Documente Academic
Documente Profesional
Documente Cultură
Submitted To:
1. PGDPC, PROGRAM
TRICHANADRA MULTIPLE CAMPUS
FACULTY OF HUMANITIES AND SOCIAL SCIENCES
TRIBHUVAN UNIVERSITY
Submitted by:
PRAGYA SHRESTHA
ROLL NO: 19
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ACKNOWLEDGEMENT
I would like to take the opportunity to express my sincere gratitude towards Dr.
Govind Prasad Adhikari (Director of ECHO), who encouraged me to take the
counseling course and supported as the best he could. I would like to thank Mr. Bal
Kumar Thapa (Chairman), Ms. Narayani B.K (Yoga trainer) and all the staffs of
ECHO for allowing me to do internship in ECHO.
Special thanks go to Dr. Bharati Adhikari, Ms. Kishori Thapa and Mr. Kedar
Raymajhi for their valuable suggestions on dealing with the client’s problem.
Pragya Shrestha
26 July, 2006
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TABLE OF CONTENTS
1 Executive Summary………………………………………………………. 5
2 Background Introduction …..……………………………………………. 6
3 Methodology………………….………………………………………….. 7
4 Definition of Psychosocial……………………………………………….. 8
4.1 Psychosocial Problems outside Kathmandu Valley………………………. 9
4. 2 Psychosocial Problems inside Kathmandu Valley………………………. 10
5 Psychosocial counseling…….……………………………………………. 10
6 Stages in counseling………………………………………………………. 11
7 Conclusion………. ……………………………………………………… 12
8 Recommendation………. ………………………………………………… 12
9.1 Annex 1 – Case Study (1)………………………………………………… 13
9.2 Annex 2 – Case Study (2)………………………………………………… 14
9.3 Annex 3 – Case Study (3)………………………………………………… 15
9.4 Annex 4 – Case Study (4)………………………………………………… 16
9.5 Annex 5 – Case Study (5)………………………………………………… 17
9.6 Annex 6 – Case Study (6)………………………………………………… 18
9.7 Annex 7 – Case Study (7 ~ 10)…….……………………………………… 19
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1. ACRONYMS USED IN THE REPORT:
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1. EXECUTIVE SUMMARY
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2. BACKGROUND and INTRODUCTION:
ECHO has been conducting one of the programs called “ECHO & KOPION Alternative
Therapy Center” (EKATC). In the clinic, few patients who have psychosomatic problems
come for the treatment. Therefore, Ms. Shrestha has chosen those patients. Similarly,
TPO-Nepal has been conducting one of the projects “Emergency Psychosocial Support
for Kapilbastu” for 3 months with the support from UNICEF. Thus, Ms. Shrestha has
chosen to take clients from Kapilbastu.
GOAL: To counsel ten clients using the counseling skills in Psychosocial approach.
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3. METHODOLOGY:
In Counseling Room:
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4. DEFINITION OF PSYCHOSOCIAL:
We are social human being and we live in the society. Our thoughts, emotions and
behavior (Psychological aspect) towards the social aspect (family, society, culture, norms
and value) or society towards us is different. This interrelation between psychological
aspects and social aspects is called Psychosocial. If the society accepts his/her behavior,
s/he can adjust in the society and shows good daily functioning. But, if the individual
cannot balance them, it impacts his/her thinking, emotions and behavior that lead to
psychosocial problems (lack of concentration, fear, guilt etc) and develop bad daily
functioning.
Individual
Consequences
Positive Negative
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4.1 PSYCHOSOCIAL PROBLEMS FOUND OUTSIDE KATHMANDU VALLEY
Due to these various problems, children left schools due to fear. Physical and mental
problems have increased due to loss of loved one and assets. The resources (land,
domestic animals, etc) were left in the village as they were. Most of the villages, family
and community have feelings of insecurity and do not want to go back to their own
villages where the incidents had happened. They have nothing but the tents in the camps
and have houses without roof in the villages. Thus, people living in camps as well as in
villages are suffering from coldness, which may lead to severe physical problems, as the
winter season has already started. They are in stress which may lead to long-term mental
illness. These various reasons are negatively affecting children, women and other adult
and old as well.
