I.
Personal Data
Name: Address: Tel. No.: Highest Educational Attainment: Parents/Guardian Address: Tel. No.: Referred by: II.
Age: 23 Birthdate: Birthplace: Batangas City Civil Status: Single Height: 5' 6 1/2" Weight: Birth order: 2nd Relation to Examinee:
Reasons for Referral The client has expressed the need to come to terms with various personal and interpersonal issues that she has been experiencing for the past several months. The client has expressed her desire to be more in control of her emotions, particularly in managing her anger. She indicates that her failure to control her anger causes strain on her relationships, especially with her partner. The client has also admitted experiencing suicide ideation recently, with occasional recurring episodes.
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Other Assessment Procedures Social Case History Behavioral Observation Intake Form
IV.
Tests Administered Myers-Briggs Type Indicator (MBTI) Edwards Personal Preference Schedule (EPPS) NEO Personal Inventory-Revised (NEO PI-R)
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November 19, 2008 December 4, 2008 December 11, 2008
Test Results and Interpretations A. Quantitative Summary of Test Results and Brief Qualitative Description:
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MBTI Type: INFP I – 25 N – 27 F – 29 P–9
Clear Preference Clear Preference Clear Preference Slight Preference
Depth of Concentration Grasp of Possibilities Warmth and Sympathy Adaptability
Dominant: F (I) Auxiliary: N (E) Tertiary: S (E) Least-preferred: T (E) EPPS Need Achievement Deference Order Exhibition Autonomy Affiliation Intraception Succorance Dominance Abasement Nurturance Change Endurance Heterosexuality Aggression Consistency
Raw Score 16 4 5 6 16 20 14 18 15 14 24 23 10 10 15 14
Percentile 77 1 1 9 85 73 42 88 85 29 91 94 11 66 87 97
Interpretation Average Very Low Very Low Low High Average Average High High Average High High Low Average High
NEO PI-R Scale Neuroticism Anxiety Anger Hostility Depression Self-Consciousness Impulsiveness Vulnerability
Raw Score 139 26 27 20 25 27 14
Interpretation Very High Very High Very High High Very High Very Low Very Low
Extraversion Warmth Gregariousness Assertiveness
117 21 14 17
Average Average Low Average
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Activity Excitement-seeking Positive Emotion
16 31 18
Average Very High Low
Openness Fantasy Aesthetics Feelings Actions Ideas Values
140 24 27 32 24 23
Very High Very High Very High Very High Low High Average
Agreeableness Trust Straightforwardness Altruism Compliance Modesty Tender-Mindedness
87 14 6 22 8 15 22
Very Low Very Low Very Low Low Very Low Low Average
Conscientiousness Competence Order Dutifulness Achievement Striving Self-Discipline Deliberation
86 20 12 17 17 13 7
Very Low Average Very Low Very Low Low Very Low Very Low
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B. Test Interpretations 1. Intellectual Functioning The general mental ability of the client appears to be above average, the best indicator of which is her acceptance into the Graduate School Program of the Ateneo de Manila University, which entails going through a battery of psychological tests that measure intellectual ability across various fields. At the very least, verbal and numerical ability can be deemed as above average, as well as oral and written communication skills.
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Based on the client’s test results, particularly the NEO PI-R subscales on Order, Discipline and Deliberation, the client does not seem to deliberate long in arriving at solutions as well as in making decisions, which can be seen as advantageous in a sense that she is more likely to possess a good grasp of possibilities. The client may find it difficult to be with people who deliberate longer before making a decision. It would be useful for the client to consider that her preferred method of problem-solving may enable her to grasp opportunities, but the opposite method of slow deliberation brings with it a certain degree of caution and certainty as well, advantages that are not evident in her preferred style. The client’s NEO PI-R results on the subscale of Assertiveness and Competence seem to indicate that the way the client proposes her views on solving a problem is achieved in an assertive but not forceful way: she is prepared to let others have their say on the matter and is willing to defer to someone else’s opinion, at least, in issues that do not violate her own personal standards. This preferred style of problem-solving reflects the client’s intuitive stance, that of preferring opportunities to be inventive and move out of the box, as it were; to go about things in ways that can be deemed as unconventional. Hunches or intuitive guesses seem to indicate a lessened degree of deliberation, and the client seems to prefer going by what she feels is the right thing to do, again highlighting that knack for grasping opportunities, be it in the workplace or among personal and family relationships.
