INTERNSHIP REPORTS

ABOUT AGENCY SUPERVISOR:-

Public Education Society,P.E.S. Aurangabad is reputed NGO in

the Marathwada Region of Maharashtra in Healthcare &
education sector. P.E.S. Aurangabad is established in 1987 under
charity act of Maharashtra government (Reg.No:- F-1544),Head
office at Near Government Medical College & Hospital ,Ghati
Hospital,Aurangabad. P.E.S. is working in the field of education &
health care since last 30 years. Irrespective of work in
Educational field P.E.S. is largely involved in improvements of
people physical,mental & social health.

Date 01/10/2019

RADHA WAGH (BORDERLINE PERSONALITY

DISORDER)

CASE STUDY DETAILS

Radha is a 26-year-old from Aurangabad,Maharashtra, woman

who presents with a history of non-suicidal self-injury,
specifically cutting her arms and legs, since she was a teenager.
She has made two suicide attempts by overdosing on prescribed
medications, one as a teenager and one six months ago; she also
reports chronic suicidal ideation, explaining that it gives her
relief to think about suicide as a “way out.”

When she is stressed, Radha says that she often “zones out,”
even in the middle of conversations or while at work. She states,
“I don’t know who Radha really is,” and describes a longstanding
pattern of changing her hobbies, style of clothing, and
sometimes even her job based on who is in her social group. At
times, she thinks that her partner is “the best thing that’s ever
happened to me” and will impulsively buy him lavish gifts, send
caring text, and the like; however, at other times she admits to
thinking “I can’t stand him,” and will ignore or lash out at him,
including yelling or throwing things. Immediately after doing so,
she reports feeling regret and panic at the thought of him leaving
her. Radha reports that before she began dating her current
partner she sometimes engaged in sexual activity with multiple
people per week, often with partners whom she did not know.

SYMPTOMS

1) Anger 2) Anxiety 3) Concentration Difficulties 4) Emotion

Dysregulation 5)Impulsivity 6) Mood Cycles 7) Risky
Behaviors 8) Self-Injury 9) Suicidal thoughts

DIAGNOSES AND RELATED TREATMENTS

1. BORDERLINE PERSONALITY DISORDER

The following treatments have empirical support for individuals
with Borderline Personality Disorder:

Dialectical Behavior Therapy for Borderline Personality Disorder

Mentalization-Based Treatment for Borderline Personality
Disorder
Schema-Focused Therapy for Borderline Personality Disorder
Transference-Focused Therapy for Borderline Personality
Disorder

Date:- 03/10/2019

NAGESH KAMBLE (SOCIAL ANXIETY)

CASE STUDY DETAILS

Nagesh is a 20 year-old from Ambad, Jalana who reports to you

that he feels depressed and is experiencing a significant amount
of stress about school, noting that he’ll “probably flunk out.” He
spends much of his day in his dorm room playing video games
and has a hard time identifying what, if anything, is enjoyable in a
typical day. He rarely attends class and has avoided reaching out
to his professors to try to salvage his grades this semester.
Nagesh has always been a self-described shy person and has
had a very small and cohesive group of friends from elementary
through high school. Notably, his level of stress significantly
amplified when he began college. You learn that when meeting
new people, he has a hard time concentrating on the interaction
because he is busy worrying about what they will think of him –
he assumes they will find him “dumb,” “boring,” or a “loser.”
When he loses his concentration, he stutters, is at a loss for
words, and starts to sweat, which only serves to make him feel
more uneasy. After the interaction, he replays the conversation
over and over again, focusing on the “stupid” things he said.
Similarly, he has a long-standing history of being uncomfortable
with authority figures and has had a hard time raising his hand in
class and approaching teachers. Since starting college, he has
been isolating more, turning down invitations from his roommate
to go eat or hang out, ignoring his cell phone when it rings, and
habitually skipping class. His concerns about how others view
him are what drive him to engage in these avoidance behaviors.
After conducting your assessment, you give the patient feedback
that you believe he has social anxiety disorder, which should be
the primary treatment target. You explain that you see his fear of
negative evaluation, and his thoughts and behaviors surrounding
social situations, as driving his increasing sense of
hopelessness, isolation, and worthlessness.

