NTCC Srishti K 144
NTCC Srishti K 144
NTCC Srishti K 144
Section E
A0403422144
Observational study
We Avec U was founded in 2015 by Mr. Sundeep K and Jasmeet Singh on the principle
of "Do to others as you would have others do to you." Simply put, put yourself in
someone else's shoes and treat them the way you would like to be treated: with respect,
empathy, acceptance, kindness, and friendliness. We share the same philosophy and strive
to provide people with a harmonious, functional, and positive way of life. To accomplish
this, we have chosen the path of self-union, self-understanding, and subsequent work on
processes that streamline the journey towards the growth of nurtured self.
We Avec U is one of the few who want to become someone's someone and help them see
the brighter side of life once more. Working with a variety of prominent professionals in
the field of mental health advancements, they realised that many people still lack support
and access to mental health services. There is a primary need for early detection, and
access to treatment and recovery measures will follow. This organisation was formed in
order to intervene and reach the unreachable. They want to build a world that promotes a
collaborative approach to psychic wellness, where anyone, at any time, can get the help
and resources they need.
➔ Goal
We Avec U is a concept that represents Mental Growth and promotes psychological
happiness for all. We hope to accomplish this by teaching, caring for, and loving the
untaught, uncared-for, and unloved, in that order. We believe that when you become one
with your inner-self, the resulting union inspires you to devise methods to liberate
yourself and welcome a positive outlook. Through our holistic approach to mental health,
we hope to create a safe environment for those in need, connect with them, and reduce
the unjustified trivialization of mental health in communities. In this regard, we make
every effort to:
1. Improve the connection between the mind and the body.
2. Increase public awareness of mental health issues.
3. Educate individuals on the potential causes of mental agitation and, as a result,
provide services and an aura to help eradicate that fear and promote a faster
recovery.
4. Access to mental health services and support for those in need of special attention
➔ Vision
We believe that everyone can help to make the world a better place. We hope to
significantly improve the psychic well-being of everyone around us by bridging the gap
between those who need access to mental care and the purpose of providing this support.
We at Avec U want everyone to understand that you have the ability to heal and recover
no matter what! It only takes the right pair of hands to hold you and guide you down the
path of mindful healing. Our Vision is further defined by a set of attributes that
demonstrate our contributions, knowledge, and fulfilment:
We Avec U's foundations are based on becoming someone's someone. Through our
mental health services, they hope to reach those in need and provide them with all
necessary care and support. Well-being is not limited to a specific type; it applies to
everyone. They attempt to address people's feelings and challenges in life by educating
them about mental health issues. After all, the goal is to live, not just to survive!
There are many stigmas associated with mental healthcare right now. Their goal is to
challenge those assumptions and raise awareness about the prevalence of these
conditions.
1. Begin with the unreached - People in rural areas are unaware of the concept of
mental health, let alone the practises of a typical psychologist. We want to raise
awareness about this issue through We Avec U.
2. One step at a time - your beliefs indicate the likelihood of your success. Beginning
with one step at a time, we hope to create a dynamic shift in people's lives by
assisting them in achieving a calm, undisturbed, and serene state of mind in order
to promote overall harmony.
3. Let the world know about us - we work to be recognised by everyone by creating
opportunities and forming relationships all over the world, because collaboration
increases outreach and fosters creativity.
4. Striking a balance – Psychological well-being is similar to physiological
well-being in importance, and it must be treated as such.
5. Promote health and solve problems - We promote the importance of a healthy
lifestyle and the prevention of mental diseases by implementing the necessary
strategies.
● Key learning
Internship with we avec u was informative. Each week we learned something new. The
internship mainly focused on clinical psychology.
Week one
We were first introduced to the programme and its benefits during the first week. The
following day, we discussed counselling skills and counselling steps. The facilitator
described nine fundamental counselling skills, including listening and empathy.