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The client’s work style jives well with her chosen profession, that of a guidance counselor, focusing her attention on the myriad possibilities for her clients, and handling them with personal warmth. The client seems to be well-suited to this profession, and while understanding and communicating well with people are essential for almost every occupation, these are integral in counseling. It seems that the client, with her intuitive and feeling preferences, will find her work in counseling as rewarding and satisfying; her abilities are best suited in the helping professions, particularly as a guidance counselor. Intuitive types like the client prefer exploring new things, and the counseling profession is indeed apt for her, what with the constant influx of her client’s personal stories, which can be a source of her need for novelty and originality. That these clients present their problems uniquely, the client may find it very satisfying to try to work out these issues in original ways, satisfying her need for the new and the novel. This combination of intuition and feeling preferences seem to mesh well with the client’s high need for nurturance and change as reflected in her EPPS scores. The need for nurturance refers to a person’s inclination towards helping other people, in particular with their personal problems, involving confiding personal issues as well treating other people with kindness and sympathy, which are essential to any counselor or therapist. 2. Socio-emotional Functioning In terms of socio-emotional functioning, it seems that certain test results jive and complement with each other, in terms of the client’s presenting problems and in attempting to understand the client. Indeed, these results can
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best be understood when taken together, for they complement and bolster each other. The first cluster of test interpretations that have been grouped together are the following: high anxiety, anger hostility as well as low conscientiousness and agreeableness according to the NEO PI-R; high need for aggression and dominance coupled with low need for endurance and deference on the EPPS. This can be seen as a cluster of descriptions about the client which can refer to her expressed issues on extreme emotion and their management. Her presenting problems can be viewed under this combination of descriptions, which can give the client not necessarily a better understanding of herself – that will be brought about only through deep reflection as well as consultation with other people, but perhaps a more specific and delineated range of characteristics about her and her problems. The client admits to feeling a sense of shamefulness and immorality with regard to her feelings about herself; attributing these feelings to issues regarding her sexuality and the way her family’s and society in general’s acceptance of her homosexuality. She indicates that these feelings were brought about ever since she couldn’t “come out” or make known her homosexuality – which she sees as part and parcel of her whole being – to other members of her family. For the client, her sexuality is inextricably linked with her identity, and being unable to be herself in front of some family members – family being an important part of her life as well – creates conflicts and flows back into her self-concept. Being unable to be herself, she may see this repression as an indication of her immorality, and thus she experiences shame and other negative emotions such as guilt and sadness. This may very
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well explain why the client has been experiencing problems regarding anger management; this may also be an important factor in her recent thoughts of suicide. Not only is the client angry at people who may not be as accepting of homosexuals as herself, it is also clear that the client is angry at herself, perhaps as a direct result of other people’s intolerance for homosexuality. This anger – which the client readily accepts – is echoed in her high need for aggression coupled with low need for endurance according to her EPPS scores, as well as her high scores on the anger hostility and anxiety subscales on the NEO PI-R. A high need for autonomy underscores these feelings of anger and hostility, which refers to the client’s need for the freedom to be what one wants to be regardless of what other people may think and to readily express them. Thus her self-concept may be threatened by what the client perceives to be as the narrow-mindedness of some people, which is amplified by the fact that the people she deems as intolerant of her sexuality being members of her own family. She expresses a degree of positive emotions for her father, who she says is bisexual, in that he is not shackled by what other people think of him. While this is definitely a positive force that is helping the client cope – the client expresses pride in her father’s acceptance and understanding – the fact that her father works abroad may be doubly distressing for the client: her source of consolation and understanding being physically absent at home, where she experiences majority of conflict in her life. This conflict can appear to be particularly distressing for the client, for individuals with her INFP type tend to avoid conflict in favor of receiving praise and positive affirmation.
