Experiences at NCMH during the OJT

My experiences in the National Center for Mental Health had been filled me great memories to remember. My practicum in the clinical setting taught me many things that will surely of great help in the near future.
Part of my duty as an intern in the Pavilion 2 – Out Patient Service, under Mrs. Victoria Pagkanlungan, is the infinite and diverse tasks those exist; part of my challenge is being not only prepared but flexible for that diversity. My typical day as an intern would begin, 7am, early with smiles for the guards, nursing attendants and other interns, especially to my clinical instructor Ma’am Vicky. Unfinished jobs from yesterday are given attention like general observation (GO as we call it), scoring of WAIS-R or MMPI, outpatients that need to be scheduled, and etc.
At 7:15 – 7:30am and even beyond, clients go straight into the Psychological Section - OPS for scheduling and testing. During free times, small discussions on working diagnosis or impression, strategic meetings, concerns and even comical/personal question were post with our clinical instructors (C.I.). A bit of attention from our co-intern and C.I. brings open smiles and can set me off to positive day. A very important role for me is to make the client understand the nature of the psychological service while presenting an objective and cooperative yet calm atmosphere to them.
First thing in the morning, I would regularly log my time-in at pavilion 1 then to pavilion 2, where we usually stay. About nine (9) clients were entrusted to me by Ma’am Vicky for IQ and projective tests.
Headed by Ma’am Vicky, we had this Social Skills Training (SST) with the geriatric in-patients done at pavilion 30 (Chinese pavilion) for research purpose. It’s quite big opportunity for me…another fruitful learning endeavor that caters my passion for this helping profession. The program runs from reading of the “Layunin”, “Mga Hakbang Pangkasanayan”, by the clients; modeling from the interns doing the “Mga Tagpo na Gagamitin sa Pagsasadula”; imitation of the clients themselves; integration by Ma’am Vicky thru the “Mga Tanong at Takdang Aralin”; and lastly, the most favorite part, the snacks! Often times, we offer the stage for a song and/ or dance number from the clients. For more than two months, I have almost memorized their names, gestures, mannerisms and even the way they speak. In turn, these clients were conditioned to the flow of our training, especially the food portion. They would not even need further instigation compared from our previous SST. It is good to know that when doing this two week Social Skills Training they would greet or recognize us and would call our name while waving their hand to say hello. Moreover, seeing marked or even little improvements open feelings of gratitude.
We, the interns, were given opportunities to experience first-hand test administration with real-life mentally-ill clients. Psychological cases ranges from mild to chronic, functional to disturbed, profound to superficial predispositions, and etc. On occasion, referrals for SSS/GSIS loan, adoption, return for work, and the like.
Upon having this test administration and evaluation, I felt amazement for the hypothetical terms from books gradually came into real life. “Is for real?!” I feel like saying. Theoretical training from books and lectures brought a lot of help in every test administration and evaluation I embark on. With these, I’m able to understand the clients’ immediate need and present predicaments which led me in dealing with them effectively and offering an intellectual input to my work. Provided I’m just a neophyte in this kind of noble career, my testing sessions would not be as successful as it is without the supervision, expertise, untiring effort, and valuable suggestions from Ma’am Nimia, Ma’am Rea, and most especially from Ma’am Vicky.
I learned strategic way of administering battery of tests and furnishing a more comprehensive and time bound psychological report. One difficulty that I have encountered during the training is the very long and strenuous jo urney from our residence to Mandaluyong City. I just hope my efforts will be rewarded a grade of 1.0…
In every end of the day, even though I’m feeling so exhausted and drained, I had to prepare myself for another new day!

