Datasets:

michelleyunun

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therapydata

like 15

7

reducing alcohol consumption

therapist

Okay. Does that concern you at all?

question

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7

reducing alcohol consumption

client

Um, I mean, the 10 drinks seems like not a lot, uh, for like-for me and like my tolerance.

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sustain

7

reducing alcohol consumption

therapist

Mm-hmm.

other

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7

reducing alcohol consumption

client

I guess I've kind of built it up over the years.

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neutral

7

reducing alcohol consumption

therapist

Okay.

other

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7

reducing alcohol consumption

client

Um, so that's a little- a little bit, uh, concerning I guess to me.

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change

7

reducing alcohol consumption

therapist

Do you feel like you have any reasons to kind of bring your alcohol use down within the limits?

question

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7

reducing alcohol consumption

client

Uh, any reason to? Uh, I guess health-health reasons.

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change

7

reducing alcohol consumption

therapist

Tell me more about that.

question

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7

reducing alcohol consumption

client

Um, well, I mean, clearly I don't feel good right now. Um, and it's-- I definitely feel more productive when I don't have a hangover. Uh, so I see a benefit.

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change

7

reducing alcohol consumption

therapist

So you can see some advantages to reducing the amount of drinking-

reflection

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7

reducing alcohol consumption

client

Yeah.

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change

7

reducing alcohol consumption

therapist

-um, that you consume during the week?

question

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7

reducing alcohol consumption

client

Yeah

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change

7

reducing alcohol consumption

therapist

Is this something you would be willing to explore with me a little further at another time maybe when you're feeling a little bit better? Is this something you'd be willing to come back and talk to me about?

question

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7

reducing alcohol consumption

client

Yeah, yeah, I think when I'm feeling a little- a little better. Maybe when I haven't gone all out the-the night before and sprained my ankle.

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neutral

7

reducing alcohol consumption

therapist

I'd love to, uh, set up an appointment for you if you can come in later this week or early next week to-

therapist_input

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7

reducing alcohol consumption

client

Okay, okay.

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neutral

7

reducing alcohol consumption

therapist

-kind of explore this a little bit further and maybe some of those advantages of reducing to the safe limits. Is that something that we could do?

question

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7

reducing alcohol consumption

client

Sure. Yeah, just not on a Saturday morning. [chuckles]

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neutral

7

reducing alcohol consumption

therapist

That's okay with me.

other

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7

reducing alcohol consumption

client

Okay.

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neutral

7

reducing alcohol consumption

therapist

Thank you.

other

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7

reducing alcohol consumption

client

Yeah. Sounds good.

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neutral

8

smoking cessation

therapist

So, what brings you here, Bob? What's, what can I do to help?

question

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8

smoking cessation

client

Yeah. Yeah, well, the only reason I'm here is 'cause my wife thinks I've got a problem with smoking. I've been smoking all my life and, uh, six months ago, uh, she thought, she got into this health kick, right? And now everyone who smokes is evil. And, uh, so that's why I'm here just to please her, get her off my back and—

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sustain

8

smoking cessation

therapist

So, you're not too happy to be here. This is the last thing that you want to be doing this afternoon.

reflection

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8

smoking cessation

client

Yeah. That's an understatement. I mean, I'm supposed to be at work right now, too, right? So-

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neutral

8

smoking cessation

therapist

You've taken time off you, it's costing you time and money being here.

reflection

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8

smoking cessation

client

Yeah, yeah. I'm only here because my wife forced me to come, you know. Like this has come to a head six months of just nagging me, relentless every day, because she was able to quit smoking and now I have to quit.

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sustain

8

smoking cessation

therapist

So, let me ask you this, Bob, what are some of your wife's concerns about your smoking?

question

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8

smoking cessation

client

Well, she's concerned about my health and she cuts out all these articles from the paper about second-hand smoke and—

n/a

change

8

smoking cessation

therapist

Wow, that she's been showing you and making you read.

reflection

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8

smoking cessation

client

Yeah, I've got to read this. That's my reading assignment for breakfast and I want to go out and have-- We used to go out and have a cigarette together at the table. Now I have to go outside in this weather, you know, what's that about? And she used to smoke more than me and now she's like holier than now?

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neutral

8

smoking cessation

therapist

So, you're pretty angry about it. It's pretty outraging that you're forced to change your whole life because of a decision she made six months ago.

reflection

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8

smoking cessation

client

And she's got my kids on this against me, you know, my son and my daughter, they're, it's like, they're ganging up on me, you know what I mean?