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Based on: Jordans. M.J.D.(2003). Training handbook: Psychosocial counseling for children in need of
special protection- Trainer’s guide. UNICEF Nepal
5. PSYCHOSOCIAL COUNSELLING
Counselling is a planned intervention between the client and counsellor/helper to assist
the client to alter, improve, or resolve his/her present behaviour, difficulty, or
discomforts. It is a process of helping the client to discover the coping mechanisms that
he/she found useful in the past, how they can be used or modified for the present
situation, and how to develop new coping mechanisms.
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6. STAGES IN COUNSELING:
The six stages of counselling are applied “Identification”, “Beginning”, “Assessment”,
“Formulation” “Implementation” and “Ending”. The arrows on the diagram represent the
movement through the stages.
Stage 1: IDENTIFICATION
Stage 2: BEGINNING
Stage 3: ASSESSMENT
The process of gaining information
about the problem and the client
Stage 5: IMPLEMENTATION
INTERVENTION
Stage 5: Implementing the counselling goals
REFERRAL Problem management
TO OTHER
SERVICE You may need to
Stage 6: adjust your
ENDING intervention…
EVALUATION
Is the intervention working?
…or you may need to rethink
your formulation
Stage 6: ENDING
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Source: SAHARA’s counseling manual
7. CONCLUSION:
The emotional support, play therapy, muscle relaxation exercise, communication skills,
drawings in counselling in psychosocial approach was very effective for the people
outside the Kathmandu Valley and inside the Kathmandu Valley to reduce psychosocial
problems.
8. RECOMMENDATION:
1. The academic sector has to work with national governments and private sectors. This
networking will provide the government to develop monitoring and evaluating the
program so that government encourages such kinds of program (Post Graduate in
Psychological Counseling) to be strengthen further.
2. It is recommended to the Academic Sector, GOs, NGOs and INGOs, if the Counseling
program is conducted in different part of Nepal rather than only inside Kathmandu Valley.
Also, it would be very effective and fruitful to reduce the psychosocial problems of the
community people, only if there are enough counselors in different parts of Nepal.
3. The referral system should be strong so that the counselor can refer the clients to the
concerned organizations.
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Annex 1:
CASE STUDY
Name: Laxmi Nepal (Name and caste change)
Age: 24 years
Education: B.A
Marital Status: Single
Occupation: Reporter
Problem faced from: 1 year
District: Lalitpur
Beginning and Problem identification: The presenting problems she mentioned were
worry about the career; father talked negative things about her with other people;
boyfriend does not care much now; she has to look after herself and her younger sister.
Identified problems psychosocial problems were anxiety about the career, suicidal
thoughts, extreme fear, loneliness, feelings of ambivalence, sleep disturbance, poor
appetite and weight loss. She has been taking anti-depressant drugs.
Assessments, Formulation and Ending:
Family Information: There are mother, father, she and younger sister. She and her father
earn the bread for the family. The relationship with her aunts and other relatives is not
good as they complain negative things about her with her father. She said her father
thinks that she made his reputation down.
Personal Information: The client is a reporter. At the same time, she is doing graduation
and worry about her career. Many times, she reaches home at night. She thinks this is the
reason that her aunt doubt on her and complains about her with her father. She has an
affair with another reporter. She is in ambivalence that on one hand she thinks he does not
love her anymore and on the other hand she thinks he loves her as he becomes jealous
when he saw any boy with her.
Strength: She has been using Emotional-focus coping strategies such as venting emotions
(Share feelings with closest friend), and Problem- focus coping strategies such as
Instrumental social support (Seeks concrete advice, assistance, information).
Support: Counselling (Uses communication skills, ask about the expectation to the client,
empathy, encouragement of strength)
Implementation- Action and Evaluation:
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Action Plan: After doing brainstorming, for the worry about career, she said she would
finish the graduation her and search for work and study in foreign country. About the
boyfriend problem, she said she would do clear conversation with him.
Annex 2:
CASE STUDY
Name: Maya Dhakwa (Name and caste change)
Age: 61 years
Marital Status: Married but widow. One son and one daughter
Problem faced from: 1 year
District: Lalitpur
Beginning and Problem identification: The presenting problems were pain in finger,
hand, back and legs.
