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45_32
Um, and I know some clients have expressed just really valuing their freedom. They didn't realize how much they really valued that until it was gone.
other
communication behavior
45_34
Your freedom?
question
communication behavior
45_36
What would be some ways you could go about being able to get your freedom back?
question
communication behavior
45_38
Mm-hmm, yup that's one step, just sign the papers when I come by. Even though it seems like it's kinda annoying at times, it is something that we're contracted to do.
therapist_input
communication behavior
45_40
What are some other ways you feel like you can get your freedom back?
question
communication behavior
45_42
So that's something that will motivate you to not do what you did, not commit that crime, and, um, 'cause you do not like when we stop by?
question
communication behavior
45_44
That's okay. Well, I know that you are making an effort. I do appreciate then and when-when I do stop by that you still sign the paperwork even though you feel like it's annoying at times. So, thank you for, uh, at least doing that.
other
communication behavior
45_46
Okay. Um, before I leave today is there anything else you'd like to add or-or need to share with me?
other
communication behavior
45_48
Okay, well just so you know, again, I do have to come back so I'll see you later today then.
therapist_input
communication behavior
45_50
All right.
other
communication behavior
46_0
So, Jacob, everything looks very normal on your physical exam. Do you have any questions for me?
question
communication behavior
46_2
Okay. I see that you filled out our, um, alcohol and drug questionnaire. Is it okay if we go through this together?
other
communication behavior
46_4
Okay. What we talk about is confidential. I only tell your parents about what we say if you give your permission or if I become worried about a danger to-to you or to someone else. Does that make sense?
therapist_input
communication behavior
46_6
Okay. So, let's take a look. So I see that you have marked that you sometimes use alcohol, and that you have used alcohol to relax, feel better about yourself or fit in. Do you mind telling me a little bit more about your alcohol use?
therapist_input
communication behavior
46_8
Okay, so how many do you usually have at a time?
question
communication behavior
46_10
Okay. And how often?
question
communication behavior
46_12
Okay. So, you drink with friends, sort of three or four beers or mixed drinks, one or two times a month. How long have you been doing that?
question
communication behavior
46_14
So, for about six months. I'm curious. What do you like about drinking alcohol?
question
communication behavior
46_16
Yeah.
other
communication behavior
46_18
Okay. So, it sounds like you feel relaxed and have fun when you're drinking with friends and you like the taste.
reflection
communication behavior
46_20
Okay. I'm also curious, are there any parts about your alcohol use that you don't like?
question
communication behavior
46_22
Mm-hmm.
other
communication behavior
46_24
Have you ever experienced a-a blackout, like when you've been drinking and you wake up and you don't remember what happened?
question
communication behavior
46_26
Okay. And have you had any problems related to-to your drinking alcohol, like at home or school or somewhere else?
question
communication behavior
46_28
Mm-hmm.
other
communication behavior
46_30
Mm-hmm. Have you told your mother that you drink with your friends?
question
communication behavior
46_32
So more negative things about your drinking, like getting into trouble with your mom and missing a class at school when you had a hangover?
question
communication behavior
46_34
Okay. I see on the questionnaire that you have not ridden in a car with someone who's been drinking and you haven't driven a car, um, after you've been drinking. Is that correct?
therapist_input
communication behavior
46_36
That's great. And I hope you continue to avoid those things. As your doctor, I want you to know that I'm concerned about your drinking. When teens drink, things can go wrong, like injuring yourself. Even when you don't drink too excess, though, your brain is still developing and is very sensitive to the effects of alcohol.
therapist_input
communication behavior
46_38
That's why I recommend that all my adolescent patients not drink at all. So if you were thinking today about how ready you feel to stop drinking alcohol on a scale of zero to ten, with zero not being ready at all and ten feeling very ready, what number would you pick?
question
communication behavior
46_40
A five? So, I'm curious. Why didn't you pick a lower number like a two or three that would mean you're only a little bit ready to stop drinking?