Sincerity, unconditional positive regard, concreteness, open questioning, counsellor
self-disclosure, interpretation, information sharing, and removal of barriers to change
The facilitator also discussed the various stages of counselling. It consists of five
steps. The first step is to establish a friendly relationship with the client. He focuses
first on developing a warm relationship and mutual trust so that you do not hesitate to
speak about the problems you are facing. The next step is analysis. At this point, the
professional encourages you to speak in detail about your problems in order to get to
the bottom of the issue. Setting a goal is the third step. The counsellor establishes a
goal based on the issues you are dealing with. That could be you overcoming the
problem or coming to terms with it. The fourth step is the action plan. The counsellor
devises an action for you to try in order to see the results. The fifth and final step in
overcoming the plan. We also learned history taking and MSE.
Week two
The first step is to establish a friendly relationship with the client. He focuses first on
developing a warm relationship and mutual trust so that you do not hesitate to speak
about the problems you are facing. The next step is analysis. At this point, the
professional encourages you to speak in detail about your problems in order to get to the
bottom of the issue. Setting a goal is the third step. The counsellor establishes a goal
based on the issues you are dealing with. That could be you overcoming the problem or
coming to terms with it. The fourth step is the action plan. The counsellor devises an
action for you to try in order to see the results. The fifth and final step in overcoming the
plan. Interpersonal therapy (IPT) is a type of short-term treatment. It assists patients in
understanding underlying interpersonal issues that are troubling them, such as unresolved
grief, changes in social or work roles, conflicts with significant others, and interpersonal
problems. Dialectical behaviour therapy is a type of CBT that helps people regulate their
emotions. It is frequently used to treat people who have suicidal thoughts on a regular
basis, as well as those who have borderline personality disorder, eating disorders, or
PTSD. Psychodynamic therapy is based on the idea that childhood experiences and
inappropriate repetitive thoughts or feelings that are unconscious (outside of the person's
awareness) influence behaviour and mental well-being. Psychodynamic therapy is a more
intensive form of psychoanalysis. Sessions are usually held three or more times per week.
Guidance and encouragement are used in supportive therapy to assist patients in
developing their own resources. It aids in the development of self-esteem, the reduction
of anxiety, the strengthening of coping mechanisms, and the improvement of social and
community functioning. Supportive psychotherapy assists patients in dealing with issues
related to their mental health conditions, which have an impact on the rest of their lives.
Another training session covered ethics, report writing, and role playing.
Ethics investigates the rational basis for our moral judgments; it investigates what is
morally right or wrong, just or unjust. In a broader sense, ethics considers human beings
and their interactions with nature and other humans, as well as freedom, responsibility,
and justice. According to the five general principles of the American Psychological
Association (APA) Code of Conduct, all psychologists must strive for beneficence and
nonmaleficence, fidelity and responsibility, integrity, justice, and respect for people's
rights and dignity.
A report is a written document produced at the conclusion of a psychological
assessment.It combines information from the case history, behavioural observations, test
results, and any other assessment findings to answer the specific referral question.
In Cognitive-Behavioral Therapy, role play is frequently used for skill training. While
learning to manage their anxiety, aggression, and other interpersonal difficulties, clients
can practise and improve their assertive and social skills. While explaining this
phenomenon, our facilitator instructed us to role play as either a client or a counsellor in
order to better understand the concept.
Week 3
We talked more about psychotherapies in the third week, including how they should be
used and for which disorders. We talked about psychological evaluation the next day. We
discussed what it is used for and how it can help. Psychological assessment is a complex,
integrative, and conceptual activity that entails drawing conclusions from multiple
sources of information in order to gain a comprehensive understanding of a client or
client system. Norm-referenced tests, interviews, observations, and informal assessment
procedures are the four pillars of assessment. And we were told to finish our assignments
and reports in the last two days.
Week 4
We were given some assignments last week, which we completed with the help of the
notes provided to us.
● Skills acquired
So, here's a list of the top seven things I learned from doing an internship.
I learned how to communicate with and build relationships with the people I worked with during
my internship. I learned how to introduce myself, discuss my interests, knowledge, and skills
with entrepreneurs and business owners, and how to ask questions and gain a better
understanding of businesses not only in the co-working space, but also in the market. Overall,
this process aided in the development of my professional network and emphasised the
importance of making these connections. I also connected with the majority of them on
LinkedIn, which is an obvious professional networking platform.
