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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
|
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