OBSERVATION STUDY- REPORT

Submitted in Partial Fulfilment of Requirement for degree of

Masters in Clinical Psychology

Name- SAAVI ANEJA

Enrolment number-

A0403423099 Batch- 2023-2025

Name of Institute- Amity Institute of Psychology and Allied

Sciences, Noida
Program name- M.A Clinical Psychology

Faculty Guide- Dr. Ritu Raj

Head of the Department- Dr. Ranjana Bhatia

 NTCC COMPLETION
CERTIFICATE

This is to certify that Ms Saavi Aneja, Enrolment No. A0403423099, Masters in Clinical
Psychology, Semester 3 , Batch 2023-25 , student at Amity University of Psychology and
Allied Sciences has completed her SUMMER INTERNSHIP
( AASI600 ) under my guidance from 15/05/2024 - 01/07/2024 .

Dr. RITU RAJ

Amity University of Psychology and Allied Sciences

Amity University Noida

 DECLARATION CERTIFICATE

I, Saavi Aneja certify that the work embodied in this report is my

own bonafide work carried out by me under the supervision of Dr.
Ritu Raj.

SAAVI ANEJA

Enrolment No. - A0403423099

Amity University of Psychology and Allied Sciences

Amity University Noida.

 ACKNOWLEDGEMENT

First and foremost, I wish to express my deep and sincere gratitude to AMITY UNIVERSITY,
NOIDA, UTTAR PRADESH, for curating NTCC program for all the students, which gives them an
external exposure to the world of research. Further I'd like to extend my gratitude to Director, Amity
Institute of Psychology and Allied Sciences, Dr. Ranjana Bhatia, for giving us this opportunity.
I would like to extend my heartfelt gratitude to Dr. Ritu Raj professor, Amity Institute of psychology
and allied sciences, who have been guiding me exceptionally, supporting me and has given her
valuable time to nurture me throughout this dissertation.
Last but not the least, my heartfelt gratitude to my parents and all the family members who have been
directly or indirectly helping me to complete this project successfully. I am deeply
thankful to all of them.

SAAVI ANEJA
Enrolment no. - A0403423099
Semester - III
Amity University of Psychology and Allied Sciences
Amity University Noida
 TABLE OF CONTENT

S.No Content

1 Completion of Certificate (by the faculty guide)

2 Declaration by Student
3 Acknowledgement
4 About the Organisation
5 Roles and Responsibilities undertaken
6 Case Study 1,2,3,4,5
7 Key Learning’s
8 Annexures
1. In & out log report
2. Weekly progress report
3. Daily log Sheet
Plagiarism Report
9 Completion Certificate
 INTRODUCTION OF THE
ORGANISATION

The Psychiatry Department at SIR GANGARAM HOSPITAL, New Delhi, offers

comprehensive mental health services.

The department was founded and has a long history that dates back to British colonial
days. It is prepared to address a wide range of mental problems. From Monday through
Saturday, the department offers outside consultation services. New and repeat
consultations must register at specific times. The hospital's emergency wing also offers
daytime special clinics, de-addiction therapies, counseling, evaluations, and emergency
consultations.

To guarantee that you receive the finest care possible, the department's Mental Health
Services make use of clinical research and the power of a multidisciplinary team.
Psychiatrists oversee the coordination of comprehensive mental health exams and
treatment plans.

Social workers, occupational therapists, psychologists, special educators, counselors,

psychotherapists, yoga therapists, experienced nurses, and professionals from other
departments as needed .
They collaborate to create a customized treatment plan that addresses your needs. The
goal is to handle the issue, prevent it from happening again, and support mental health.

During the last few decades the demand for the Mental Health Professionals has
increased tremendously. People have become more aware of psychological
problems and benefits of caring for their psychological health. The department
has been performing the responsibility well while continuing to strive for
excellence.

Objectives:

1. To make mental health care more holistic and relevant to the unique social
and cultural needs of our country.

2. To incorporate Indian philosophical thought and yoga and collaborate with

colleagues from indigenous medical systems in the practice of Psychiatry
at Sir Ganga Ram Hospital.
 3. To deliver evidence based health care.