SYMPTOMS

1) Anxiety 2) Depression 3) Ruminations 4) Social Anxiety

DIAGNOSES AND RELATED TREATMENTS

1. SOCIAL ANXIETY DISORDER AND PUBLIC SPEAKING
ANXIETY

The following treatments have empirical support for individuals

with Social Anxiety Disorder and Public Speaking Anxiety:

Cognitive Behavioral Therapy for Social Anxiety Disorder

Date:- 04/10/2019

LATA GATHE (ATTENTION-DEFICIT/HYPERACTIVITY

DISORDER​)

CASE STUDY DETAILS

Lata is a 29 year-old woman from Chaligaon, Jalgaon who

presents to your clinic in distress. In the interview she fidgets
and has a hard time sitting still. She opens up by telling you she
is about to be fired from her job. In addition, she tearfully tells
you that she is in a major fight with her husband of 1 year
because he is ready to have children but she fears that she is
“too disorganized to be a good mother.” As you break down
some of the processes that have led to her current crises, you
learn that she has a hard time with time management and tends
to be disorganized. She chronically misplaces everyday objects
like her keys and runs late to appointments. Although she wants
her work to be perfect, she is prone to making careless mistakes.
The struggle for perfection makes starting a new task feel very
stressful, leading her to procrastinate starting in the first place.
As a consequence, she has recently received a number of
warnings from her boss related to missing deadlines for
assignments and errors in her work, which has led to her acute
fear of being fired. As her performance at work has plummeted
and she has grown increasingly anxious and doubting of herself,
she has grown more pessimistic about starting a family. You
learn that she received extra time for test taking in school as a
child but never had any formal neuropsychological testing. With
Lata’s permission, you conduct additional structured
assessments, including collecting collateral information from her
fiancé, and conclude that she has adult ADHD.

SYMPTOMS

1) Anxiety 2) Concentration Difficulties 3) Impulsivity 4) Worry

DIAGNOSES AND RELATED TREATMENTS

1. ATTENTION DEFICIT HYPERACTIVITY DISORDER (ADULTS)

The following treatments have empirical support for individuals

with Attention Deficit Hyperactivity Disorder (Adults):

Cognitive Behavioral Therapy for adult ADHD

Date:- 05/10/2019

PRADHAN BANSODE (PSYCHOTIC DISORDER)

CASE STUDY DETAILS

Pralhad is a 20-year-old male,Khltabad,Aurangabad who is in

his second year of college. He is seeking treatment due to
persistent fears that campus security and the local police are
tracking and surveilling him. He cites occasional lags in his
internet speed as evidence that surveillance devices are
interfering with his electronics. His intense anxiety about this has
begun getting in the way of his ability to complete schoolwork,
and his friends are concerned – he says they have told him,
“you’re not making sense.”

Pralhad occasionally laughs abruptly and inappropriately and

sometimes stops speaking mid-sentence, looking off in the
distance as though he sees or hears something. He expresses
concern about electronics in the room (phone, computer)
potentially being monitored and asks repeatedly about patient
confidentiality, stating that he wants to be sure the police won’t
be informed about his treatment. His beliefs are fixed, and if they
are challenged, his tone becomes hostile.

SYMPTOMS

1) Anxiety 2) Delusions 3) Hallucinations 4) Psychosis

DIAGNOSES AND RELATED TREATMENTS

1. SCHIZOPHRENIA AND OTHER SEVERE MENTAL ILLNESSES

The following treatments have empirical support for individuals

with Schizophrenia and Other Severe Mental Illnesses:

