REPUBLIC OF THE PHILIPPINES

OFFICE OF THE MAYOR

XXXXXX REHABILITATION CENTER
XXXXXXX CITY

PSYCHOLOGICAL REPORT

NAME: XXXXXXXXX

AGE: 35 years old

CIVIL STATUS: Separated

REASON FOR REFERRAL:

Mr. XXXXXXXX applied voluntarily at XXXXXXX Rehabilitation Center for the 1st time
last October 27, 2016 with the help of his family. It was also advised by his medical doctor to be
admitted at rehabilitation for being a drug dependent and due to some observable behaviors that
causes harm to his family and to others.

I. Interview
The subject was 35 years old. Hes currently residing at XXXXXXXX st. Brgy.
Taong, XXXXXXX city. He was born on October 16, 1981 and he was the youngest among
four siblings of Mr. XXXXXX and Mrs. XXXXXXXXX. The subject is also married to Ms.
XXXXXXX for 11 years, they have four siblings but they are separated to each other since
2010 and by the year 2011, he had a live in partner and they also had three siblings but they
separated too since 2014.
Mr. XXX is a college graduate at XXXXXX Polytechnic College with a course of
Mechanical Engineering. He worked also in Dubai at Petroleum Company as a Service
Assistant for almost one year. He had a regular job at Fortune Company since 2005 to 2008.
The subject start to be a drug dependent when he was 16 years old, he was influence by
his peers, but when he got married to his first wife he stopped using drugs and he started to
used drugs again when they had a family problem with his wife. He applied voluntarily in
Rehabilitation and was admitted on October 27, 2016. He stated that his parents and his
siblings are his motivation to change his attitude, behaviors and his life.

II. General Appearance, Behavior and Affect

 a. General Appearance
During the Interview, the subject is wearing a blue shirt and a knee jersey
short, the usual dressed in XXXXX Rehabilitation Center. It can be observed also that
he has a proper hygiene.

b. Behavior
During the interview, the subject can be observed with a high energy, hes
very cooperative too and he answered every questions that I asked, but there are times
that he hesitate to answer some of my questions and asked the purpose of the
following questions in the interview. There is also a doubt in answering some
questions when there is someone listening to us or when there are people around us, it
looks like the subject is uncomfortable. An eye contact can be observed also but he
cannot maintain it, there are times that he looks to the ground and ceiling too during
the conversation.

c. Affect
At first, the client was very lively and cooperative, he used to tell his
memorable experiences happily and silly, but when he started to tell about his parents,
family and siblings he became serious and looks sad, but in overall the subject has a
happy and lively mood.

d. General Impression
In the overall interview, it can be observed that the subject have a good mood,
he has willingness in taking an interview and despite of some doubts and hesitations,
he continue to share some of his experiences and his personal lives openly. The
subject is cooperative and has initiative in the whole interview.

III. Test Administered

The following psychological test was administered to determine the abstract
reasoning and intellectual capabilities of the patient. The test administration can use to assess
the information that had been gathered during the interview with the subject regarding his
psychological and emotional functioning as well as his personalities. The psychological test
that was administered includes the following:

Test Administered Date of Admission

A. IQ Test
Purdue Non Language Test November 29, 2016
B. Projective Test
Bender Gestalt Visual Motor Test January 5, 2016
Draw a Person Test November 24, 2016
House Tree Person Test November 24, 2016
 C. Pen and Paper Test

Sack Sentence Completion Test November 24, 2016

Hand Test December 5, 2016

Self Analysis November 24, 2016

IV. Test Interpretation

a. IQ Test

Purdue Non Language Test

Raw score: 35
Percentile: 65 %
Interpretation: Above Average

b. Projective Test
Bender Gestalt Visual Motor Test
The subject got eleven (11) figures out of sixteen (16) in the recall phase
and during the copy paste the subject completed all the figures in a given period
of time. Hes focusing on what he has drawn yet he has a hard time in copying the
exact figure and recalling it.

