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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.
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