November 9, 2009 (Monday)
General Orientation Day! The first day of our Internship…
We arrived in the Pavilion 1 at 8am in the morning to attend our general orientation. Mrs. Nimia Hermilia C. De Guzman (Psycholgist II) oriented ten NEU senior psychology students and me, together with the interns from PUP and UDM. A short history of the National Center for Mental Health (NCMH) was shared. After which, we were asked thought-provoking questions and our expectations about the institution. We were given safety tips and the dos and don’ts: No promises to the client; No Feeding; Use pseudonyms and other personal information when asked by the client; Settle problem with your Clinical Instructor first; Be snappy; Always close the gates; Always wear the white uniform (if not, white shirt) and etc. Ma’am Nimia told us that patients see people in white as an authority figure. The time-ins and out was also emphasized. Ma’am Nimia generously shared her personal experiences working in the different pavilions (especially Pavilion 4), the cases she handled, standing in court trials, and to the previous interns’ deviant behaviors.
We learned that there are 35 Pavilions in all. There are also wards (observation, open, semi-open, and restricted), cottages within pavilions and an administrative office. Ma’am Nimia told us the process in admitting patients in the inastution. We were taught the sequence of the battery of test: (1) Interview, (2) BVMGT, (3) DAPT, (4) WAIS-R, (5) SSCT. According to them, this sequence will lessen the boredom and fatigue of the client. The formulas for prorated scoring and the applicable situations in using it were shared. Also, the formula in computing the premorbid I.Q. was taught.
Before the general orientation was ended, we were designated to different pavilions. We met our respective clinical instructors and paid our bill. Jake, Ralph, and I were assigned in Pavilions 2, 5, and 30. Carlo was assigned to Pavilion 4. Hazel, Carina, Ema, Janine, Eileen, Joie were assigned to Pavilions 12 and 13. Diamitsu and Rhea were assigned to Pavilion 2. We were dismissed before 5pm.
We still have our worries but very excited…we shared our plans on what to do especially time budgeting. At the end of the day we aspired and agreed to be “THE EMPLOYEE OF THE YEAR!”
Though we had several misfortunes before reaching this point, we were glad we made it still alive and kicking!

November 10, 2009 (Tuesday)
Ralph, Jake and I arrived at NCMH around 7:30am, 30minutes before our usual time-in. We attended Ma’am Nimia’s short lecture on WAIS-R, and doing their way of psychological report. After which, she distributed our ordered psych-testing kit, daily time record (DTR), and our internship I.D. At that lecture, we met our co-interns from PUP. Ma’am Nimia also taught us making our working diagnosis.
We met our Clinical Instructor Mrs. Victoria Pagkanlungan and oriented us her rules and regulations. We negotiated about the days of duty, time-ins and out and the required protocols were asked. For now, we were only required to submit the general observation (G.O.) inclusive of Physical Appearance/Description, History of Present Illness, Substance History, Family History, Mental Status Examination, and Behavioral Report. We learned her way of administering the batteries of test that was discussed yesterday. From now on we will be staying at Pavilion 2 where our C.I. stays. While we were waiting our call to Pavilions 5, and 30, we will be doing out-patient service such assisting client in scheduling, administering psychological test (projective and I.Q.) and etc.. After our clinical instructor’s orientation, a scheduled client named Romeo came. He’s our first client! Ralph, Jake and I was immediately deployed in administering battery of tests to the said client. Good thing we learned it before, we know something how to administer the WAIS and it pleased our C.I.

November 11, 2009 (Wednesday)
OUR First Assignment!
I arrived at NCMH around 7:15am…I saw a crowd of Nursing students everywhere. I went straight to Pavilion 1 to log-in at NEU log book. We were told from our orientation to log-in first at Pavilion 1 before going to the assigned pavilion, then, log-in at our DTR kept by out C.I. Same as doing our time-out.
Frances (PUP), Jake and I team up to do an interview and administer BVMGT, DAPT, WAIS-R, and SSCT to Mrs. Leonora. Frances does a behavioral observation all throughout while Jake and I alternately administering the tests. When it is Jake’s turn to administer, I assist Ralph and Angelica (PUP) in administering the said tests to Mrs. Marichu in the nearby table. After long hours of test administration, we helped each other in scoring and verifying the test scores.
Funny thing about this day is that our clients call us “Dok!”
Ma’am Nimia taught us about the Lie Score Scale of MMPI.


November 13, 2009 (Friday)
Writing our First G.O.!
Ralph, Jake and I finished the general observation of Mr. Romeo(Mr. Crispy Pata), Mrs. Leonora(Balik-bayan) and Mrs. Marichu(Engineer). It took us the whole day.
Ma’am Nimia invited us to observe in her test administration of RIBT (Rorschach) to a client. Because of this, we have an idea how to administer the RIBT.I assisted our co-interns from PUP in scoring the WAIS-R. While walking along the corridor, I saw a disturbed client on a wheel chair shouting. It is my first time seeing one.

