id text label dimension 100_137 Oh, you do? question communication behavior 100_139 Good for you doing that. reflection communication behavior 100_141 Yeah. Smart. reflection communication behavior 100_143 Discouraged. reflection communication behavior 100_145 Discouraged, yeah. reflection communication behavior 100_147 Mm-hmm. other communication behavior 100_149 Mm-hmm. other communication behavior 100_151 Uh, yeah, it does. Uh, I am yet to- it-it seems to me just in this time we've been talking together that you, um, um, do have a sense that a lot of it has to do-do with, uh, timing, luck, who you know, and being, are you able to have that conversation where you know that you can sell yourself and your skills and, um, and your competencies and the fact that you've overcome so many things like, um, substance abuse problem and, uh, have been, you know, uh, a good upstanding citizen all this time. Um, to me, if I were an employer, you know, I would- I would be impressed with that. reflection communication behavior 100_153 Uh-- You're welcome. And- so what about, um, I know I had a client that told me a couple of things. He was doing some work on this, uh, if you- if you'd be interested I could tell you what he shared with me. therapist_input communication behavior 100_155 Okay. Um, he found the most valid information on blogs done by felons. therapist_input communication behavior 100_157 They are your experts. therapist_input communication behavior 100_159 And, uh, they-they are actually, uh, uh, much what you have said, they said, but they also, uh, uh, talked about which places and companies they did find were open. For instance, family-owned businesses just tend to-- They can, if they can-- therapist_input communication behavior 100_161 Right, right. other communication behavior 100_163 Or start your own business. That was another thing that I thought was really-- therapist_input communication behavior 100_165 Uh-huh. other communication behavior 100_167 So being an entre- being an entrepreneur fits for you. reflection communication behavior 100_169 Mm-hmm. other communication behavior 100_171 Mm-hmm. other communication behavior 100_173 Well, that, you know, now that's a-a really different way of looking at it than how you were looking at what you can do versus what's getting in your way that you know you can't do. reflection communication behavior 100_175 So, um, what kinda- what-what are you starting? What's this business? If you-you don't have to tell me if you don't want, I know it's on the up and up, but you don't have to tell me if you don't want. question communication behavior 100_177 You'd be so good at that. reflection communication behavior 100_179 Uh-huh. other communication behavior 100_181 You-you would be the corporate company. reflection communication behavior 100_183 CEO. reflection communication behavior 100_185 [laughter] other communication behavior 100_187 So. Yeah, I- I've heard that-that in recession, uh, those are often the best opportunities for people to start doing business is to, um, see an area where you see a need go in and fill it. therapist_input communication behavior 100_189 One. other communication behavior 100_191 You're comfortable with that? question communication behavior 100_193 I know. That's fantastic. It is. reflection communication behavior 100_195 Acting out would be what? question communication behavior 100_197 Okay. Gottcha. other communication behavior 100_199 Like you are now. reflection communication behavior 100_201 So the-the-the law of, um, felony convictions is-is something that you don't have any control over. I mean, nobody does. So, um, you know, and I'm thinking about how you were talking about getting all the way through the interview and then getting rejected, you know, versus being upfront about it and-and even on the telephone to see whether it's a deal breaker or not, because it must- it sounds like it's so much harder to have that good interview and walk out of there ad know you've done well, and then get turned down. reflection communication behavior 100_203 Mm-hmm. other communication behavior 100_205 And your brother didn't know that when he gave you the lead on the job, that there was a background check involved? question communication behavior 100_207 Okay. other communication behavior 100_209 Mm-hmm. other communication behavior 100_211 You're not a criminal. reflection communication behavior 100_213 That's right. You're rehabilitated. reflection communication behavior 100_215 A plus shining new guy. reflection communication behavior 100_217 Oh, I think so, too. other communication behavior 100_219 I guess I would just have a tendency to say it. I'm a recovering person, and back in my former life, I have a felony conviction. And before we go any further, I don't wanna waste your time. Uh, would that be a problem in even getting the interview, what would you think about saying something like that? therapist_input communication behavior 100_221 Mm-hmm, mm-hmm. other communication behavior 100_223 Okay. I mean, I'd be happy if you wanna work on a few, you know, things, uh, to write down that sound comfy and fit, you know, how you talk and you use words and stuff. 'Cause I-I also think, you know, interviewing is a good schoo- a good skill, and the more you do it, the better you get at it. And you've been getting a lot of practice at it. So that's-that's been useful too. therapist_input communication behavior 100_225 I mean, even-even though you get turned down, that feels terrible. The actual and, I bet you with every single one, you get better at it. therapist_input communication behavior 100_227 Uh-huh, uh-huh. other communication behavior 100_229 Yeah. I bet you're even better now. therapist_input communication behavior 100_231 You got lots of practice. reflection communication behavior 100_233 Yeah. Well then lastly, just getting back, um, to this, another source that that same client was an advocacy group called the John Howard Society. therapist_input communication behavior 100_235 I don't know if you've ever- other communication behavior 100_237 Yeah. other communication behavior 100_239 Uh, he, yeah, uh, he- they have a lot of, uh, they have a lot of really good stuff on there about this because they're trying to change the laws about that because- therapist_input communication behavior 100_241 -they are so, um, they are so prejudicial. They really are. And I would check with the ACLU too. I mean, just as I-I don't know much, and now I'm very curious and I wanna find out about it myself, but yeah. therapist_input communication behavior 100_243 Mm-hmm. other communication behavior 100_245 Oh, absolutely. other communication behavior 100_247 Absolutely. other communication behavior 100_249 You're not allowed to vote. therapist_input communication behavior 100_251 And you're not allowed to vote. therapist_input communication behavior 100_253 That shocked me when I found that out. therapist_input communication behavior 100_255 I couldn't believe that. therapist_input communication behavior 100_257 Do you know how many millions of people and when you think about that racially, um, hmm. therapist_input communication behavior 100_259 Yeah, mm-hmm. other communication behavior 100_261 Mm-hmm. other communication behavior 100_263 That's a great word for it there. Yeah. So, um- reflection communication behavior 100_265 Yeah. So-so maybe you- if you- if you wanted to, and this is really up to you, you could check out the blogs, you know. Um, I can see if I can track him down and stuff and the John Howard Society. And, um, I'd be really interested if-if you wanna get together to see what you have found out. therapist_input communication behavior 100_267 Mm-hmm, mm-hmm. other communication behavior 100_269 But this has affected