Beruflich Dokumente
Kultur Dokumente
Department Of Psychology
MA in Social Psychology Program
Practicum in Social Psychology
(PSYCH-652)
Final Report
PGRS/014/10
E-mail- tesfuayz@gmail.com
Besides, I am grateful to all the staffs of agriculture college clinic for their sincere cooperation
on facilitating rooms for counseling process and making arrangements by assigning clients for
each practioners and Lastly I would like to thank my client for his cooperation providing each
and every information and also on implementing whatever professional guidance who helped me
to see my professional competence
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Abstract
People are social organisms. Reproduction and survival depend on successful, cooperative
interactions with other people. We form social alliances for many purposes, such as raising
families, doing our jobs, and living in a community. We also compete with others, and in some
cases we have to protect ourselves from others. These relationships are governed by a variety of
psychological mechanisms that, taken together, constitute our personalities.
This case study focuses on schizoid personality disorder which is a poorly studied disorder, and
there is little clinical data on SPD because it is rarely encountered in clinical settings. The
effectiveness of psychotherapeutic and pharmacological treatments for the disorder has yet to be
empirically and systematically investigated (David S. Kosson, 2008).
Cognitive behavioral therapy and Socialization groups may help people with SPD. Educational
strategies in which people who have SPD identify their positive and negative emotions also may
be effective. Such identification helps them to learn about their own emotions and the emotions
they draw out from others and to feel the common emotions with other people with whom they
relate. This can help people with SPD create empathy with the outside world.
Psychologists are highly needed on the current time of globalization to help individuals with
such kind of psychological difficulties and Psychology is becoming a golden helping profession
as the Ethiopian society transforming from collectivism to individualism there by merely
adopting western mind set and way of living and degrading well grounded social values.
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Table of Contents
Acknowledgement ........................................................................................................................................ 1
Abstract ......................................................................................................................................................... 1
Introduction ................................................................................................................................................... 4
3. Literature Review................................................................................................................................ 10
3.7. Treatments................................................................................................................................... 17
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4.4. Evaluation ................................................................................................................................... 22
5. Recommendation ................................................................................................................................ 24
6. Appendices.......................................................................................................................................... 25
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Introduction
Personality refers to enduring patterns of thinking and behavior that define the person and
distinguish him or her from other people. Included in these patterns are ways of expressing
emotion as well as patterns of thinking about ourselves and other people (Kosslyn, 2011). When
enduring patterns of behavior and emotion bring the person into repeated conflict with others,
and when they prevent the person from maintaining close relationships with others, an
individual’s personality may be considered disordered (Michelle L. Esterberg, 2011)
Personality disorders are characterized by an enduring pattern of behaviour and experience that
deviate markedly from cultural expectations and which lead to significant personal distress or
significant impairment in social functioning. With personality disorders there are marked
difficulties in two or more of the following domains: cognition, affect, impulse control,
behaviour, and interpersonal functioning. With cognition, there may be peculiarities or
difficulties in the way self, others and events are interpreted. At an affective level, the range,
intensity, liability and appropriateness of emotional responses may be out of keeping with
cultural expectations. There may be serious difficulties with impulse control, leading to highly
erratic or impulsive behaviour, markedly inhibited behaviour, or peculiar behaviour. With
respect to interpersonal behaviour, there are typically serious difficulties making and maintaining
stable and fulfilling inter-personal relationships. Most people find the rigid behavioral patterns
of people with personality disorders aversive and so avoid them. In the long term, the social
isolation or negative response of others to people with personality disorders causes them
personal distress (APA, 2013; Carr, 2011; Michelle L. Esterberg, 2011).
In DSM IV the ten main personality disorders are subdivided into three clusters on the basis of
their cardinal clinical features. The first cluster includes the paranoid, schizoid and schizotypal
personality disorders which are grouped together because they are characterized by odd or
eccentric behaviour also related to psychotic disorders. The second cluster includes the
antisocial, borderline, histrionic and narcissistic personality disorders which are characterized by
dramatic, emotional or erratic-impulsive behaviour. The third cluster includes the avoidant,
dependent and obsessive-compulsive personality disorders, all of which are characterized by
anxiety and fearfulness (APA, Diagnostic and Statistical Manual of Mental Disorders, Fourth
Edition. , 1994). A very similar classification system is used in ICD 10 (Kosslyn, 2011).
