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95_30
-How could it be the right one? Ending your life hurting yourself when it's just you and your mom. And you just said, she's a single parent. She doesn't have a husband, you don't have a dad. It's just the two of you. So how could it be the right choice? But I understand your pain and I know where you're coming from. And I know that the release that you feel physically is something that helps you in the moment. Are there other things that we can help you find to start replacing, um, that behavior?
question
communication behavior
95_32
You're not sure. So you have a lot of on your mind right now. You just opened up to me. You told me that you've been cutting, that you've also been thinking about hurting yourself, killing yourself, not being here. Short-term, the cutting is helping you. You feel like a burden to mom, that stresses you out. That makes you sad. You see how much she struggles, but also on the same hand, we see how much you've been trying and how much you've been trying to help out by trying to go to school. We know your attendance is good. You go most of the time, you know, you're trying to keep up your grades.You have a C average, even having A in math, which we know was the lowest grade you had all semester. So all of those things shows how much effort you've put in and we see that effort. So you've been doing what you can and it's normal to feel like sometimes it's not enough. But that's-that's what we're here for so that you can tell us those things and we can help you.
reflection
communication behavior
95_34
Oh, thank you, Ruth. Thank you for coming today.
other
communication behavior
96_0
Thank you for coming in today, Katie. I'm looking forward to getting to know you, and maybe just wanna start off with just sharing a little bit about you and what brought you in today?
question
communication behavior
96_2
So you're following through on meeting with me today and you mentioned he has some concerns. Can you tell me a little bit about that?
question
communication behavior
96_4
Okay. And I'm wondering if you have any concerns about that.
reflection
communication behavior
96_6
No. Okay. So that's- that's not been an issue for you. Uh, it is an issue for him and not for you at this point.
reflection
communication behavior
96_8
Okay. So what about maybe sharing a little bit about your alcohol intake and maybe a little bit about what your- what your life's like a little bit for me today?
question
communication behavior
96_10
Okay.
other
communication behavior
96_12
So it was kind of been a part of your culture a little bit, and you know, just find alcohol, maybe takes the edge off a little bit and-
reflection
communication behavior
96_14
Okay. So you don't feel very comfortable with somebody telling you what you should be consuming, what kind of alcohol, and how much alcohol you should be consuming. And, um, it sounds like you've been getting some mixed messages, your doctor's saying there's no safe amount of alcohol you can drink, and asked you to come and see me. And then also, you've been checking- sounds like you've been checking things out a little bit.
reflection
communication behavior
96_16
Okay.
other
communication behavior
96_18
So you know yourself best and you wanna be sort of the boss of your body and you don't want somebody else telling you what- what's okay and what's not okay. And it seems like you're not maybe too concerned right now about your substance use.
reflection
communication behavior
96_20
Okay. And I'm wondering if that concern is coming from, "It's been okay. I've got these messages from friends."
reflection
communication behavior
96_22
"Um, media has said it's okay to drink during alcohol. And so that concern, um, just sort of, I don't have it and, and maybe the doctor might be wrong."
reflection
communication behavior
96_24
You're not sure if he's sort of playing things up a little bit there?
reflection
communication behavior
96_26
It might be a bit extreme to-
reflection
communication behavior
96_28
-to quit drinking. Um, I'm just wondering, have you, um, would you be open maybe to just kind of taking a look at what Canada's guidelines say about drinking? Um, is that something you'd be open to?
therapist_input
communication behavior
96_30
Yeah.
other
communication behavior
96_32
What if- uh, can I show you a brochure about that?
question
communication behavior
96_34
Yeah?
question
communication behavior
96_36
Well, if we take a look at the low-risk-alcohol drinking guidelines, what it says is for women, um, the safe limits are 10 drinks a week for women and 2 drinks a day. And that's if a woman isn't pregnant. And when it says in the guidelines, as far as drinking, uh, throughout pregnancy, there is no safe amount to drink during pregnancy. So really zero alcohol is, um, the woman should not be drinking any at all. And I'm just wondering what-what are your thoughts on that?