it. reflection communication behavior 100_271 Rejection-rejection, yeah. reflection communication behavior 100_273 Yeah. other communication behavior 100_275 Yeah. other communication behavior 100_277 I'll do some checking around for you. I will. Yeah. reflection communication behavior 100_279 Oh, you are welcome. Thanks for being so open with me. I appreciate it. reflection communication behavior 100_281 Yeah. Okay. other communication behavior 101_0 So, Jill, um, I know you're here to talk about your blood pressure today. reflection communication behavior 101_2 Um, before we get into that, I see you filled out our annual screening forms here. So if-if you're okay, can we take a minute to talk about that? question communication behavior 101_4 Okay, great. It looks like, um, the way you filled out the alcohol form puts you into our, uh, third zone of drinking. Can you- can you tell me a little bit about your drinking habits, where you drink, what do you like to drink? question communication behavior 101_6 Okay. other communication behavior 101_8 Mm-hmm. other communication behavior 101_10 Okay. Kind of socializing? reflection communication behavior 101_12 All right. How often do you do that? question communication behavior 101_14 Okay. And on a regular night, how much do you-- how many glasses of wine would you guess you drink? question communication behavior 101_16 Mm-hmm. other communication behavior 101_18 Okay. Okay. other communication behavior 101_20 Mm-hmm. Okay. So let me just show you on this, um, card here, um, from a medical perspective, we know that there's good evidence that shows that women you're age who drink more than, um, three drinks on any one occasion at any- at any sitting or more than seven in a week, are likely to run into health problems from their drinking, either problems they're having right now or maybe in the future. therapist_input communication behavior 101_22 Yeah. Surprised, ain't you? reflection communication behavior 101_24 It sounds like you're drinking a bit more than that right now. reflection communication behavior 101_26 Mm-hmm. From this, uh, drinker's pyramid over on this side of the card, you can see that the-the score on your screening sheet shows that you're up in the harmful category of drinkers. So that it's likely you're drinking, you know, in quantities probably more than about 90% of the folks who come in to see me here at the clinic. therapist_input communication behavior 101_28 It doesn't feel like a problem to you right now, yeah. reflection communication behavior 101_30 Yeah, okay. And then the other thing I should mention, Jill, um, drinking more than these quantities, it's-it's possible it could be pushing your blood pressure up a bit, and I'm wondering if that might be affecting the difficulty we're having getting your blood pressure down right now. therapist_input communication behavior 101_32 Mm-hmm. Yeah, it can sometimes. therapist_input communication behavior 101_34 My perspective as a doctor, it would be good if you could think about cutting back a little bit or doing something different about your drinking. What-what do you think about that? therapist_input communication behavior 101_36 Okay. So on a scale of 0 to 10, 0 being not ready at all to do that and 10 being very ready, where would you lie on that scale? question communication behavior 101_38 Okay. Okay, so that sounds-- I think that's great. So why would you be up at a six and not down at a two level? What kinds of thing would push you to be there? question communication behavior 101_40 Yeah. other communication behavior 101_42 Okay. other communication behavior 101_44 Yeah. Yeah. So you've got some good reasons to try to cut back a little bit. reflection communication behavior 101_46 Yeah. And it sounds like you're willing to maybe try not going to the bar quite as much and maybe drinking a little bit less when you go to the bar. reflection communication behavior 101_48 Okay. So to what levels do you think you could do that? Where-where would you wanna go with your drinking? question communication behavior 101_50 Okay. Okay. other communication behavior 101_52 Mm-hmm. So you'd drink maybe just a couple of times a week and maybe a little bit less on each occasion? Is that what you're saying? reflection communication behavior 101_54 Okay. Okay. other communication behavior 101_56 And you think you're-you're able to cut down to those levels of no more than seven a week? question communication behavior 101_58 Okay. I think that sounds like a great step for you as your doctor. Why don't we revisit this the next time you come in to talk about your blood pressure in about six weeks or so and, um, then we can see how you're doing with it. therapist_input communication behavior 101_60 All right? other communication behavior 101_62 Well, let's get back to your blood pressure then and see what we need to do about that. other communication behavior 103_0 Thanks for coming back, [unintelligible 00:06:00]. I know last time we talked about, uh, maybe going out and joining some activities in the community- other communication behavior 103_2 -to work on meeting some people, so- other communication behavior 103_4 -maybe you could tell me about how that's going? question communication behavior 103_6 Yeah, I know you've mentioned that in the past. When we were talking about the pros and cons of going out to one of these activities- other communication behavior 103_8 -you really mentioned that anxiety- reflection communication behavior 103_10 -is a big con. other communication behavior 103_12 I remember that. other communication behavior 103_14 Okay. To make a change- reflection communication behavior 103_16 -that you've wanted for some time. reflection communication behavior 104_0 Before you go, do you mind if I take a look at the questionnaire you filled out before the visit? question communication behavior 104_2 Thanks. I want you to know that whenever patients and I talk about alcohol and drugs, my role is to share information and learn from what they want to do, if anything. Does that make sense? therapist_input communication behavior 104_4 Great. So, you wrote here that you've used alcohol in the last year on at least eight days? question communication behavior 104_6 Okay. How would you describe your drinking? question communication behavior 104_8 Okay. What kind of alcohol do you drink at parties? question communication behavior 104_10 How much do you think you usually drink at a party? question communication behavior 104_12 Yes. other communication behavior 104_14 Speaker 1: Okay. You checked the box here that drinking helps you feel relaxed, feel better about yourself or fit in? question communication behavior 104_16 And you also checked that sometimes you forget things when you drink. question communication behavior 104_18 What kind of things do you forget? question communication behavior 104_20 Sometimes you forget where you're at. reflection communication behavior 104_22 Here's the part where I share information. The safest level of drinking for teenagers is zero drinks. That's because we know a number of negative things are more likely to happen when adolescents drink. We know alcohol can harm how the brain develops as an adolescent and teens who drink are more likely to hurt themselves by accident. Sexual assault is another thing more likely to happen and so are sexually transmitted diseases. I'm curious, do you think your drinking has anything to do what the possibility of having an STD? therapist_input communication behavior 104_24 Do you remember giving consent when you had sex? question communication behavior 104_26 How do you think drinking alcohol affected using a condom this time? question communication behavior 104_28 Sounds like drinking changes how you think in