4. To promote research relevant to patient well being and public health.

5. To provide good training to resident doctors, nurses, psychologists etc.

6. To eliminate the stigma surrounding mental health issues and their

treatment by educating the public.

Our Hospital is licensed for mental health care by "Mental Health Authority"
Govt. of NCR Delhi w.e.f. 13 April 2007 , It follows the norms set by DNB
 ROLES AND RESPONSIBILITIES

I engaged in a variety of activities related to understanding and observing clinical

cases, taking case history and MSE, discussing theoretical concepts, and participating
in case discussions.
Here's an elaboration on the roles and responsibilities I undertook while doing the
internship:

Documentation and Orientation Session : During the orientation, I completed the

required paperwork and learned about the history of the hospital's psychiatry
department, its psychologists and psychiatrists, and the subjects covered in the
theoretical and practical workshops. During this time, it was my duty to become
acquainted with the procedures and organizational structure.

Case History and MSE Taking: Took case histories and Mental Status
Examinations
(MSE), every day to gain insight into the assessment process and understanding of
how to evaluate clients' mental health status.

Observation of Therapeutic Sessions: Observed therapeutic sessions between

psychologists and clients, gaining exposure to different therapeutic approaches and
techniques used in clinical practice.

Case Observations: Observed schizophrenia, OCD, Adjustment, Depression,

Anxiety, Mania, BPD, Dissociation, Somatoform, Delusional disorder, Sexual
dysfunction etc. including its symptoms, followed by discussions on its clinical
presentation and treatment approaches.

Brushing My Concepts: Participated in discussions regarding the clinical picture and

associated symptoms. I gained insights into the assessment and management of PTSD,
including comorbide conditions like ADHD and substance abuse.
Delivering Presentations and Data Collection: Potentially involved in giving
presentations on schizophrenia and mood disorders and taking notes during case
presentations and discussions.

Personality Disorders Discussion: Engaged in discussions about personality

disorders, including diagnostic features, and studied a case of borderline personality
disorder to illustrate clinical concepts.

Participation in Seminars and Different awareness programs: Participated in

various drug awareness programs, Schizophrenia Day events, and seminars, actively
engaging in community outreach and education on mental health issues.

Observation and Discussion of Sexual Dysfunction and Paraphilia Disorders:

Observed and participated in discussions about sexual dysfunction and paraphiliac
disorders, further expanding understanding of psychiatric conditions.

Child Cases: Engaged in child case observation, detailed case history taking, mental
status examinations (MSE), and the observation of assessments, culminating in
comprehensive case presentations to enhance clinical understanding and training.
 Case Studies

Ishank (9 years old)

Ishank is a 9-year-old child who came in with his parents as per the requirements of
school counselors who noted that the child was facing academic difficulties and failing
to keep up like his peers. He is currently in 4th grade. Family members include parents,
Ishank and his younger brother. The primary issues revolved around the difficulties in
focusing and understanding tasks and what is required of him in classes. His mother
reported that he started his school during the COVID-19 pandemic with the online
classes–she believes that this might have caused his attention issues. No history of prior
evaluation and no reported history of disorders were noted in the family.

Birth and Developmental History

● Birth type and weight: full term normal delivery and 3kgs, kept in NICU after birth
due to difficulties in breathing.
● Has a history of jaundice and however, no history of seizure or high fever.
● Birth cry: immediate
● Mother reported that the child met development milestones on suitable times.

Chief Complaints
● Has difficulty focusing especially when a task is being discussed
● Academic difficulties like writing
● Forgets what is being taught-usually very forgetful

Behavioral observation
Ishank behaved like a child of his age and appeared very mellow in the first few
sessions. Although mellow, the child was able to keep up with the conversations with
the psychologist. After rapport was established, the child became more cooperative and
asked doubts when he did not understand something. He was very attentive to his
surroundings and loved playing blocks with the psychologist. When instructions were
provided and doubts were cleared before assessments, the child understood them
clearly but had difficulty as the test progressed. The child expressed the dissatisfaction
he feels with his parent’s not focusing on his emotions.