Assertive Community Treatment (ACT) for Schizophrenia

Cognitive Adaptation Training (CAT) for Schizophrenia
Cognitive Behavioral Therapy (CBT) for Schizophrenia
Cognitive Remediation for Schizophrenia
Family Psychoeducation for SchizophreniaIllness Management
and Recovery (IMR) for Schizophrenia
Social Learning/Token Economy Programs for Schizophrenia
Social Skills Training (SST) for Schizophrenia
Supported Employment for Schizophrenia
Acceptance and Commitment Therapy for Psychosis

Date:- 07/10/2019

TUKARAM PATIL (TOBACCO USE DISORDER)

CASE STUDY DETAILS

Tukaram is a 43-year-old married man from

Nageshwarwadi,Aurangabad who was referred to you by his
employee assistance program for help with quitting smoking. He
reports to you that he has been trying to quit “cold turkey”
without success and has noticed that he has been smoking even
more than his typical pack per day. Tukaram first started
smoking cigarettes when he was in college. At that time, he
considered himself to be a “social smoker” – smoking one or two
times per week, when out with friends. He recalls a distinct shift
in his smoking habits when he transitioned to his first full-time
job after college, noting that the transition to “being a full-fledged
adult” was difficult for him and he would pick up a cigarette at
the end of the work day as a reward or to relieve stress. Over
time, his smoking increased to the point where he felt like he
needed to smoke throughout the day. He worried that if he didn’t
have the cigarette his body was expecting he might have
symptoms of withdrawal or he might not be able to manage his
stress. He has always been aware of the potential negative health
effects of smoking but has told himself that if he quit smoking
“soon” he would be okay. He also believes that smoking has
helped him to keep his weight in check – he struggled to
maintain a healthy weight as an adolescent and is convinced that
he will “gain a ton of weight” if he quits smoking. In recent years,
as public establishments have become smoke-free, he has
become self-conscious about his smoking habit and actively
works to hide it from others, particularly his 4-year-old daughter.
He is seeking help with smoking cessation now because it is
negatively impacting his marriage (his wife reminds him daily,
“You promised me you would quit”) and he worries that he won’t
be able to keep his habit a secret from his daughter much longer.

SYMPTOMS
 1) Anxiety 2) Emotion 3) Dysregulation 4) Substance Abuse

DIAGNOSES AND RELATED TREATMENTS

1. SMOKING

The following treatments have empirical support for individuals

with Smoking:

Smoking Cessation with Weight Gain Prevention

Date:- 09/10/2019

VISHAL JADHAV (BIPOLAR DISORDER)

CASE STUDY DETAILS

Vishal is a 19-year-old from Milind college Aurangabad, withdrew

from college after experiencing a manic episode during which he
was brought to the attention of the Campus Police (“I took the
responsibility to pull multiple fire alarms in my dorm to ensure
that they worked, given the life or death nature of fires”). He had
changed his major from engineering to philosophy and
increasingly had reduced his sleep, spending long hours
engaging his friends in conversations about the nature of reality.
He had been convinced about the importance of his ideas,
stating frequently that he was more learned and advanced than
all his professors. He told others that he was on the verge of
revolutionizing his new field, and he grew increasingly irritable
and intolerant of any who disagreed with him. He also increased
a number of high-risk behaviors – drinking and engaging in
sexual relations in a way that was unlike his previous history. At
the present time, he has returned home and his been placed on a
mood stabilizer (after a period of time on an antipsychotic), and
his psychiatrist is requesting adjunctive psychotherapy for his
bipolar disorder. The patient’s parents are somewhat shocked
by the diagnosis, but they acknowledge that Vishal had early
problems with anxiety during pre-adolescence, followed by some
periods of withdrawal and depression during his adolescence.
His parents are eager to be involved in treatment, if appropriate.