question
communication behavior
46_42
Okay. What could you do to avoid getting into trouble?
question
communication behavior
46_44
[chuckles] Have you ever tried not drinking or stopping drinking?
question
communication behavior
46_46
Okay. What some people your age do is try stopping drinking for a period of time just to see what that feels like.
therapist_input
communication behavior
46_48
So, how long do you think you could go without drinking?
question
communication behavior
46_50
Do you think you could go two months without drinking?
question
communication behavior
46_52
Okay. What things would make it easier for you to not drink?
question
communication behavior
46_54
Anything else to make things easier for you?
question
communication behavior
46_56
Okay. Is there anybody in your life that you can talk to about this, who give you some support for not drinking?
question
communication behavior
46_58
Great. So you've come up with some reasons to stop drinking, like having hangovers and throwing up and getting into trouble. And you've developed some strategies to-to try to not drink, like spending more time with friends who don't drink or having non-alcoholic drinks when people around you are drinking alcohol. I think that's a great plan. I'm really proud of you for giving this a try. How about if I have you make an appointment for two months from now and then I'll see you back and we can see how things are going?
reflection
communication behavior
47_0
Hey, Mary, how are you?
question
communication behavior
47_2
Um, I noticed some yelling going on in the house, what's going on?
therapist_input
communication behavior
47_4
So nothing you want to talk about right now?
reflection
communication behavior
47_6
My guess is you're probably involved in that.
reflection
communication behavior
47_8
Okay, I understand that sometimes if you're feeling angry or upset about something, the last thing you want to do is share with your caseworker at that time, but, um, you know I am here for you, and if there's anything you ever want to talk about or share with me, that is something that I would love to-to here, and I'll just see sit here and listen if that's something that you would find helpful.
therapist_input
communication behavior
47_10
Okay. You know what? I-it seems like things have been really a struggle for you lately, and I have noticed that you haven't been in the best mood, so I'm really- I am concerned about you, but again, it's your choice if that's something that you feel like you want to share with me.
reflection
communication behavior
47_12
All right, well, you know I will be by later today. If, um, you have any questions or if you want to talk, um, otherwise, again, I'll stop by and call you later.
therapist_input
communication behavior
47_14
All right, take care, bye.
other
communication behavior
48_1
Mm-hmm.
other
communication behavior
48_3
Mm-hmm.
other
communication behavior
48_5
Okay.
other
communication behavior
48_7
Uh-huh.
other
communication behavior
48_9
Uh-huh.
other
communication behavior
48_11
Sure.
other
communication behavior
48_13
Mm-hmm.
other
communication behavior
48_15
Uh-huh. Uh-huh.
other
communication behavior
48_17
Uh-huh.
other
communication behavior
48_19
You probably think that I'm going to get on your case about that or something.
reflection
communication behavior
48_21
Yeah.
other
communication behavior
48_23
Hmm.
other
communication behavior
48_25
Yeah and I-- Yeah, you really-- You're already like, you're taking a look at this and sure don't need me like-- Obviously, you don't want to be doing that in the first place, but—
reflection
communication behavior
48_27
Yeah, clearly, you made a decision because you didn't want to stand out in some way I'm guessing. So, let's-let's talk more about that. Tell me where would you like to take this?
reflection
communication behavior
49_0
All right, Catherine, welcome back. I'll be interested to, sort of, after we met last time, what-what were you-- what have you been thinking about over the week 'cause, you know, I-I remembered last time I asked you what you were thinking about coming, but-
question
communication behavior
49_2
-what was different this time and your thoughts about coming?
question
communication behavior
49_4
Yeah.
other
communication behavior
49_6
Okay, okay. So, there's a shift from last time?
