INTERNSHIP REPORT

A report submitted in fulfilment of the requirements of the project for the Award of the Degree
of

M.Sc. PSYCHOLOGY

IN

ST PAULS COLLEGE

By

KARUTURI BHAVANA

FIRST SEMESTER

SUBMISSION DATE:

UNDER THE SUPERVISION OF

UNNATHI S

PSYCHOLOGIST

UNDER GUIDANCE OF

GOPIKA PRASANNAN

ASSISTANT PROFESSOR

DEPARTMENT OF HUMANITIES
INDEX

SL NO PAGE
CONTENT NUMBERS

1 Introduction

2 About the organization

3 Methodology

4 Daily log

5 Case studies

Annexures

Introduction
Nature of the Internship

The nature of the internship is clinical-based and was at a Psychiatric Hospital. It involves assessing
and analysing the behaviour of the patients who exhibit symptoms of various psychological
disorders. The internship in a clinical setting requires primary communication skills to develop
rapport with the patients and record the case study for further reference for prognosis and treatment.
It also involves undertaking assessments, observation of individual and group therapy, and
conducting activities for the patients.

Objectives of the Internship:

• To enhance the assessment and diagnostic skills

• To gain efficiency in psychological testing and assessment techniques used for various
psychological disorders
• To learn and improve in communication with patients and clients to build a better relationship
with them
• To understand and follow the ethics and rules that a psychologist must follow in a work set-up
• To gain efficiency in interviewing and recording the case study of the patients
• To develop the ability to apply the concepts and theories to more practical use

Duration of the Internship

The internship started on 1st November 2023 and ended on 17th November 2023. The duration was
15 days with a total of 60 hours of attendance.

About the organization

Spandana Health Care is the largest of the sister organizations under the umbrella of the Spandana
Institutions.
Spandana Institutions the leading Tertiary licensed Mental Health Care setup was started to provide
comprehensive, cost-effective and accessible Mental health services to the general population in the
private sector. Established in 1980 for the mentally ill, it was upgraded to a Multi-speciality
Hospital with about 35 renowned specialists treating various kinds of people.

Vision and Mission of the organization

The vision is to improve each patient's quality of life through intensive, highly flexible
rehabilitation and care programs delivered in safe, supportive environments.

Administrative structure

Spandana Hospitals has an organized administrative structure that helps the effective functioning of
the organization. There is a team of three clinical psychiatrists who majorly are responsible for
diagnosis and initiating a treatment plan. They have two counselling psychotherapists assigned with
patients depending on the diagnosis. There a team of three psychologists who play an important role
in conducting assessments to the patients and also guide the interns. There is a management team
and Care Team consisting a duty doctor and psychiatrist. The nursing staff is a team of about 20
members who take care of patients needs and maintain their daily records.

Programmes of the organization

• Suicide Prevention Program: Most suicidal individuals give warning signs or signals of their
intentions. The best way to prevent suicide is to recognize these warning signs and know how to
respond if you spot them.
• De-addiction program: treatment for addiction of Cannabis, Alcohol, Drug Dependence, Nicotine
and Prescription Drugs along with Media/ Internet / Gaming
• Outpatient Rehabilitation program: designed to provide treatment and support for individuals
dealing with psychiatric conditions while allowing them to live at home.
• Inpatient Rehabilitation program: designed for individuals with severe psychiatric conditions that
require intensive and continuous care.
Specific services provided by the organization

• Intensive/critical care unit: ICU is round-the-clock 24/7 service with equipped with standardized
accessories assisting immediate & accurate diagnosis for immediate treatment of the patient's
condition.
• Psychological Tests: Psychological tests are written, visual, or verbal evaluations administered to
assess the cognitive and emotional functioning of children and adults.
• Chronic care centre: Chronic care refers to medical care which addresses pre-existing or long-
term illness, as opposed to acute care which is concerned with short term or severe illness of brief
duration.
• Daycare: Supervise and care for people who cannot be fully independent, such as children, elderly
people, physically or mentally disabled children/adults that is provided during the day.
• Geriatric care: Aim to promote health by preventing and treating diseases and disabilities in older
adults by geriatric physician or Geriatrician who are specialized in the care of elderly people.
• De-addiction: Main aim is to reduce addiction towards Alcohol, Cannabis, Substance & other
addictive drugs among people by counselling & further treatments in order to Recover from the
addiction.
• Psychotherapy: Various counselling services include, Individual Counselling, Couple
Counselling, Marriage Therapy, Family Therapy, and Child Therapy.
• Pharmacy: Spandana Hospital have its own Pharmacy with well stocked latest medicines from
reputed pharmaceutical companies and is available 24/7.
• Ambulance: The ambulance service provided in need of any transport for admission or drop back
and is available 24/7.

Methodology

Activities undertaken by the intern

During my internship I got the opportunity to undertake various activities that involved interaction
with patients regularly and observation of their behavior, resulting in better analysis of their
symptoms and condition. I had spoken to patients with various mental disorders and recorded the
case study throughout my internship. I conducted physical activities for the patients every day.
Memory evaluation was done for the patients diagnosed with dementia and Alzheimer's. I got the
chance to observe Art therapy and psychotherapy sessions.

Reflections
At the beginning of the internship, I expected to get as much exposure as I could from a clinical set-
up and ended up reflecting on a lot of aspects by the end of it. I discovered that my listening skill is
one of my biggest strengths to tried to use that to improve my communication with the patients.
This internship helped me become more confident in my skills and abilities. I have learnt how to
maintain professional ties with the patients. My ability to handle tough situations has improved and
it influenced my future goals and approach to the psychology practice.

