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78_32
Okay. When-when somebody has asthma, their lungs are like hypersensitive. If I could use an analogy, again, if-if you had the skin burnt off your arm, if somebody brushed up against you before he had the skin burned off your arm, it wouldn't bother you at all. But when the skin's burned off your arm, you literally react to it. Her lungs are exquisitely sensitive. Uh, and like the skin on your arm would be if the skin got burned off. And what this drug can do? This chronic inhaler is reduce the inflammation in her lungs so that her lungs don't remain exquisitely sensitive. Because otherwise, everything in the air like dust, pollen, uh, reacts with her, uh, in ways that it would not normally affect us.
therapist_input
communication behavior
78_34
And so this chronic inhaler can really prevent that from happening. Okay? Which is why it's so important to use it.
therapist_input
communication behavior
78_36
The other thing I was going to tell you is that, unfortunately, uh, even though you are smoking outside and keeping the smoke away from her, the smoke on your clothes, because her lungs are so sensitive, can also affect her lungs and cause her to have a reaction. Now, something I'd like you to think about is that, if you use the chronic inhaler every day, she may not be sensitive to the smoke on your clothes, but she still maybe because her lungs are just very different than ours. Um, honestly, I'd love to see you quit smoking for you too because, you know, as you know, it's not real good for you.
therapist_input
communication behavior
78_38
Uh, and it would certainly help her. Um, but what I'd like you to do is to, kind of, keep an eye on what happens when she uses the chronic inhaler. And if she's still flaring up when you're around her, if there are any, if there is smoke on your clothes because it-it can flare her up.
therapist_input
communication behavior
78_40
Yeah. Yeah.
therapist_input
communication behavior
78_42
It-it-it-- Yeah. It may not- it may not when she uses the chronic inhaler, uh, but you'll need to keep an eye on that. Obviously, it would be- what would be best if it didn't get on your clothes, or you quit smoking.
therapist_input
communication behavior
78_44
Mm-hmm.
other
communication behavior
78_46
Very hard. It's very relaxing, and-
reflection
communication behavior
78_48
And-and it's hard to replace it with something.
therapist_input
communication behavior
78_50
So, uh, any thoughts on what you may be able to do to-to help at this point, if you don't choose to quit right away?
question
communication behavior
78_52
Oh, that-that sounds like it would be great if you were able to do that. Obviously, don't smoke in the house, you know- you know.
therapist_input
communication behavior
78_54
Um, so yeah. If you're willing to do that, that certainly would help.
therapist_input
communication behavior
78_56
Uh, again, if you get to the point sometime down the road where you're willing to quit for both you and her, uh, we'd be glad to help you do that. Because you're right it is- it's not an easy thing to do.
therapist_input
communication behavior
78_58
Okay.
other
communication behavior
78_60
So it sounds like right now where we are, is you're willing to-to have her use the chronic inhaler-
reflection
communication behavior
78_62
-to try to get the inflammation down, so she doesn't need to go to the emergency room and do whatever you can at this point to keep the smoke off your clothes. And I think you're gonna see big changes in terms of, uh, her not needing to go to the emergency room, and you probably won't need to use the rescue inhaler hardly at all.
therapist_input
communication behavior
78_64
Yeah, because you'll get that inflammation down.
therapist_input
communication behavior
78_66
Okay.
other
communication behavior
78_68
Yeah. So we'll go ahead and get both of those prescriptions ready.
therapist_input
communication behavior
78_70
Use the chronic inhaler every day, keep the rescue inhaler around if she needs it. Uh, and let's see how that works.
therapist_input
communication behavior
78_72
Okay?
question
communication behavior
78_74
All right. Good.
other
communication behavior
79_1
How did you know you messed up?
question
communication behavior
79_3
Was it that something happened, um, where you put something that was really important to you at risk? Is that what that was about, um, when you say you felt guilty, uh, you felt bad talking to Erin on the phone?
reflection
communication behavior
79_5
So you saw yourself putting something that was important to you at risk.
reflection
communication behavior
79_7
Here you are actually, three months on, three long months as you say, um, and things have been going really well, Uh, you even get a bit of—
reflection
communication behavior
79_9
Yeah. Well, and then you get the kind of, I don't know if it felt like a green light or a yellow, it went from red to cautionary, you could see your kids, and that was something that was really what you were working for.
reflection
communication behavior
80_0
Jean, it's good to see you again.
other
communication behavior
80_2
So, what's been different since the last time we talked a week ago?
question
communication behavior
80_4
Okay.
other
communication behavior
80_6
Mm.
other
communication behavior
80_8
Sure.
other
communication behavior
80_10
Sure.
other
communication behavior
80_12
So, you've been able to cut down by two or three cigarettes? That's amazing. I mean, given how much you were smoking.
reflection
communication behavior
80_14
So, you were able to keep the, uh, the journal?
question
communication behavior
80_16
You-- Sounds like you did that, and that allowed you to really focus on the time [unintelligible 00:00:57] delaying your cigarettes. So-so that's gone well. So, what are the things that are not going as well as you'd liked?
therapist_input
communication behavior
80_18
Right.
other
communication behavior
80_20
Yeah.
other
communication behavior
80_22
Okay. So, these automatic cigarettes, when you're socializing and you're-- you have time on your hands, really, are the problems that you're facing-
reflection
communication behavior
80_24
-uh, and that you've noticed are more difficult than the others?
