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Outline of Psychological Report

An outline for making psychological report

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klasoldevilla
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72 views2 pages

Outline of Psychological Report

An outline for making psychological report

Uploaded by

klasoldevilla
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
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Outline of Individual Activity for Psychological Report

I. Identifying data of client


- Alias/Codified Name of Client: Violet
- Age: 15
- Sex: Female
- Marital Status: Single
- Grade Level: 10

II. Name of Examiner: Kyle Louie A. Soldevilla


III. Referred Source: Tomas del Rosario College
IV. Referral Question: Assess the current psychosocial functioning of the student. In what
ways does it impact their academic functioning?
- Negative psychosocial functioning is evident in Violet. She lacks social
support resulting in low motivation. She identifies herself as a shy person and
having difficulties engaging in a conversation with people around her.
V. Evaluation Procedures: (Summary table of the evaluation process conducted according
to date/s of visit)
VI. Behavioral Observations
● Attitude toward examiner and test situation – Excellent attitude and not guarded.
● Habits – Tends to play with pencil and touch her bracelet.
● Reaction to antecedents (i.e, failure; praise, questions) – Normal
● Speech and language – Normal
● Visual-motor – Normal

VII. Background Information: (Extensive interview from the client and secondary sources)
● Family background:
- Her father is a chief engineer overseas.
- Her mother oversees the family’s business.
- She has a 17-year-old brother.

● History of medical condition (if any)


- None

● Current life situation (at home and school)


- Not open to family, describes their family relationship as casual to “stranger like”.
- Always sleeps at school.

● Personal history (probe on any encountered problems among peers, school and family;
adjustment and coping styles)

- History of bullying (physical)


- Having difficulty engaging with peers
- Eating problems. Signs of bulimia nervosa
- Low self-esteem and motivation due to lack of social support
- Record of suicidal ideation and self-harm
- Record of sleeping difficulties resulting in hallucinations

NOTE: You can use their shared information from the life story activity to describe your client.

VIII. Mental Status: (Comprehensive and objective narrative using the MSE; make sure you
describe each domain)
IX. Test Results: (Comprehensive report of scores and interpretations)
X. Summary and Recommendations: (Synthesis of the answer to the referral question)
● Recommended Psychosocial Intervention (if any)
● Specific (objective recommendations that can benefit the student in case difficulties were
prominent from the assessment result)

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