those moments? reflection communication behavior 104_30 There's something else I wanna share. When people forget where they are or how many drinks they've had, that's a sign of heavy drinking. And when people keep drinking despite experiencing negative consequences, that can be a sign of what we call alcohol use disorder. therapist_input communication behavior 104_32 I'm curious. What do you like about drinking alcohol? question communication behavior 104_34 Okay. And what about your drinking do you not like? question communication behavior 104_36 Anything else? question communication behavior 104_38 Right. So, on one hand, you like the feeling of being relaxed and having fun when you're drinking and on the other hand, you don't like forgetting where you are or forgetting how many drinks you've had and you don't like putting yourself at risk for STDs? reflection communication behavior 104_40 So, when you think about what you like and not like about your drinking, where do you wanna go from here? What would you like to change about your drinking? question communication behavior 104_42 How ready are you to not drink too much? If I asked you to pick a number on a scale of 0 to 10, and 10 being totally ready, what number would you pick? question communication behavior 104_44 Very ready to stop drinking too much. Why do you think you picked such a high number like nine rather than a lower number like a six or a seven? question communication behavior 104_46 Okay. What plan could you come up with to make sure you achieve that goal? question communication behavior 104_48 Great. Who could help you reach this goal? question communication behavior 104_50 Okay. And how about unprotected sex? It sounds like you don't want to experience that again. reflection communication behavior 104_52 All right. So, you're very motivated to change your drinking and you have a plan to keep from drinking more than two drinks at parties and keep from having unprotected sex. I would like to share how it's working for you. What do you think about coming back in six weeks or so? reflection communication behavior 104_54 Great. Thanks for talking with me and I look forward to seeing you again soon. other communication behavior 105_0 . So, um, tell me about the exercise. question communication behavior 105_2 You have? question communication behavior 105_4 That's fantastic. other communication behavior 105_6 So, what else have you noticed other than your-your pants are fitting better? question communication behavior 105_8 Mm-hmm. other communication behavior 105_10 Your-- my what? question communication behavior 105_12 Wow. other communication behavior 105_14 Mm-hmm. So and what would you-- What would- What would help you get to building up to it? Spending more time there. question communication behavior 105_16 Mm-hmm. other communication behavior 105_18 Mm-hmm. other communication behavior 105_20 Mm-hmm. other communication behavior 105_22 Mm-hmm. But you made it-- You made it one day- reflection communication behavior 105_24 -instead of zero days. reflection communication behavior 105_26 That's fantastic. other communication behavior 105_28 Even with this, you know, pretty horrendous schedule going on. reflection communication behavior 105_30 So you-you'd like to get buffed? question communication behavior 105_32 So, but for right now, it sounds like the-- just having the pants fit better- reflection communication behavior 105_34 -sounds really, you know, like it's making you feel good about yourself and— reflection communication behavior 105_36 What other positive things have you noticed about the exercise? question communication behavior 105_38 In what way have you gotten a little bit better? question communication behavior 105_40 So you're at the second thought part. And what do you think would-- might take you, uh, over to actually doing it if you wanted to? question communication behavior 105_42 Mm-hmm. other communication behavior 105_44 Oh, okay. The payoff just wouldn't be worth that two hours of treadmill versus that double fudgy browny thingy. reflection communication behavior 105_46 'Cause it is decadent, it's lovely. therapist_input communication behavior 105_48 Yeah, yummy, so- therapist_input communication behavior 107_0 Well, let's talk about then how you ended up cutting yourself. other communication behavior 107_2 So, what happened. So first of all, tell me what you did, exactly. other communication behavior 107_4 Well, I mean, where did you cut yourself? I know you said you cut yourself when you- question communication behavior 107_6 Like your arm? other communication behavior 107_8 What did you cut yourself with? question communication behavior 107_10 How deep? question communication behavior 107_12 Yeah. Let me see. You know those look to me like they-they-- did you go to the-- It doesn't look like you went and got any stitches, but that looks to me like you could have used them. What do you think? question communication behavior 107_14 Okay, but part of the problem is those look deep and like you're going to have significant scars. So my suggestion is in the future, if you do it, is that you put some sort of bandaid on it to keep it closed. But let's talk about how, um, how this happened. First of all, tell me, you were telling me on that phone that you wanted to die. But, um, did you-- Was this a suicide attempt or do you think it was just-just a cutting? Were thinking of killing yourself or wanting to kill yourself or wanting to die when you did it? therapist_input communication behavior 107_16 Okay. So let's-- Okay, so it sounds like me not being avai-- Was me not being available with you, rela-related to you cutting yourself? question communication behavior 108_0 Well, I want to thank you for coming in today to see me. Um, I do understand from talking with your counselor that you've got quite a bit on your plate, you've got a lot going on. Can you tell me a little bit about that? therapist_input communication behavior 108_2 Yeah, I could see that. Um, may I ask, are you also a single mom? question communication behavior 108_4 So you've got a lot of stressors right now. You're a single mom raising a two-year-old, you're working full time, and you're going back to school. What do you think would be the most helpful for us to focus on today? reflection communication behavior 108_6 Okay. Can you tell me a little bit about that? question communication behavior 108_8 Okay. So I'm hearing you say that the situation with your mom's not ideal. You actually miss class sometime and had to lose some work shifts as well, and that's problematic. reflection communication behavior 108_10 Okay. Um, outside your mom, is there anyone else that can help with childcare? question communication behavior 108_12 Okay. other communication behavior 108_14 Hmm. So what I hear you saying is this neighbor was supportive when you really needed her to be. reflection communication behavior 108_16 Stepped in last minute. Um, when you picked up your son, you didn't have any concerns and he seemed happy? reflection communication behavior 108_18 Okay. Let's pursue that neighbor a little bit. Um, people like that, I like to think of as natural resources, but I know for a lot of people, the major problem with, uh, childcare is affordability. therapist_input communication behavior 108_20 Have you given any thought to, if you'll be able to afford to pay someone on a regular basis to watch your son? question communication behavior 108_22 Yeah, I can understand that. Um, what are some of your natural skills? question communication behavior 108_24 Oh, I bet you're a really good cook then. Um, what would you think about a plan where you worked out an arrangement with this neighbor, where in exchange for her watching your son, you would prepare