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neutral

8

smoking cessation

therapist

So, from your perspective, do you see any consequences to your smoking?

question

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8

smoking cessation

client

Well, the big one of course is how it's affecting my wife and the family. Like my dad's 85, he still smokes. I mean, yeah, you know, sometimes I thought of quitting, but I mean, I don't know. I don't know if I can-- I don't know if I can quit.

n/a

change

8

smoking cessation

therapist

So, let me make sure I understand kind of the whole scenario 'cause there's a lot of pieces to it. Your wife is on your case and your kids are ganging up too. So, you're sort of isolated, you're put in a corner and you're being told this is something you have to do, you have no choice in the matter.

reflection

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8

smoking cessation

client

Yeah.

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neutral

8

smoking cessation

therapist

You have a few concerns about your health, but that's not really the driving force. It sounds like it's most of all that it would be nice if things just went back to the way they were before she quit smoking and that all of this stuff wasn't something that you had to deal with anymore. Does that pretty much sum up--?

reflection

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8

smoking cessation

client

Yeah. Yeah. I-I'm just, I don't want to lose her or my family over smoking.

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change

8

smoking cessation

therapist

I get the feeling that your relationship is really important to you. That you would do anything.

reflection

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8

smoking cessation

client

Well, yeah, I mean, we've been married over 25 years, and uh, we've never had any major problems. Like this is-- this is the first problem. I don't even really see it as a problem cause we used to both smoke and I was trying to accommodate them by smoking outside, but it's feeling like we're going like this and I'm just concerned, like if this keeps going, like.

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change

8

smoking cessation

therapist

So, it strikes me that the way that we're talking about it, it's like it's all or nothing. Either you keep smoking the way you are, things continue to go downhill and get worse, your wife gets more and more on your case, or you put your cigarettes down starting the moment you walk in the door tonight and never pick them up again. It's almost like one or the other. It strikes me that as well there might be some middle ground here that it took you a long time to learn how to be a smoker and maybe it's going to take some time to learn how to stop smoking.

reflection

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8

smoking cessation

client

So, I can actually do it that way like gradual taber?

n/a

neutral

8

smoking cessation

therapist

There are some medications and some different approaches that we can use that aren't so abrupt. Recognizing that it-it's going to take some time and practice to get to where you might want to be.

therapist_input

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8

smoking cessation

client

I wish my wife could have come today cause she's feels after like, just stop like right away. So do you think she could come with me at a future appointment or something and she could hear that message?

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neutral

8

smoking cessation

therapist

If you wanted to bring your wife along, I'd be more than happy to talk with both of you.

other

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8

smoking cessation

client

Okay. I'll have to talk to her as well because their schedule changes from week to week, she works shifts, so I'll call you back tomorrow and we'll set something up.

n/a

neutral

8

smoking cessation

therapist

Okay. That sounds good.

other

n/a

8

smoking cessation

client

All right.

n/a

neutral

8

smoking cessation

therapist

Thanks for coming in.

other

n/a

8

smoking cessation

client

Okay. Thanks.

n/a

neutral

9

reducing alcohol consumption

therapist

So now that we've discussed a little bit of your medical history and- and taking your vitals, I'd like to ask you a few more questions. The-

therapist_input

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9

reducing alcohol consumption

client

Sure.

n/a

neutral

9

reducing alcohol consumption

therapist

-the rise in your blood pressure is concerning to me, so I'd like to gather a bit more information about your lifestyle.

therapist_input

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9

reducing alcohol consumption

client

Okay.

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neutral

9

reducing alcohol consumption

therapist

Okay. Have you had any major stressful events recently or any change in your work situation?

question

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9

reducing alcohol consumption

client

Not really, I haven't been stressed. Uh, I've been working steady, you know, these days, I'm glad to have a job, I really am happy that I'm working, so.

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neutral

9

reducing alcohol consumption

therapist

Yeah, that's certainly true. I'd also like to ask about some health habits that can contribute to high blood pressure.

other

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9

reducing alcohol consumption

client

Okay.

n/a

neutral

9

reducing alcohol consumption

therapist

Okay, do you smoke at all?

question

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9

reducing alcohol consumption

client

I don't smoke. I smoked, you know, as a young adult, quit 20 years ago. I went cold turkey. I was proud of that, haven't even thought about smoking.

n/a

neutral

9

reducing alcohol consumption

therapist

Okay, great. Um, do you drink alcohol, including beer or wine?

question

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9

reducing alcohol consumption

client

Uh, I do drink beer, I drink, you know, two to three pints on weekdays, sometimes on weekends, maybe four or five.

n/a

neutral

9

reducing alcohol consumption

therapist

Okay. Well, I'm concerned about the amount that you're drinking currently. It sounds like you're having about 15 to 20 drinks per week, and that's definitely more than what we would recommend and could certainly be contributing to your high blood pressure.