November 16, 2009 (Monday)
Only 1 client came…
For the whole day, I’m with a client named Mr. Rex (Paa); from interviewing to assisting in administering the WAIS-R. It took us really long hours to finish all the tests since he’s slow and easily fatigue.
Ma’am Vicky invited us to observe in her test administration of RIBT (Rorschach) to a client and do her separate interview with Rex and his mother.
After taking our lunch and while waiting for the office to open, Ralph, Carlo, Jake and I play the “Ice Breaker.” It is composed 130 cards with challenging, surprising, probing, enlightening, engaging, enlivening, interesting, and revealing questions. Thru these cards, we get to know each other deeper still. Ralph, Jake and I started playing it November 11. Later on, Carlo joined us, then our co-interns from PUP. We do this every after lunch while waiting.
We met an intern from Adamson University, Manuel Yang. He came to complete his requirements to Ma’am Vicky. He is nice so we did not have a hard time inviting him to join the “Ice Breaker.”

November 17, 2009 (Tuesday)
The UST interns came.
Since last week, there were UST students inquiring for internship and today is their orientation. While an orientation was going on, we were busy with our clients. I assisted in scoring the WAIS-R of Mr. Raul, client of a PUP intern. After the orientation, NEU, UST and PUP interns under the OPS Psychologists were toured at the Pavilions 5 and 8. It is a privilege being there because it is another learning experience.
I understand with what I saw…the place is quite OK except the smell.
Ma’am Vicky informed us that we will start preparing materials for the Social Skills Training at Pavilion 30 tomorrow. Actually, Ralph, Jake and I were informed about conducting such training before (Nov11) and were really excited about it. Ma’am Vicky gave us a fund and were asked to buy manila papers and markers as part of our preparation.

November 18, 2009 (Wednesday)
Jake’s Birthday!
I brought the manila papers and markers. While waiting for my group mates, I assisted again the PUP interns in scoring the WAIS-R. Around 8am, Ralph and Jake came and we started folding the manila papers. For the rest of the day, we wrote each session on the manila papers. For this day we finished sessions 1-5.

November 20, 2009 (Friday)
We continued writing to manila papers…we finished sessions 6-12. After, Ma’am Nimia sent Mai (UST), Jeremy (PUP), Ralph and I to Pavilion 35 to deliver testing materials. From there, Ma’am Rea asked us to assist the UST interns in administering the WAIS-R among the clients there. Mai and I team up to administer WAIS-R to Mrs. Belinda.
The place is good and no bad smell is present.
At 4pm, Jeremy and Ralph went back to Pavilion 2. We, the UST interns and I, finished by 4:30pm…the rest of the interns went home before we came at Pavilion 2. This is my first time to go home by myself since the first day of our internship.

November 23, 2009 (Monday)
Ralph, Carlo, and Jake absent themselves this day to attend the CAS Week Volleyball game. In addition, the PUP interns have class every Monday.
I am alone until the RTU interns came. I arranged the materials for the Social Skills training and retraced the left pencil markings by colored markers as requested by Ma’am Vicky. After that, the RTU interns asked me to assist them in administering the WAIS-R and MMPI to a client. Since were done before lunch and the only client scheduled is done, Ma’am Vicky sent us home early.

November 24, 2009 (Tuesday)
Carlo and I interviewed Ms. Virginia and administered BVMGT, DAPT, WAIS-R, and SSCT. We finished it before lunch and the Rorschach test is left for our clinical instructor to do. Ma’am Vicky sent us home early.
NEU, PUP, and RTU decided to socialize while having our lunch at Mauway Gym nearby, before going home.

November 25, 2009 (Wednesday)
Carlo and I finished our general observation (Physical Appearance/Description, History of Present Illness, Substance History, Family History, Mental Status Examination, Behavioral Report) of Ms. Virginia and hand it over to Ma’am Vicky.
Before going home, NEU, PUP, and RTU planned for a small socialization to the resident clients at Pavilion 8 as requested by Ma’am Nimia. We came up with a small program for them that will commence this coming Friday. We have designated task to everyone and canvassed the prices of the things we needed on the said date.

November 27, 2009 (Friday)
PAPJA day!
Eight of the psychology students, Dr. Ryan B. Coroña and I, attended the 23rd PAPJA Convention at the University of Sto. Tomas. Denisse, Krisha and I represented the New Era University Psychology Program at the Quiz-bee challenge of the said event. Hence, I was not able to attend today's internship. Good thing I was able to ask permission before from Ma'am Vicky prior to the said activity. Next, the scheduled socialization with the in-patients at the Pavilion 8 pursued without me. But there's nothing to be fret about because I was able to inform my groupmates. Also, I have given my contribution.
We won the 10th place! - Out of 36 schools all-over the Philippines that joined this year.