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This report organized under four sections there by focusing on one of cluster A odd eccentric
(psychotic disorders), schizoid personality disorder. The first section includes discussion or
description of clients problem, ethical considerations and field observations. The scond section
includes review of related literatures on the problem starting from historical coining, general
descriptions, theoretical justifications about the causation of the problem, the signs and
symptoms of persons with SPD, the prevalence and epidemiology of the problem, its risk factors,
diagnostic features and recommended techniques were discussed.
The third section presents the observation/ counseling process all the counselors arguments,
justifications and the techniques and procedures employed discussed in detail. The last section
elaborates the results or the outcomes of intervention strategies and then the evaluation of the
counselor’s progress, lessons learned and recommendations were also clearly stated
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1. Background of the Problem
Personality disorder is a common and chronic disorder. Its prevalence is estimated between 10
and 20 percent in the general population, and its duration is expressed in decades. Persons with
personality disorder are frequently labeled as aggravating, demanding, or parasitic and are
generally considered to have poor prognosis (David S. Kosson, 2008).
The client name is (XXXX) 20 years old male 1st year food science student of Hawassa university
agricultural college of agriculture, who came from Oromiya Region Wolliso town, his religious
background is orthodox Christian. He is the 4th child of five children of his parents who were sociable but
he has very little connectedness with his siblings and father except his mother.
The client came to counseling the complaints that he has been facing difficulties to lie sleep or minor
insomnia due to hallucinations during bed time in which the communications he had had during day time
has been disturbing him by hallucinating while he planned to sleep and also he reported that he has poor
social interactions with his friends (dorm mates and class mates), and even with his families at all.
The onset of the present problem, i.e., the insomnia and hallucination has no previous experiences it is a
recent phenomena but poor social interaction was started from the childhood up to now on. Behaviorally
the client is very shy, avoids eye contact, while communicating with the practitioner he prefers not to talk
much Constricted facial affect , Lack of nonverbal expression, Detachment (lack of engagement), Lack
of verbal expression,, Guardedness, Lack of variability in affect/expression over time, Poor rapport,
Absence of spontaneity in speech, Lack of verbal responsiveness to interviewer’s remarks. However, his
interest to develop interpersonal relationship and also to improve his interpersonal communication was
very impressive and highly motivated the practitioner to provide his professional support for the client
Emotionally, based on mental status examination and also Hamilton depression rating scale, he is
experiencing mild depression, restricted emotional response or blockages even though he is conscious, he
is very cold and insensitive. While communicating he has been preoccupied with nail biting, roping hair,
and shivering his leg on the ground
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Based on his mental status examination, in terms of the clients insight the client is very aware of his
problems and admits that he has such problems mentioned above and all others mentioned in daily
observation sheets and other tests and diagnostic tools and also he does not blames any one for his current
problems rather than himself but he is very curious to improve the skills in the areas he lacks
His lack of participation in the class room on answering questions by raising hands during middle and
late childhood period, though he has been among best achievers, due to fear of criticism if he fails, and
also having poor relationship and mild negative attitude towards peers and play mates as a result of the
minimal role they gave him during playing games resulted for having poor interpersonal relationship and
communication affected his current status for having poor interpersonal relation hip.
As he claimed that “most of the time during playing games they gives me a minimal role, for instance if
we play foot ball they gives me a goal keeper role as if I can play better in the midfield position because I
am younger in age hence I cannot react to change my position rather I prefer to keep silent even to give
up the game and prefer to play solitary games”.
Currently he has been worrying about his future life if the continues in this manner regarding his poor
interpersonal communication and also the insomnia and hallucinations affecting his life will affect his
career and there by considering this he wants to improve them.
Based on the information’s gathered from the client through different mechanisms like
observations, interviews, testings (hamiltaon depression scale, mental status examination and
also Psychiatric history) the problem of the client confirms the clinical features, signs and
symproms of schizoid personality disorder because it satisfies all the seven criterions of DSM-IV
TR, and also as ICD10 categorized SPD under (F60) and requires at least 4 of 9 criteria’s but in
this case the clients condition satisfies 6 symptoms out of 9. Not only this but also Akhtar (2013)
classified overt and covert behaviors of persons with schizoid disorder under six dimensions
(like interms of self-concept, interpersonal relations, social adaptations, love and sexuality,
ethical standards and ideals and also cognitive styles), except ethical standards and ideals the
clients behavior mostly the coverts meets most of other five dimensions.