therapist_input

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9

reducing alcohol consumption

client

Well, I-- you know, my pressure has been high for years and, um, you know.

n/a

neutral

9

reducing alcohol consumption

therapist

Well, according to your chart, your blood pressure has gone up since July, and you said that you've been drinking more recently, so do you see the connection there?

therapist_input

n/a

9

reducing alcohol consumption

client

Maybe a little bit.

n/a

change

9

reducing alcohol consumption

therapist

Alcohol can have some dangerous effects on your body. So along with contributing to high blood pressure, it can have a big impact on your liver, which you need to keep in mind. So your liver has several different roles in your body. First, it helps process excess fatty acids before they get distributed to the rest of your body. It also helps process alcohol and other drugs. So when you have an excess of alcohol, your liver can't work as efficiently and the fatty acids build up, and over time, your liver won't be able to work as well.

therapist_input

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9

reducing alcohol consumption

client

Okay.

n/a

neutral

9

reducing alcohol consumption

therapist

Okay. And how about the use of other drugs like cocaine, heroin, marijuana?

question

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9

reducing alcohol consumption

client

I don't use heroin or cocaine. I've never even thought about using the hard drugs. Back in school, 20 years or so ago, I smoked reefer, you know. Once I got out of school, I haven't used that at all.

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neutral

9

reducing alcohol consumption

therapist

Okay. Have you ever used any prescription medications that weren't prescribed for you or in a way that wasn't prescribed?

question

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9

reducing alcohol consumption

client

No, I don't- I don't, uh, really like the idea of taking pills. Uh, as a matter of fact, a couple of years ago, I had this jaw surgery. They gave me a prescription for Percocet. I took one, maybe feel weird. I think they're still sitting in the medicine cabinet.

n/a

neutral

9

reducing alcohol consumption

therapist

Okay, excellent. Well, it sounds to me like the increase in your drinking could certainly be contributing to your high blood pressure. I think decreasing the number of drinks that you have when you go out and maybe decreasing the number of times that you go to the bar each week could be the best thing that you can do for your health.

therapist_input

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9

reducing alcohol consumption

client

Well, I guess I'll try.

n/a

change

9

reducing alcohol consumption

therapist

Okay. And then we'll set up an appointment for about a month from now. We'll recheck your blood pressure and see how you're doing with all this, sound okay?

therapist_input

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9

reducing alcohol consumption

client

Okay.

n/a

neutral

9

reducing alcohol consumption

therapist

Okay.

other

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10

diabetes management

therapist

Hi. You are [unintelligible 00:00:02]?

question

n/a

10

diabetes management

client

Yeah.

n/a

neutral

10

diabetes management

therapist

Okay. Um, what brings you in?

question

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10

diabetes management

client

Well, I'm supposed to come to learn about my-- how to manage my diabetes. Just got diagnosed.

n/a

neutral

10

diabetes management

therapist

Mm-hmm. I see- I see that your A1C or your blood glucose is very high.

therapist_input

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10

diabetes management

client

Yeah, that's what doctor said. She-she really laid into me about that. Said it was-- I guess, this is really serious stuff. She was talking about losing eyesight, mm, my feet, mm, problems with a lot of other stuff, and it really scared me. Uh, so, [sighs] you know, how-how-how to manage all this, I guess, is what I gotta learn, but it just sounds massive.

n/a

neutral

10

diabetes management

therapist

Mm-hmm. Well, you do need to take your medicine. We, uh, will need to start dieting, uh, you know, lose some weight, change-change your eating habits, exercise, uh, to get your diabetes under control, because your doctor is right, it is very serious.

therapist_input

n/a

10

diabetes management

client

That's, uh, that's a huge amount of stuff to do and, I'm not- I'm not certain I can do all that, and on top of it, it's-it's-- if I don't get it all done, all this stuff happens to me?

n/a

neutral

10

diabetes management

therapist

So, it sure can.

therapist_input

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10

diabetes management

client

[sighs]

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neutral

10

diabetes management

therapist

So, uh, you know, we-we need to start looking at doing all those different things to get your diabetes under control 'cause your-your number is very high.

therapist_input

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10

diabetes management

client

Well, I-I [unintelligible 00:01:35]

n/a

neutral

11

reducing recidivism

therapist

What else has brought you here?

other

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11

reducing recidivism

client

They found a little bag of weed.

n/a

neutral

11

reducing recidivism

therapist

Mm-hmm.

other

n/a

11

reducing recidivism

client

It's not a lot though.

n/a

sustain

11

reducing recidivism

therapist

Mm-hmm.

other

n/a

11

reducing recidivism

client

It's not like I was gonna sell it or anything. It's like—

n/a

sustain

11

reducing recidivism

therapist

Just enough for your own use?

question

n/a