dinner for her and her, um, daughter? therapist_input communication behavior 108_26 Um, you know, you could maybe swap a meal for child care. What do you think of a idea like that? therapist_input communication behavior 108_28 Okay. Okay, I'm glad you think so. Um, so, other than this neighbor, or is there anyone else that could help you? question communication behavior 108_30 Okay, I can respect that. You-you really have to go with kind of your gut and follow your own intuition on that. Um, what about the baby's father, is he of any help? question communication behavior 108_32 Okay, fine. You know what? We've got one really good lead with the neighbor. I think if you would follow up in pursuing that, you might find some relief and resolve some of your childcare issues. Um, how many days a week are you in school? therapist_input communication behavior 108_34 Okay. Um, so what would it look like if you had a plan where both your neighbor and your mom were helping you out? question communication behavior 108_36 Okay. So what I'm hearing you say is that, if you could just reduce the amount of time that you're needing your mom, she might be more supportive, more onboard? reflection communication behavior 108_38 All right. Um, so what do you think would be your next steps in working out a plan between your neighbor and your mom? question communication behavior 108_40 Okay. Sounds like you got a good plan to follow up on there. All right. Um, now you mentioned that your son is two. When will he turn three? reflection communication behavior 108_42 Okay. Well, in that I-- in that case, I've got another idea for you. Um, what about, um, maybe when he turns three, you could enroll him in Head Start? Are you familiar with that program? therapist_input communication behavior 108_44 Okay. Head Start is a very affordable, very high-quality preschool program. Um, it was really created for parents and families, just like yours, folks who have a lower income and fewer resources, but Head Start really prepares your child both socially and intellectually for going to school. Um, and you know, by the time he turns three, you may find that that routine is something that's better for him to get used to before he starts kindergarten. Uh, would you like some more information on local Head Start sites? therapist_input communication behavior 108_46 Okay. Well, good. Um, all right. It sounds like you've got a good plan there going forward. Um, now I did see from the nurse practitioner's notes, you're also working on reducing your smoking and your drinking. How's that going? question communication behavior 108_48 Okay. So what I hear you say is that it was a bigger challenge than you expected, yeah, but you're working on it. You're-you're still committed to it. So yeah, that's really to be commended. I just want to ask you one thing though. Have you thought about secondhand smoke and the dangers of that and how that might be impacting your son? reflection communication behavior 108_50 Oh, okay, good. You know, I can tell you really have your son's best interest at heart here. You know, just from our conversation today, I can tell you're a really good mom. Um, let's reflect back on what we've discussed here so far. Now, we've got a couple of good options between the neighbor and Head Start programs for childcare. What do you see as your next steps in getting that going? reflection communication behavior 108_52 Okay, okay. Good. Um, I think you've got a good plan there. Um, what would you say to us getting back together, say, in two weeks, just for us to kind of revisit and see what kind of progress you've made, you know, if you've got something worked out, great, but if you've hit a bump in the road, I tell you what, we'll put our heads together. We'll come up with another plan. question communication behavior 108_54 All right. Good. Well, I want to thank you again for coming in today, Sarah. It was really nice to have met you. other communication behavior 108_56 You're very welcome. other communication behavior 109_0 Okay, hard part's over. So the good news is no cavities. therapist_input communication behavior 109_2 Yes, always happy to hear that. I do have some concerns though because I'm seeing some irritation in your mouth in the palate that's called nicotinic stomatitis and- therapist_input communication behavior 109_4 Yeah, it is. It's some damage to the roof of your mouth that happens from tobacco smoking and so I'm wondering if you can tell me a little bit how-- about how tobacco fits in your life right now. question communication behavior 109_6 So you've made a decision in your life not to smoke cigarettes, that's something you didn't want to do. It sounds like you're kinda concerned about the health effects of cigarettes. But you have been smoking the little cigarillos at least one or two every time you go out. reflection communication behavior 109_8 Yeah, so you're not-- You're not like those chain smokers, you're not smoking packs and packs a day. reflection communication behavior 109_10 The amount you smoke is so miniscule you can't even imagine that it would cause any harm and yet here it is damaging the roof of your mouth. reflection communication behavior 109_12 Uh-huh. So smoking has kind of become a big part of your social life now. When you go out, you're smoking, and even during breaks at work, you're smoking. reflection communication behavior 109_14 So aside from that social aspect, what are the things you like about it? question communication behavior 109_16 Okay. other communication behavior 109_18 Okay. How about the other side? Have you noticed any not-so-good things about the smoking? question communication behavior 109_20 Yeah. So we're noticing some pretty negative effects in terms of your oral health with the smoking. Are there any other things that you're concerned about? question communication behavior 109_22 Mm-hmm. So there's your oral health, there's the financial aspect, and then e-earlier you brought up some concerns about smoking cigarettes and how that can be harmful for you. reflection communication behavior 109_24 Were you aware of the fact that smoking these little cigarillos, the Swisher Sweets, can have some of the same negative health effects? question communication behavior 109_26 Mm-hmm. So it's kind of surprising to you that something you've been doing and you've been doing more and more of it is actually pretty bad for you. reflection communication behavior 109_28 Mm-hmm. What do you kind of make of that now that you realize that you're actually a tobacco user and that you might actually be causing some pretty se-serious health effects. question communication behavior 109_30 Mm-hmm. other communication behavior 109_32 Well, the good news is in terms of the nicotinic stomatitis, at the point in which you stop smoking, you can actually reverse all the negative effects that occurred and you might also know that you can stop the progression of any other diseases that had started, just by quitting smoking. therapist_input communication behavior 109_34 Yeah. Is that something you'd be interested in? question communication behavior 109_36 Mm-hmm. Well, if you think about it on a scale of 1 to 10 where 1 is really don't think you could do it at all and 10 is really confident that you could quit if you tried, where do you think you fall? question communication behavior 109_38 Okay, what made you choose seven or eight as opposed to a-a five? question communication behavior 109_40 Mm-hmm. So, it sounds like just to kind of summarize, you've noticed some negative effects of the smoking, you have some concerns about health effects that could occur, there's the financial aspect, and yet you feel pretty confident that you could quit if you tried. So, where do you think we should go from