As a result this case study focuses on schizoid personality disorder which is a poorly studied
disorder, and there is little clinical data on SPD because it is rarely encountered in clinical
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settings. The effectiveness of psychotherapeutic and pharmacological treatments for the disorder
has yet to be empirically and systematically investigated (David S. Kosson, 2008).
SPD is not the same as schizophrenia or schizotypal personality disorder, but there is some
evidence of links and shared genetic risk between SPD, othercluster A personality disorders, and
schizophrenia. Thus, SPD is considered to be a "schizophrenia-like personality disorder"
(Sadock & Sadock, 2007 )
SPD overlaps with the negative symptoms of schizophrenia: flat affect, lack of motivation, and
social withdrawal. SPD have also traits in common with other personality disorder such as lack
of empathy with narcissistic (NPD) and antisocial personality disorder (ASPD), withdraw (self-
sufficiently in the case of NPD) from others, and failure to form human and social relationships
with NPD and avoidant personality disorder (Martens, 2010).
Millon & Davis (2012) speculated that the significant deficit in the schizoid disorders is the
person’s intrinsic incapacities to experience the joyful and pleasurable aspects of life. Klein
suggested that there are at least two quite separate categories of patients with schizoid
personality disorder: shy, socially backward, inept, obedient persons who are fearful and
therefore isolated but appreciates sociability and would like to be part of the crowd: and there are
the asocial, eccentric, (imperceptive and undiplomatic) persons who seek to be alone and have
difficulty in relationships with the peers, frequently resulting in social ostraction and
scapegoating
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3. Literature Review
SPD can be first apparent in childhood and adolescence with solitariness, poor peer relationships,
and underachievement in school. This may mark these children as different and make them
subject to teasing. Being a personality disorder, which are usually chronic and long-lasting
mental conditions, schizoid personality disorder is not expected to improve with time without
treatment; however, much remains unknown because it is rarely encountered in clinical settings
(Fairbairn, 1952)
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responses may create a self-fulfilling prophecy, where others begin to act in ways consistent with
the original distortion. (Pincus, 2017)
Personality pathology occurs when an individual chronically distorts the agentic and
communal behavior of self and others resulting in maladaptive interpersonal functioning.
Because they often distort reality, individual with personality disorders may react chaotically,
self-protectively, or rigidly pull for complementary responses, but have difficulty responding to
others in complementary ways. This reduces the likelihood that the agentic and communal needs
of both people will be satisfied in the interpersonal situation and create disturbed interpersonal
relations (APA, 2013).
An integrative perspective then suggests that the biological, psychological, and social risk factors
for personality disorders be integrated within a single interactive and integrative model.
Heritable factors influence individual variability in temperament and trait dimensions. However,
this variability usually only becomes maladaptive when amplified by cultural context and
cumulative life stressors. Thus, according to the integrative model, temperamentally predisposed
individuals who experience multiple risk factors would be most likely to develop a personality
disorder later in life (Pincus, 2017)
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3.2.6. Attachment Theory
Another influential way of thinking about personality disorders stems from attachment theory.
This theory is credited to John Bowlby and Mary Ainsworth. Insecure attachment styles are
behaviors that are overly clingy or proximity seeking (ambivalent attachment), or behaviors that
are rejecting of the caregiver (avoidant attachment). Some insecurely attached children develop a
disorganized attachment style, which is characterized by alternating back and forth between
clingy behavior, then rejecting behaviors, coupled with a fear of the caregiver (Simone
Hoermann, 2014).
SPD is uncommon in clinical settings (about 2.2%) and occurs slightly more commonly in males.
It is rare compared with other personality disorders, with a prevalence estimated at less than one
percent of the general population. There is also a very high rate of SPD and other Cluster A
personality disorders (up to 92%) among homeless people (Carr, 2011)
Studies also indicated that approximately 1% of the UK population has schizoid personality
disorder. It is more common in men than women. Schizoid individuals frequently act out with
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substance and alcohol abuse and other addictions which serve as substitutes for human
relationships (APA, 2013).
Suicide may also be a running theme for schizoid individuals, though they are not likely to
actually attempt one. They might be down and depressed when all possible connections have
been cut off, but as long as there is some relationship or even hope for one the risk will be low.
The idea of suicide is a driving force against the person's schizoid defenses (Michelle L.
