender: Female Education: Not School going Occupation: Student Marital status: Single Siblings: 3 Sister(s): 1 Brother(s): 2 Birth order: 4th Occupation father’s: Sales Man Present address: Toriyan wala Permanent address: Toriyan wala Socio-Economic status: Low

Reason for Referral The client was referred by the OPD for assessment and management of her problems such as Hypoxia, Muscles problems, delayed milestones, speech problem and severe level of intellectual disability. Initial Observation The child was came with her mother. Both of the client and her mother were not in neat dresses. Rapport was not developed in first session with the client and her mother. The client has muscle problems in her hands. Her hands muscles were weak. She did not even caught the pencil in her hands. The clients condition was very critical. She entered in the room with her mother and sat on the corner of the chair by keeping both of her legs on the chair. And when she said down he put her scarf on her eyes. And she was continuously moving her hands. Eye contact was not maintained of the client. She sat down on her head, As long she sat down. She was not paying attention to any one and only giving attention to the actions of her hands. Developmental history of the problem The clients problem was basically started from her birth. the client was belonged to backward area. The delivery of the client was normal in the home. She has lack of oxygen at the time of the birth. As the client belong to the backward family so that's why she could not be taken to the hospital at time. After 2 days of her but she had high fever and she had also fits. She had also muscles problem in her hands. She used to do nothing at home and was sitting quietly at all the time. She always kept bowing down and kept looking at the movements of her hands. She did not even understand anything about anyone. When she was called at work, she did not understand even though she was also told by the signs. She could not do anything herself even though her clothes also changed her mother. Her hair also made her mother. when the fever broke out the family did not have enough when the fever broke out the family did not have enough care to take her to the hospital. She had high fever and fits with several breaks. as her family was belong to backward area so she was not treated at the time. Background Information

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Personal History The client was with very critical condition. She belonged to backward area. She could not speak. And she did not even listen to anyone. Where she sat down there she said for hours. Whenever she sits she looks at the movements of her hands. She could not even understand anything. And her mother told that before coming here I took the treatment of my child from Civil Hospital for 1 month. But she could not recovered. The brain test was done in civil hospital of my child. And in this test it was said that she had little mind you do not getting oxygen at the time of her birth. There was no benefit from the child's treatment they recommend the client took her to the Children Hospital. Family History The client was belong to the low socio-economic status. Her father was not doing any type of job because he was also suffered mental problem. Her father was uneducated person. The client’s mother said that my husband also has a mental problem. her mother also told that when she got married, she and her family did not know that her husband had a mental problem. Her mother was also housewife and an uneducated woman. The client has three siblings. She had one sister and two brothers. Her elder brother was also had mental problem. She could not speak and even could not listen. He had also problem in remembering. All the above factors show that the client had strong family history. Educational History The client did not have any kind of understanding related to the environment and herself. And her family was also belong to backward ideas. That’s why she never went to school. And her mother told that her other siblings did not even go to school. Relationship with other family members The clients relation with her mother was very good. The relation with her siblings was also good. But the relationship of the client with her father was not good. As her father was also has mental problems. He was always in angry mood. He always used to scold his children. Her father’s mood was always aggressive on his children. History of Psychiatric /Medical illness The client admitted in civil hospital for a month The CAT (Computerized Axial Tomography) Scan was done of the client in Civil Hospital. But she could not recovered. So that she was referred to the children hospital Faisalabad. Assessment Assessment was carried out with the help of different assessment tools. Following tools were used to get in depth information about the child’s problem.

 Behavior Observation  Clinical Interview  with the client  With the psychologist  With the client's Mother  Mental state Examination  PGEE (Portage Guide Early Education) Behavior Observation In order to assess the client more deeply, behavior observation was done in multi settings such as during session, during group activity and in common room. It was observed on daily basis that she was not involving herself in any activity in the unit. Clinical interview with the psychologist The client was referred by the psychologist therefore clinical interview was taken from the psychologist about the presenting complaints of the client and also to elicit her routine in the unit. She had provided little information. Clinical interview with the mother The client had loving and strong relations with his mother only. Therefore mother was involved so that she might be prove as protective factor in managing the client’s problem. It was a combine session of both the client and mother. The client’s mother gave very constructive information about the client that how he spent his childhood and father’s attitude toward the client. The client was quite comfortable in presence of his mother but she didn’t responded well. After taking details from the client’s mother counseling was done with both the client and mother.

Portage Table Areas Functional Age Cognition 0 Self-help 0 Motor Area 2.5years Language 0 Social Skills 0 Diagnosis  Severe level of intellectual disability  Psychotic disorders Other Factors:  Father client relationship problems  Economic problems (low income)  Low Awareness (Backward Area) Rapport Maintaining The therapist tried to build and maintain rapport with the client in order to make her comfortable during session and to manage her problems. But the rapport was not built. Initially rapport was not easily built with the mother of the client but it was developed later. Therapy Implementation

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The cognitive level of the client was zero. So, the therapy can not be applied because cognitive level was zero. Case 3 Bio data sheet Name: P. P Father name: M. G Age: 20 years Gender: Female Education: BS Occupation: Student Marital status: Single Siblings: 1 Sister(s): 0 Brother(s): 1 Birth order: 1st Occupation father’s: Business Man Present address: Laiya Permanent address: Laiya Socio-Economic status: High

Session 1 I met Parwasha. I asked her name she told me Parwasha. She was a good student in BS 3 rd (operation theatre). Her family was also very good she told me that my craze in MBBS doctor but I failed in test and did not applicable for MBBS. Her father is a good businessman. I said that Sana I want to apply some test to her and observed her personality. I asked some other questions like about her family background her peers, friends. Session 2 I asked from Sana way you do not applicable for MBBS. She told me that her marks is not good in matric. Then I gave RISB test and gave some instructions. Then she complete the test. Then scored are.  Complete these sentences to express your real feelings.  Try to do everyone.  Be sure to make a complete sentence. Scoring P1 16 C1 10 Omission Response 1 P2 8 C2 8 Neutral Response 1 P3 0 C3 0 Grand Total Total 43 Interpretation As the Cut of score is 135-145 and the subject’s score is 54. So, the subject is well adjusted.

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