question
communication behavior
80_26
In marking it down, okay.
reflection
communication behavior
80_28
Okay. So, and you've thought about already, what you might do, such as getting a hobby. Any other thoughts of what you might do to help you overcome this?
question
communication behavior
80_30
Okay.
other
communication behavior
80_32
Right.
other
communication behavior
80_34
Right.
other
communication behavior
80_36
Sure.
other
communication behavior
80_38
Okay. So, from now to the next time you come back and see me, what is it that you'd like to-to work on?
therapist_input
communication behavior
80_40
Okay, so you can continue with that.
therapist_input
communication behavior
80_42
Sure.
other
communication behavior
80_44
Okay.
other
communication behavior
80_46
You said five cigarettes this time.
therapist_input
communication behavior
80_48
And any thoughts about what concretely you could do to make that happen?
question
communication behavior
80_50
Right.
other
communication behavior
80_52
Right. [unintelligible 00:02:58]
other
communication behavior
80_54
Sure.
other
communication behavior
80_56
Sure.
other
communication behavior
80_58
So, given what you're-you're attempting to do, when would it be good for you to come back and talk about this?
question
communication behavior
80_60
Absolutely. Okay.
other
communication behavior
80_62
Good. So, we'll see you in a week.
other
communication behavior
81_0
Did you like how your parents raised you?
question
communication behavior
81_1
Tell me about how your parents raised you?
question
communication behavior
81_2
Tell me about how you've been feeling?
question
communication behavior
81_4
Mm, what's that like for you?
question
communication behavior
81_6
So you're feeling uncomfortable with changes in your body?
reflection
communication behavior
81_8
Mm.
other
communication behavior
81_10
Why do you think it makes you so hesitant to call?
question
communication behavior
81_12
What about it seems overwhelming?
question
communication behavior
81_14
Mm. So some of your feelings, uh, of being overwhelmed or about the logistics of the appointment, and some of it is you just don't like medical appointments and medical people?
reflection
communication behavior
81_16
How can I help you with these things?
question
communication behavior
81_18
Sure, we can do that together.
other
communication behavior
81_20
I can try. I can't guarantee because it depends on my schedule, but we can brainstorm about ideas on who can go with you to support you so you feel better about attending.
therapist_input
communication behavior
82_0
Would you like to answer some questions and kind of do a self-evaluation about how you're feeling around alcohol and the contraception?
question
communication behavior
82_2
Okay. So we're working on a 10 point of scale 1 to 10, 1 being not important, 10 being very important. One being not confident, one being very confident. So on a scale of 1 to 10, which number best reflects how important it is to you to drink the-- what risk limits?
question
communication behavior
82_4
You'd say an eight. Okay. And on a scale of 1 to 10, how confident are you at the present time that you can drink below risk levels?
question
communication behavior
82_6
Amount of four.
reflection
communication behavior
82_8
Okay. And so let's look at those two. You're-you're thinking it's pretty important, but your confidence is down here, uh, a four, but it's not a one. What makes you confident that you can drink below risk levels and you remember what those are?
question
communication behavior
82_10
Okay. So that gives you a good reason not to drink. Okay. Anything else?
question
communication behavior
82_12
So you have a support group that gives you the ability to have fun and still drink below risk levels?
reflection
communication behavior
82_14
Okay. Anything else?
question
communication behavior
82_16
Now let's look at your self-evaluation of your birth control. So now we're doing the risk of pregnancy and the use of birth control. So on a scale of 1 to 10, how important is it to you to use effective birth control every time you have sex to keep from getting pregnant?
question
communication behavior
82_18
An eight. Okay. And on a scale of 1 to 10, how confident are you at the present time that you- that you can use effective birth control?
question
communication behavior
82_20
Every time.
therapist_input
communication behavior
82_22
Correctly as it's prescribed.
therapist_input
communication behavior
82_24
Probably a six. Okay. So you're pretty confident that you can do it. And why are you a six and not a two or three?
question
communication behavior
82_26
Okay. So it's kind of linked to your drinking, the fact that, um, that you can-- if you can take care of that drinking, you can take care of the-
reflection
communication behavior
82_28
-birth control issue and this importance comes down as your reason why you're not down here.
reflection
communication behavior
82_30
Very good. So it looks like, um, you're using a good method of birth control, you're just not able to use it effectively. And you've linked it back here to the drinking. So would you like to develop a plan around your alcohol use at this-- today?
question
communication behavior
82_32
Yes.
other
communication behavior
82_34
Okay. And if you need more information, we can get that for you.
therapist_input
communication behavior
82_36
Okay.
other
communication behavior
83_0
Hello, Rick. Welcome.
other
communication behavior
83_2
Good to see you here. I see on your file that you're, uh, [unintelligible 00:01:18].
other
communication behavior
83_4
What part of the [unintelligible 00:01:22] are you from?
question
communication behavior
83_6
Oh, okay.
other
communication behavior
83_8
Right down the bottom? Down Bluff?
question
communication behavior
83_10
Oh, are they? So you were born down there and-
question
communication behavior
83_12
-raised down there?
question
communication behavior
83_14
Country boy. Been up in Christchurch how long?
question
communication behavior
83_16
Oh, so you've been here a while?
question
communication behavior
83_18
Oh good. You got family out here?
question
communication behavior