Esterberg, 2011).
In general, prenatal caloric malnutrition, premature birth and a low birth weight are risk factors
for being afflicted by mental disorders and may contribute to the development of schizoid
personality disorder as well. Those who have experienced traumatic brain injury may be also at
risk of developing features reflective of schizoid personality disorder (Martens, 2010).
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The attachment style established during childhood often continues into adulthood, affecting how
the individual relates to others. People with personality disorders are more likely to have
insecure attachment. People can develop insecure attachments for a variety of reasons, such as
childhood abuse (sexual, physical, or verbal), neglect, or inconsistent discipline (Brunero, 2009;
Michelle L. Esterberg, 2011)
Poor parenting might have a strong, lasting, negative impact on the social-emotional, cognitive
and moral development of the child. Low parental affection or nurturing was associated with
elevated risk for offspring schizoid. Youths who experienced childhood verbal abuse had
elevated SPD symptom levels during adolescence and early adulthood after the covariates were
accounted for. The author suggests that physical, social and verbal abuse may provoke in the
already vulnerable and shy child strong feelings of being unlovable, inferiority, shame (and
linked self-hate) and frustration (Torgersen, 2012).
The essential feature of Schizoid Personality Disorder is a pervasive pattern of detachment from
social relationships and a restricted range of expression of emotions in interpersonal settings.
This pattern begins by early adulthood and is present in a variety of contexts.
A. Individuals with Schizoid Personality Disorder appear to lack a desire for intimacy, seem
indifferent to opportunities to develop close relationships, and do not seem to derive
much satisfaction from being part of a family or other social group (Criterion Al).
B. They prefer spending time by themselves, rather than being with other people. They often
appear to be socially isolated or "loners" and almost always choose solitary activities or
hobbies that do not include interaction with others (Criterion A2).
C. They prefer mechanical or abstract tasks, such as computer or mathematical games. They
may have very little interest in having sexual experiences with another person
(CriterionA3)
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D. Take pleasure in few, if any, activities (Criterion A4).
E. There is usually a reduced experience of pleasure from sensory, bodily, or interpersonal
experiences, such as walking on a beach at sunset or having sex. These individuals have
no close friends or confidants, except possibly a first-degree relative (Criterion A5).
F. Individuals with Schizoid Personality Disorder often seem indifferent to the approval or
criticism of others and do not appear to be bothered by what others may think of them
(Criterion A6).
G. They may be oblivious to the normal subtleties of social interaction and often do not
respond appropriately to social cues so that they seem socially inept or superficial and
self-absorbed. They usually display a "bland" exterior without visible emotional
reactivity and rarely reciprocate gestures or facial expressions, such as smiles or nods
(Criterion A7).
They claim that they rarely experience strong emotions such as anger and joy. They often display
a constricted affect and appear cold and aloof. However, in those very unusual circumstances in
which these individuals become at least temporarily comfortable in revealing themselves, they
may acknowledge having painful feelings, particularly related to social interactions (APA, 2013).
The Classification of Mental and Behavioral Disorders of ICD-10 lists schizoid personality
disorder under ( F60). The general criteria of personality disorder (F60) should be met first. In
addition, at least four of the following criteria must be present (Sadock & Sadock, 2007 ):
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3.6. Signs and Symptoms
In 2013, Akhtar provided a clinical case study of a schizoid man as an illustration of his phenomenological profile
and summarized Clinical Features of Schizoid Personality Disorder as follows (Akhtar TA, 2013)
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3.7. Treatments
People with schizoid personality disorder rarely seek treatment for their condition. This is an
issue found in many personality disorders, which prevents many people who are afflicted with
these conditions from coming forward for treatment: They tend to view their condition as not
conflicting with their self-image and their abnormal perceptions and behaviors as rational and
appropriate. There is little data on the effectiveness of various treatments on this personality
disorder because it is seldom seen in clinical settings. However, those in treatment have the
option of medication and therapy (Sadock & Sadock, 2007 ).
3.7.1. Medication
No medications are indicated for directly treating schizoid personality disorder, but certain
medications may reduce the symptoms of SPD as well as treat co-occurring mental disorders.
The symptoms of SPD mirror the negative symptoms of schizophrenia, such as anhedonia,
blunted affect and low energy, and SPD is thought to be part of the "schizophrenic spectrum" of
disorders, which also includes the schizotypal and paranoid personality disorders, and may
benefit from the medications indicated for schizophrenia (Kosslyn, 2011).
