SPECIALIZATION CLINICAL PLACEMENT

PORTFOLIO

SUBMITTED TO:
SIR YOUSAF RAZA

SUBMITTED BY:
AFRAH ARSHAD

F2019-527

MS – IV

INSTITUTE OF PSYCHOLOGY,

BEACONHOUSE NATIONAL UNIVERSITY,

PUNJAB INSTITUTE OF MENTAL HEALTH, LAHORE

SESSION 2019-2021
4th June, 2021

Department of Clinical and Counseling Psychology

Beaconhouse National University, Lahore

Respected Sir,

I am pleased to present to you the final internship report, due June 2021, as partial fulfillment

for the degree of MS Clinical and Counseling Psychology. The purpose of the internship

report is to inform you about the details of internship. The content of this internship report

concentrates the goals of internship, roles and responsibilities at internship and the

knowledge gained during the period. This internship deals with the psychological aspects of

assessment and management of clients. The time duration of my internship is 3rd March 2021

till 3rd June 2021.

Thank you for all your reflection and support in putting this report together.

Yours Sincerely,

Afrah Arshad

F2019-527

________________________

Internal Supervisor

Sir Yousaf Raza

Designation

________________________
 Table of Contents

Contents Page No
Abstract 4

Introduction 5

Section I

Independent Clinical Work 6

Section No II

Work I have Observed 9

Section no III

Joint work with other trainees and supervisor (Group sessions) 12

 Abstract

This present report is the outcome of the Specialization Placement Program at Punjab

Institute of Mental Health at Drug Addiction division. The objective of the program was to

familiarize self with the implementation of knowledge earned at university. The practical

knowledge is far different from the theoretical knowledge that one achieves in the

classrooms. The report focuses on a few of an important aspect of the institution especially

on mental health and the different therapies related to substance abuse and other disorders.

The purpose of working at Punjab Institute of Mental Health as at internee was to improve

and polish my theoretical learning by practical experiences and assessing different kinds of

behaviors and mental states of substance abused individuals through complete case histories

and psychological tests. It helped me to develop facility with a range of diagnostic skills,

including: clinical interviews and observation, case-history taking, mental status examination,

risk assessment, diagnostic formulation and providing management plan such as counseling

and implementing different therapies. In addition, psycho-educational charts/posters/flyers

for educational awareness of addiction have been designed to enhance the understanding

in health center.
 Introduction

Specialization placement was carried out at Drug Addiction Unit as a clinical

internee, as partial fulfillment for the degree of MS Clinical and Counseling Psychology. The

placement was supervised by Sir Yousaf Raza and was carried out in this field in order to

develop psychological consultation, through individual cases and participation in

multidisciplinary teams, including consultation to: the patients, their parents, the mental

health staff (e.g., psychiatrists, social workers) and the legal system. Consultation training

took place in both the inpatient and outpatient setting, both downtown and in the suburbs, and

ranges. The significance of internship is to learn the clinical, legal, and ethical involved in

certification of mental health services within a medical setting. The placement also provided

the opportunity to learn and promote the integration of clinical psychology and practice,

related to theories and practice of assessment, intervention, and consultation.

The history of Punjab Institute of Mental Health (PIMH) dates back to 1908 when it

was first constructed at its present premises and given the title of “Lunatic Asylum”. It was

spread over an area of 172 acres. The name was later changed to “Government Mental

Hospital” and over the years, the area of the hospital was reduced to 52 acres which it

continues to occupy under the new title of “PIMH”. The hospital has a capacity for 1400

patients and currently has an inpatient population of 1000 patients.

 Section – I –
Independent Clinical Work

Case Demographic Presenting No. of Assessment Management Outcome

no. information complaints sessions

1. 29 years old Breathing 6 Clinical Psychosocial Completed

male, problems, interviews, interventions;

Unmarried, migraine, cold Mental Status Individual

Pharmaceutical shivers, cravings Examination, therapy,

Representative and lack of DSM V psychotherapy,

. concentration due Symptom Cognitive

to intake of checklist for Behavioral

heroine. Opioid Use Therapy (CBT).

Diagnosis: Disorder, Therapeutic

Opioid Use Subjective techniques of

Disorder, Severe Rating of the Rapport Building,

304.00 (F11.20) Problem, The Psychoeducation,

Drug Abuse Relaxation

Screening Test techniques, Social

(DAST), The Skills Training

Rotter along with Family

Incomplete and Group

Sentences Blank Therapy. Craving

(RISB), Management,

University of ABC model,

Rhode Island Relapse

Change prevention
 Assessment techniques

Scale (URICA).
2. 28 years old, Drug addiction, 12 Clinical Rapport Building, Completed

unmarried, cravings, interviews, Psychoeducation,

employee. sleeplessness, Mental Status Relaxation

lack of Examination, techniques,

concentration, DSM V Family/Group

fatigue, constant Symptom Therapy, Craving

headache and checklist for Management,

weakness in his Opioid Use ABC model,

body. Disorder, Relapse

Subjective prevention

Rating of the techniques, Goals

Problem; The Setting, and

Drug Abuse Cognitive

Diagnosis: Screening Test Behavior

Opioid Use (DAST), The Therapy.