4. Enthusiasm is priceless.
As an intern, I discovered that being enthusiastic and open to learning new skills, asking for
more work, and being curious to learn and ask questions are all essential. This attitude will
demonstrate that you enjoy being a part of the team and are eager to assist. Curiosity and
enthusiasm also mean that, as an intern, you get a lot out of what you do, which opens up a lot of
doors.
5. Keeping a journal is beneficial to personal development.
I kept a journal and took notes every day about new things I learned, feedback from my manager,
strengths and weaknesses I noticed, and topics I wanted to research and learn more about during
my internship. This helped me better understand myself and identify areas where I needed to
improve.
Communication is essential for success in the workplace. I learned that if I have questions or
don't know how to complete a task, I should contact my manager via phone, email, or SMS.
Asking for assistance and clarification is preferable to pretending you understand what you need
to do. However, I discovered that if you can Google something, you should. Avoiding questions
when you can find answers elsewhere is part of being a good communicator; remember that
everyone's time is valuable. As an intern, effective communication is essential for productivity,
efficiency, engagement, and growth.
● Case studies
Case 1
The patient was a 15-year-old adolescent from Puerto Rico who lived with her parents and a
younger brother. His parents, who had significant marital problems, had separated several times
and were discussing a divorce. Her mother reported receiving psychiatric treatment for
depression and anxiety and indicated that the patient's father had bipolar disorder and was
receiving psychiatric treatment. He had been hospitalized several times over the past few years
due to severe psychiatric symptoms.
The patient was failing several classes at school and her family was in the process of finding one
new school. due to his bad grades and difficulty getting along with his classmates.
She presented with the following symptoms: sadness and frequent crying, increased appetite and
overeating, guilt, low self-esteem, anxiety, irritability, insomnia, hopelessness, and difficulty
concentrating. He also experienced difficulties in his interpersonal relationships, persistent
negative thoughts about his appearance and academic ability, and feelings of guilt about his
parents' marital problems.
The patient's medical history indicated that she had asthma, wore glasses and was overweight.
Her mother reported that she was diagnosed with MDD 3 years previously and was treated
intermittently with supportive psychotherapy and antidepressants (fluoxetine and sertraline;
dosing information not available) for 2 years. This first episode was prompted by the rejection of
a boy she had romantic feelings for. His most recent episode appeared to be related to
his parents' marital problems and academic and social difficulties at school.
DIAGNOSTICS
An MDD diagnosis was made using the Diagnostic Interview Plan for Children (DISC-IV).
16 In addition, according to DISC-IV, she also met criteria for generalized anxiety disorder,
separation anxiety disorder, and attention deficit disorder. During therapy, depressive symptoms
were recorded every 2 to 4 weeks using the Childhood Depression Inventory – CDI17 (Fig. 1).
The Childhood Depression Rating Scale – CDRS-R18 was also used to assess depressive
symptoms at baseline, completion and follow-up (Table 1 ). In addition, other variables related to
depression were assessed before, during, after, and after treatment using the Piers Harris Child
Self-Concept Scale: PHCSC,19 the scale of hopelessness for children - HSC,20 the
Dysfunctional Attitude Scale - DAS,21 and the Suicidal Ideation Questionnaire - SIQ- Jr22
(Table
1).
On pre-treatment assessment, the patient presented with severe depressive symptoms and
suicidal ideation, as well as severely dysfunctional attitudes and low self-concept.
TREATMENT
The patient was treated with manual CBT, which has shown success in treating depression in
Puerto Rican adolescents.8 , 11Participated in a research project on the treatment of depression
in adolescents, comparing a standard 12-session "dose" of CBT alone versus CBT reinforced
with group psychotherapy. educational intervention for parents of 8 sessions. They were
randomized to the CBT-only condition of the study. As part of a complementary research project,
adolescents whose depression did not resolve after treatment were offered additional sessions (up
to a maximum of 12) to assess the optimal dose required for complete remission and
characteristics associated with treatment response.