Assessment Tools
The child was assessed on Malin’s intelligence Scale for Indian Children, a scale
developed to assess the intellectual disabilities in Indian children of age 6-15 years. The
child was also assessed on NIMHANS SLD Battery due to reported issues in writing
and learning.

Final Result Interpretation

Ishank obtained a total score of 85 with verbal quotient of 75 and performance quotient
of 90. His score indicated a below average intellectual functioning when taking in
consideration his age.
Aarti (4 years 11 months old)
Aarti came in with her mother to address some delayed behaviors and bouts of
aggression witnessed by her mother and grandmother. Ira was described as a child of
temper but is able to calm herself down easily. Her mother reported that she started
spending a longer amount of time in front of screens (TV and phone) during COVID-19
which coincided with her bouts of aggression. Family members consist of mother,
father, grandmother, Aarti and her younger brother. Mother also reported that Ira used
to not acknowledge the presence of her younger brother for around an year but later
grew considerate of him.

Birth and Developmental History

● Birth type and weight: full term cesarean delivery, 4 kgs
● Spent one day in NICU due to mild jaundice.
● Was able to achieve milestones like sitting and walking on time
● Speech was reported to be delayed
● Achieved bladder control at the age of 3
● Is able to eat, dress on her own
● Very good in drawing

Chief Complaints
● Bouts of aggression (occasional)
● Speech difficulties
● The child often repeats or imitates what is said to her

Behavioral Observation
Aarti looked similar to kids her age and was able to engage actively in the sessions. She
quickly got comfortable. She was able to talk with relevant information but was
repeating the questions asked to her. Play sessions were fun for her and she was able to
understand complex instructions during psychological assessments. The child was
overall very cooperative.

Assessment Tools
Aarti was assessed on Seguin form board test, gessel;s drawing test, indian scale for
identification of autism, children’s apperception test

Final Result interpretation

SFBT attributed a mental age of 5 for the child which indicates an IQ test of 98
indicating an average level of intellectual functioning. GDT showed a mental age of 66
months i.e. an IQ of 110 indicating an average level of intellectual functioning. ISAA
score was 67 indicating no autism. CAT showed orientation to reality and could not
perceive underlying emotions of the story. Content of the story was mostly positive and
depicted a healthy family environment with an emphasis on objectivity.
Saksham (13.3 years old)
Saksham is a 13 year old currently studying in 8th grade. He came in with his parents
who were concerned about his difficulty in understanding instructions and had body
posture issues. They reported that the child had difficulty making friends throughout his
life but spent a considerable amount of time with his cousins and relatives. Mother
reported that she noticed a change in saksham a few years back as the child would get
irritated quickly. His teachers also complained that he got into fights quite often.
Saksham reported that he would mostly fight to protect himself as others would bully
him.

Birth and Developmental History

● Birth type and weight: full term Cesarean delivery, around 4 kg
● Birth cry: immediate
● Mother reported that Sahil was able to attain all developmental milestones apart from
speech which was delayed.
● There was a history of jaundice

Chief Complaints
● Low academic progression since childhood with an average of 40% in mathematic
and
science
● Self confidence issues
● Increased screen time of about 4-6 hours a day
● Stubborn and aggressive with occasional outbursts

Behavioral Observation
Saksham looked age appropriate and was well groomed. He was a shy child and was
not able to keep eye contact for long. After rapport was established, the child was
opened up. His posture was bent on the front. The child also had dark circles around his
eyes and was blinking a lot. He was able to pay attention to instruction and follow
through however had difficulties comprehending and performing complex tasks.

Assessment Tools
Saksham was assessed on Malin’s Intelligence scale for Indian Children to test for
Intellectual disability, House Tree Person test, a Projective test and Child Behavior
Checklist (undertaken by the parents)

Final Result Interpretation

Saksham scored a total IQ of 78 indicative of Borderline level of intellectual
functioning. He had a verbal quotient of 79 and a performance quotient of 76 indicating
borderline functioning in both. The HTP test revealed the child was constantly seeking
emotional satisfaction and was over concerned with the past. There were also feelings
of frustration. Saksham did not draw a chimney which indicates a lack of psychological
warmth and conflicts with male figures. CBCL, as undertaken by the parents, indicated
an overall tendency of unsatisfied emotional needs and anxious and withdrawn
tendencies by the child most likely caused by his intellectual functioning and
environment.
Manvi (29 years old)
Manvi is a 29 year old medical student who is currently doing her residency in a
hospital. She booked a session online. She presented with concerns of work life
imbalances and her constant thoughts that would overwhelm her. She reported that her
supervisors call her outside of work hours even at night to reach to assist the senior
doctors. Family members included parents, Manvi and her two younger sisters. She has
been constantly feeling tired and used and felt that she needed to take a stand. She is
very close with her mother and her boyfriend but she relies on her mother during hard
times.

