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Psychological Report Sample

The psychology is undoubtedly a significantly crucial fields of the science and medicine. Thus, the workers and the students of this sphere have to perform their tasks with the great responsibility. Writing the psychological reports is a typical part of such occupation, yet it can be challenging as it includes a considerable number of substantial details that have to be kept in mind. The psychological report sample points out them for one to understand the most significant elements of such type of work. In addition, the psychological report sample provides an example of the structure, style, and a clear outline of the psychological report.

questionnaire free material

1.Identifying Information

Name: James Blake

Age: 11 years 5 months

Date of birth: 11.08.05

Sex: Male

Educational level: Fifth grade (complete)

Source of referral: Ms. Adriana Blake, the mother

Examiner: Judy Hallway, school psychologist

Reason for referral/referral question: James’ mother is concerned about James’ problem behavior at home and at school as reported to her by his teachers. As Ms. Adriana states, such situation appeared for the first time as James used to be an obedient and diligent child, active and successful at study and communication with classmates. Two months ago, in October, James started behaving in a completely different way; he became much less concentrated and concerned about the study, his relationship with the mother became tense and less trusting, considerable problems in the communication with his peers appeared. Ms. Adriana made efforts to clarify the situation and solve the problem by herself but James refused to answer her questions, thus, she applied to the school psychologist for help.

2.Tests Administered:

Draw-A-Person Test  (date of conducting 15.12.16)

Vineland Social Maturity Scale (date of conducting 28.12.16)

Vineland Adaptive Behavior Scale (date of conducting 05.01.17)

3.Physical and Behavioral Observation

The interviews were conducted twice a week since the 12 of December until the 10th of January; there was one personal meeting with the patient and one with his mother being present weekly. James behaved acceptably, he was never late to the interview, even to those that he attended just by himself. Still, he was unwilling to talk openly, especially at the beginning of the work; he was more likely to speak at the personal interviews than at ones with his mother attending. There were not revealed any displays of the aggression or antisocial behavior. All results of the conducted tests did not differ from the normal indicators.

4.Family Background

James’ parents are divorced for four years; they stay in a friendly relationship. The boy lives with his mother but has weekly meetings with the father, he spends at least one week of the summer vacations with him.  Mr. Robert Blake, James’ father, is going to get married for the second time; his fiancée, Ms. Mary Brown, is fourth months pregnant.


James is most likely to be concerned about his relationship with the father after his new marriage, especially considering the fact that Mr. Robert is going to have a second child. The boy is afraid of being unwanted in the new family and ‘replaced’ by the newborn baby.

6.Diagnostic Impression:

depression and anxiety.


The parents of the boy have to explain the situation and the future development of it to James, he needs to be ensured of being needed and loved by his father in order to feel safe and to overcome the diagnosed issues. In addition, it would be helpful for the boy to spend some time, a week or two, with Mr. Robert and his fiancée as this will demonstrate him that he is a part of his father’s new family.

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