SYMPTOMS

1) Alcohol Use 2) Depression 3) Elevated Mood 4) Impulsivity

5) Irritability 6) Mania/Hypomania 7) Mood Cycles 8) Risky
Behaviors

DIAGNOSES AND RELATED TREATMENTS

1. BIPOLAR DISORDER

The following treatments have empirical support for individuals

with Bipolar Disorder:

Cognitive Therapy (CT) for Bipolar Disorder

Family Focused Therapy (FFT) for Bipolar Disorder
Interpersonal and Social Rhythm Therapy (IPSRT) for Bipolar
Disorder
Psychoeducation for Bipolar Disorder
Systematic Care for Bipolar Disorder

Date:- 10/10/2019

BHAVNESH SHARMA (POST-TRAUMATIC STRESS

DISORDER)

CASE STUDY DETAILS

Bhavnesh is a 27-year-old man from Sillod,Aurangabad who

comes to you for help at the urging of his friends . He was an
infantryman with a local Marine Reserve unit who was honorably
discharged in 2014 after serving two tours of duty in Army. His
fiancé has told him he has “not been the same” since his second
tour of duty and it is impacting their relationship. Although he
offers few details, upon questioning he reports that he has
significant difficulty sleeping, that he “sleeps with one eye open”
and, on the occasions when he falls into a deeper sleep, he has
nightmares. He endorses experiencing several traumatic events
during his second tour, but is unwilling to provide specific
details – he tells you he has never spoken with anyone about
them and he is not sure he ever will. He spends much of his time
alone because he feels irritable and doesn’t want to snap at
people. He reports to you that he finds it difficult to perform his
duties as a security guard because it is boring and gives him too
much time to think. At the same time, he is easily startled by
noise and motion and spends excessive time searching for
threats that are never confirmed both when on duty and at home.
He describes having intrusive memories about his traumatic
experiences on a daily basis but he declines to share any details.
He also avoids seeing friends from his Reserve unit because
seeing them reminds him of experiences that he does not want to
remember.

SYMPTOMS

1) Hypervigilance 2) Intrusive Thoughts 3) Irritability 4) Loss of

Interest 5) Sleep Difficulties 6) Trauma

DIAGNOSES AND RELATED TREATMENTS

1. POSTTRAUMATIC STRESS DISORDER

The following treatments have empirical support for individuals

with Posttraumatic Stress Disorder:

Cognitive Processing Therapy for Post-Traumatic Stress

Disorder
Eye Movement Desensitization and Reprocessing for
Post-Traumatic Stress Disorder
Present-Centered Therapy for Post-Traumatic Stress Disorder
Prolonged Exposure Therapy for Post-Traumatic Stress Disorder
Psychological Debriefing for Post-Traumatic Stress Disorder
Stress Inoculation Training for Post-Traumatic Stress Disorder
Seeking Safety for PTSD with Substance Use Disorder
11/10/2019

TUSHAR PANDE (BORDERLINE PERSONALITY

DISORDER WITH CO-MORBID ALCOHOL USE)

CASE STUDY DETAILS

Tushar is a 33-year-old single, Caucasian male who reports

experiencing pervasively depressed mood following the
dissolution of a six-month romantic relationship. Tushar
describes feeling overwhelmed with feelings of “emptiness” and
is convinced that he will be “alone forever.” He additionally
reports being “in and out” of psychosocial treatment for suicidal
thoughts though denies ever having made any suicide attempts.
He also denies engagement in non-suicidal self-injurious
behaviors.

Tushar reports chronic difficulty managing his strong emotions

and recognizes that others would describe him as “moody.” He
further recognizes that he can quickly escalate with inappropriate
and/or intense anger over minor transgressions, which
subsequently results in feelings of guilt and embarrassment. His
anger makes it difficult to sustain both platonic and romantic
relationships. To cope, Tushar frequently seeks reassurance
from others (e.g., calling in desperation to make sure they still
care about him) and drinks excessively (i.e., six or more drinks
per sitting). Due to the heaviness and frequency of his drinking in
the recent weeks, Tushar has called out sick a few times from
work to recover from drinking the night before. Tushar is looking
for a treatment that will help him manage/regulate intense
emotions in an adaptive manner. In addition, he hopes to learn
strategies to better navigate interpersonal relationships (e.g.,
effective communication).