November 28, 2009 (Saturday)
The last day of PAPJA…
We attended parallel workshops and seminars at Miriam College. The said workshops catered array of interesting psychological topics and presentations – about 30 topics. Mini-kits and certificate were given. Though drained from a long-day, we have to gather ourselves together to attend our Filipino Psychology subject this afternoon.

November 30, 2009 (Monday)
The start of our Social Skills Training for the in-patients at Pavilion 30 and 5 was postponed because the request letter made by our clinical instructor was not yet approve.

December 1, 2009 (Tuesday)
CAS WEEK Opening Ceremonies!
All of us in our practicum class absent ourselves to attend the opening of the CAS WEEK that started-off with the “Pamamahayag at Tanging Pagtitipon”. This was due to the request of our practicum professor, Dr. Ryan B. Coroña. We are able to inform our clinical instructor about it and for the interns under Ma'am Vicky, it was permitted.

December 2, 2009 (Wednesday)
Ma'am Nimia asked me to score the MMPI of Mr. Serrano. Although this task was the only task assigned to me and was able to accomplish this day, it put me to a test of patience, endurance, and visual acuity. Only two patient came and were assigned to the UST interns since they just started their internship.
Since only two patients came, Ma'am Vicky sent us (her interns) to a half-day. Before I went home, I passed my handmade clipper to Ma'am Vicky as part of our preparation for the upcoming Social Skills Training for the in-patients.

December 4, 2009 (Friday)
The social skills’ training was approved!
Finally! That’s one of the good news, so far, I ever heard since we started our internship. We did not have much to do today, no clients came, just waiting for a call from our clinical instructors on what to do, and most of the time asks things they want us to do so as get busy, not to get bored and sleepy.
After lunch came, ma’am Vicky sent us on a half-day duty and reminded us to prepare ourselves for our first social skills training with the in-patients on Monday.

December 7, 2009 (Monday)
First Social Skills Training.
This morning, Ma’am Vicky led a short planning conference with us, her interns (RTU and NEU). Since we were informed that the clients that we will meet this afternoon are geriatric in-patients from Pavilion 30 (Chinese Pavilion), we made such considerations. We talked about the refreshments to be served after the SST, the arrangement and proximity of the seats, the do’s and don’ts, the roles that are expected us to play and etc. For this day I played the role of a director in the role playing activity of the SST.
With the budget from ma’am Vicky, we bought plastic bags, “graciosa” (bread from Julie’s Bakeshop), and zesto juice drinks for the refreshments. We walked with ma’am Vicky from Pavilion 2 to Pavilion 30. There are two roads to get there: the long uphill and the short downhill. We tried the long uphill one. On the way, we pass by the Pavilion 5 and we heard sounding screams from patients. We saw some patients on the second floor near the barred window: some quietly looking somewhere, others wave their hands, a few shout, while others dance in nude.
The patients were drawn by a lottery method. We arranged the seats in U-formation, a white board in the front where our visual aids were placed and some interns monitor the patients. We made nametags for us and for the participants. Around 2pm we started the first session with the title ”Pag-uumpisa ng Usapan sa Bagong Kakilala”.
The first session brought us a good learning experience from the preparation to the culmination. Also, enjoyment. Why? Because of the way the patients operate and feedback throughout the session. Not to mention their funny antics that they never knew they have done that brought us bursts of laughter as we recall the whole session while walking back to Pavilion 2. Mang Grendo is the most memorable one because of he’s active participation all throughout the session.

December 8, 2009 (Tuesday)
We, the NEU Interns, were off-duty today!
A week ago, we informed our clinical instructors that we would have a field trip and today it was pursued. We went to Cavite Center for Mental Health and a Drug Rehabilitation in Tagaytay. I was assigned at bus #4 (first year) with Jean Denolo, Prof. Felida Tucker-Rustia and Prof. Nanette Espina Calaor. Though given a short time for each venue, over-all, the field trip was so much enjoyed.
At NCMH, the second SST: “Pagpapanatili ng Usapan” was done with the other interns (RTU and PUP) while we, the NEU interns, were at the educational field trip.

