INTERNSHIP OF

Ms. JASDEEP SIHOTA IN COMMAND HOSPITAL WESTERN COMMAND

CHANDIMANDIR

EXPOSURE TO VARIOUS DEPARTMENTS

DEPARTMENT OF PSYCHIATRY HEADED BY LT.COL.T.R.JOHN

DEPARTMENT OF PAEDIATRICs HEADED BY COL. S.K.JATANA

DEPARTMENT OF

DERMATOLOGY HEADED BY COL. Y.S. BISTT

DEPARTMENT OF Neurology HEADED BY SGT. CDR. LAZARUS

DEPARTMENT OF ONCOLOGY HEADED BY LT.COL. S. KANNAH

ASHA SCHOOL, CHANDIMANDIR

SCHEDULE OF INTERNSHIP & ACTIVITIES INVOLVED IN IT Total period of 90 days{ 3 months }

15 days of rotation in each department.

Reporting on time.

To adhere to rules and regulations.

To take classes on regular basis and follow up with the counseling of patients.

To attend lectures and presentation in the Psychiatry department as and when required.

Working with children of Asha School.

Taking classes of Religious Teacher Counselor in the Department of Psychiatry for an hour everyday in the morning.

Sitting with the doctor in their OPD’s and taking up counseling of the required patients.

Briefing the doctor about the same and taking suggestions for further course of action.

Fixing up appointments with the OPD patients for their counseling sessions.

Taking up counseling cases in the wards.

Debrief the Psychologist and the Psychiatrist about each case on daily basis.

Attending Group Therapy sessions of Alcoholic patients admitted in Psychiatry Ward and taking up their sessions independently as and when required.

DAILY ROUTINE

FACILITIES PROVIDED BY THE HOSPITAL

Access to the hospital library. Use of Internet facility in the library.

Issue of books.

Use of Recreational Room.

ACTIVITIES IN ASHA SCHOOL

Interacting daily with MR children in their classroom and doing activities like

• drawing & coloring,• playing games,• giving them work of Math's and English.

Counseling sessions with the parents.

Taking oil paintings classes with children of all classes.

Helping teachers in their preparation of class activities and doing up the class boards.

Taking care of the class along with the class teacher.

Power Point presentation to the staff and the parents on MENTAL RETARDATION.

ASHA SCHOOL This school is for differently able children and is run by AWWA

[Army Wives Welfare Association ] of Western Command.

Children are admitted here after they are assessed for their IQ and referred by a Clinical Psychologist.

Children are from both services background as well as from civil setup from nearby cities.

It has well trained teaching staff who are exposed to various workshops from time to time.

Children are exposed to various vocational, social and cultural activities.

It has a Speech Therapist and a Physiotherapist coming from Command Hospital on weekly basis.

It has it’s PT meeting on regular basis.

DEPARTMENT OF PSYCHIATRY Sibling rivalry disorder.• This category is listed in ICD-10 for children who show

extreme jealousy or other signs of rivalry of a sibling , starting during the months following the birth of that sibling.

• The signs are clearly greater than the emotional upset and rivalry which is common in such circumstances , and they are persistent and cause social problems.

When the disorder is severe there may be hostility and even physical harm to the sibling.

The child may regress in behavior, for example losing previously learned control of bladder or bowls, or act in a way appropriate for a younger child.

There is usually opposition to the parents and behavior intended to obtain their attention, often with temper tantrums.

There may be sleep disturbance and problems at bedtime.

• The older child is jealous of the dependence of the younger one, who is more protected and seems to be better loved.

• One child may be envious of the other because of better achievement in school, greater talents or personal appearance.

• Envy is intensified if the parents emphasize and harp on these matters.

The intensity of the rivalry feeling is proportional to the dependence of the child on the mother and hence is particularly noticeable in the overprotected child.

Hostile behavior towards the younger child may be overt, manifesting itself by biting , pushing and hitting.

Negativism and aggression are the characteristics most often found in jealous children.

Hostility is intensified by parental preferences for one child and by parental comparison.

The child’s jealous behavior towards a sibling may be an outlet for his jealousy of the parent whose affection he resents sharing with the other parent.

• Sibling rivalry is less common when the child is six years older at the time of the birth of his sibling,

• probably because the older child has a better understanding of his position in the home.

• and because the home situation is less important to him as his interest and experience broaden.

It is possible that jealousy is present but is concealed because the child realizes that it is undesirable.

CASE STUDY OF SIBLING RIVARLY This particular case was of a 15 years old boy who fought with

his younger brother the previous night.

Loosing his temper , he pushed the younger one away and threatened to hit him with his belt.

The younger one fell and hit his forehead on the side of the bed and bruised himself.

Mother on seeing him injured jumped of the bed and ran after the elder son.

He locked himself in the kitchen.

She kept banging her head against the door and fainted.

When she regained conscious she had a severe headache and no memory of the incident of what happened but kept saying that her younger one is dead.

Her husband brought her to the department the next morning along with the two boys.

She narrated the incident of the previous night and kept saying that her younger son was dead.

When the younger son told her that he is alive and is sitting besides her, she kept denying that he was not her son.

The elder son was very upset on seeing his mother in this state but had no ramose of hitting the younger one.

He liked his own space and did not like being bugged and he would not think twice of hitting out.

He always warned his brother of not pushing him beyond a limit.

No one loved him anymore especially his father and on seeing his behavior over past over few years, had decided to put him in a hostel.

When he was asked that if it was ok with him if his father was

spoken to, he agreed but did not want be around and went home.

Father said that he was fed up with his son’s behavior and that he was also getting lot of complaints from his school.

He further said that wanted his son to go away to the hostel so that he would learn to be in discipline and the younger one would not be bulled.

The father was made to see that sending his elder son to the hostel was not the answer to the problem but it would rather distant him from the family and he in turn would become more lonely and aggressive.

The father was also made to see that the child should be loved and taken care of from all angles.

Keeping him home would help in boosting up his moral and

make him feel wanted.

It will give him a feeling of being loved and cared which would further help him coming out of his shell.

He is also spending more time with is brother playing both outdoor and indoor games.

He had to be give reassurance that he was loved by everyone and that he was a mature and a responsible child.

He is also spending more time with is brother playing both outdoor and indoor games.

The mother is under Psychiatric treatment.

He was just like any other adolescent who was experiencing emotional turmoil and feeling alienated from his father.

He was undergoing common problems like moodiness, anxiety, minor problems of school refusal, difficulties in relationship with peers, disobedience and rebellion and sibling rivalry which are quite common among children aged from 12 to 16.

The following song clearly speaks about the turmoil adolescents go through.

ADOLESENT CONFLICT: MEANINGLESSNESS AND ALIENATION AS SEEN BY THE BEATLES. “He’s a real Nowhere Man,

Sitting in his nowhere land, Making all his nowhere plans for nobody. Doesn't have a point of view, Knows not where he’s going to, Isn’t he a bit like you and me?

Nowhere Man please listen, You don’t know what you are missing. Nowhere Man. The world is at your command. He’s as blind as he can be. Just sees what he wants to see, Nowhere Man don’t worry. Take your time, don't worry, Leave it all till somebody else lends you a hand.” [Lennon & McCarteny,1965]

THANK YOU

HAVE A NICE DAY