here? reflection communication behavior 109_42 Okay, well, I'd be happy to talk to you more about that and give you some tips and advice and give you some suggestions about where you can get some support with quitting. therapist_input communication behavior 109_44 I really appreciate you talking to me about this today. other communication behavior 110_0 --today. other communication behavior 110_2 Okay. So, you want your son to grow up in a great environment and to have more than you had? reflection communication behavior 110_4 Is that right? so that's on your mind right now? question communication behavior 110_6 Mm-hmm. other communication behavior 110_8 Mm-hmm. Is there anything in particular that's happening right now where this is more of a concern for you than usual? other communication behavior 110_10 What you want to do in life? Can you explain? question communication behavior 110_12 So you feel that your differences in career choices is-is having an impact on your relationship with your son? reflection communication behavior 110_14 Mm-hmm. other communication behavior 110_16 Mm-hmm. other communication behavior 110_18 Mm. Okay, so your boyfriend? question communication behavior 110_20 Is he your fiance or your boyfriend? question communication behavior 110_22 Okay. other communication behavior 110_24 Okay. And he's a truck driver? question communication behavior 110_26 Does he drive long distances- question communication behavior 110_28 -or just local? question communication behavior 110_30 And so sometimes he's gone away from home for, what like, days, weeks? question communication behavior 110_32 Okay. And so he's a truck driver and you are an aspiring social worker, and you have a son who you want to give a really great life to, and you feel that you and your boyfriend are in different, going in different directions- reflection communication behavior 110_34 -maybe? Is-- Can you elaborate on the part that you're maybe the most concerned about or that's the most on your mind right now? question communication behavior 110_36 Mm-hmm. other communication behavior 110_38 Okay, okay. And so that-that realization that you're having right now is, it sounds like, it seems like maybe, just from your nonverbal, that maybe you feel like you need to make some sort of a choice. Is that right? reflection communication behavior 110_40 Yeah? Okay. reflection communication behavior 110_42 Mm-hmm. other communication behavior 110_44 Well, you know that he's not physically available- reflection communication behavior 110_46 -to do these things that you want to do- reflection communication behavior 110_48 -like go on picnics. reflection communication behavior 110_50 "He's saying to you, ""why is it a problem?""" reflection communication behavior 110_52 Mm-hmm. other communication behavior 110_56 Yeah. other communication behavior 110_58 So, your heart says you want this great relationship where there's like a true family unit and you can go on picnics and be together but your mind says, what? reflection communication behavior 110_62 Mm-hmm. other communication behavior 110_64 Mm-hmm. other communication behavior 110_66 Mm-hmm. other communication behavior 110_68 Mm-hmm. other communication behavior 110_70 Mm-hmm. other communication behavior 110_72 Mm-hmm. other communication behavior 110_74 Okay, so you know what you want, you're not so sure that your boyfriend wants the same thing. His actions indicate that he doesn't. reflection communication behavior 110_76 His words indicate that he does or he doesn't? You're not sure? I'm not sure about that part either? question communication behavior 110_80 Yeah. other communication behavior 110_82 Mm-hmm. So now you have this information and it's on your mind, is there-- have you given any thought about what you might want to do about it? question communication behavior 110_84 Mm-hmm. other communication behavior 110_86 Mm-hmm. [chuckles] other communication behavior 110_88 Mm-hmm. other communication behavior 110_90 Mm-hmm. other communication behavior 110_92 Mm-hmm. other communication behavior 110_94 Mm-hmm. other communication behavior 110_96 Oh. other communication behavior 110_98 So that's another realization. reflection communication behavior 110_100 "It's like, ""Wow,"" it's really, really prevalent for you right now, you realize that you are the caretaker, you are the person who listens to other people but you don't necessarily have someone like that for you and so—" reflection communication behavior 111_0 Hi, are you Katie? question communication behavior 111_2 Hi, my name is Beth. I'm the nurse that works with the nurse practitioner Mrs. Smith that you just saw. Do you have a moment to talk? therapist_input communication behavior 111_4 I know you were here to get a prescription for birth control but while you were waiting to see Mrs. Smith, you filled out a healthy habits questionnaire- therapist_input communication behavior 111_6 -and you answered some questions about your marijuana use. Would it be okay if I asked you some questions about how marijuana plays a role in your life? question communication behavior 111_8 I notice you use marijuana regularly, and I wanted to ask you more about that. therapist_input communication behavior 111_10 No. No, no, no. Not at all. Um, I just wanted to ask you how it helps you and how you use it. Can you tell me a little more about how you use it? question communication behavior 111_12 Marijuana is really useful in your life in helping you relax? reflection communication behavior 111_14 Mm. You're a very successful student and you have a lot of responsibilities, and it's really adding to your stress. reflection communication behavior 111_16 Mm. You've been very successful academically and the transition to college has been hard for you. reflection communication behavior 111_18 I promise you, you're not in trouble, I wanna help. therapist_input communication behavior 111_19 Uh, tell me besides helping you relax, what are some positives about pot? question communication behavior 111_21 Hmm. Uh, when you use pot in a group you feel more at home with your peers and more accepted? reflection communication behavior 111_23 So how is it working to help you fit in? question communication behavior 111_25 Mm. So smoking pot with your peers to try to fit in more but it doesn't seem to be making you feel more comfortable with your friends. reflection communication behavior 111_27 What are some downsides to smoking pot? question communication behavior 111_29 So smoking pot doesn't help you feel more socially comfortable with your peers and it increases your stress because you're worried about your family and legal consequences? reflection communication behavior 111_31 Can you think of any other downsides to smoking pot? question communication behavior 111_33 So smoking pot also reminds you of your financial situation and you don't have extra cash to spend on things? reflection communication behavior 111_35 Katie, it sounds like smoking pot is helping you somewhat in helping you relax and it's also causing you a lot of stress because you're trying to use it to fit in and that's not helping, you're worried about getting caught, you're worried about family disapproval. Having said all that, what do you think you wanna do about your pot use? reflection communication behavior 111_37 Would it be okay if I made a suggestion? question communication behavior 111_39 You mentioned at the beginning of our conversation that you have a history of dealing with anxiety, have you ever talked to a counselor about that? question communication behavior 111_41 Can you tell me more? question communication behavior 111_43 Mm. So the idea of counseling in your family is for crazy people only and it's looked down upon and the cost would cause a problem