Disorder, Severe Rotter

304.00 (F11.20) Incomplete

Sentences Blank

(RISB) and

URICA.
3. 34 years old Opioid addiction, 3 History taking, Anger Dropped

male, married, anger issues, lack Mental Status management,

salesman of acceptance. Examination, Deep Breathing,

Diagnosis: The Drug Abuse Rubber band

 Opioid Use Screening Test technique,

Disorder, Severe, (DAST) Mindfulness and

304.00 (F11.20) Relaxation

exercises.
 Section –II–

Work I have observed

Cas Demographic Diagnosis Department What was observed? Whom did you

e no. information observe?

1. 32 years old Major OPD Clinical interview Senior

female Depressive Psycho-education, Psychologist

Disorder relaxation exercises

2. 39 years old Delusional OPD Clinical interview, Senior

male disorder detailed history taking, Psychologist

identifying the stressor

3. 54 years old Schizophrenia OPD Clinical interview, Senior

male detailed history taking, Psychologist

CBT
4. 34 years old Schizophrenia Unit C detailed history taking, Senior

male Occupational therapy, Psychologist

group therapy
5. 25 years old Conversion OPD Clinical interview, Supervisor

female disorder detailed history taking,

identifying the

stressor, Extinction,

family psycho-

education
6. 31 years old Schizoaffectiv Unit C History taking, Senior

male e disorder Clinical Interview, Psychologist

MSE Vertical descent,

CBT.
7. 24 years old Mild-moderate Unit C History taking, Senior

male intellectual Clinical Interview, Psychologist

 disability MSE, Symptom

Checklist, Assessment

scale (SPM)
8. 55 years old Schizophrenia Unit C History taking, Senior

male Clinical Interview, Psychologist

MSE, Symptom

Checklist, CBT
9. 34 years old Bipolar Unit C History taking, Senior

male disorder II Clinical Interview, Psychologist

MSE, Symptom

Checklist, Family

Psychoeducation,

Couple therapy,

Activity scheduling,

Baseline chart

10. 65 years old Schizophrenia Unit C History taking, Senior

male Clinical Interview, Psychologist

MSE, Sleep Hygiene

Skills,

Social skills training,

CBT,
11. 55 years old Schizophrenia Unit C History taking, Senior

male Clinical Interview, Psychologist

MSE, CBT for

psychosis
 Section – III –
Joint work with other trainees and supervisor (Group sessions)

Sr. Coworker’s name Nature of work Department What did you do?
no. and professional
status

1. Fellow trainees and Art therapy Addiction unit Introduction and

supervisor psychoeducation importance to art therapy

was provided. Art therapy

was conducted on drug

addiction clients. They

were asked about the

meaning behind their

drawings.
2. Fellow trainees and Supportive Addiction unit I observed the other

supervisor therapy trainees conducting

supportive group sessions.

3. Fellow trainees and Motivational Addiction unit Supervisor explained the

supervisor interviewing process of MI in front of

(MI) all fellow trainees

Craving Ways to Deal With Urges

management and Cravings were

explained to clients with

real life examples and

charts.
4. Fellow trainees and Social skills Male Receptive and expressive

supervisor training Rehabilitation skills were taught and

Open discussion Centre practiced with clients.

 about member’s Each client was asked to

qualities share their good and bad

qualities to the trainees so

that they can practice cost

benefit analysis.
5. Fellow trainees and Therapeutic Addiction unit Psychoeducational

supervisor group sessions were conducted

in group therapy about the

drug addiction.
6. Fellow trainees and Music therapy Female Clients were encouraged

supervisor and relaxation Rehabilitation to dedicate or sing their

techniques Centre favorite songs to their

loved ones. Each one of

them was also provided

with a reinforcement.
7. Fellow trainees and Refusal skills Addiction unit Scenario was provided to

supervisor and role plays to clients in which they were

refuse the offer asked to refuse the offer

of drugs. of drugs via role plays.

8. Fellow trainees and Anger Addiction unit Techniques such as

supervisor Management Backward counting, Glass

and Cognitive of water, Deep breathing,

Restructuring Exercises were illustrated

and practiced in group

therapy.

Patient’s Negative

Automatic Thoughts were

 converted to

positive/alternative

thoughts through

discussion and baseline

charts.
9. Fellow trainees and Self-esteem Male Client’s strengths and

supervisor boosting activity Rehabilitation weaknesses were

Centre discussed in these

sessions.
10. Fellow trainees and Relapse Addiction unit Chances of getting back to

supervisor Prevention and drugs once they are out of

Maintaining rehab center were

Resilience discussed and techniques

were provided on how to

avoid it.
11. Fellow trainees and Awareness Male Clients wrote down or

supervisor about family Rehabilitation shared details about their

importance Centre favorite family member(s)

along with fun and their importance in

activities their lives, which was

discussed later.
12. Fellow trainees and Open discussion Addiction unit A topic was selected

supervisor Fun activity through mutual consent of

session. the fellow trainees and

supervisor. The topic

selected was ‘How to

Lead a Happy and

 Addiction Free Life’

Fun activity: Coupons

were provided to clients

which consisted of

different activities like

share the most happiest

moment of your life or

count 10 backwards.

Clients were encouraged

to do what it says.

13. Fellow trainees and Factors Addiction unit Clients were asked to

supervisor contributing discuss their resources of

towards drug drug intake and were

addiction psycho-educated on how

Triggers and to stay away from those

impulse suppliers.

management