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It seems clear that the client values her sense of identity strongly, and needs to assert it when she feels threatened. In particular, perceives her sexuality as integral to her sense of self, and thus intolerance or narrowmindedness with regard to sexual preferences seem to distress her. This import placed on her sexuality seems to be rooted in her deep-seated need for love and commitment, characteristic of individuals with her particular MBTI type, and bolstered by her EPPS and NEO PI-R test scores. It seems as if the client’s love and care for another partner is threatened by members of her own family and society in general, and several coping mechanisms such as anger and hostility as well as shame and perceptions of immorality result, often in maladaptive ways that hurt or damage her relationships with the persons she values most. Her sense of self is also negatively affected by these coping strategies. The client attests to feeling extreme emotions such as anger, guilt, jealousy and sadness. At first glance, individuals with the INFP type present a calm and soothing demeanor to the world, seemingly peaceful and serene. In reality, underneath this veneer of calm and peace lies an intensity that is deeply felt by persons with this type. INFPs reserve the deepest love and caring for a select few who are closest to them, which does not seem apparent initially. As can be seen in the client, she is fiercely loyal, especially to her partner, in the face of social intolerance and adversity regarding their relationship. An interesting facet of INFPs is their stubborn defense of their own core values should they be violated, perhaps as can be seen in the client’s anger and hostility towards people who she feels she has to pretend to because they are
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not as open or accepting of other people’s identity. INFPs value authenticity and depth in their personal relationships, and they are usually quite perceptive about other people’s feelings and motives, often hidden under the veneer of calm and peacefulness. Indeed, the client’s perception of other people who are abrasive towards her sexuality is natural for INFPs, who may feel threatened by people with strong judging and thinking preferences. With the recognition and apparent acceptance of her own anger, the client is distressed at how this anger, in her own terms, messes up her relationships with her friends, and most especially her long-time relationship with her partner. This anxiety at the repercussions of her own anger and her failure to control it can be seen in the high anxiety scores the client garnered in her NEO PI-R. This anger, turned toward herself, can be one of the reasons behind the client’s fairly recent suicide ideation episode. While no overt acts have been indicated by the client, these thoughts are a cause for concern. That her anger and hostility, coupled with anxiety, leading to shame and a sense of immorality in her very being, lead the client to entertain thoughts of suicide, is a fact that cannot be ignored. It would be best that social support be bolstered at this point in the client’s life, especially care and love from her significant other as well as from her immediate family. The client’s type indicates tremendous loyalty and commitment to her relationships. INFPs generally exhibit a need to be in a committed relationship. This is echoed in her high scores with regard to the need for succorance as well as the need for nurturance, both of which can be easily seen in a committed loving relationship. Succorance and nurturance refer to a need to be cared for
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as well as to care for others, respectively; the client’s combination of scores from the EPPS as well as from the MBTI generally agree with each other, in that the client prefers a mutual loving relationship, fostered by deep care and loyalty to one’s partner. This stance or inclination towards a committed relationship can also be seen as a major driving force in the client’s life, often feeling the need to defend her choice of lifestyle from other people. This selfsame need for a committed relationship and its maintenance may be the main motivation for the client to become aggressive and hostile towards other people who she perceives does not understand her, even at the cost of hurting the very people she desires to protect. The client’s INFP type is indicative of an individual who needs a career which is more than a particular job or occupation. People with this particular MBTI type feel that everything they do must be in accordance with their strongly-felt value systems, moving them and others in a positive, growthoriented direction. Service-oriented and deeply loyal, the client’s current occupation can be viewed along the lines of a vocation, which is typical of individuals with this particular type according to the MBTI; they are driven to do something purposeful and meaningful in their lives. 3. Summary Areas of Strength It is clear from the client’s test results and subsequent interpretations that she has several strength areas that should be fostered and maintained. First, the client possesses a warm and caring outlook towards other people. While this is clearest in her close personal relationships, a general outlook of
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concern is still evident. This may prove extremely beneficial in any field of work, but this is ever more important in her chosen field of counseling. Her warmth may be seen as authenticity towards people – she herself competently perceives this in other people – and will enable them to open up to her. This strength is also bolstered by the client’s high need to care for other people. In other words, while the client possesses the initial warmth for people to open up to her and seek her for help, she also has within herself the capacity to establish deep personal relationships with people, and to nurture and maintain these relationships. The client can also be seen to be flexible and diverse, preferring inventive ways of going about a problem and desiring excitement in her life. The fact that she is a counselor makes perfect sense: encountering new people and devising new ways of helping them makes this career path very viable and highly productive for the client and her needs. This knack for understanding people in an immersive rather than analytical way is bolstered by the client’s ability to express herself well and to do so creatively, making her an effective counselor by any standards. Areas of Improvement On the other hand, several areas for improvement arise from her test results and interpretations. First and foremost perhaps are her issues regarding her extreme emotions. This can be rooted in the client’s strong need to receive praise and positive affirmation. When this need is not met, especially by people who are close to her, the client’s inner world is troubled, often resulting in extreme emotions. “Nasa loob ang kulo” is a Filipino term
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that is very apt for the client, both positively and negatively, as beneath the facade of shyness and reservation lies a roaring beast, should it be sufficiently aroused. Introverted though the client may be, her inner workings are her source of energy, from the depth of her relationships to the barely contained anger and hostility simmering underneath. Being an idealist, while initially viewed as positive, does have its negative side as well. In the case of the client, her idealism can lead her to blame herself for all her problems, that it is failure on her part that is the source of all her issues and anxieties. Perfectionistic tendencies as inherent in idealists may produce a tendency on the client’s part to not give herself enough credit, as it were, and may sell herself short, without reaping their well-deserved rewards. Also, the client being intuitive and perceptive can lead her to become detached from reality, preferring to remain in lofty heights of ideas and abstractions and dreams rather than work on what is there, on what is realistic. Perhaps another area for improvement with regard to the client is her dislike for routine and monotony. It can be argued that routine and monotony is more the rule than the exception in the workplace, especially in the Philippines, and thus the client may be hard-put to find the constant excitement and novelty that she needs, perhaps leading towards job dissatisfaction. Coupled with the fact that the client prefers a career over profession, this lack of novelty can potentially become a maladaptive experience for the client.