too? reflection communication behavior 111_45 Katie, we know that many kids come to college and have a lot of stress and deal with a lot of anxiety, and we've also found that when they talk to our counselors and learn specific skills about dealing with anxiety, they do much better. Um, and it's been really successful for a lot of kids. Um, I'm wondering if you think it might be helpful for you? therapist_input communication behavior 111_47 Can you describe why you're hesitant? question communication behavior 111_49 Well, the cost is free and the counseling services we provide, we are legally obligated to protect your privacy. We can't tell your parents. There are some exceptions to that privacy rule, including, uh, mostly if we're concerned about- that your safety. therapist_input communication behavior 111_51 Exactly. other communication behavior 111_53 Well, uh, we can go into some more specifics if you decide to see the counselor about what-what privacy rules there are, but for the most part, you wouldn't need to worry about us sharing anything with your parents. therapist_input communication behavior 111_55 So, uh, if-if you're walking out now, I can walk out with you and just take you around our counseling center. I can even introduce you to one of the counselors. therapist_input communication behavior 111_57 No. No, no. I just wanted to show you where it is and let- make sure you know about our resources here at the college. therapist_input communication behavior 112_0 So, Chris, I wanted to talk to you. Um, you know, you're one of our star athletes. I really value you as a team player. As Athletic Director, one of my jobs is to, kind of, keep tabs on the players and make sure everybody is performing at their best. And something came up this weekend. I've been hearing some chatter about a big party that went down and understand you were there. And so I wanted to talk to you a little bit about how partying and alcohol fits in your life right now. therapist_input communication behavior 112_2 Mm-hmm. other communication behavior 112_4 Mm-hmm. other communication behavior 112_6 So, here you are. You're an honors student. You're a star athlete. You've, kind of, been doing everything you've been told for all these years, and maybe last month sometime, you started getting more involved in the party scene. reflection communication behavior 112_8 And it was fun at first. But now you're already noticing some consequences. reflection communication behavior 112_10 Mm-hmm. other communication behavior 112_12 It's really changed your focus. What do you like about drinking? question communication behavior 112_14 So, it helps you, kind of, loosen up, feel more relaxed. reflection communication behavior 112_16 Sounds like you're noticing quite a few not so good things about alcohol though your mom got mad at you, you're having decreased focus, you're, kind of, not doing so well in school, maybe- reflection communication behavior 112_18 -or any other things? question communication behavior 112_20 Mm-hmm. other communication behavior 112_22 So, your-your friends that you were hanging out with, there's a little tension there now. reflection communication behavior 112_24 Mm-hmm. other communication behavior 112_26 Okay. other communication behavior 112_28 Well, given that you've sort of noticed all these changes where it's affecting your friendships, it's affecting your studying, it's affecting your relationship with your mom. Where do you think you should kind of go from here? question communication behavior 112_30 Mm-hmm. other communication behavior 112_32 Mm-hmm. other communication behavior 112_34 Yeah. other communication behavior 112_36 Your mom is really important to you. reflection communication behavior 112_38 And how she feels about you is important to you. reflection communication behavior 112_40 How important is it to you to make, uh, an adjustment in your drinking or even to quit? question communication behavior 112_42 Okay. other communication behavior 112_44 Okay. other communication behavior 112_46 How confident are you that you could actually change your drinking or-or even cut down or quit? question communication behavior 112_48 O-on a scale of 1 to 10 where one is not at all 10 is completely what number would you give. question communication behavior 112_50 Okay. other communication behavior 112_52 Why did you say eight or nine rather than six or seven? question communication behavior 112_54 Mm-hmm. other communication behavior 112_56 All right, what do you think's a realistic goal for you then? question communication behavior 112_58 Mm-hmm. other communication behavior 112_60 So your goal is kind of to do not drink at all or if you are at a party, uh, a maximum of one at the very most. reflection communication behavior 112_62 Yeah. Chris, I really appreciate you talking with me about this. I know it seems like something that's been on your mind as it is and, you know, like I said I really care about you as a student and an athlete and want what's best for you. So I'm glad we were able to talk about this. It really seems like you have a good plan going forward, you know, really striving for not drinking alcohol at all and if you find yourself in a situation where there's alcohol, making sure to have that limit of one drink maximum. It sounds like something that will work for you. reflection communication behavior 112_64 It's my-- yeah it's my pleasure. It's part of my job and it's probably like this so. I'm going to hurry up and get changed for practice. therapist_input communication behavior 113_0 Hi, Sandra. other communication behavior 113_2 Thanks for coming in and talking with me for a couple of minutes. I understand you don't have very much time, but I really appreciate you stopping by. reflection communication behavior 113_4 So I get the impression that there are some things that you're concerned about, but that overall, coming in here wasn't necessarily the first thing that was on your mind when you came to the hospital with your daughter. Um, so can you tell me, what was it that made it possible for you to even come in? What-what were some of the things you were thinking about? reflection communication behavior 113_6 So the last thing you'd want is for your daughter to start smoking. reflection communication behavior 113_8 Hmm. And it sounds like your smoking, setting an example, those are some things that-that you're also, uh, a bit concerned about, um, but as you said earlier, not-not really ready to put down your cigarettes immediately. reflection communication behavior 113_10 So Sandra, what's good about smoking? What do you like about it? question communication behavior 113_12 What else? Tell me what else is good about it. question communication behavior 113_14 Okay. So is there anything else that you like about it? question communication behavior 113_16 So let me make sure that I understand all of the good things about smoking, the things that you like about it, and let me know if I've missed anything or left anything out. reflection communication behavior 113_18 So it sounds like it's a way to relax. It's a way to socialize with your friends from work, and it's hard to imagine what it would be like for you at work if you couldn't go outside and smoke. reflection communication behavior 113_20 You also mentioned that smoking is a way to manage your weight, and concern that if you were-were going to quit smoking, what that would do in terms of, um, gaining weight, and that smoking after meals is pleasurable, that it's something that would be really hard to give up. reflection communication behavior 113_22 I also heard that it's very much a part of your life. It's something that you've done for a really long time and almost impossible to think about yourself as a