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88_65
What a great plan and you said you're going to start tomorrow.
reflection
communication behavior
88_67
Great. Well, thank you.
other
communication behavior
91_0
Hi, Jean. I'm Dr. Selby. Nice to meet you.
other
communication behavior
91_2
How can I help you today?
question
communication behavior
91_4
Yes.
other
communication behavior
91_6
Right.
other
communication behavior
91_8
It's time to do something, okay. So you've been diagnosed by-
question
communication behavior
91_10
A respirologist diagnosed that, and-and how are you feeling right now?
question
communication behavior
91_12
Mm-hmm.
other
communication behavior
91_14
All right. So it sounds like you've been smoking for such a long time and then this diagnosis was given to you, uh, and now that's really causing you to be afraid and frightened.
reflection
communication behavior
91_16
Okay, okay. Now, have you thought about when you wanted to quit by?
question
communication behavior
91_18
Okay. So what I'm hearing you say is that, although you want to quit smoking in the next six months, you're feeling a bit, um, under-confident that you'll actually be able to do this and you're-you're worried about failing.
reflection
communication behavior
91_20
Mm-hmm.
other
communication behavior
91_22
Right. So you've been able to quit smoking, but only when you were in the hospital.
reflection
communication behavior
91_24
Okay. Let me just step back a little bit and ask you a question so that I can better understand where the difficulty that you're having with is. Uh, could you tell me what is good about smoking for you?
question
communication behavior
91_26
Mm-hmm.
other
communication behavior
91_28
Right.
other
communication behavior
91_30
Sure. So, Jean, I want to make sure that I've understood what you've told me of what you find good about smoking. So it helps you calm down. It gives you something to do. It's been part of your image. You know, you feel sophisticated. You feel like a movie style. In fact, the way you talk about it, it seems like that's what it makes you feel like. Is that right?
reflection
communication behavior
91_32
Okay. Is there anything I missed?
question
communication behavior
91_34
Mm-hmm.
other
communication behavior
91_36
Right.
other
communication behavior
91_38
Sure.
other
communication behavior
91_40
So it's hard for you to quit smoking when everybody else around you is smoking. And it's so easy to go out and take a break and have a cigarette.
reflection
communication behavior
91_42
You've told me what is good about smoking for you. Uh, can you tell me what is not so good about smoking for you?
question
communication behavior
91_44
Mm-hmm.
other
communication behavior
91_46
Is there anything else that's not good about smoking for you?
question
communication behavior
91_48
Okay. So let me make sure I've understood this piece as well. So the not good things or the not so good things about smoking for you are the effects on your health, effects on your physical appearance and how you'll look and-and-and the amount of investment that you're making in makeup and getting your nails done, et cetera. And then the cost of smoking.
reflection
communication behavior
91_50
So-so let me ask you this, given everything going on in your life right now on a scale of 1 to 10, where 10 is the most important thing to do, and 1 would be the least important thing to do, how important is it for you to quit smoking?
question
communication behavior
91_52
Definitely most important.
reflection
communication behavior
91_54
Let me ask another question and follow up to that. Again, given everything going on, where 10 is the most confident you've ever felt about anything and 1 is the least confident, how confident are you that you will be able to quit?
question
communication behavior
91_56
35-40%. Okay.
reflection
communication behavior
91_58
Okay. Now, help me understand why you said 40 and not something like 10 or zero because you mentioned that you don't even want to quit.
reflection
communication behavior
91_60
Mm-hmm.
other
communication behavior
91_62
Okay. So you said 30 to 40%. What would it take to build that confidence to about 45%?
question
communication behavior
91_64
So if you got help, that would help you say that you went from 40% to 45%.
reflection
communication behavior
91_66
Okay.
other
communication behavior
91_68
Okay. So Jean, I really want to congratulate you on taking this very important first step towards addressing this problem that you've had for such a long time, but as the first small step, I wonder whether you'd be open to actually just monitoring your smoking for the next week. And the reason why I say that- because as you were mentioning to me, smoking is so automatic for you that sometimes writing it down helps make every cigarette a conscious act. And I noticed that you were saying to me, you feel a loss of control over these cigarettes. And sometimes just being mindful and writing something down will help you get some control over what you're doing. And that's often the first small step. What are your thoughts about that?
therapist_input
communication behavior
91_70
That's correct. And writing it down helps that process.
therapist_input
communication behavior
91_72
Mm-hmm.
other
communication behavior
91_74
Okay. And I can give you a little card that can help you keep track of it. And if you can bring that back to the next appointment, it could be something we could discuss. Okay. Anything else?
therapist_input
communication behavior
91_76
Excellent. Well, thank you so much for coming in today.
reflection
communication behavior
91_78
You're welcome.
other
communication behavior
93_0
So there are a lot of different directions that we could take. Um, you've mentioned wanting to make changes in your physical activity. You've mentioned wanting to make changes in your eating habits and also just wanting more body confidence. Um, what- what's on your mind is as far as a- as a change topic for the rest of our session today?
reflection
communication behavior
93_2
Yeah. Okay. So physical activity is feeling like the easiest change to look at first.
reflection
communication behavior
93_4
Great. So tell me a little bit more about your motivators for getting started in being more physically active. I know you shared energy levels and I know you've shared, um, that you'd like to see a boost in your mood and feeling less irritable and stressed. Any other benefits that really make you wanna make this change right now?
reflection
communication behavior
93_6
Yeah. So you're wanting to feel stronger so that you can open jars and other things and- and also just have a better sense of confidence.
reflection
communication behavior
93_8
Great. So on a scale from zero to 10, zero being not at all ready to make a change in the area of physical activity, and 10 being let's- let's do this. I'm excited. I'm ready. Um, where- where do you fall on that scale?
