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stringlengths 1
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|---|---|---|---|
37_10
|
Things are looking pretty good.
|
reflection
|
communication behavior
|
37_12
|
So you've rung your mom, had a chat to her.
|
other
|
communication behavior
|
37_14
|
Any other whānau members? You talked about your brothers and sisters last time.
|
question
|
communication behavior
|
37_16
|
Here in Christchurch?
|
question
|
communication behavior
|
37_18
|
Okay.
|
other
|
communication behavior
|
37_20
|
No?
|
question
|
communication behavior
|
37_22
|
What are you not sure about?
|
question
|
communication behavior
|
37_24
|
Okay. Just sort of interested, when you rang your mom and, um, told her what's happening, how difficult was it to talk about the issue of violence and being violent towards your partner?
|
question
|
communication behavior
|
37_26
|
We-we talked about, uh, last time that this is hard stuff and that, um, we are prepared to kind of do the hard yard. So you've gone away, you've talked to your folks, put it out there about your issue of violence? Um, I'm thinking about, uh, with-with Tristan and the whole alcohol issue there. So it sounds like to me if you've- you've started to put quite a bit of stuff in place.
|
reflection
|
communication behavior
|
37_28
|
Yeah. What does it tell me about you as a man, as a father, as someone who wants to get moving?
|
question
|
communication behavior
|
37_30
|
Grand. You talked a little bit about, uh, you'd really like to get back with Kristie?
|
question
|
communication behavior
|
37_32
|
And-and-and your kids and developing that whānau. Have you had an opportunity to get in touch with her and—
|
question
|
communication behavior
|
37_34
|
Right.
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other
|
communication behavior
|
37_36
|
Okay. So what do you think you're gonna need to do to show her and others, uh, to convince them that you are serious?
|
question
|
communication behavior
|
37_38
|
Mm-hmm.
|
other
|
communication behavior
|
37_40
|
Yeah.
|
other
|
communication behavior
|
38_0
|
Hi, Sarah, it's great to meet you. My name is Delwyn, and I'm a counselor here at the clinic. And I heard from your nurse practitioner that you recently had an annual exam in which the topics of smoking and alcohol use came up. Would you mind filling me in a little bit about that?
|
question
|
communication behavior
|
38_2
|
So, you've decided you wanna cut back on your smoking a little bit, but, you're not really concerned about your drinking.
|
reflection
|
communication behavior
|
38_4
|
It's a nice sort of form of stress relief.
|
reflection
|
communication behavior
|
38_6
|
Sort of escape from your hectic schedule.
|
reflection
|
communication behavior
|
38_8
|
So, you're working, and then, on top of that, juggling being a single mom and going to school?
|
reflection
|
communication behavior
|
38_10
|
It's pretty exhausting work.
|
reflection
|
communication behavior
|
38_12
|
So, you're not only doing really tiring work and going to school, but you're also worrying about your finances.
|
reflection
|
communication behavior
|
38_14
|
Yeah, it does. It sounds like a lot that you're trying to deal with, and it makes sense that you feel like you need some kind of break or reward.
|
reflection
|
communication behavior
|
38_16
|
So, tell me a little bit more about your drinking. Tell me a little bit about how much you're drinking, and, um, the pattern, and what raised concern.
|
question
|
communication behavior
|
38_18
|
So, you're drinking, perhaps, two drinks a day. Um, and I'm wondering, what have you heard about the recommendations for drinking levels?
|
question
|
communication behavior
|
38_20
|
Okay, will you be interested in hearing about those recommendations?
|
question
|
communication behavior
|
38_22
|
Okay. Well, so, the recommendation for women is to have no more than three drinks a day, and no more than seven drinks over the course of a week. Yeah, um, and, really, the reason for those recommendations is to just reduce the risk that people have trouble with accidents, or chronic diseases. Like certain types of cancers, or high blood pressure, and then also psychological problems. I don't know what you think about all that?
|
question
|
communication behavior
|
38_24
|
It just doesn't seem that abnormal to you, especially when you compare it with your family.
|
reflection
|
communication behavior
|
38_26
|
Yeah, you really feel like you need that reward.
|
reflection
|
communication behavior
|
38_28
|
And then it also sounds like, um, your drinking has perhaps increased a little bit over time?
|
question
|
communication behavior
|
38_30
|
Yeah, and so it sounds like you've noticed that the more stressed you're feeling, the more you're drinking.
|
reflection
|
communication behavior
|
38_32
|
So, let me summarize a little bit what you've told me. It sounds like you have a pretty hectic, stressful life, and you really feel like you need some kind of-
|
reflection
|
communication behavior
|
38_34
|
-reward or stress relief. Um, and then, on the other hand, you've noticed, um, that your drinking has increased a little bit over time. And also that the more stressed you're fe- you feel, the more you're inclined to drink.
|
reflection
|
communication behavior
|
38_36
|
So, I'm wondering, have you noticed any problems from your drinking?
|
question
|
communication behavior
|
38_38
|
So, you've noticed that it's starting to call to you a little bit in the evenings.