December 9, 2009 (Wednesday)
The third SST!
This morning ma’am Nimia assigned me to finish scoring the MMPI of Mr. Cablao.
At the afternoon, again, we prepared the refreshments and the program for the third SST: “Pagtatapos ng Usapan”. Today, the session was prepared by the NEU, RTU, and PUP. Again, I served as the director of the scenes while ma’am Vicky gave the instructions.
As requested last meeting by the participants, we prepared the juice that can be drink in a cup and today we serve fruit cakes. What was new today? It is the patients want to sing for the whole group. We were surprised by this, so we accommodate the stage for each of them. Though they sung unfamiliar old songs and we can not relate, it’s still good because of their enthusiasm to participate and how they do it.
Compared from our first session, the participants were more active; the quiet and shy ones now speak and participate more. Ma’am Vicky and us were happy about that!
Before we went home, we saw a “taong-grasa” brought inside the Pavilion 2. We learned that he was from Las Piñas. He was old man, dressed with overlapping clothes and still single. Morbid it was, seeing his right hand and left feet in gangrene. Despair may be the right word to describe when the clothes that wrapped the gangrene was removed. I commend the attendant, the lady nurse, and the two male “barangay tanod” attending the poor man, for despite the gruesome situation they were able to do their job.

December 11, 2009 (Friday)
Ms. Rizabel was supposed to be my first client today but I have to leave half of the work to Ivy (RTU) because a call from pavilion 4 needing extra male interns was made.
Ralph, Carlo, Jake and I went to the said pavilion. It’s my first time to be at Pavilion 4 – Forensic Psychiatry. There I met Mr. Matt , a detainee from Marikina, which has murder case. Being there is really a challenge because the patients there are really dangerous. Thus, we have to be at extra care and modify our approach in the testing session. We were able to finish before lunch.
After lunch, we pursued to the 5th SST: “Paghingi ng Paumanhin” at the Chinese pavilion.

December 12, 2009 (Saturday)
The hospital was silent this day…an unusual day.
I thought I would fail to attend our 6th SST: “Pagpapahayag ng Positibong Damdamin”, but luckily I was able to appear before it ended. Filling up of the jeepney made the delay.

December 14, 2009 (Monday)
I administered WAIS-R and SSCT to Mr. Darius . An interview followed. He’s my first client referred for SSS loan…unlike to my previous ones that needed for treatment.
7th and 8th SST: “Pagbibigay at Pagtanggap ng Papuri”
Ralph and I worked together for an interview and the WAIS-R of Mr. Garcia.
As we go on thru the SST, the attendance of our group mates decline…

December 15, 2009 (Tuesday)
A new referral came in the name of Mr. Sherwin. He was referred for his competency to cater an open house charity for the inmates of the Nayon ng Kabataan this coming Christmas. He was with the PUP interns.
At the Chinese pavilion, the Regional Trial Court attorney catered an early Christmas gift giving program. The patients’ happiness seem cannot be contained…
I hope the participants in the SST can still accommodate our brought refreshment for the 9th SST: “Paghahanap ng Makakatulad na Hilig”.


December 18, 2009 (Friday)
We have no SST today because according to Ma’am Vicky, it’s the patients Christmas party…
The arrival of Mr. Jeben for IQ and Projective test sends to a whole day work. His case is interesting…a good subject for a psychological report so I asked permission to Ma’am Vicky, Jeben, and his mother for my proposal to pursue. He’s thrift in speech making it hard for me to collect information. He has to be frequently instigated to respond and seems he needs to be deliberate in his tasks.
He’s my last client…I can’t believe it. I’m half-way thru with my internship…I’ll surely miss it.

December 19, 2009 (Saturday)
Our last SST: “Paghiling”,”Pagtanggap at Pagtanggi sa Kahilingan ng Iba”…
The whole session seem so fast…
We catered porridge for our participants this time, as requested beforehand for our final session. They seem so happy with their new snack with us. They have just informed today that it’s our last session with them. It sends us to awe hearing words what they learned all thru out the session. I’ll never forget Mang Jose’s quietness, Mang Godofredo’s requests and childish antics, Mang Grendo’s songs and cooperation, Mang Agutin’s packed things in his shirt, Mang Graciano’s and Mang Nemencio’s shakes, Mang Rogelio’s smile and everyone. Every session with them awakes the humor in me. Our co-interns from Adamson College, UST, PUP, RTU, the staffs, the clients, Ma’am Nimia, Ma’am Rhea, Ma’am Vicky, psych test manuals and kits, the smell, tables and chairs, lunchtimes, ice breaker sessions, everything…Surely, I’ll miss them.