question
communication behavior
93_10
Okay. So you're- you're feeling fairly motivated.
reflection
communication behavior
93_12
Uh, why didn't you pick a six?
question
communication behavior
93_14
Okay. You're noticing there- there are too many great benefits to being physically active and, um, today you've mentioned energy, mood, strength and body confidence.
reflection
communication behavior
93_16
Am I missing anything else?
question
communication behavior
93_18
Okay. Those are the big ones for you.
reflection
communication behavior
93_20
Fantastic. Well, um, now we can start looking at if you're interested in how that might look-
therapist_input
communication behavior
93_22
- and- and what activities you might end up, um, choosing.
other
communication behavior
93_24
Okay.
other
communication behavior
94_0
Good, so, um, we're here today to talk just, uh, about whatever it is you'd like to talk about it.
other
communication behavior
94_2
Okay, so, um, there would be, so what you're, what you're attempting to do is, um, well-- Tell me, I guess, uh, tell me a little bit more about it so I understand it a little bit more.
reflection
communication behavior
94_4
Mm-hmm.
other
communication behavior
94_6
So that's a really kind thing of you to do to take someone into your home like that when they need help like that. And, um, but right now, you're thinking that, uh, time is up you'd like to get this person, you know, you're-you're-you're ready to have him or her move out and have your place back to yourself.
reflection
communication behavior
94_8
Mm-hmm. And what would, uh, what would help you get to the point of actually, um, booting them out?
question
communication behavior
94_10
Mm-hmm. So you kind of feel two ways about it. You-you'd like to, um, you feel like at some level that the time is up for that person to go, and on the other hand, there's a certain amount of security in having him in the house and in knowing he's around.
reflection
communication behavior
94_12
But you're not quite ready if you wanna sing that song.
reflection
communication behavior
94_14
I thought you did a pretty nice job singing there right there, it's scary to be quite honest with you and I appreciate, I also appreciate your sense of humor in-in doing that.
reflection
communication behavior
94_16
That really helps you get through things is to be able to laugh about it.
reflection
communication behavior
94_18
Your new career.
reflection
communication behavior
94_20
So, um, what are the uh, uh, what would be the benefits to you right now to having him out of the house?
question
communication behavior
94_22
Tell me a bit more about that.
question
communication behavior
94_26
Uh-huh.
other
communication behavior
94_28
Cause you wanna do the right thing because you're- because you're a good person and that's a- that's a really important value to you is that you- is that you help people out.
reflection
communication behavior
94_30
But you've done your duty. Duty is done.
reflection
communication behavior
94_32
And so, what have you done in order to start getting them to Hit The Road, Jack?
question
communication behavior
94_34
Okay.
other
communication behavior
94_36
So, uh, you were telling me earlier though that you've talked to some other people and he has some options about some other places to go to.
other
communication behavior
94_38
Mm-hmm.
other
communication behavior
94_40
So, you might have to literally like pack his bags and help them get to those places, um.
reflection
communication behavior
94_42
Okay. Are you-- This is something you've done before.
reflection
communication behavior
94_44
So whe-when-when are you gonna do it?
question
communication behavior
94_46
Mm-hmm, Mm-hmm.
other
communication behavior
94_48
And it's kind of scary.
reflection
communication behavior
94_50
And he's that extra trunk.
reflection
communication behavior
94_52
Okay.
other
communication behavior
94_54
Okay. All right. So, it sounds like you-you've actually worked this out until be out within a couple of days.
reflection
communication behavior
94_56
Okay.
other
communication behavior
94_58
Okay. Well, I have a funny feeling your plans will prevail. [laughter]
other
communication behavior
94_60
Well, thanks for-for talking and playing with our little things here.
other
communication behavior
95_0
Right. Hi, Ruth, thank you for coming today. How are you?
question
communication behavior
95_2
Well, Ruth, it sounds like you're very frustrated first of all. And you're saying that you're just tired. You've lost all your willpower.
reflection
communication behavior
95_4
You don't want to continue.
reflection
communication behavior
95_6
So you feel really, really like you've had it up to here.
reflection
communication behavior
95_8
Yeah. You're-you're tired. You're stressed. You feel so sad to the point that you're hurting yourself physically so that you can feel something other than what you're feeling right now.
reflection
communication behavior
95_10
So you were in a lot of pain?
question
communication behavior
95_12
I'm sorry about that. It must be very, very frustrating to feel all that pain and not be able to do anything about it. And it seems like the only thing that you can do right now is to cry.
reflection
communication behavior
95_14
It's okay, Ruth. I understand. Pain inside.
reflection
communication behavior
95_16
So your mom doesn't understand you and you don't have a dad, that's around?
reflection
communication behavior
95_18
So you feel like your hands are tied, you feel like you're a burden to mom. She's a single parent. She works a lot. You have all of these problems in your life. And it sounds to me like you feel like you're just adding more problems to her.
reflection
communication behavior
95_20
And if you're not alive, that's gonna solve the issue for her. She'll do better.
reflection
communication behavior
95_22
How is she gonna be better off without you?
question
communication behavior
95_24
And how are you a burden now?
question
communication behavior
95_26
And how do you help her now?
question
communication behavior
95_28
Okay. So then even by you coming here today, Ruth, and talking to me and opening up and telling me that you don't feel like you want to continue moving in and telling me and-and confiding in me that, you know, you hurt yourself and all this pain that you feel, that is you trying to help yourself out in one way or another. And that shows that you care. And even more, it shows that you care about your mom and that, in the end, it doesn't sound like you wanna leave her alone because you're still worried about ot-you're still worried about all the burdens on her that you're even thinking of removing yourselves to make her life easier. That shows me that you care about her so, so much, but right now the immediate solution that you have in your mind, it seems like it's-it's-
reflection
communication behavior