question
communication behavior
49_8
Yeah. Yeah. My sense is we'll be able to work pretty well together. That's my, sort of, sense of, uh-- After last time, I thought, you know, "Here's a young woman who's, you know, got some energy to get things together-
therapist_input
communication behavior
49_10
-and, uh--" So, really, what we'd like to talk about today is-is get a sense of, um-- Let's talk about the things that would be good to work with, um, over the next, you know, nine months together, really.
therapist_input
communication behavior
49_12
So, one of the things that we started to touch on, last time, was this issue of gambling, and, um, you were talking, last time, about how the gambling had, sort of, got you into trouble with your family.
reflection
communication behavior
49_14
Yeah. So, thinking about, like, you know, last time, you-you started to say that, well, you thought it was-- you deserved it and there was some thinking around that, so I'm, sort of, wondering how open you are to-to exploring that from some different angles?
question
communication behavior
49_16
Yeah. Yeah.
other
communication behavior
49_18
Yeah. Yeah.
other
communication behavior
49_20
Yeah, so how-how-- You know, like-- 'Cause, sometimes, when we start to open things up, and then you think, "Oh, it feels a bit uncomfortable." So, how do you manage things when you get uncomfortable? How have you managed those in the past?
question
communication behavior
49_22
Yeah. Yeah. So, how would I know if we were talking and you were blocking off? What would I notice, uh, in our session together?
question
communication behavior
49_24
Yeah?
other
communication behavior
49_26
Yeah, that's okay.
other
communication behavior
49_28
So-so, what would be really helpful maybe because I might miss it, you know, so, like, could you tell me? It would be really helpful if—
question
communication behavior
49_30
Yeah, yeah. If you could just say, "Ken, hi, I am starting to, you know, tune it out here, starting to get uncomfortable," that would be really helpful.
therapist_input
communication behavior
49_32
Yeah?
question
communication behavior
49_34
Yeah, thanks for that, okay. So, let's think about the-- It has to do with how you just sorted out the thing around the gambling 'cause last time you were here, you told me that you get a buzz, you know, it seemed like you were gambling a bit more than your girlfriends were aware of, and-and you said you owe one of your friends some money.
reflection
communication behavior
49_36
So, um, how serious do you think this issue is to sort?
question
communication behavior
49_38
Yeah, okay.
other
communication behavior
49_40
Yeah.
other
communication behavior
49_42
Okay. So, again, on a scale of 1 to 100, how serious-- how important is it to sort it out? Yeah.
question
communication behavior
49_44
About 80? Right up there, yeah, yeah? And another question that's, sort of, related to that, how confident are you that you can, you know, you can actually get it sorted and get on with life?
question
communication behavior
49_46
Yeah? But, what would-
question
communication behavior
49_48
-your level be on a scale of 1 to 100? Where does your confidence sit?
question
communication behavior
49_50
Well, to get it sorted. Not necessarily to stop. But we don't- we don't know whether-whether stopping's the right answer here, I don't know, but-but, your confidence to sort it out.
therapist_input
communication behavior
49_52
Mm.
other
communication behavior
49_54
Hmm.
other
communication behavior
49_56
Yeah. Yeah, so-so, you fluttered last night with them?
question
communication behavior
49_58
Yep. Okay, okay. And-and when they stopped fluttering, were you still fluttering or did you stop with them? Where-where were you with—
question
communication behavior
49_60
Okay. Okay. Okay. Yeah, yeah. So, you were saying before that, you know, there was, you know, money you couldn't really afford-
reflection
communication behavior
49_62
-'cause you owed your mom and dad some money, and they weren't bailing you out anymore, and you had to go out and find some money, I think?
question
communication behavior
49_64
Yeah? Yeah. Yep. So, it seems like almost, like, you're still in the behavior, you know, still creating some problems?
question
communication behavior
49_66
Yeah? Yeah.
other
communication behavior
49_68
There's some feelings when you, kind of, think about that?
question
communication behavior
49_70
Yeah.
other
communication behavior
49_72
Mm.
other
communication behavior
49_74
Yeah.
other
communication behavior