NTCC - OBSERVATIONAL STUDY

Final Report

Overview of the organization:

We Avec U is a Mental Health Organization registered under the Government of

India as an academic MSME with Reg. No: UDYAM-UP-28-0005282 and is ISO
Certified (9001:2015). The organization provides mental healthcare that are
delivered via online and telecommunications technologies through Internships and
Training Programs covering almost all areas of Psychology, Academic, and
Educational Research Services. We Avec U aims to conduct and provide
certification courses in the field of Research, behavioral Sciences, Psychotherapy,
and other Mental Health and Humanities Programs on higher education leading to
a degree or equivalent courses, and strives to symbolize Mental Growth and
promote psychological happiness for everyone.

Description of tasks undertaken:

Introduction to the internship was given to us and we were told what all we would
be covering. The differences between the diagnostic criteria of DSM and ICD for
different disorders was discussed and explained. ICD (international classification
of diseases) is given by the WHO (world health organization) and DSM
(Diagnostic and statistical manual of mental disorders) is given by APA (American
Psychological association)
Schizophrenia and disorders related to it were discussed in detail. Differences
between illusions, delusions and hallucination were also explained.
Diagnostic criteria of schizophrenia according to ICD and DSM were discussed.
Schizophrenia has a slightly different diagnostic criterion according to DSM and
ICD. A case study was given of Mr.S, 37 yrs old, male diagnosed with Paranoid
schizophrenia F20.0. He had been showing signs of auditory hallucinations since
years, decreased appetite, delusions of grandeur, delusions of control etc. We
discussed treatment plans for the case, which included Medication and therapy,
psycho-education of the client and his family. Delusions and hallucinations are the
common symptoms of paranoid schizophrenia.

The same case study was continued and the treatment plan was discussed in detail.
The types of schizophrenia and there diagnosis were also discussed. DSM 5 got rid
of subtypes of schizophrenia as separate diagnostic categories.
According to DSM 5 a diagnosis of schizophrenia is made if a person has two or
more core symptoms-one of which must be hallucinations, delusions or
disorganized speech for at least a month. According to ICD, 7 out of 11 of the first
rank symptoms must be present. The subtypes of schizophrenia include- Catatonic
schizophrenia, paranoid schizophrenia, disorganized/hebephrenic schizophrenia,
residual schizophrenia and undifferentiated schizophrenia. The schizophrenia
spectrum disorders include- Schizoaffective disorder, schizophreniform disorder
and schizotypal disorder.

The next topic was psycho oncology. Details of psycho oncology as a field and
how to deal with the patients suffering from cancer was discussed .Causes of
cancer were also discussed in detail with the help of flow chart, the effect of
psychological stress was explained. Psycho-oncology is the field of psychology
that deals with giving the patient necessary support mental and physical health
wise.
Continued psychological stress can cause increased secretion of certain hormones
which causes T cells and B cells getting damaged which could ultimately lead to
tumor formation.
Therapies that help the most are existential therapy, acceptance-commitment
therapy, mindfulness, relaxation techniques etc.
The case study we discussed was of a 45yrs old male diagnosed with cancer. He
showed fear of death, feelings of helplessness and worthlessness and constant guilt.
Precounseling and post counseling of the client is effective in such cases. Details
of psycho oncology as a field and how to deal with the patients suffering from
cancer was discussed and explained. Psycho-oncology is the field of psychology
that deals with giving the patient necessary support mental and physical health
wise.
Continued psychological stress can cause increased secretion of certain hormones
which causes T cells and B cells getting damaged which could ultimately lead to
tumor formation.
Therapies that help the most are existential therapy, acceptance-commitment
therapy, mindfulness, relaxation techniques etc.
The next topic was Psychological assessments and tests. Which assessments are
used in which disorders was explained to us. Psychological tests are used to
evaluate an individual’s behavior. Tests can be verbal or written, speed tests or
performance tests. Some tests are also used for diagnostic purposes and we focused
on these.