Draw a Person Test

First drawing: Male

Description Interpretation
Dim out facial while emphasizing the Importance of self and a strong drive
contour of the head participation but egocentrically blocked.
Dim line Occurs more frequently in the timid self-
effacing and uncertain individuals.
Mouth: Single line Marked expression of tension as if shutting the
mouth tightly against something.
Repeating small circles for the eyes Extremely childish or regressed adults, low
grade defectiveness.
Trim eyebrow Social stereotypes reflecting refinement and
grooming
Vigorous shading of hair with poor Expression of virility conflicts brimming over
form delineation into some sexually deviant behavior
Long nose Suggest sexual virility
 Merge hands Expression of strength
Emphasis on joints Associated with mother dependence,
psychosexual immaturity.
Figure to the left Self-oriented

House-Tree-Person Test

Second drawing: Female

Description Interpretation
Dim out facial while emphasizing the Importance of self and a strong drive
contour of the head participation but egocentrically blocked.
Dim line Occurs more frequently in the timid self-
effacing and uncertain individuals.
Mouth: Single line Marked expression of tension as if shutting the
mouth tightly against something.
Repeating small circles for the eyes Extremely childish or regressed adults, low
grade defectiveness.
Vigorous shading of hair with poor Expression of virility conflicts brimming over
form delineation into some sexually deviant behavior
Long nose Suggest sexual virility
Street attire, female reaching ankles Strong mother image
Figure to the left Self-oriented
Side view drawing Indicative of less neurotic trend and more
withdrawal and artistic realization of
narcissistically oriented drive of social
dominance.
Long hair Show social acceptable ;
Sensuality

c. Pen and Paper Test

Sack Sentence Completion Test
The results show that the subject has an emotional conflict toward his
father, mother, and family unity as well as to his guilt feelings and fears, but it
also appears that those emotional conflicts are able to handle without any
therapeutic aid.

Hand Test
Pathological Degree: 2
Interpretation: low experience of psychological disturbances
 Acting-out Response: 4:2
Interpretation: greater expectancy of overt anti-social behavior.

Raw scores in other area

Interpersonal Response: 6
Environmental Response: 13
Maladjustment Response: 0
Withdrawal Response: 2

Experiential Ratio: 6:13:0:2

Self Analysis
Based on the responses of the subject in self-analysis, it can be
observed that hes aware on his good and bad attitudes and despite of being a
drug dependent, hes still hoping that he has a chance to change his life. The
subject has a lot of dreams also and that is to be with his children and be a
successful man someday and for him that is his future.

V. Test Evaluation

Purdue Non-Language Test

The subject got a raw score of 35 out of 48 items from IQ Purdue Non-Language
Test that has a percentile of 65% which is classified as Above Average. The result shows
that the subject has a high ability in analysing and recognizing the differences of each
figure. His capacity in comprehending abstract concepts, ideas and situations is adequate.

Bender Gestalt Visual Motor Test

Bender Gestalt Visual Motor Test result, shows that the subject can draw the
following figures accordingly, though he draw the figures slowly and accurately, he still
have a hard time to copy the exact figures. Based on the drawing too, the patient has no
problem in the perception, because he can draw what is in the card board. In recalling
phase, he recall what he draw first and last, he had a hard time to recall some figures that
he draw in the middle part.

Draw a person Test

Based on the result of Draw a Person Test, it reveals that the subject is a self-
oriented person, he tend to deal with his own interest and wants, especially when it comes
to his decision in life. He dont want others meddling on his plan and decision in his life
because he want to stand up for himself. He also tends to give importance to himself by
demanding time, patient and attention from the others, but he tends to be ignored that
cause him to lose his courage to be part of a given attention.
 The subject is likely to communicate verbally with aggressiveness, and there are
times that he shown up a sadistic personality but he try to control it by shutting the mouth
tightly when hes against to something. The results reveal that the subjects is striving
virility and has an expression of virility conflicts that brimming over into some sexually
deviant behaviour, but despite of that it also shows that the subject has been reflect on the
changes of his behaviors and appearances that was caused by drugs, so he try to improve
himself through making small changes onto his behaviors and appearances that he think
is right.
The subject used to express strength but he has a side of being dependent toward his
mother that makes him to be extremely childish or a regressed adult, which clearly shows
on the other test and during the interview.