Five adolescents agreed to participate in this study and received an average of seven additional
sessions. The adolescent selected for the case study had a therapist who was a graduate student in
clinical psychology trained in CBT and who received weekly supervision from a licensed clinical
psychologist with a PhD. Qualitative data from this case study was analyzed by reviewing
progress notes and video recordings of therapy sessions.
DISCUSSION
In this case, CBT appeared to reduce depressive symptoms as well as dysfunctional attitudes and
suicidal ideation. The number of CBT sessions needed to achieve partial remission in this case
was 16; four additional sessions to the standard 12 in most CBT studies. In addition, the patient
continued to show improvements several months posttreatment in depressive symptoms and
other related areas of outcome such as low self-concept and dysfunctional attitudes. Nonetheless,
a possible limitation in the interpretation of these results is that improvements in depressive
symptoms might be attributed to common factors (e.g. talking about one's problems with an
attentive professional, receiving a credible treatment rationale, etc.) that reduce feelings of
hopelessness in the patient.23 In addition, simply the passing of time could account for the
changes, since studies have found that some patients with depression recover without treatment.
This patient presented several of the characteristics that have been found to be related in the
literature to partial or limited response to treatment: greater initial severity of depressive
symptoms, earlier depressive episodes, co-morbidity with other mental disorders, and parental
conflict. Although she met diagnostic criteria for generalized anxiety disorder, separation anxiety
disorder, and attention deficit disorder at pretreatment, these diagnoses were not evident in
therapy sessions; hence, they were not specifically addressed in treatment. Also, she was
participating in a research trial that tested a manual-based CBT depression intervention, which
was not designed to address symptoms of other disorders although many cognitive and
behavioral strategies used in the manual could generalize to symptoms of anxiety.7 The CBT
research literature is beginning to recognize that treatments for specific disorders evaluated in
clinical trials may not always generalize to “real world” settings. Youth treated in community
mental health clinics tend to have higher rates of co-morbidity, and depression tends to be more
chronic and severe, often resulting in lower treatment effects.9 As a result, some investigators are
recommending that CBT manual-based treatments be tested in effectiveness trials and become
more flexible in content, structure, and format, in addition to involving other family members in
therapy.24
In this case, CBT appeared to reduce depressive symptoms as well as dysfunctional attitudes and
suicidal ideation. The number of CBT sessions required to achieve partial remission in this case
was 16; four additional sessions to the standard 12 in most CBT studies. In addition, several
months after treatment, the patient continued to show improvements in depressive symptoms and
other related outcome areas, such as: B. low self-concept and dysfunctional attitudes. However, a
potential limitation in interpreting these results is that improvements in depressive symptoms can
be attributed to common factors (e.g.,
Discussing one's problems with a caregiver, getting a credible justification for treatment, etc.)
that reduce the patient's sense of hopelessness.23 Also, simply Die Passage of time could explain
the changes, as studies have found that some patients with depression recover without treatment.
This patient exhibited several of the characteristics found in the literature Partial or limited
response
He also participated in a research study testing a manual CBT intervention for depression that
was not designed to treat symptoms of other disorders, although many of the cognitive and
behavioral strategies used in the manual could be generalized to anxiety symptoms .7 The CBT
research literature is beginning to recognize that treatments for specific disorders evaluated in
clinical trials cannot always be generalized to clinical settings. Adolescents treated in
community psychiatric hospitals tend to have higher comorbidity rates, and depression tends to
be more chronic and severe, often resulting in lower treatment effects.9 As a result, some
researchers recommend that manual CBT treatments be tested in efficacy trials and become more
flexible in content, structure, and format, as well as involve.