therapist_input
communication behavior
96_38
So when you see it here in kind of black and white, you're not sure if this is, uh, you know, enough-
reflection
communication behavior
96_40
-to con- sort of convince you that-that it might be dangerous to be drinking through alcohol?
question
communication behavior
96_42
So you feel like, um, what the doctor's saying and this brochure just kind of feels like, yeah, it's just kind of blowing things up out of proportion a little bit.
reflection
communication behavior
96_44
And it sounds like you-you've got some solid information already that alcohol, you know, has been safe to-to have during pregnancy. Tell me about that information that you've-you've explored.
reflection
communication behavior
96_46
Mm-hmm. You mentioned you looked up some articles and it sounds like evidence is really important to you. So, um, those articles, is that something recent? Um, you can tell me about that.
reflection
communication behavior
96_48
Mm-hmm.
other
communication behavior
96_50
So you felt like, um, the information that you found supports the values that you have of being able to be independent and autonomous, to be able to make your own choice and the information that your doctor shared or spoke to you about, and then this brochure kind of feels like that's challenging sort of your values.
reflection
communication behavior
96_52
Mm-hmm.
other
communication behavior
96_54
Mm-hmm.
other
communication behavior
96_56
Wha-what's the big deal if you're drinking and—
reflection
communication behavior
96_58
Maybe we can kind of put that on the shelf for a moment, and we'll come back to it and sort of look at, you know, what is- what does the guidelines have to say about why. And, um, and-and I'm wondering if we can kind of just have a look for a moment at, um, your pregnancy, and is this something that you were- you were hoping to have a baby?
question
communication behavior
96_60
That was something that you'd been planning?
question
communication behavior
96_62
Okay. And I'm wondering as far as, um, bringing the baby into the world and, you know, your future as a parent, ho-how important is it to have a healthy baby to you?
question
communication behavior
96_64
Mm. What does being a good parent look like? Tell me more about that.
question
communication behavior
96_66
Hmm. Kind of like protecting your baby and-
reflection
communication behavior
96_68
-guiding your baby and-
reflection
communication behavior
96_70
-you know, nurturing that baby is really important to you-
reflection
communication behavior
96_72
-and raising your baby well?
question
communication behavior
96_74
That's something that- that really matters to you and, um, I'm-I'm hearing you say that, you know, protecting your baby is important to you and at the same time, um, kind of clashes with some of the information that's in the brochure.
reflection
communication behavior
96_76
What do you make about that- what do you think about that?
question
communication behavior
96_78
You wanna see it in black and white.
reflection
communication behavior
96_80
You wanna know that it's the latest and the greatest kind of thing. Um, this is information that, uh, that I have been sharing with you earlier, this is the latest information evidence-based, um, on the latest research since 2011 and, um, a lot of research has gone into what is-what is okay for a mom to consume, like, alcohol. There's the-the evidence that we have, um, but in the end, you choose what's best for you and what's best for your baby. What are your- what are your thoughts on that?
therapist_input
communication behavior
96_82
Mm-hmm, kind of feels like, you know, you were making some really good decisions about your baby. You've done research and you wanna be able to bring your baby up well and take care of your baby. And I-I can see that that's really important to you. I hear you saying that and it kind of feels like this information isn't kind of what you were expecting to hear.
reflection
communication behavior
96_84
What would you feel like would be helpful as far as next steps, like when you think about maybe moving away from drinking alcohol throughout the rest of your pregnancy?
question
communication behavior
96_86
Mm-hmm, that's some really significant steps you're talking about. You're talking about putting the alcohol away, that's huge. That's-that's really big steps.
reflection
communication behavior
96_88
I really want to thank you for, you know, exploring this with me today, and I'm wondering if we can kind of continue this conversation again, and talk about those steps, and how it goes with talking to your partner about giving up drinking and, um, the- giving you a chance to do some more research and, you know, maybe looking through these brochures and kind of just coming back and sharing a little bit more about, you know, what you thought about the information and what feels right for you. Is that something you'd be open to?