House-Tree-Person
The results reveal the oral dependency of the subject as well as his immediate needs
in emotional satisfaction which may be related to his family and siblings. As what have
seen in DAPT result, still the results reveal his dependency and regression which is
associated to his mother.
The subject is frozen at present and vulnerable to environmental pressures which have
been said also in the interview that he gets easily influence at any risk and that hes
weaknesses but despite of that he tried to be reluctant to accept any visual stimulating
that may cause any harm or danger.
It also shows that the subject feels that he socially accepted now.

Sack Sentence Completion Test

The Sack Sentence Completion Test results reveals that the subject has an
emotional conflict toward his father and mother as well as in family unity that does not
need any therapeutic aid but those conflicts are needed to be settle as soon as possible, for
the improvement of the subject.
Based on the result, the subject often blame his father on what happen to his life
now, because if his father has been good also in their life since then, it would not happen
to his life too. But despite of those blame, he still care to his fathers health and he also
feel ashamed toward his father because of what he have done in his life. The subject also
felt guild toward his mother, because he knows how her mother hurts so much as well as
her sacrifices for him to be good but he still make her mother disappointed to him that
cause their relationship to each other changed.
The subject blame himself for making his family broken, he also blame his
wrongdoings and his decisions in life that makes his life miserable. As of now, the subject
had been reflect on what he have done wrong in his past life, he slowly realize his
mistakes towards his parents and family. But there are things he was afraid of, which is
his own self. He was afraid to himself, because there are things that he cannot control by
his own self, he was afraid of the things that he might do which can cause him to blocked
that things that can make him good.
 Hand Test
The subject response shows that he likes engaging in interpersonal relationships. He
has a sensitivity and interest in involving to a relationship with other people. He also
shows affection to others that reveals his likeliness to engage in a pleasurable relationship
which involves the mutual interchange of positive feelings and attitudes. He gets along
well with others too.
The subject used also to represent generalized attitudes toward the impersonal world.
He has a readiness to respond with his environment in a typical way.
The results show that the subject has no any psychological disturbances but he have a
greater expectancy of overt-antisocial behaviour and hostility.

VI. Summary
The subject appears to have a good ability to adjust in his environment and
cognitively, he can easily response and cope every situations and circumstances in his
life. Emotionally, the subject has emotional needs toward his parents, family and mostly
to his children, he has wishes over his parents and that is to make their relationship to
each other be back again, especially his relationship towards his mother. He also has
wishes towards his family and children, which is to make his family complete again and
to be with his children too. The subject was verbally aggressive but he knows now how to
control his behaviors when hes against into something. He slowly improves himself by
making small changes in his behaviors.
The subject gets along well with others and has a good interpersonal relationship, he
has a readiness to cope or adjust in his environment in his own way. But he shows a sign
of overt-antisocial behaviour too as well as hostility.

VII. Recommendation
Based on the following results on the psychological test and upon the interview, the
client must complete the rehabilitation for his recovery with a minimum of six (6)
months. The subject and his parents as well as his family must have a group counselling
to make them both aware about their problems and conflicts to each other. The subject is
also needed to participate in any group activities, lectures and bible study for his further
improvement cognitively, emotionally and spiritually. Participating to those activities can
help him to modify his behaviors and reflect on his wrongdoings.
A counselling session is a great help also to help the client release his emotional
conflicts toward his environment, so that it cant cause any harm to the subject and to the
other patients.
During the rehabilitation, it is important to expose the subject to his family more
often, especially to his children, to make the subject motivate in changing his life and
behaviors continuously. After the rehabilitation, the subject is needed to be monitored
regarding to his environment and activities outside the rehabilitation, to see if there is
improvement and provide a necessary actions if there is a problem or conflict in his
changing process.