non-smoker. Does that capture, for you, some of the good things or things that are keeping you smoking? reflection communication behavior 113_24 So I'm hearing there are some things you really like about smoking. What about the other side? Can you tell me about some of the not-so-good things? reflection communication behavior 113_26 Sandra, can you give me an example of a time that you did something that you think left an impression on your daughter or set a bad example for her? question communication behavior 113_28 So this morning, that experience, it really brought home how she does watch you, and she does really look up to you and notice what you do. How did that feel when you looked up and saw her watching you? reflection communication behavior 113_30 And again, thanks for your honesty in talking about this. I appreciate that this is a- this is a tough topic. This is a-a hard behavior to think about giving up. Um, I guess one thing that- one thing that doesn't make sense to me is that, you know, on the one hand, you talk about how being a good parent is your highest priority, it's really important to you to set a good example for your daughter- reflection communication behavior 113_32 -um, and on the other hand, I'm hearing you say that smoking is important in terms of stress relief, socializing, and it's something you can't imagine ever changing. How do those two things fit together? question communication behavior 113_34 So what would it take for quitting or changing your smoking to be something that was more important, that raised it up in the list of priorities for you? question communication behavior 113_36 Okay. other communication behavior 113_38 "So, it's-it's not so much that you don't wanna quit in a way, it's almost, ""How could I do it that would work for me?""" reflection communication behavior 113_40 Okay. I appreciate. We've- we've probably used up the time that we have. I would love to see you next week if you'd be willing to schedule another appointment and talk with you more about this. Is that something that would be helpful? therapist_input communication behavior 113_42 Okay. So I hear-- [crosstalk] other communication behavior 113_44 [chuckles] Not necessarily the-the most exciting thing for you to do, but I appreciate you are willing to do that. Can I also ask you to do a little bit of homework between now and next week? I promise it's not too time-consuming. Um, we have a booklet that we like to give folks who are just thinking about changing, who aren't sure that this is something that they're ready to do, and one of the exercises is to write down your top three reasons for change, why you would even consider quitting smoking. And then to reflect on some of the good things as we talked about, as well as some of the less good things about quitting and about continuing to smoke. Is that something you'd be willing to do over the next few days? therapist_input communication behavior 113_46 Okay, here you go. other communication behavior 113_48 So thanks for coming in, Sandra. We'll see you next week. reflection communication behavior 114_0 In summary, the Minnesota State Mankato security report states that you were stopped on stadium road last Friday, cited for driving under the influence and you're transported to detox. Plus the report lists your age as 20. Dylan, what is the accuracy of the report? And can you share with me some details leading up to the incident? question communication behavior 114_2 You decided to drink more than you intended because you were disappointed at how the Vikings were playing. And when your roommate couldn't give you a ride home, you decided to drive yourself home. Did I get that right? therapist_input communication behavior 114_4 Yeah, I understand that your intention was to have a good time while watching the game with your friends. You didn't think about what could go wrong when you drank alcohol underage because you were at your friend's house and not a big party and you made an effort to be safe by finding a ride home. reflection communication behavior 114_6 Dylan, you told me what brought you here today, what do you think the problem really is? question communication behavior 114_8 Sounds like you attribute your current situation to bad luck. If that's what you believe and you don't attempt to make any change in your behavior, what consequences might result? question communication behavior 114_10 How important is it that you avoid future problems with the police or school, Dylan? question communication behavior 114_12 Yeah. What would you be willing to do to prevent going to detox again and getting suspended? question communication behavior 114_14 On a scale of 1 to 10, how confident are you that you'll be able to follow through with that plan with 10 being very confident? question communication behavior 114_16 What steps could you take to move that six to a seven or eight? question communication behavior 114_18 "In what ways might your life be better if you succeed in making the changes you mentioned?" question communication behavior 114_20 College is all about making choices. Can you tell me about your beliefs and values that influenced your decision-making and how do those beliefs and values align with the decisions you plan to make about drinking? question communication behavior 114_22 Thanks for coming in for participating today. Your sanction will involve being placed on university disciplinary probation and attending an alcohol education seminar that will cost $150. therapist_input communication behavior 116_0 Molly, thank you so much for coming over and yakking with me today. other communication behavior 116_2 Yeah, I appreciate it. So, um, uh, your mom had given me a call and said that, um, um, there were some problems with kids kinda given you problems at school and being mean and things like that, and, uh, that's a hurtful thing. therapist_input communication behavior 116_4 That's a- that's a lot of school to, yeah, and, you know-- therapist_input communication behavior 116_6 People like to make up stories. reflection communication behavior 116_8 For, like why do you think, wh-what kinds of- question communication behavior 116_10 So it's, uh, so when you were talking about like nagging on, tell me a little bit more about, can you give me an example of what you mean? question communication behavior 116_12 And-and what happens when you don't leave it be, what usually happens? question communication behavior 116_14 Okay. other communication behavior 116_16 Okay. other communication behavior 116_18 Okay, so and then what-what's it like for you after that, once you get spanked in the principal's office? question communication behavior 116_20 Mm-hmm. other communication behavior 116_22 Mm-hmm. other communication behavior 116_24 That's pretty cool that you did that. reflection communication behavior 116_26 You should be proud of yourself, and how did you do that? question communication behavior 116_28 Uh, that says a lot about you and your mom's relationship though that you can kind of put yourself in her head and think about how she would feel about it. reflection communication behavior 116_30 You know what I mean? It's pretty cool, not everybody can do that, so. So you could kind of put yourself ahead, uh, it's almost like watching a movie ahead- reflection communication behavior 116_32 -and knowing how it's gonna turn out. reflection communication behavior 116_34 That's the worst, the silent treatment. reflection communication behavior 116_36 Yeah, so, um, so but that worked for you, where you just let it go, you thought about your mom, you like what we would call like, you channeled to your mom, you know, and, uh, channeling mom, and then, um, you were able to walk away, and you were proud of yourself and nothing bad happened. reflection