The next day substance abuse disorders were discussed in detail. Addiction is an
uncontrollable and compulsive use of drugs or alcohol despite negative health and
social consequences. The individual doesn't have control over his actions with
regard to drug or alcohol use. The difference between abuse and addiction is very
slight. One can abuse a drug without having an addiction, but abuse can lead to
addiction. Substance abuse is characterized by the destructive use of a drug,
leading to problems in the user's everyday life. ‘Dependence’ is a term used to
describe a person’s physical and psychological loss of control due to substance
abuse. If a person uses many drugs and develops a physical dependence on these
drugs, that person is usually described as dependent. That alone isn’t always an
addiction, but it can accompany addiction.
The case study discussed was of Mr. K 50 yrs old male suffering with Alcohol
dependence syndrome. Alcohol dependence and aggressive behavior since last 5
years was present him. The treatment included psycho educating the family
members, counseling and medication.
We continued the discussion with the same case study the next day and also
discussed the treatment plans. Tolerance is a person’s diminished response to a
drug that is the result of repeated use. People can develop tolerance to both
illegal and legal drugs. Tolerance is a physical effect of repeated use of a drug.
Tolerance does not always equal addiction. 
Withdrawal includes the symptoms a person experiences when not using a
substance, due to the body reacting to no longer having the substance. Symptoms
of marijuana withdrawal typically begin within 48 hours and can last between 2-10
days. Symptoms include: Irritability, Sleeplessness, Strange dreams, Anger and
aggression, Depressed mood, Decreased appetite, Nausea/stomach upset, Anxiety,
Drug craving
Many options that have been successful in treating drug addiction, including:
behavioral counseling, medication, medical devices and applications used to treat
withdrawal symptoms or deliver skills training, evaluation and treatment for co-
occurring mental health issues such as depression and anxiety, long-term follow-up
to prevent relapse

Mood disorders were discussed. Mood is defined as a sustained and pervasive

emotional attitude which colors the whole life.
Affect is a short-lived emotional response to an idea or an event (what people
observe)
Classification of mood disorders:
 Manic episode
 Depressive episode
 Bipolar mood (affective) disorder
 Recurrent depressive disorder
 Persistent mood disorder
 Other mood disorders
The case study discussed was of Mr. S, 26yrs old male who showed anxiety in
closed spaces, avoiding trains, metro, flights, buses etc. since past 6 years. He was
diagnosed with F 40.2 Specific phobia. The treatments included Cognitive
Behavior Therapy (CBT) and systematic desensitization.

Next topic was Neurocognitive disorders, their types, symptoms, causes and
treatment.
Neurocognitive disorders are a group of conditions that frequently lead to impaired
mental function. These disorders tend to involve problems with thinking,
reasoning, memory, and problem solving. Some types, such as Parkinson’s disease,
can lead to physical disabilities.
Various factors can lead to different kinds of NCD, but some form of nerve cell
damage is common to all these conditions. How these changes impact an
individual will also depend on where in the brain the damage occurs.
Neurocognitive disorders can be reversible or irreversible, depending on their
cause. They are characterized by damage to nerve cells in the brain. Symptoms
vary depending on the area of the brain affected.
Some cases of neurocognitive disorder – especially if due to vitamin deficiency,
infections, metabolic problems, one-time injuries and temporary hypoxia – may be
reversible. Others are nonreversible and progressive, but treatments may help
manage symptoms and maintain quality of life for months or years. 

Neuropsychological rehabilitation can be defined as the use of all available means

to improve the independence and the quality of life of persons with
neuropsychological impairments
Rehabilitation aims to help people achieve or maintain an “optimal level of
physical, psychological and social functioning” in the context of specific
impairments arising from illness or injury.
Analysis Description of the skills learned:

During the internship I learned about various disorders their diagnosis and
treatment plans. I learned how a diagnosis is made and how to understand the
symptoms of the client, the various diagnostic criteria for different disorders. I also
learned about how some disorders can be confused with each other and how to
avoid misdiagnosis. I got to know what it would be like to work as a clinical
psychologist in India and the various challenges it would present because in our
country there isn't enough awareness about mental health yet. The experience made
me realize I would like to work in a clinical setting, so I can start working towards
it. Though I would still like to learn about other fields as well.