Chief complaints
● Feelings of exploitation
● Feeling drained out and stressed out
● Overwhelming thoughts of being useless
● Unable to draw boundaries and say no
● Unable to manage her thoughts

Counseling Session
I observed her third session. She came with the primary complaint of feeling
exploitation and being tired. She was crying during the session. She described a fight
that she had with her mother which caused her to be irritable. Throughout the past
session, the psychologist had noted that she often goes to her mother seeking validation
and finding comfort. She believes that her mother knows what is right and best for her.
The psychologist noted that Manvi goes to her mother for the smallest of things. She
has a tendency for reassurance seeking but she said that “I want my mind to not be
affected by others”. She is also unable to say no to requests which cause her to get
burdened with other’s work and as a result get tired. When asked what she does to
manage her thoughts she noted she changes her environment, sleep, watching
something or talking to her mother. Psychologists noted that she had negative coping
mechanisms like distraction and escape tendencies. Towards the end of the session, the
psychologist noted that there is a need for Manvi to draw boundaries and learn to say
no. few exercises were done to see how she can go about saying no and how she can
deal with the accompanying feelings of discomfort.
Paramjeet (24 years old)
Paramjeet is a 24 year old man working in the entertainment industry. He came to then
session with relationship issues but they broke up. Paramjeet was dating a girl for
around 3 months when he found out that she was cheating on him with multiple guys.
He was unable to confront her and felt used. Currently he is facing some issues. They
are coworkers and have to communicate. He had consumed some substance before
attending the session.

Chief Complaints
● Felt used and like an “emotional dumping ground”
● Felt confused and didn’t how to proceed
● There is also some confidence issues as he feels he can do better than her
● Has a tendency to avoid confrontation

Counseling session
The session started with him stating that he is very frustrated with what is happening
and is feeling like “she is trying to overpower him”. He felt like she used him to get
connections and then left when she wanted to go back to her previous boyfriend. He felt
like she treated him like an option. Paramjeet also kept on repeating that she will come
back to him and now he will use her to gain more power in the industry. He is also
scared that she might do something to destroy his career and get credit for his work. He
looked scared and seemed to hide some information. The psychologist kept the session
so he could talk his feelings out and get his head cleared.
 KEY LEARNINGS FROM THE
INTERNSHIP

I completed my internship at Sir Gangaram Hospital for a total of 240 hours.

The internship commenced on 15** May 2024 and was completed by 01th July.

The internship was part of our 3rd semester as a non-teaching credit course the topic
for which was Summer Internship. The main objective of our internship was to learn
through experience by working under a trained Psychologist to gain skills and
knowledge in the field of Psychology.

Throughout my internship, I learned about many things which were really helpful for
me, or which improved me a lot as a whole person. So, during my internship I took
case histories and mental status examination of patients which guided me and slowly
taught me how I can have a better understanding for the same in my career.

I also got to know about some assessments out of which some are HTP (House tree
person ), MISIC (Malin's intelligence scale for Indian children) and WAPIS
(Wechsler's adult performance intelligence scale). Furthermore, some of the more
assessments were Bhatia battery performance test) and SLD (Specific learning
disability). And I also acquired knowledge about how to assess SCT (Sentence
completion test) and TAT (Thematic apperception test) in the cases I observed.
During my internship I also had a brief discussion about drug addiction by the
psychiatrists. And also had sessions on different therapies like firstly starting with
ethics and guidelines, then had brief sessions on DBT (Dialectical behavioural
therapy), CBT (Cognitive behavioural therapy) etc.