|
reflection
|
communication behavior
|
38_40
|
And it's perhaps taking you away from things that are more important to you?
|
reflection
|
communication behavior
|
38_42
|
And it doesn't feel good?
|
reflection
|
communication behavior
|
38_44
|
Yeah. And so, it sounds like there's a bit of a dilemma there, because-- And I guess we should be clear, it's not the occasional drink that's an issue. Um, it's-it's really the quantity of drinking, and-and whether your drinking is escalating and interfering with things that are, perhaps, more important.
|
reflection
|
communication behavior
|
38_46
|
And you've perhaps never seen it in that light before.
|
reflection
|
communication behavior
|
38_48
|
I-it seems like it-it would be quite a hard pattern to change.
|
reflection
|
communication behavior
|
38_50
|
So, it seems like it would be really difficult to change because it's something that's really important to you right now.
|
reflection
|
communication behavior
|
38_52
|
But on the other hand, it does sound like there are things that you- that you value that you don't want the drinking to interfere with.
|
reflection
|
communication behavior
|
38_54
|
So, I guess I'm wondering if you've given any thought to other ways in which you could cope with stress without relying on the drinking so much.
|
question
|
communication behavior
|
38_56
|
So, if you could somehow tackle some of these stressful issues, um, that could make a difference, and, what-what would that be, for example?
|
question
|
communication behavior
|
38_58
|
So, having more reliable childcare could make a big difference.
|
reflection
|
communication behavior
|
38_60
|
And it sounds like your mom has been an option in the past, but perhaps not so much anymore.
|
reflection
|
communication behavior
|
38_62
|
So, one thing that could make a big difference is if you could figure out some sort of more reliable, affordable childcare, and that would help you not want to drink as much.
|
reflection
|
communication behavior
|
38_64
|
Anything else?
|
question
|
communication behavior
|
38_66
|
Yeah. It-it sounds like, um, you know, money could make a big difference, and you are working full time and trying to go to school to address that in the long run. Um, but on the other hand, you know, it sounds like you have some other ideas of cope- of how you might cope with stress better. Um, so, I guess I'm-I'm wondering, given our conversation so far, kind of where you are with everything.
|
question
|
communication behavior
|
38_67
|
Um, we started off talking about how your drinking has sort of drifted into a risky area, and it would be advisable to cut back. Um, but it sounds like you feel like that's fairly important to you and not something you necessarily want to do. But on the other hand, we've talked about ways in which that perhaps could be made a bit easier, but I'm not sure if you're ready to tackle that or pursue that right now. I'm just kind of wondering where you are.
|
question
|
communication behavior
|
38_69
|
So, um, it would perhaps be helpful if you could narrow it down to just one thing, and what would that be?
|
question
|
communication behavior
|
38_71
|
Okay. Yeah. It sounds like from everything you're saying, that keeps coming up as one of the main issues. Um, so there may be some resources I can point you towards, but I'm- guess I'm wondering, have you looked into alternatives, more affordable, reliable childcare?
|
question
|
communication behavior
|
38_73
|
Okay. Well, one thing you could consider is talking to one of our social workers, they sort of specialize in helping people who have a lot on their plate identifying resources that they may need, uh, things you haven't thought of or aren't aware of. So, I don't know, would you be interested in doing something like that?
|
question
|
communication behavior
|
38_75
|
Okay. Great. Well, I can definitely set you up with that, and you can-
|
other
|
communication behavior
|
38_77
|
-um, try to tackle, um, your childcare issue, um, with some assistance. Is there anything else you'd like to do, um, for example, would you be interested in talking with me again, um, just as things progress?
|
question
|
communication behavior
|
38_79
|
Yeah. So, these are not problems that are going to go away in a week. It's going to take some time to resolve. Okay, great. So, um, it sounds like we have a couple of things, uh, to pursue.
|
other
|
communication behavior
|
38_81
|
Anything-anything else?
|
question
|
communication behavior
|
38_83
|
Would you be interested in perhaps thinking about setting a goal with respect to your drinking?
|
question
|
communication behavior
|
38_85
|
Okay. Try to cut back a bit and see how that goes.
|
reflection
|
communication behavior
|
38_87
|
Okay. So, you can give it a go and, I think doing managing, you might just learn a little bit about how easy or difficult it's going to be, and-and also what it's like to cope with stress in other ways.
|
reflection
|
communication behavior
|
38_89
|
Okay. So, it sounds like we have two avenues to pursue, anything else?
|
question
|
communication behavior
|
38_91
|
Okay. Well, that sounds good. So, why don't we meet again in a couple of weeks and you kind of update me on how cutting back on your drinking has gone, and also, what it was like when you met with a social worker? Sound good?
|
question
|
communication behavior
|
38_93
|
Okay, great. I look forward to talking next time.
|
other
|
communication behavior
|
39_0
|
Um, so you've talked a bit about like the emphysema. Um, what did the doctors say to you when you were diagnosed? I mean the obvious, right?