The identified psychosocial problems are poor concentration, suspicious nature,
loneliness, and feelings of guilt and sleep disturbance.
Assessments, Formulation and Ending:
Family Information: There are a son, daughter-in-law and a grandchild. Her son and
daughter-in-law earn the bread for the family.
Personal Information: The client does some household work like cleaning rooms, doing
Puja. She feels alone at home as her son and daughter-in-law go for job and her
grandchild comes home late from school. She has feeling of guilt as she cannot do
household work and she is getting older.
Strength: Participate in socio-cultural activities; spend time in religious activities such as
visiting temples, worshipping, listening and singing religious songs.
Support: Psychosocial Counselling (Uses communication skills) empathy, encourage the
strength
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Annex 3:
CASE STUDY
Name: Sita Nepal (Name and caste change)
Age: 16 years
Class: Class 6
Marital Status: Single
Problem faced from: 1 year
District: Kapilbastu
A 16 years old girl, leaving in Western side of Nepal and studying in school, was raped 4
times by her own father.
Beginning and Problem identification: After 5 sessions, a counsellor has identified the
problem of the client (16 years old girl). The identified psychosocial problems were poor
concentration in study, suspicious nature, feelings of guilt, suicidal thoughts, extreme
fear, feelings of insecurity, ambivalence, loneliness, cannot do eye contact, Humiliation
of feeling, Isolation, Sleep disturbance, poor appetite and hopelessness.
She has been sexually abused from one year. As the father comes in front of her, she
totally becomes numb. To resolve the problem she tried to attempt suicide 3 times.
Except her mother, sisters and brother nobody in the community knows she is raped from
her own family.
Assessments, Formulation and Ending:
Family Information: There are mother, father, brother, sister and sister-in-law. Source of
income is from agriculture. Her brother earns the bread for the family. Client’s relation
with other family members (except father) is good. Family is from Bramhin caste. Father
is drunkard and use very bad/dirty words.
Personal Information: The client does the daily house hold work. She is studying in
school and wants to pass the S.L.C. She is shy kind of girl. Friends tease her in school.
She cannot study because of bad environment at home.
Support: Psychosocial Counselling individually and with family (Talk with mother,
father, brother, sister and sister-in-law). Ask with mother about suicide; ask about the
expectation to the client. A commitment was taken from one of the member of
community to observe the client behaviour and to look after her.
YCL has threatened her father as he uses bad words in the community. Family does not
want the legal action/process as they think when the legal process is done their reputation
will be down in the community because they are from Bramhin caste (major caste).
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Family want to solve the problems within the house. As a result, her mother and her elder
sister have been protecting to her.
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Note: This case is taken/handled by an experienced Psychosocial counsellor Mrs. Jamuna Shrestha
(Supervisor of Ms. Pragya Shrestha) and Ms. Pragya Shrestha assisted her.
Annex 4:
CASE STUDY
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Annex 5:
CASE STUDY
Name: Suman Dahal (Name changed)
Age: 14 years
Education: Class 7
District: Lalitpur
Need follow-up
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Annex 6:
CASE STUDY
Name: Rupesh Majhi (Name changed)
Age: 14 years
Education: Class 9
District: Lalitpur
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Annex 7:
CASE STUDY
Group intervention
Nos. of children: 10
Age: 6 ~ 12 years.
Male: 4 and Female: 6
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BIBLIOGRAPHY:
1. FINAL Sahara reader_proofread
2. Handouts prepared by Ms. Jamuna Shrestha and Ms. Pragya Shrestha
3. Jordans, Mark. Powerpoint: Trichandra Lecture Psychosocial counseling.
4. Jordans. M.J.D.(2003). Training handbook: Psychosocial counseling for children in
need of special protection- Trainer’s guide. UNICEF Nepal
5. Mixed Type Group Test of Intelligence test (MGTI).
6. (October/November, 2007) “3-Days Orientation on Psychosoical counseling for
students of St. Xavier’s college”
7. Case study and sharing from Ms. Jamuna Shrestha, a psychosocial counselor.
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