Originally, low doses of atypical antipsychotics like risperidone or olanzapine were used to
alleviate social deficits and blunted affect. However, a recent review concluded that atypical
antipsychotics were inef fective for treating personality disorders (APA, 2013)
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therapist consultation team meetings, and between-session telephone coaching is offered to
patients in moments of crisis (Brunero, 2009).
One of the most importance aspects of DBT is the “dialectics” of acceptance and change. That is,
therapists accept the patient as they are (in the context of emotional validation), but also actively
encourage the patient’s need for behavioral change (Brunero, 2009).
To accomplish this, SFT uses four core mechanisms: limited reparenting, experiential imagery
and chair dialogue work, education and cognitive restructuring, and Behavioral pattern breaking
(David S. Kosson, 2008).
Individual gains from MBT include more gratifying relationships, greater tolerance of distress
and negative emotions, and a reduction in impulsive behaviors. MBT can be delivered in
individual, group, or family settings (Brunero, 2009).
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3.7.2.4. Transference-Focused Psychotherapy
Transference-focused-psychotherapy (TFP) is a highly structured, once to twice weekly,
psychodynamic treatment designed for patients with BPD and other severe personality disorders.
The aim of TFP is to help patients “integrate all aspects of their internal world. In order to
experience themselves and others in a coherent and balanced way”. As the patient develops the
capacity to think more flexibly, realistically, and benevolently about their own mental states and
those of important others, he or she tends to experience a reduction in self-defeating and self-
destructive behaviors, increased emotion regulation and behavioral control, increased coherence
of identity, greater capacity for intimacy, and general improvement in symptoms (e.g.,
depression, anxiety) and functioning (Brunero, 2009).
During the first year of treatment, TFP focuses on the following hierarchy of goals: containing
suicidal and self-destructive behaviors, recognizing and addressing threats to the treatment, and
identifying and recapitulating the patient’s predominant relational patterns as they are expressed
and experienced outside the consulting room and within the transference. The therapist
repeatedly uses the techniques of clarification, confrontation, and interpretation to provide the
patient with the opportunity to integrate split off and disorganized motives, thoughts, and
feelings, thereby leading to changes in both symptoms and personality structure over time
(Torgersen, 2012; Brunero, 2009).
IM focuses on exploring the unfolding relationship between the patient and therapist, as the
therapeutic relationship is thought to contain important information about how the patient views
his or her self and their relationships with others. In the initial phase of IM, the therapist becomes
“hooked” and reacts to the patient in ways that others do. The therapist must become aware of
this pattern and should question his or her experience of the patient by asking questions such as
“What is this patient doing to me?” and/or “What am I feeling when I’m with this patient?”
(David S. Kosson, 2008)
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4. Observation/ Counseling Process
Based on the approach, on the first session we established rapport to get to know each other
(even our nick names), adjusted our meeting schedules, shared addresses of each other (phone
number, dorm number), I assured the clients by providing commitments regarding ethical issues
like confidentiality and privacy and the client reflected his chief of complaint and lastly the
practioners recommended some home works on his current problem and besides highlighted
some important basic social skills to cope up with life challenges in the campus and also
adolescence and also important study skills
In the second and third session, the practitioner proceeded to the second step and conducted
detailed diagnosis like interviews, psychiatric history, developmental history, mental status
examination, and also Hamilton’s Depression and Anxiety rating scales were employed so as to
find out and fix the clients problem
On the third phase the results of diagnosis were analyzed and I explored all the necessary
practical and theoretical justifications about the clients problem based on the signs and
symptoms from the Book of synopsis of Psychiatry and DSMIV-TM, and also other abnormal
psychology books found out that the signs and symptoms of the clients confirms Schizoid
personality disorder.
In the next session we prepared a tentative plan to minimize/avoid his problems and modify his
behaviors like for hallucinations (auditory) and insomnia as a result of the hallucination affecting
the client recently and also poor social interaction or poor interpersonal relationship which is a
concurrent problem.