SYMPTOMS

1) Alcohol Use 2) Anger 3) Depression 4) Emotion

Dysregulation 5) GuiltIrritability 6) Mood Cycles 7)
Substance Abuse 8) Suicidal thoughts

DIAGNOSES AND RELATED TREATMENTS

1. ALCOHOL

The following treatments have empirical support for individuals

with Alcohol:

Behavioral Couples Therapy for Alcohol Use DisordersModerate

Drinking for Alcohol Use DisordersPrize-Based Contingency
Management for Alcohol Use Disorders

2. BORDERLINE PERSONALITY DISORDER

The following treatments have empirical support for individuals
with Borderline Personality Disorder:

Dialectical Behavior Therapy for Borderline Personality Disorder

Mentalization-Based Treatment for Borderline Personality
DisorderSchema-Focused Therapy for Borderline Personality
Disorder Transference-Focused Therapy for Borderline
Personality Disorder

Date:- 12/10/2019

SARAH KHAN (BIPOLAR DISORDER)

CASE STUDY DETAILS

Sarah is a 42-year-old married woman who has a long history of

both depressive and hypomanic episodes. Across the years she
has been variable diagnoses as having major depression,
borderline personality disorder, and most recently, bipolar
disorder. Review of symptoms indicates that she indeed have
multiple episodes of depression beginning in her late teens, but
that clear hypomanic episodes later emerged. Her elevated
interpersonal conflict, hyper-sexuality and alcohol use during her
hypomanic episodes led to the provisional borderline diagnosis,
but in the context of her full history, bipolar disorder appears the
best diagnosis. Sarah notes that she is not currently in a
relationship and that she feels alienated from her family. She has
been taking mood stabilizers for the last year, but continues to
have low level symptoms of depression. In the past, she has
gone off her medication multiple times, but at present she says
she is “tired of being in trouble all the time” and wants to try
individual psychotherapy.

SYMPTOMS

1) Alcohol Use 2) Depression 3) Elevated Mood 4) Impulsivity

5) Mania/Hypomania 6) Mood Cycles 7) Risky Behaviors

DIAGNOSES AND RELATED TREATMENTS

1. BIPOLAR DISORDER

The following treatments have empirical support for individuals

with Bipolar Disorder:

Cognitive Therapy (CT) for Bipolar Disorder

Family Focused Therapy (FFT) for Bipolar Disorder
Interpersonal and Social Rhythm Therapy (IPSRT) for Bipolar
Disorder
Psychoeducation for Bipolar Disorder
Systematic Care for Bipolar Disorder

Date:- 14/10/2019
GANPAT SHRIRAME (BIPOLAR DISORDER, SUBSTANCE USE
DISORDER)

CASE STUDY DETAILS

Ganpat is a 62-year-old single man who says that his substance

dependence and his bipolar disorder both emerged in his late
teens. He says that he started to drink to “feel better” when his
episodes of depression made it hard for him to interact with his
peers. He also states that alcohol and cocaine are a natural part
of his manic episodes. He also notes that coming off the cocaine
and binge drinking contribute to low mood, but he has not
responded well to referrals to AA and past inpatient stays have
led to only temporary abstinence. Yet, Ganpat is now trying to
forge a closer relationship to his adult children, and he says he is
especially motivated to get a better handle on both his bipolar
disorder and his substance use. He has been more compliant
with his mood stabilizing and antidepressant medication, and his
psychiatrist would like his dual diagnoses addressed with
psychotherapy.

SYMPTOMS

1) Alcohol Use 2) Depression 3) Elevated Mood 4) Impulsivity

5) Mania/Hypomania 6) Mood Cycles 7) Substance Abuse

DIAGNOSES AND RELATED TREATMENTS

1. BIPOLAR DISORDER
The following treatments have empirical support for individuals
with Bipolar Disorder:

Cognitive Therapy (CT) for Bipolar Disorder

Family Focused Therapy (FFT) for Bipolar Disorder
Interpersonal and Social Rhythm Therapy (IPSRT) for Bipolar
Disorder
Psychoeducation for Bipolar Disorder
Systematic Care for Bipolar Disorder