therapist_input
communication behavior
96_90
We definitely can cover that again on our next meeting. Thank you for coming to see me.
reflection
communication behavior
97_0
Well, Mr. Smith, that's your medication sorted out.
therapist_input
communication behavior
97_2
Blood pressure's a little on the high side.
therapist_input
communication behavior
97_4
Okay. I wonder if I could raise the subject of your weight.
question
communication behavior
97_6
I wondered if we could spend just a couple of minutes talking about your weight.
question
communication behavior
97_8
Yeah.
other
communication behavior
97_10
Yeah.
other
communication behavior
97_12
Yeah.
other
communication behavior
97_14
Yeah.
other
communication behavior
97_16
Yeah.
other
communication behavior
97_18
Yeah.
other
communication behavior
97_20
Right, and you-- so you're busy enough, and—
reflection
communication behavior
97_22
Yeah.
other
communication behavior
97_24
Yeah, yeah.
other
communication behavior
97_26
And it wasn't essentially easy for you to make the time to come down, and you had to wait in the waiting room, and now I raised the subject of weight just when you're thinking of going.
reflection
communication behavior
97_28
Yeah, yeah, yeah.
other
communication behavior
97_30
Right.
other
communication behavior
97_32
Right.
other
communication behavior
97_34
Right. And so it-it-it's been a bit of a rush for you coming in.
reflection
communication behavior
97_36
And, I- I'm sorry about the wait in the waiting room.
other
communication behavior
97_38
Yeah, yeah, that's, um, and that- that's not easy for you, because you- you'd like to go really soon, and here I am asking you to spend just a couple of minutes with me.
other
communication behavior
97_40
Yeah.
other
communication behavior
97_44
Yeah.
other
communication behavior
97_46
Yeah.
other
communication behavior
97_48
Yeah.
other
communication behavior
97_50
Yeah.
other
communication behavior
97_52
Yeah. It counts.
reflection
communication behavior
97_54
Yeah, exactly. Exactly. It's up to you, just a couple of minutes.
other
communication behavior
97_56
I promise.
other
communication behavior
97_58
I want- I wanted to simply ask you how you feel about it?
question
communication behavior
97_60
Yep.
other
communication behavior
97_62
Right.
other
communication behavior
97_64
Right. So you can see the links between your weight and your health, and you'd like things to be a bit better.
reflection
communication behavior
97_66
You'd like to, if you could?
reflection
communication behavior
97_68
Yeah.
other
communication behavior
97_70
Yeah.
other
communication behavior
97_72
Ready meals, and that sort of thing.
reflection
communication behavior
97_74
Okay, yeah.
other
communication behavior
97_76
Let me see if I can summarize what you've said, um, and then we'll see what next. Um, you lead a busy life.
reflection
communication behavior
97_78
Um, you run a business, and you've got a lot to do.
reflection
communication behavior
97_80
Yeah. Um, you're- you're- you're aware of the- of the links between your health and your weight, and you are concerned, to some extent, about that, and ideally it sounds like you'd like to do something about it, it's just that your life is busy and rushed, and you tend to use convenience foods in order to get the work done.
reflection
communication behavior
97_82
Yeah, yeah.
other
communication behavior
97_84
I get it. I get it. And so, if you could fit it in, you would like things to be different, but that's not so easy.
other
communication behavior
97_86
Okay. Can I suggest that you come back and see me in a couple of weeks time just to chat about this?
question
communication behavior
97_88
Right.
other
communication behavior
97_90
Right, right.
other
communication behavior
97_92
Exactly.
other
communication behavior
97_94
Exactly. I'll tell you what might be a nice solution, is if you come down first appointment, and I give you an appointment at 8:30-
other
communication behavior
97_96
- and then there'll be absolutely no waiting. And, the purpose of that- of that visit will be to have a look at how you really feel about how you could move forward, and somehow fit in a more healthier lifestyle into the busy work life that you've got.
other
communication behavior
97_98
Yeah.
other
communication behavior
97_100
Yeah.
other
communication behavior
97_102
Good.
other
communication behavior