On the counseling phase the practitioner used cognitive behavioral therapy or dialectical, as
recommended by many findings and also the supervisor, to enable the client to accept and then
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actively encourage him to change. Specific techniques used were home works and relaxation
techniques like to take bath before bed, doing aerobic exercises, listening waltz instrumental
music, managing light in the room in order to cope up with hallucination and insomnia, and also
Reattribution (Clients may attribute responsibility for situations or events to themselves when
they have little responsibility for the event. By placing blame on themselves, clients can feel
more guilty or depressed), Decatastrophizing (Clients may be very afraid of an outcome that is
unlikely to happen. A technique that often works with this fear is the “what-if” technique) and
also Cognitive rehearsal (Use of imagination in dealing with upcoming events) since he has the
problem of fear of criticism.
On the final follow up sessions we have been reached on agreement to get along at least once in
a month and also biweekly through telephone as much as possible to evaluate his progress on
overcoming his life challenges.
4.2. Result
On the three informal follow up sessions the client has been reported that he has been recovered
from the auditory hallucination and the insomnia resulting from the hallucinations. Currently he
can sleep even without using the procedures or the techniques which has been recommended on
the therapy like taking bath before bed, aerobic exercises, listening to instrumental music’s and
he is very happy for these changes.
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I encouraged him to never give up his effort to improve himself and plan to even a motivational
speaker and also encouraged and given him to watch three impressive movies influenced my life
like “The Gifted hands : Ben Carson Story”, “Forest Gamb” and also “The Pursuit of happiness”
which teaches one to be persistent in his efforts to overcome life changes and even to be an
extraordinary personality. To create a more adaptive and self-enriching interaction with others in
which one "feels real," the client is encouraged to take risks through greater connection,
communication, and sharing of ideas, feelings, and actions.
4.3. Discussion
Based on the above findings and theoretical justifications on the clients problem like his
unsociability, quietness, reservedness, depression, eccentricity, timidity, shyness with feelings,
indifference, silence, cold emotional attitudes, and also all other behaviors were highly
associated and/or connected with his childhood experiences.
For instance, the attachment style established during childhood was in secured, since his mother
and father were government employees they leave him with the care giver who becomes changed
frequently and most of them rejects him and he spends all the day in the well fenced home.
Poor parenting , i.e., low parental affection or nurturing also affected because of his siblings are
numerous, his birth order is 4th and his immediate 2 years younger sibling was the only girl
among them and they lover and gives much attention for her than him and as a result they
communicates him poorly.
More over during late child hood period the physical, social and verbal abuse he faced from his
peers and play mates and also the minimal role they usually gives him highly affected him to
develop feelings of unlovable, inferiority, shame, shy and to prefer solitary games and activities
and develop loneliness
4.4. Evaluation
The results of the intervention strategies reflects that the cognitive home work or assignment
were very effective where as reattribution decatastrophizing, cognitive rehearsal and also
systematic desensitization techniques are showing steady progress and also using role models by
watching films also will help the client to improve his interpersonal communication.
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I believe that the client’s motivation and enthusiasm to change not only let him improve the
social interaction problem but also enhances his future life to higher level
The problems related with their childhood experiences and communication barriers mostly
requires or needs long term therapies like Supportive psychotherapy is also used in an inpatient
or outpatient setting by a trained professional that focuses on areas such as coping skills,
improvement of social skills and social interactions, communication, and self-esteem issues.
People with SPD may also have a perceptual tendency to miss subtle differences.
Socialization groups may help people with SPD. Educational strategies in which people who
have SPD identify their positive and negative emotions also may be effective. Such identification
helps them to learn about their own emotions and the emotions they draw out from others and to
feel the common emotions with other people with whom they relate. This can help people with
SPD create empathy with the outside world.
Lessons Learned
The lessons the practitioner learned from this practicum session benefited very much on dealing
with some social problems there by applying the theoretical concepts of social and cultural
psychology in the real social world so as to take appropriate preventive and rehabilitative
measures on various psychosocial problems and also on putting in practical application of
psychological knowledge in real world by the identification of psychological intervention to be
done in particular area.
I also understand that psychologists are highly needed on the current time of globalization to
help individuals with such kind of psychological difficulties and Psychology is becoming a
golden helping profession as the Ethiopian society transforming from collectivism to
individualism there by merely adopting western mind set and way of living and degrading well
grounded social values.