2. MIXED SUBSTANCE ABUSE/DEPENDENCE

The following treatments have empirical support for individuals

with Mixed Substance Abuse/Dependence:

Friends Care for Mixed Substance Abuse/DependenceGuided

Self-Change for Mixed Substance
Abuse/DependenceMotivational Interviewing, Motivational
Enhancement Therapy (MET), and MET plus CBT for Mixed
Substance Abuse/DependencePrize-Based Contingency
Management for Mixed Substance Abuse/DependenceSeeking
Safety for Mixed Substance Abuse/Dependence

Date:- 15/10/2019

MADHUKAR BANSODE (CHRONIC PAIN)

CASE STUDY DETAILS

Madhukar is a 50-year old male on disability support. In your

intake, he tells you that he was “just fine” until he got injured on
the job, which led to a series of acute medical procedures,
physical therapy, and major stress from filing disability
paperwork. Disability was recently awarded. He tells you that he
sits at home most days, despite his wife’s attempts to get him
out of the house with her. He dislikes leaving the house because
he never knows when his pain will flare up and therefore feel the
immediate need to lay down and take his pain medication. He
feels very guilty for not being a better partner to his wife and tries
to make up for this by taking care of long-standing home repairs.
Madhukar recognizes that he often overdoes it when he takes on
one of these projects, which exacerbates his pain and leads him
to feel hopeless. He starts to focus on all that he has lost and
imagines a future in which he is weak and house-bound. He also
acknowledges that, when he is in this physical and emotional
state, he is likely to snap at his wife and say things he later
regrets.

SYMPTOMS

1) Chronic Pain

DIAGNOSES AND RELATED TREATMENTS

1. CHRONIC OR PERSISTENT PAIN

The following treatments have empirical support for individuals
with Chronic or Persistent Pain:

Multi-Component Cognitive Behavioral Therapy for Fibromyalgia

Acceptance and Commitment Therapy for Chronic Pain
Behavioral and Cognitive Behavioral Therapy for Chronic Low
Back Pain
Cognitive Behavioral Therapy for Chronic Headache
Multi-Component Cognitive Behavioral Therapy for
Rheumatologic Pain

Date:- 16/10/2019

VIKAS KHILLARE (PANIC DISORDER)

CASE STUDY DETAILS

Vikas is a 41-year-old male who was referred by his primary care

physician after presenting to the ER with difficulty breathing.
Vikas’s physician was unable to find a medical explanation for
his symptoms, which left Vikas feeling confused, stressed, and
angry. Over the last 6 months, Vikas has had several instances
where he felt an intense fear that would reach a peak within a few
minutes. During these instances, he would also experience
sweating, heart palpitations, chest pain and discomfort, and
shortness of breath. At times, Vikas worried that might die. As a
result, Vikas has persistent worry about having another attack. In
addition, he has begun to avoid unfamiliar places and people
where it may be difficult to get help in the event of another panic
attack. The panic and associated avoidance are significantly
impacting Vikas’s life as he has been turning down social
invitations, making excuses to stay at home whenever possible,
and relying on his wife to drive their children to their various
activities. Although she was understanding at first, Vikas’s wife
has grown frustrated with what she perceives as his irrational
fear of panic attacks.

SYMPTOMS

1) Agoraphobia 2) Anger 3) Anxiety 4) Panic 5) Suicidal

thoughts 6) Worry

DIAGNOSES AND RELATED TREATMENTS

1. PANIC DISORDER

The following treatments have empirical support for individuals

with Panic Disorder:

Applied Relaxation for Panic Disorder

Cognitive Behavioral Therapy for Panic Disorder
Psychoanalytic Treatment for Panic Disorder
Date:- 17/10/2019

BHIKAJI GADE (ALCOHOL USE DISORDER,

MILD/MODERATE)

CASE STUDY DETAILS

Bhikaji is a 66-year-old Caucasian man whose wife has

encouraged him to seek treatment. He has never been in therapy
before, and has no history of depression or anxiety. However, his
alcohol use has recently been getting in the way of his marriage,
and interfering with his newly-retired life. He describes drinking
increasing amounts over the last year, currently consuming
approximately a six-pack of beer per day. He notes that this
amount “doesn’t give me the same buzz as it used to.” He denies
ever experiencing “the shakes” or any other withdrawal
symptoms if he skips a day of drinking.