The maximum full-size stressor contributing to the protection of this patient's signs become
parental war. This become evidenced with the aid of using her fluctuating temper in the course of
remedy, which seemed to be contingent upon mind referring to her mother and father'
relationship. Familismo is an critical price in Puerto Rican and different Latino cultures, and
there's a robust correlation among parental and own circle of relatives variables to adolescent
despair.25, 26 Forty percent (40%) of Puerto Rican teenagers in a medical trial of remedy for
despair taken into consideration their maximum common hassle to be a own circle of relatives
hassle27 and 70% taken into consideration their maximum common interpersonal hassle to
contain one or each mother and father.28 Familismo is a cultural price that refers to a
conventional modality in Latino cultures that displays the significance of own circle of relatives
integrity, each nuclear and extended.29 It shapes individuals' behavior with the aid of using
anticipating them to guard the protection and hobbies of different individuals and accordingly
keep away from bringing bad public interest to the own circle of relatives's honor. This would
possibly give an explanation for why own circle of relatives elements had a full-size function in
preserving the patient's depressive signs notwithstanding the presence of different defensive
elements consisting of nice friendships and educational experiences. She required 4 extra CBT
classes and a consultation together along with her mother and father to deal with parental war. It
isn't clean whether or not this emphasis at the own circle of relatives context and its popularity
with the aid of using this Latino adolescent will be the identical for a non-Latino girl.
While CBT and anti-depressants on my own seem to were in part powerful in this example, a
mixture of the 2 would possibly have tested to be a higher opportunity for entire recuperation and
prevention of relapse. In addition, booster classes were located to boost up the recuperation of
nonresponders to CBT1 and may have helped enhance reaction in this example after remedy
termination. Other opportunity or complementary remedy modalities consisting of own circle of
relatives remedy ought to additionally be taken into consideration for despair in childhood that
gives restrained reaction to remedy, in particular with Latino populations wherein the own circle
of relatives can play a full-size function withinside the perpetuation of depressive signs. Family
remedy has been located to be efficacious with Latino teenagers offering externalizing
disorders30 however, no research the usage of own circle of relatives remedy for despair in
Latino teenagers were identified. Family remedy has currently started to be studied as an
intervention for depressed teenagers demonstrating initial nice results.31, 32
This case examine illustrates a number of the demanding situations of the usage of
guide-primarily based totally CBT and the range in reaction to despair remedy. Cases consisting
of this one, with partial reaction and full-size own circle of relatives stressors, will regularly
require extra classes in addition to changes withinside the remedy guide to especially deal with
those problems with a view to reap entire remission. Some options may be dismantling remedy
to deal with the patients' unique wishes and strengths with the aid of using growing the emphasis
on sure remedy components (i.e. interpersonal skills, behavioral activation), and including
particular own circle of relatives and/or parent–toddler modules to deal with war and
communication. This case have a look at offers similarly assist to the suggestions cited above
that investigators have presented alongside this line withinside the remedy of teenagers
depression.2, 7, 9, 32, 33 Also, figuring out the traits related to remedy reaction withinside the
preliminary levels of remedy can assist tell remedy making plans in phrases of choice of remedy
format, components, and quantity of sessions (“dosage”) to maximise fine outcomes.
Case 2
Case presentation
A 28-year-old Caucasian woman presents to the hospital with complaints of joint pain
(arthralgia) and intermittent back pain. The patient cannot remember any mechanism of injury.
She reports that she has trouble falling asleep at night and cannot sleep well. She often feels
"restless" or "jittery," which she associates with insomnia. She says she is constantly worried
about her academic performance, her family and the health of her mother, who was recently
diagnosed with
stage IV small cell carcinoma.
The patient also states that she wakes up at night with a throbbing headache that lasts for a few
hours. You feel tense for most of the day, which makes you feel stiff. He also has trouble paying
attention in class and doing his homework.
Subjective:
Joint pain, weak Back pain, headache, muscle stiffness, trouble sleeping and attention for about a
year. Previously diagnosed with PTSD and treated with CBT.
Comorbidities:
hypertension, consumption of more than 10 alcoholic beverages per week (possible drug abuse),
Depression
Previous treatment or treatment: PTSD treated with cognitive behavioral therapy by a clinical
psychologist after car accident
in 2000.