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5. Recommendation
Ethiopian psychologists association has much to do on promoting psychology as a discipline
much more important for the current problems of the community. There for our department
since enriched with higher level psychologists has to cooperate with other universities with
department of psychology and Ethiopian psychologists to enhance the influence of
psychology on the country at large
Awareness creation: Conditions should be created by which administrators, parents, students
and teachers would gain better awareness of what better parenting is all about and the
influence of parenting on the future life on developing psychological difficulties. The medias
like television, news papers and also others should work together on better parenting
Government and professional bodies at national and local levels should work together to
develop policies, mission statements and guidelines that define the purpose and goal of
counseling and its place in the educational system. While taking account of local socio-
economic realities, these instruments should ensure that the services are geared towards
enriching the educational experience of the student and aim at making guidance and
counseling an integral part of the school system, not peripheral to it.
Government and Institutions of higher learning should begin to work together to change the
system of training and developing the professional strength of counselors. The current
practice of assigning graduates whose BA level training in Psychology gives them only very
basic ideas about counseling should give way to more focused graduate-level training in
Counseling Psychology, and even better in School Guidance and Counseling.
Disciplines such as Curriculum and Instruction, Educational Leadership and Management as
well as basic teacher training programs should incorporate courses and/or materials on SGC.
School counseling that would provide school administrators, curriculum experts, and teachers
with adequate knowledge and awareness in the field.
The future researcher inspired to look at the correlation between parenting style and
adolescents facing psychological difficulties. Since parents’ cultural background and
communication domain have an effect on parenting style
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6. Appendices
6.1. References
Akhtar TA, e. a. (2013). The tomato cis-prenyltransferase gene family. Plant J 73(4):640-52.
APA. (1994). Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition. .
APA. (2013). Diagnostic and Statistical Manual of Mental Disorders 5TM, Fifth Edition. .
Masterson, J. F., & Klein, R. (1995). Disorders of the Self – The Masterson Approach. : . New
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Research Gate .
Sadock, B. J., & Sadock, V. A. (2007 ). Kaplan & Sadock's Synopsis of Psychiatry: Behavioral
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6.2. Diagnostic Tools
6.2.1. Outline of Psychiatric History
I. Identifying data
II. Chief complaint
III. History of present illness
A. Onset
B. Precipitating factors
IV. Past illnesses
A. Psychiatric
B. Medical
C. Alcohol and other substance history
V. Family history
VI. Personal history (anamnesis)
A. Prenatal and perinatal
B. Early childhood (Birth through age 3)
C. Middle childhood (ages 3-11)
D. Late childhood (puberty through adolescence)
E. Adulthood
1. Occupational history
2. Marital and relationship history
3. Military history
4. Educational history
5. Religion
6. Social activity
7. Current living situation
8. Legal history
F. Sexual history
G. Fantasies and dreams
H. Values
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6.2.2. Outline of a Developmental History
A. Prenatal and perinatal
1. Full-term pregnancy or premature
2. Vaginal delivery or caesarian
3. Drugs taken by mother during pregnancy (prescription and recreational)
4. Birth complications
5. Defects at birth
B. Infancy and early childhood
1. Infant -mother relationship
2. Problems with feeding and sleep
3. Significant milestones
a. Standing/walking
b. First words/two-word sentences
c. Bowel and bladder control
4. Other caregivers
5. Unusual behaviors (e.g., head-banging)
C. Middle childhood
1. Preschool and school experiences
2. Separations from caregivers
3. Friendships/play
4. Methods of discipline
5. Illness, surgery, or trauma
D. Adolescence
1. Onset of puberty
2. Academic achievement
3. Organized activities (sports, clubs)
4. Areas of special interest
5. Romantic involvements and sexual experience
6. Work experience
7. Drug/alcohol use
8. Symptoms (moodiness, irregularity of sleeping or eating, fights and arguments)
E. Young adulthood
1. Meaningful long-term relationship
2. Academic and career decisions
3. Military experience
4. Work history
5. Prison experience
6. Intellectual pursuits and leisure activities
F. Middle adulthood and old age
1. Changing family constellation
2. Social activities
3. Work and career changes
4. Aspirations
5. Major losses
6. Retirement and aging
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6.2.3. Outline for the Mental Status Examination
1. Appearance
2. Overt behavior
3. Attitude
4. Speech
6. Thinking
a. Form
b. Content
7. Perceptions
8. Sensorium
a. Alertness
c. Concentration
e. Calculations
f. Fund of knowledge
g. Abstract reasoning
9. Insight
10. Judgment
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6.2.4. Hamilton Depression Scales
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6.2.5. Hamilton Anxiety Rating Scales
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