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1. ABNORMAL PSYCHOLOGY
MS 1 Spring 2017
Tooba Khalid
Total Sessions: 10
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Dr. Zainab Bhutto

2. Case Study
Client’s Background:
Allishba Khan, is a 7 year old female, lives with her parents in a nuclear setting, belonging to a
middle socioeconomic class and is a Pathan. Both her parents work and come back home at 5
o’clock sometimes a little later. She spends some days with her grandparents who help her
parents in looking after her. She is the only child and is currently in the first grade.
Case Summary:
The mother further explained that Allishba becomes overwhelmed in large crowds, causing her
heart to race and have difficulty in breathing. Because of this, she often wants to leave the room
immediately. The mother also reported that Allishba would have tantrums before school started
because she would not want to leave her to go to class. Specifically, Allishba would cry, kick,
and scream. A couple of times, Allishba would become overwhelmed in class.
The first three weeks of school (1st grade), Allishba would throw tantrums very similar to the
ones she had last year where she would cry, kick, and scream. Allishba reported to liking
spending time with her mother but also stated that the time that they spend together is no more
than a few hours. On further inquiry the client also mentioned that they usually watch tv or go
out. The client also does not sleep in a separate room and always sleeps with her mother.
Her mother reports that two years back Allishba’s dependency on her was more than it was now
as Allishba would begin to cry even if she saw her mother leaving the house and would run after
her, or when she would realise her mother was not at home she would begin crying.
Allishba also responded to whether she liked going to her grandparents or not and she mentioned
that going there was fun but she did not like staying there for too long and preferred staying at
home. She also reported that she does not have many friends, however at grandparents’ houses
she plays with a few cousins.
In terms of health, Allishba suffers from seasonal allergies and asthma. In the month of October,
when her mom was replacing the carpet on their house, Allishba experienced an asthma attack
that caused her to stay at her grandmother’s and away from school for two days. Allishba also
has had several colds since beginning counseling this academic year.
Mental Status Exam:
Allishba is a casually dressed and cooperative seven year old who appears her stated age. She is
alert and oriented to person, place, and time and makes good eye contact. Allishba’s memory is
intact and her attention and concentration are good. Her speech is normal in rate, rhythm,
volume, and tone and her stream of thought is logical. Allishba’s affect is congruent. Anna’s
insight and judgment are fair for her age.

3. Tentative Diagnosis:
Allsihba seems to be exhibiting symptoms of Separation Anxiety as she has developed a
dependency on her mother and likes spending time with her and every time her mother tries to
leave her at school Allishba starts to cry and scream. This behavior occurred during her
Kindergarten years as well and has started again during the first few weeks of First Grade.
She exhibits persistent reluctance to separate from her mother, shows a reluctance to go away to
school due to fear of separation, and reluctance to sleep away from major attachment figure
(sleeps with her mother every night).
Differential Diagnosis:
 Social Anxiety Disorder
o Allishba is an only child and has taken few initiatives to socialize with peers and
exhibits extreme behavior (kicking, shouting, screaming) when taken to school.
Also her environment consisting mostly of adults or adolescents could lead to her
experiencing distress when having to face social situations by herself. And also
becomes over whelmed in large crowds, her heart begins to race.
Tentative Causal Factors:
 Lack of confidence due to no one near her age group to socialize with at home
 Dependency on mother as she sleeps with her every night, prefers spending time with her
mother.
 Being an only child has led to all the attention being on her from the beginning and now
as she is growing up the realization that her parents work full time and the divided
attention could lead to her dislike of separating from her mother.
 Her asthma attacks could also be a reason as to why she does not like being separated
from her dependant figure.