GAD-7 = 16/21, Penn State Worry Questionnaire (PSWQ) = 64/80, McGill Pain Questionnaire =
42/78
Physical performance measurement: Oswestry Disability Index (ODI) = 38%
Intervention:
The ratings from the consequences measures found out that the affected person has symptoms
and symptoms and signs which might be constant with a fairly intense shape of GAD. Therapist
encouraged that the affected person follows up together along with her number one care doctor to
speak about the consequences of the final results measures and notice what strategies her doctor
recommends might be first-class for her because she has a widespread clinical history.
The therapist defined to the affected person that bodily remedy can't therapy her feasible GAD;
but therapists can deal with the signs via training due to the fact there may be no precise bodily
remedy intervention to deal with GAD.
Therapist furnished academic records referring to tension control that the affected person can
make use of outdoor of remedy. Stress control strategies together with: mediation, deep
respiration, revolutionary muscle rest strategies, exercising and enhancing her diet. Therapist
additionally mentioned affected person’s alcohol intake and training on alcoholism and the
outcomes it has at the thoughts and the body.
Outcomes:
After being recognized with GAD from her number one care doctor, affected person changed
into referred lower back to PT for remedy of the musculoskeletal deficits secondary to GAD. Her
number one care prescribed her Paxil to boom her stages of serotonin, which significantly
advanced her motivation for remedy. Within 2-three weeks her AROM advanced and the ratings
on her final results measures reduced notably.
GAD-7 = 10/21
Penn State Worry Questionnaire = 48/80
McGill Pain Questionnaire = 31/78
Discussion:
There is constrained studies on bodily remedy interventions to immediately deal with GAD.
However, bodily remedy may be very powerful whilst treating musculoskeletal impairments
which might be secondary to GAD. An vital position bodily therapists can take is affected person
training. By teaching sufferers approximately sticking to an adherent clinical regimen (medicinal
drug schedule) which can assist enhance affected person compliance and may train the affected
person at the complexity in their condition. Also, coaching the affected person rest strategies,
together with deep respiration sporting activities and rubdown strategies can assist to lower
muscle tension. Exercise is any other manner that bodily therapists can useful resource in
lowering tension and notably enhance cardiovascular health. Physical remedy whilst blended
with different interventions together with cognitive behavioral remedy and holistic strategies can
notably enhance the general high-satisfactory of lifestyles in sufferers laid low with GAD.
Case 3
DETAILS OF THE CASE STUDY
Mike is 20 years old- alt, who tells you he's feeling depressed and has significant stress at school,
noting that he's "probably going to fail." He spends much of his day in his bedroom playing
video games and has trouble identifying what, if anything, is fun on a typical day. She rarely
attends classes and has avoided contacting her professors to try to salvage her
grades this semester. Mike has always described himself as a shy person and had a very small,
close-knit circle of friends from elementary school through high school. In particular, his stress
levels increased significantly when he entered college.
You learn that when he meets new people he has a hard time concentrating on the interaction
because he is busy worrying about what they will think of him; Expect them to think you're
"stupid," "boring," or a "loser." When he loses concentration, he stutters, becomes speechless,
and breaks out in a sweat, which only makes him more uncomfortable. After the interaction,
repeat the conversation over and over again, focusing on the "stupid" things he said. Similarly,
has long felt uncomfortable around authority figures and has had difficulty raising hands and
approaching teachers in class. Since he started college, he's become more withdrawn, turning
down his roommate's invitations to eat or hang out, ignore his cell phone when it rings, and
routinely skip classes.
Your concern about how others see you drives you to engage in these avoidance behaviors. After
you conduct your assessment, let the patient know that you believe they have social anxiety
disorder, which should be the primary goal of treatment. You state that you see your fear of
negative evaluation and your thoughts and behaviors in social situations as drivers of your
increasing feelings of hopelessness, isolation and worthlessness
.
SYMPTOMS
● Anxiety
● Depression
● Reflections
● Social Anxiety
RELATED DIAGNOSIS AND TREATMENTS
Mike has been diagnosed with social anxiety disorder and fear of public speaking. And the
treatment used for this was cognitive behavioral therapy (CBT).
● Documents
1. WPR
wpr4 (1).pdf
srishti 144.pdf