Bhikaji comments that his wife is his biggest motivation to

decrease his alcohol use. She tells him that he gets
argumentative and irritable when he drinks, though he does not
always remember these incidents. He has also fallen while
intoxicated twice, causing bruises both times and hitting his
head on one of the occasions.

SYMPTOMS
 1) Alcohol Use 2) Irritability 3) Substance Abuse

DIAGNOSES AND RELATED TREATMENTS

1. ALCOHOL

The following treatments have empirical support for individuals

with Alcohol:

Behavioral Couples Therapy for Alcohol Use

Disorders Moderate Drinking for Alcohol Use
Disorders Prize-Based Contingency Management for Alcohol Use
Disorders

Date:- 18/10/2019

POOJA JADHAV (OBESITY)

CASE STUDY DETAILS

Pooja is a 52 year-old health care professional who comes to you

for assistance with losing weight. She reports that she has been
overweight her whole life and is concerned with recent weight
gain that occurred over the last several months as she recovered
from a major medical procedure. She tells you that she is
particularly worried because her body mass index is now in the
obese range and, as a health care professional, she knows that
she is at increased risk for a number of chronic medical
conditions. She has tried to lose weight in the past and has had
some success. She is seeking your assistance because she is
committed to making positive lifestyle changes and would like
your help in establishing realistic goals for which she can be
held accountable.

SYMPTOMS

1) Obesity/Overweight

DIAGNOSES AND RELATED TREATMENTS

1. OBESITY AND PEDIATRIC OVERWEIGHT

The following treatments have empirical support for individuals

with Obesity And Pediatric Overweight:

Behavioral Treatment for Obesity

Date:- 19/10/2019

MEERA KAMBLE (BINGE EATING DISORDER)

CASE STUDY DETAILS

Meera is a 38-year-old divorced woman who works in a higher

level administrative position for a large l agency. She is
well-established in her career and has several close friends with
whom she enjoys spending time. She comes to you following
years of unsuccessful attempts to get appropriate treatment for
her binge eating. She reports a prior experience with counseling
during college after she experienced a sexual assault. She
shared with her counselor her concerns about binge eating but
the counselor told her that they needed to remain focused on
working through issues directly related to the sexual assault.
Embarrassed for having brought up her binge eating behavior,
she waited years to seek help again and, when she did on two
other occasions, it was recommended that she meet with a
dietitian to “learn how to eat healthily.” She explains to you that
she needs help with binge eating and that it’s not a matter of
knowledge – “I know what to do. I just can’t do it. I cannot control
my eating.” She describes a pattern where she works hard to
“get on track” with her eating but finds it difficult to maintain.
She is 5’4”and weighs 180 lbs. She first started binge eating in
college and her weight quickly increased from 135 lbs. as a
freshman to 160 lbs. by graduation. She has been treated for
hypertension and high cholesterol for the last 5 years. She is
coming for help now at the recommendation of her physician
after a recent visit where she reported increasing problems with
back and knee pain due to her excess weight.

SYMPTOMS
 1) Disordered Eating 2) Obesity/Overweight 3) Trauma

DIAGNOSES AND RELATED TREATMENTS

1. BINGE EATING DISORDER

The following treatments have empirical support for individuals

with Binge Eating Disorder:

Cognitive Behavioral Therapy for Binge Eating

DisorderInterpersonal Psychotherapy for Binge Eating Disorder

Date:- 20/10/2019

SEEMA MORE (BULIMIA NERVOSA)