communication behavior 116_38 Is that right? question communication behavior 116_40 Does it-- question communication behavior 116_42 Yeah, so- and so when you- when somebody else told you that they or people said you that you're an easy target, um. question communication behavior 116_44 Okay. other communication behavior 116_46 Okay, so they-they kinda know how to hook you. reflection communication behavior 116_48 -and reel you in- reflection communication behavior 116_50 -right, and get you upset. And then bad things happen and then you get in trouble. reflection communication behavior 116_52 Yeah. So, yeah. And it's, uh-- So, um-- so you-you know that when you're kind of channeling your mom, that helps. It sounds like you taught yourself almost. Like there's- reflection communication behavior 116_54 -a conversation inside. What other ideas do you have about what you could do? question communication behavior 116_56 Mm-hmm. other communication behavior 116_58 I don't know what pickleball is. other communication behavior 116_60 It looks like a pickleball? question communication behavior 116_62 There's no pickle? question communication behavior 116_64 Okay. other communication behavior 116_66 I wanted to pickle and stuff. other communication behavior 116_68 That's a really good decision. other communication behavior 116_70 Yeah. No, but how smart on your part to know that if you would- if you would had to play with her, something bad would've happened. reflection communication behavior 116_72 You knew that. question communication behavior 116_74 Right? You knew that. So- question communication behavior 116_76 So you know actually which kids- question communication behavior 116_78 -know how to push your buttons that real you in. reflection communication behavior 116_80 That's okay. That's-- Yeah, 'cause it's not important. The important thing is for you to be happy. And, uh-- other communication behavior 116_82 Uh-huh. other communication behavior 116_84 Uh-huh. other communication behavior 116_86 Yeah. other communication behavior 116_88 Yeah. That's-- that-- it's-it's really big unknown territory. Pressure High School class is probably 1,000 kids. reflection communication behavior 116_90 1,003 kids. other communication behavior 116_92 2,000- therapist_input communication behavior 116_94 -potential enemies, friends, who knows which ones. reflection communication behavior 116_96 That must have been hard for you. reflection communication behavior 116_98 Yeah. other communication behavior 116_100 Mm-hmm. So but finally after three months, time went by- reflection communication behavior 116_102 -and you got-- question communication behavior 116_104 Okay. And so how else do you identify who your friends are that you can really trust who have your back? question communication behavior 116_106 You trust her back then? question communication behavior 116_108 Okay. Well, that makes a lot of sense that people-- it goes both ways. reflection communication behavior 116_110 You know. And, um-- So and for you, friends that, um, kind of, um, give you the attention that you'd like to have. Texting you- reflection communication behavior 116_112 -calling and you hanging out with you, and stuff like that, rather than pretending to be a friend- reflection communication behavior 116_114 -when you know maybe they're gonna-- reflection communication behavior 116_116 Mm-hmm. other communication behavior 116_118 Mm-hmm. other communication behavior 116_120 Mm-hmm. other communication behavior 116_122 Mm-hmm. Wh-what don't you like about her? question communication behavior 116_124 Okay. So she sounds like she's, um-- reflection communication behavior 116_126 Or-or not worth your time. reflection communication behavior 116_128 She's not worth your time. So what would it be like for you to really just spend time with the friends that you know are really-- question communication behavior 116_130 Good. That's really good. Yeah. And if-if you need like some extra support from them-- question communication behavior 116_132 Right, and what kind of things do you ask from them? question communication behavior 116_134 'Cause they can do that. They can- they can kinda give you some, uh, information like, uh, um-- they can give some accurate information, um, and back up your story versus the other person's story. question communication behavior 116_136 So, okay. So we're-- You know what? Um, it sounds like you actually have some pretty good ideas about, um, how to handle this, and yet kids are-- I know kids-- actually, adults can be really mean too. But, um, I know in high school, i-it's really bad. reflection communication behavior 116_138 So I'm wondering if, um, uh, if-if you wanted to, we could get together again and continue to talk 'cause you-you've got some good ideas already. And I'm very open that if you wanted to bring any of your good friends in, that that would also be totally cool too. therapist_input communication behavior 116_140 So would that be something-- question communication behavior 116_142 Yeah. other communication behavior 116_144 Okay. other communication behavior 116_146 Yeah. other communication behavior 116_148 Well, I would want this session though to be for you though, Molly. therapist_input communication behavior 116_150 I mean I'm willing to see her too, you know. therapist_input communication behavior 116_152 It sounds like she really needs-- she'd like someone to listen to her. reflection communication behavior 116_154 Yeah. So, um, we could maybe talk about some other ways of, um, helping, uh, deal with this because, um, it does sound like, um, people are, you know, just being plain old mean to you for no good darn reason. reflection communication behavior 116_156 Yeah. And, um, so you'd be willing to come back and talk about it then? Okay. All right. And I just wanna let you know that I think that you're, um, really doing a good job of-of, uh, dealing with how hard it is to be in high school, 'cause it is hard. reflection communication behavior 116_158 It is. other communication behavior 116_160 Yeah. And it is hard, and-and I-I think it gets better. My experience was it got a little better. The freshman and sophomore year, you know. reflection communication behavior 116_162 But, um, anyway, I think you are hanging in there beautifully, and I love hearing that you're involved in swimming and some other things 'cause they must help connect you up with some pretty-- I would hope- other communication behavior 116_164 -[unintelligible 00:13:12] people. So okay, anything else? No? Okay. All right. question communication behavior 116_166 Thank you. other communication behavior 117_0 Hello, nice to meet you again. And, uh, and what seems to be the-the problem or what-what prompted you to come along? question communication behavior 117_2 Okay, so you feel as if drinking is a problem for you at the moment? reflection communication behavior 117_4 Okay. Wh-What makes you say that it's gotten worse? question communication behavior 117_6 Okay. other communication behavior 117_8 Yes. other communication behavior 117_10 Sure. other communication behavior 117_12 Okay, okay, so you've noticed over, I guess, uh, the last six months in particular since you decided, you know what? I'm going to take a risk and-a-and go out to try to meet a-a-a pot-potential partner again that it's with an increase in drinking. reflection communication behavior 117_14 Okay. other communication behavior 117_16 Sure, sure. So you're noticing that the drinking at the moment is a way of perhaps calming the nerves? reflection communication behavior 117_18 To-to-to speak to-to potential partners? reflection communication behavior 117_20 Who-who-who, boys? question communication behavior 117_22 Okay. other communication behavior