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4. Diagnostic Impression Client seems to be undergoing minor episodes of depression, culminating in occasional suicide ideation. No overt actions pertaining to physical self-hurting has been expressed or discovered. Client expresses feelings of extreme emotions, particularly anger and hostility towards certain members of her family, and towards her partner and other friends. Client also experiences feelings of shame and immorality, the cause of which is the interaction between her homosexuality and societal norms pertaining to sexuality. It appears that her sexual preference is at odds with the expectations of her family, leading the client to lash out at her family and friends, after which feelings of shame and immorality set in. Suicide ideation is in part due to these negative feelings about herself. The client cannot be diagnosed with any particular personality disorder because the instruments used in the assessment of the client do not indicate psychological and personality disorders. 5. Recommendations First and foremost, the client needs to realize that other people are getting hurt from the very methods she employs in trying to defend or protect them. The fact that the client uses anger and hostility – which then reverts back to her in the form of shame and guilt – should be seen by the client as a sign that this resolution strategy is clearly not working. While the intent is definitely there – the client has deep-set loyalties to the people she deems important in her life – the method, it seems, appears maladaptive to her relationships. Perhaps in her attempts to protect and defend her loved ones – especially her significant other – from societal discrimination and other forms
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of attack, she may turn a blind eye to the effects this “protection” brings about. Indeed, this protection may not by definition be any sort of protection at all, for it hurts the ones being protected. What use is it then, if even the defender hurts the protected ones? This is perhaps one of the most important realizations that the client should have, if any change in handling her emotions should take place. The client should take stock not only of her emotions – which she should do with ease given her personality preferences – but also of the effects of these feelings. This is a critical problem area perhaps because the client is focused on the subjective side of things, on her own personal travails – while the intention is for others – and it is easy for her to overlook the objective consequences these emotions may have on other people. Perhaps it would be best if the client puts the subjectivity aside for a while and attempt to look at things from another, more objective perspective. While this may seem like a hard task for the client, it is suggested that she consult with another friend, perhaps an individual with a more thinking and sensing preference, in order to assess her situation in a more realistic, more objective way. If this other individual is a close friend of the client, then all the better, for the client can easily relate and share with this thinking and sensing person, and together they can map out the causes and the effects of the client’s problems, particularly with her emotions. Consequences can be mapped out, solutions and strategies to old and new problems can be addressed, new frames of reference can be introduced. The rational and logical faculties of the client can be improved upon and reinforced by another individual who possesses these faculties. There may be a clash of
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personalities at some point, between intuitive feeling and thinking sensing individuals, but it should be underscored that the need is deemed greater than differing styles. Indeed, it is this differing styles that will help the client imagine other possibilities aided by an individual with a different way of looking at things. It is in the client’s preference to seek out the novel, the new and fresh; perhaps the insight of a person on the other side of the personality spectrum will be of benefit for the client in this sense because the other person may present new ways of doing and coping, new ways of seeing and being. The fact that the client is experiencing problems with handling her emotions is indicative of her coping strategies, which is related to her personality type. It makes sense that she is experiencing extreme emotions such as anger, shame and guilt; her character type focuses on the ideal and not on the realistic, therefore expectations have a tendency of not being met, especially with regards to people. In this regard, certain suggestions that play to the client’s strength are given. Since the client is seen to have an intuitive stance, open to possibilities and able to imagine different outcomes, it is suggested that she makes use of her imagination to think about certain situations that cause distress, and imagine herself dealing with the problem in another way, not through her anger or hostility, but in a realistic, calm and cool way. In this way this method taps into the client’s propensity to imagine possibilities, and perhaps help her in mapping out possible options when faced with distressing situations in the future. While it can be argued that the suggestion remains on the level of ideas and would be hard-pressed to be translated into action given the client’s type, it is nonetheless a fertile starting