|
question
|
communication behavior
|
39_2
|
Mm-hmm. Finger comes out.
|
reflection
|
communication behavior
|
39_4
|
Mm-hmm. And there was a war going on?
|
reflection
|
communication behavior
|
39_6
|
Yeah. Well, and your daughter.
|
reflection
|
communication behavior
|
39_8
|
And the social stigma, because you don't want your daughter to think of you like that, whatever that- that as a smoker, you know. You know there're people who make the assumption and it- it sounds like those are more important to you than the medical things, and who cares why it's important?
|
reflection
|
communication behavior
|
39_10
|
It doesn't matter. So what- what ideas do you have about what might be most helpful for you in quitting smoking?
|
question
|
communication behavior
|
39_12
|
So that was helpful for you that it's a, um, I can't remember. I know what you're trying to get a little ball.
|
reflection
|
communication behavior
|
39_14
|
It shows you your lung capacity.
|
therapist_input
|
communication behavior
|
39_16
|
But it might be helpful if you- if you quit or it's, you know, it did if you were gonna decrease or whatever, to see how much better you're doing with the ball going up and your lung capacity increasing, is it?
|
therapist_input
|
communication behavior
|
39_18
|
Okay.
|
other
|
communication behavior
|
39_20
|
So, I don't even know where you can get those. I think—
|
other
|
communication behavior
|
39_22
|
Oh, you have one?
|
question
|
communication behavior
|
39_24
|
Oh, okay- okay.
|
other
|
communication behavior
|
39_26
|
Oh, did you?
|
question
|
communication behavior
|
39_28
|
Okay. All right.
|
other
|
communication behavior
|
39_30
|
It's so interesting because there's immediate feedback. I mean, that's immediate feedback. Um, so we're- we're talking about quitting or here quitting completely. What thoughts do you have? You tried the Chan- the Chantix, meditation, you like that so, um, I can run some ideas that some other clients have used [crosstalk]-
|
question
|
communication behavior
|
39_32
|
So, um, since you like meditation so much, it's highly likely that you'd be a great candidate for hypnotherapy.
|
therapist_input
|
communication behavior
|
39_34
|
Yeah, okay.
|
other
|
communication behavior
|
39_36
|
Yes, it is true. Yeah. It is. I mean, people don't come walking through the door who are not interested in it, you know? So, um, yeah, so that's-- So you'd be interested in something like that and, um, what- what other ideas have you thought about that would work for you?
|
question
|
communication behavior
|
39_38
|
Okay. Okay.
|
other
|
communication behavior
|
39_40
|
Might become a better friend when you quit.
|
reflection
|
communication behavior
|
39_42
|
Um, because I know you mentioned you tried the Chantix. Um, what have you tried? Uh, Zyban or Wellbutrin?
|
question
|
communication behavior
|
39_44
|
Okay.
|
other
|
communication behavior
|
39_46
|
Yes, it is.
|
other
|
communication behavior
|
39_48
|
It's the same thing. It's Wellbutrin, and when they found out by accident through what we call serendipity that you know what, Viagra. [laughs] That when- when people were on Wellbutrin that they tended to decrease and stop smoking, and, um, there were a couple of different reasons for that. Number one, people tend to get depressed when they quit smoking, because it puts you in such a state of deprivation and, um also-- well, so Wellbutrin really is a good antidepressant for them.
|
therapist_input
|
communication behavior
|
39_49
|
The other thing is its a slight stimulatory effect and when people go off nicotine which is a stimulant the-they tend to get pretty tired overheard-- you know it's the opposite of however the nicotine makes them feel. And the Wellbutrin kind of with stimul-- you know stimulatory enough. [crosstalk] [unintelligible 00:05:56] And I-- the last I've read, and I've not kept real current about it, but I'm wondering about the-- what your thoughts are if any about the-- any of the nicotine replacements like the gum patch, the inhaler.
|
therapist_input
|
communication behavior
|
39_51
|
Chewing gum.
|
other
|
communication behavior
|
39_53
|
That strong spirit of you got instilled with her.
|
reflection
|
communication behavior
|
39_55
|
Could be?
|
question
|
communication behavior
|
39_57
|
It is becoming a pain in the butt
|
reflection
|
communication behavior
|
39_59
|
Mm-hmm
|
other
|
communication behavior
|
39_61
|
Like it's a little treat.
|
reflection
|
communication behavior
|
39_63
|
I've never heard of Union break. I love it how you said. I love it.
|
other
|
communication behavior
|
39_65
|
I love it. Union break.
|
other
|
communication behavior
|
39_67
|
It's great
|
other
|
communication behavior
|
39_69
|
Union break. Yeah. le-leverage, and you know so it's something else you might know about nicotine is, um is that actually depending on how you smoke it, it can- it can be stimulant when you want it to be a stimulant if you smoke it in short, shallow puffs and then it can be a depressant like after a meal and you take longer inhalations, and it really tends to act on your central nervous system as a depressant. So it kind of does whatever you want at any given moment and yet there is this price that you pay
|
therapist_input
|
communication behavior
|
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