CASE STUDY DETAILS

Seema is a 26-year-old doctoral candidate in English literature at

the local university. She is in good standing in her program and
has plans to enter the job market in the fall. In your intake, she
tells you she thinks she is “fat” and has been self-conscious
about her body since the sixth grade, at which time she began
menstruating and developing breasts earlier than the other girls
in her class. She was teased for needing a bra and remembers
feeling “chubby, too big, and just wanting to be small like [her]
younger sister.” She started dieting in the seventh grade,
following strict rules for weeks (e.g., she recalls the grapefruit
only diet), then transitioning into what she called “bad” weeks.
During these times, she would stock up on candy bars and other
snack foods and eat them, often in her bedroom late at night. Her
parents became concerned and tried to strictly limit her dieting.
This led to eating “normal” during the day and binging on those
candy bars she kept hidden in her bedroom at night if she felt
sad, scared, or mad. She grew into a habit of eating to feel better
– relief that was only temporary, as she would feel ashamed
about what she had done and resolve to not do it again. In
college, her pattern of emotional eating continued, which felt
more distressing to her because of the pressure to look “as
pretty and thin as the other girls.” In spring of her freshman year
she experimented with throwing up after the late-night eating and
found that, at least in the minutes that followed, she felt like she
had much more control and believed this would help her to
prevent the weight gain she so dreaded. She fell into a vicious
cycle of late-night binges (typically consuming about 7 candy
bars in 15 minutes, during which times Seema described feeling
very out of control) followed by making herself throw up. In
college, she engaged in these binge-purge episodes about 6
nights/week. At present, she is having a harder time hiding the
episodes because she lives with her boyfriend; she estimates
that they occur about 4 nights per week. The times when she
feels the most compelled to binge and purge are when she has a
major presentation coming up in her doctoral program and when
she gets in a fight with her boyfriend. Her BMI is in the normal
range, but she says she needs to lose weight. She wants to stop
binging and purging because she does not want her boyfriend to
find out, but she is also afraid that if she stops, she will gain
weight.

SYMPTOMS

1) Binges and Purging Body 2) ImageEmotion 3) Dysregulation

Disordered Eating

DIAGNOSES AND RELATED TREATMENTS

1. BULIMIA NERVOSA

The following treatments have empirical support for individuals

with Bulimia Nervosa:

Cognitive Behavioral Therapy for Bulimia Nervosa

Family-Based Treatment for Bulimia Nervosa
Healthy-Weight Program for Bulimia Nervosa
Interpersonal Psychotherapy for Bulimia Nervosa

Date:- 21/10/2019

ANITA KALE (ALCOHOL USE DISORDER, SEVERE

WITH CO-MORBID DEPRESSION)
CASE STUDY DETAILS

Anita is a 28-year-old Indian woman who has struggled with

alcohol use for most of her teenage and young adult life. She
began drinking in high school, at age 15, and dropped out of
college partway through her first year because she was missing
so many classes due to alcohol use. She has attempted to go
back to school twice since then but has been unsuccessful each
time due to relapses.

Anita reports multiple attempts to stop drinking, but has only

been able to maintain sobriety for 2-4 weeks at a time. Whenever
she tries to stop drinking, she gets nauseous, shaky, and
disoriented. Within the last 4 months, she has withdrawn from
her friends, feels sad almost every day, and has frequent suicidal
ideation. Her appetite has decreased, but her alcohol use has
continued to increase, and she is currently consuming
approximately half a “fifth” of vodka per day. She has frequent
arguments with her parents, who are now threatening to cut her
off financially because she spends most of her rent money on
alcohol. She “can’t stop thinking about my next drink,” and
reports feelings of guilt and worthlessness over being unable to
stop drinking.

SYMPTOMS

1) Alcohol Use 2) Depression 3) GuiltIrritability 4) Loss of

Interest 5) Substance Abuse 6) Suicidal thoughts
DIAGNOSES AND RELATED TREATMENTS

1. ALCOHOL

The following treatments have empirical support for individuals

with Alcohol:

Behavioral Couples Therapy for Alcohol Use Disorders

Moderate Drinking for Alcohol Use Disorders
Prize-Based Contingency Management for Alcohol Use Disorders