Learning

I have learnt a lot of new information and knowledge from this internship. One major skill I have
learnt is the ways to maintain and follow the ethics and standards of the clinical workplace. I have
acquired the ability to manage situations that could be new and sudden. I have also learnt ways to
build better rapport with patients and understand their backgrounds and cultural perspectives. I have
learned a lot about the procedure of the clinical diagnosis, treatment plan and program assignment
for patients with particular mental disorders.

Challenges

The major challenge during the internship was understanding and interpreting the techniques used
for the process of diagnosis. Communicating with patients that are diagnosed with severe mental
disorders was another challenge that I had eventually overcome by the end. A lot of patients are not
easy to talk and building rapport with such patients takes time. Anything said or done might trigger
them at a point so understanding that and acting accordingly might be challenging at the beginning.

Suggestions
My internship at Spandana Hospitals has been a great opportunity for me to learn new skills, reflect
on myself and also to get a view of my future in the field of psychology. The staff and professionals
were qualified and intellectual. However, the interns get very little exposure to therapy/counselling
sessions which, if increased, would help them gain knowledge about how a typical therapy session
is done. It also helps them to decide whether they would want to take up counselling as their future
goal or not. A little guidance and discussions with the clinical psychologist about various aspects of
diagnosis techniques, therapy techniques and treatment plans would help the interns understand and
interpret the case in a better way.

Case no: 1

Client Pseudonym: AK

Number of sessions with the client: 3

Demographic Descriptions of the Client

Age: 33 years

Gender: Male

Education: Engineering

Occupation: Travel agent

Marital status: unmarried

Type of marriage:

Religion: Hindu

Socio-economic status: upper middle class

Sexual orientation: heterosexual

Place of living: Bengaluru

Type of family: nuclear

Birth order: firstborn

No. of siblings: one

CASE HISTORY

PRESENTING COMPLAINTS

INFORMANT’S REPORT

Informant: self

Relation:

Reliability: stable

Adequacy: adequate/relevant

CHIEF COMPLAINTS: None

HISTORY OF PRESENTING COMPLAINT:

Treatment history (if any): De-addiction program at Spanadana hospitals in 2010,

NIMHANS for paranoid schizophrenia

PERSONAL HISTORY

Birth history: 28th December 1989

Developmental milestones: Normal

Childhood history: No negative history

Educational history: Engineer

Occupational history: Worked for a tourist agency in Nagaland

Premorbid personality:

Marital history: Unmarried

Sexual history: Normal (Onset of Puberty at 19 years)

Family history:

Father’s occupation: Doctor

Mother’s education: doctorate in physics; occupation: housewife

Type of Parent’s marriage: arrange; non-consanguine

Family tree: psychosis and depression among 2nd degree relative; BPAD and schizophrenia among
a 3rd degree relative

MENTAL STATUS EXAMINATION

GENERAL APPEARANCE

Dressing: Appropriate

Hygiene: adequate

Cooperation: cooperative

Rapport: easy to establish rapport

Eye contact: direct

Psychomotor activity: normal, relaxed

COGNITIVE FUNCTIONS

Attention and Concentration:

Digit Forward: 1, 5,6,4

Digit Backward: 4,7,8,9

Memory:

Immediate:

Recent: Adress test, by recalling the events in the last 24 hours

Remote:
Intelligence:

General knowledge:

Que: speak about any current event of the world?

Ans: Gaza war

Arithmetic:

Que: 15+8

Ans: 23

Comprehension:
Que:

Ans:

Abstract Thinking:

Que: differences between a table and a orange

Ans: one is a thing and the other is a fruit

Orientation:

Time: 11:50

Place: Spandana hospitals, Bangalore

Person: psychologist
VOICE AND SPEECH
voice: normal tone and ordinary volume
speech: relevant, coherent, high tempo, ordinary rate and clear speech

PERCEPTUAL DISTURBANCES
No presence of illusion or hallucinations were recognized. The patients was completely aware of his
surroundings.

THOUGHT PROCESS
Stream: not constant
Content: spirituality
Possession: no obsessions and compulsions
Form: no presence of formal thoughts
JUDGEMENT
Test:
Que: what would you do if you find a missing post letter on the road?
Ans: he would return the letter at the office and make sure it reaches the recipient
Personal:
Que: What do you feel about your stay at the hospital?
Ans: I don’t have any complaints or symptoms. i think im ready to get discharged
Social:
Que: How does the presence of a authoritative figure impact your social judgment within a group?
Ans: I would not prefer working under a authoritative figure
MOOD AND AFFECT
Subjective mood: peaceful most of the times
Objective mood: calm and relaxed
Affect: insignificant

INSIGHT:
Poor insight on the situation. Believes that he doesn’t need any kind of treatment and that
is capable of living without any psychiatric help.

DIAGNOSTIC FORMULATION
The patient’s diagnosis suggests presence of substance (cannabis) dependency. The patient was
previously diagnosed with schizophrenia and was admitted at NIMHANS a few years ago. No
significant comorbidities are noticed. The patient has no history of brain damage or other
neurological conditions. The conflicts with his family could be the precipitating factors for anger
issues. Patient has no impairment in daily life as a result of the impact of his symptoms.

PROVISIONAL DIAGNOSIS
Substance abuse; psychosis was the initial provisional diagnosis based on anger episodes and lose
of touch with reality.

DIFFERENTIAL DIAGNOSIS
Later diagnosed with both substance dependency and paranoid schizophrenia.

TREATMENT PLAN
Medication
Electroconclusive therapy
De-addiction program
Art therapy
Cognitive behavioral therapy

FOLLOW UP SESSIONS:
Evaluation: The patient doesn’t show any indication of hallucinations or illusion. His insight on his
condition was poor. The patient often feels drousy due to lot of medication.
Recommendation: Regular therapy session, Medication management, group or family therapy.