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point for the client to use. Imagining using a sensing stance rather than a perceptive one is a viable start, rather than immediately jumping into the fray ill-equipped or without any idea about what to do. When the client is comfortable with her idea of handling a situation differently, only then can translation of the method can take place in reality, and even so in an incremental way. As for stop-gap measures dealing with anger and hostility, it is suggested that the client keep a journal or a sketch pad, and channel her emotions through that medium. This will also play to the client’s strengths, being creative and aesthetically-inclined. In particular, it is suggested that the client carry in her bag a little notebook and a pen at all times; one can never anticipate the time nor the hour wherein anger and other extreme emotions can take hold. In this way the client has an immediate method at alleviating her extreme emotions, through writing or drawing, and can help quell her feelings at the moment and to prevent her from acting immediately upon her emotions. Writing a journal or maintaining a drawing pad can have numerous benefits aside from quelling emotions at the moment of impact, so to speak. Jotting down one’s thoughts, be it in written or graphical form, can become a kind of memory keeper, and these can be looked back on in the future. In this way memories and the emotions attached to these memories can be processed and understood in a more disengaged way in the future. This enables the writer or artist to take stock of his or her emotions and try to have a deeper understanding of them, distanced from the pain and negative affect these
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memories can recall. In this way keeping a notebook or sketchpad brings about short-term and long-term benefits, and is strongly suggested for the client. In the end, it is always in the client’s hands, whether she chooses to be free from the negative effects of her extreme emotions, or to remain shackled to them. Ultimately it is in our power of choice, not even the grand, dramatic choices, but in the little ones that we face in our day to day that will determine who we are. These little choices, little defeats and miniscule victories, make up the better portion of our existence, and as such it is always, always ours. Difficulties may arise from other people, from situations, from ourselves, but in the end, how to overcome these hardships and keep on choosing is what makes us uniquely human.
Prepared by:
_______________________ _ Pocholo Andrew Velasquez
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VI.
Appendices
Social Case History The client was born in Batangas City, Philippines, and has resided in this area ever since. The client’s father Virgilio is currently working as an overseas worker in Jeddah, Saudi Arabia, while her mother Ligaya lives with the client. The client is the second in a brood of 3; an older brother 2 years her senior is deceased and their youngest is 3 years younger than the client. The client was brought up as a Roman Catholic. The client is an assistant Guidance counselor in an institution in Batangas, having been in that position for the past 10 months. The client earned her Bachelor of Arts degree from the Ateneo de Manila University in 2006. She is currently on her first semester under the Graduate School Program of the Ateneo de Manila University, pursuing a Master of Arts degree in Counseling Psychology. The client professes to be a homosexual, and is currently involved in a relationship with a member of the same sex, this fact playing a central role in her expressed issues and problems as indicated by her intake form. She expresses pride in her father being a bisexual, noting his strength in not succumbing to narrow-mindedness and bigotry. Client has admitted to having episodes of suicide ideation, the last occurring episode happening last May 2008, with recurring thoughts on killing herself occurring occasionally.
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Behavioral Observations The client appears calm and collected in class, preferring to listen rather than engage in discussion other members of the class. The occasional chitchat occurs with old classmates, but the client seems wary of interacting with other members of the class. Client seems to pay rapt attention to discussion of other people, contributing only when discussion impacts on her, particularly on her test scores and interpretation. Often the client can be seen smiling or laughing quietly should the discussion turn humorous; one can always feel a certain authenticity to her smile and her eyes. Should an interesting point be raised in class, one can see a quizzical look on the client’s face, intimating a sense of intensity that is seldom seen in her neutral expressions Outside of class, the client prefers to stick with old classmates, and would rarely be seen engaging people, preferring to be quiet and patiently waiting for class to start. The client finishes answering her psychological tests just a little bit ahead of the average, after which she will sit quietly and wait for discussions to begin regarding the test.
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