diff --git a/HighLowQualityCounseling/README.txt b/HighLowQualityCounseling/README.txt new file mode 100644 index 0000000000000000000000000000000000000000..4793ecfb2b848a03d10fd1e47644cf84d1be8dc3 --- /dev/null +++ b/HighLowQualityCounseling/README.txt @@ -0,0 +1,58 @@ +High and Low Quality Counseling Dataset +=================================================================== +Verónica Pérez-Rosas, Xinyi Wu, Kenneth Resnicow, Rada Mihalcea +University of Michigan + +vrncapr@umich.edu +wuxinyi@umich.edu +kresnic@umich.edu +mihalcea@umich.edu + +Version 1.0 +July 2019 +----------------------------------------------------------------- +1. Introduction +This document describes the dataset used in the paper: What Makes a Good Counselor? Learning to Distinguish between High-quality and Low-quality Counseling Conversations (Perez-Rosas et. al, 2019). + +----------------------------------------------------------------- +2. Content + +The archive contains three folders and one README file. The README (this file) contains information about the data collected and their sources as well as citation and acknowledgements information. +The folders are as follows: +- Transcriptions: The folder includes the transcripts of counseling conversations in the dataset. +- labels.csv: a csv file containing the id of the transcript and its corresponding label. +- urls.csv: a csv file pairing the transcript id and the video url in YouTube (whenever available). Urls retrieved as of July 15th, 2019. +----------------------------------------------------------------- +3. Dataset Information +The dataset consists of counseling videos that are publicly available on YouTube channels and other public websites. The set of videos consist of Motivational Interviewing (MI) counseling demonstrations by professional counselors and MI role-play counseling by psychology students. Each video portrays different speakers and the conversations cover various health topics including smoking cessation, alcohol consumption, substance abuse, weight management, and medication adherence. More details on the data collection process are available in the paper that introduced the dataset (Perez-Rosas et al, 2019; full reference below). + +The dataset consists of 259 counseling conversations, with 155 video clips labeled as high-quality counseling and 104 labeled as low-quality counseling. The length of the conversations in the dataset ranges from 5-20 minutes. + +----------------------------------------------------------------- +5. Transcripts + +Transcriptions of the videoclips were collected using YouTube automatic captioning and Mechanical Turk whenever automatic transcription was not available. Speakers in the conversations are labeled manually and also following a heuristic to label the speaking sequence. + +----------------------------------------------------------------- +6. Feedback +For further questions or inquiries about this dataset, you can contact: Veronica Perez-Rosas or Rada Mihalcea +vrncapr@umich.edu +mihalcea@umich.edu + +----------------------------------------------------------------- +7. Citation Information +Bibtex: +@article{Rosas19What, +author = {P\'{e}rez-Rosas, Ver\’{o}nica, Xinyi Wu, Kenneth Resnicow, and Rada Mihalcea}, +title = {What Makes a Good Counselor? Learning to Distinguish between High-quality and Low-quality Counseling Conversations}, +journal = {Proceedings of the 57th Annual Meeting of the Association for Computational Linguistics}, +year = {2019} +} + + +Text: +Verónica Pérez-Rosas, Xinyi Wu, Kenneth Resnicow, Rada Mihalcea. 2019. What Makes a Good Counselor? Learning to Distinguish between High-quality and Low-quality Counseling Conversations. In Proceedings of the 57th Annual Meeting of the Association for Computational Linguistics (ACL). Florence, Italy. + +----------------------------------------------------------------- +8. Acknowledgements +This material is based in part upon work supported by the Michigan Institute for Data Science, by the National Science Foundation (grant #1815291), and by the John Templeton Foundation (grant #61156). Any opinions, findings, and conclusions or recommendations expressed in this material are those of the author and do not necessarily reflect the views of the Michigan Institute for Data Science, the National Science Foundation, or John Templeton Foundation. diff --git a/HighLowQualityCounseling/labels.csv b/HighLowQualityCounseling/labels.csv new file mode 100644 index 0000000000000000000000000000000000000000..3d89c5070f0f956b1a1ed54d28399279fa55d858 --- /dev/null +++ b/HighLowQualityCounseling/labels.csv @@ -0,0 +1,260 @@ +id,label +high_001,high +high_002,high +high_003,high +high_004,high +high_005,high +high_006,high +high_007,high +high_008,high +high_009,high +high_010,high +high_011,high +high_012,high +high_013,high +high_014,high +high_015,high +high_016,high +high_017,high +high_018,high +high_019,high +high_020,high +high_021,high +high_022,high +high_023,high +high_024,high +high_025,high +high_026,high +high_027,high +high_028,high +high_029,high +high_030,high 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+low_009,low +low_010,low +low_011,low +low_012,low +low_013,low +low_014,low +low_015,low +low_016,low +low_017,low +low_018,low +low_019,low +low_020,low +low_021,low +low_022,low +low_023,low +low_024,low +low_025,low +low_026,low +low_027,low +low_028,low +low_029,low +low_030,low +low_031,low +low_032,low +low_033,low +low_034,low +low_035,low +low_036,low +low_037,low +low_038,low +low_039,low +low_040,low +low_041,low +low_042,low +low_043,low +low_044,low +low_045,low +low_046,low +low_047,low +low_048,low +low_049,low +low_050,low +low_051,low +low_052,low +low_053,low +low_054,low +low_055,low +low_056,low +low_057,low +low_058,low +low_059,low +low_060,low +low_061,low +low_062,low +low_063,low +low_064,low +low_065,low +low_066,low +low_067,low +low_068,low +low_069,low +low_070,low +low_071,low +low_072,low +low_073,low +low_074,low +low_075,low +low_076,low +low_077,low +low_078,low +low_079,low +low_080,low +low_081,low +low_082,low +low_083,low +low_084,low +low_085,low +low_086,low +low_087,low +low_088,low +low_089,low +low_090,low +low_091,low +low_092,low +low_093,low +low_094,low +low_095,low +low_096,low +low_097,low +low_098,low +low_099,low +low_100,low +low_101,low +low_102,low +low_103,low +low_104,low diff --git a/HighLowQualityCounseling/transcripts/high_001 b/HighLowQualityCounseling/transcripts/high_001 new file mode 100644 index 0000000000000000000000000000000000000000..141812a8b1291311f51a0600dbb3eb5e3fc39dd1 --- /dev/null +++ b/HighLowQualityCounseling/transcripts/high_001 @@ -0,0 +1,19 @@ +T: hey Monica how are you doing today +C: I'm okay right now but I'm a little anxious because thinking about how Black Friday is soon and my friends want to go to the mall for Black Friday but I really can't go and I want to go but I really to interesting +T: so it sounds like you really want to go to Black Friday with your friends you're feeling a little anxious about it +C: yeah Monaco but interesting but I was thinking about it and maybe if I could make an image or something that I could use while I'm there maybe I'd be able to go so I was wondering if I could give you that very well +T: that sounds like a great idea can absolutely do that +C: okay +T: so we have some materials on the table but if you'd like to use anything else that we've used previously just let me know and I'll get them to you for you +C: um do you have a Sharpie +T: it do did you have a color that you wanted +C: black maybe +T: all right here +C: this +T: welcome +C: ok I think I'm done +T: all right is there anything you'd like to tell me about it +C: well I'm sure um I drew mountains and lake because when I think about things like Unicom I think of nature so I drew a scene that I think would keep me calm +T: so it sounds like nature and mountains are coming to you do you think that this will be helpful I'm black Franny +C: yes as long as I can remember to think about this image when I'm there but maybe I'll bring it with me when I go so I can refer to it when I'm anxious +T: that sounds like a great idea diff --git a/HighLowQualityCounseling/transcripts/high_006 b/HighLowQualityCounseling/transcripts/high_006 new file mode 100644 index 0000000000000000000000000000000000000000..2d8d02dd816573ea7e5df8fb5b490257789a6a6c --- /dev/null +++ b/HighLowQualityCounseling/transcripts/high_006 @@ -0,0 +1,110 @@ +T: hi Andrea thanks for coming in +C: thank you +T: so I don't know how much you know already about sort of my role here and why you're even here so I thought I'd start by telling you a little bit about myself basically my job is to meet with all of the students I meet with everybody about once or twice a semester and just talk with you a little bit about how things are going different behaviors that you might be engaging in and thinking about any changes you might want to make for your life if you decide that you do it's not my job to change you I couldn't even if I wanted to that's not my role at all it's really to help you think about you know how things are going for you and how you might like making changes or moving forward that sound okay all right so why don't we start by you telling me a little bit about yourself +C: sure um as you know I'm Andrea I uh I'm a junior I'm in the marching band I played at center sacks I mean yeah I'm also in the little bit of a band geek I play you know the Wind Ensemble and the Jazz Band things like that +T: wow you really are involved in music +C: yeah +T: when did you start +C: I started playing about 10 years ago actually +T: Wow +C: yeah I start on the violin first and then I went on explored a little with the piano clarinet finally found the tenor sax hmm yeah +T: very cool I've always wanted to be good at music all right so it sounds like you're in band and a few other musical ensembles any other hobbies you have or things you like to do for fun +C: um you know just hanging out with my friends or go to the beach things like that +T: it's kind of everyday sort of thing okay tell me a little bit about your family +C: uh well I have one older brother he's about eight and a half old years older than me my parents and I have dog +T: cute what kind of dogs +C: the golden retriever +T: oh nice +C: I'm a big boy +T: very fun all right and how are things going in school for you +C: pretty good grades have been pretty all right still like 3.7 ish +T: okay great so you're doing well what sorts of goals do you have for after college or after high school +C: I'd like to you know I'd like to of course graduate high school hopefully go to a nice Ivy League school or I mean that might not happen and then I'd like to go on become a doctor study psychology you need to come a psychiatrist or something +T: okay you have some pretty big dreams +C: yeah +T: it's great that's really exciting to think about that and he's going to be looking forward to the future and those things all right well one thing I'm going to ask you about is um you know different people have sort of different things that they really value in their life whether it's you know their cultural identity or their family or their friends or job or hobbies things like that so here's a little sheet that goes through just some basic values that might be more or less important to certain people like belonging or sense of community again cultural identity or family friendship modesty religion respect self-determination and spirituality so when you think about yourself which of these are kind of most important to you in terms of your life +C: um I think a sense of community and belonging +T: okay +C: I think those two and um respect respect +T: okay can you tell me a little bit about why you picked those three +C: yeah well I think the community belonging I kind of related them um you know how I said I was in the marching band I really you know I really enjoyed being in like that team setting of you know being with other people and all working to work together towards that one goal +T: mm-hmm +C: and then in terms of respect I I kind of view that as one of like my major like rules like I I really do think respect is important to respect myself or respect those around me so +T: okay +C: I place great importance in that +T: okay great so sort of being a part of a group and being a part of a team gives you a sense of belonging like you said a sense of purpose anyway and then the respect is really sort of all-encompassing it's not just Authority but respecting yourself respecting your teammates or your bandmates and other people around you okay that's great all right well one of the things I want to talk to you about sort of relates to belonging and your friends so what kinds of things do you like to do when you get together with your friends +C: um sometimes if you just you know go to the movies go to the beach like I had said or sometimes we just get together someone's house play some board games and hang out +T: mm-hmm and when you're hanging out with friends is there ever alcohol involved +C: yeah sometimes +T: okay can you tell me a little bit about how alcohol fits into sort of your social scene +C: uh well it's mostly just for for parties or party settings it's kind of to get things going and got everything loosened up as they say +T: mm-hmm and so when you go to parties most of the time there's alcohol there okay and how often do you think you would say you're drinking +C: I'd say um on a not busy month for instance I'd say about like two weekends out of the month two three +T: mm-hmm so about half the time you're drinking and half the time you're not can you tell me what's different about the days when you choose to drink versus not to drink +C: the days that we drink are mostly like I said they're parties so it's more of that whole partying and dancing and you know having everyone have fun and then when we don't it's a lot more relaxed it's a lot more hanging out playing board games watching a movie it's not yeah +T: so it really depends on what the activity is whether or not alcohols get +C: definitely +T: okay and do you notice a big difference or can you tell me about the difference in your enjoyment level at say a party versus and that you're playing board games +C: I think of them as as different I think you know like in playing board games and things it's meant to be relaxing so it's nice to have like that kind of breather versus with a party it's a lot more energetic it's a after at all it's very draining +T: mm-hmm +C: but in the moment it's quite fun to dance and have +T: okay so there's sort of pros and cons +C: oh yeah +T: okay what are the things that you like about drinking or like about alcohol +C: um it's you know when we drink we we tend to have more fun because I guess we're not you know everyone's drinking together we're a lot more loosened up and relaxed and not really thinking about stresses or things like that but it can be when it's too much drinking it can be can be obviously bad +T: okay so sort of in the the too much drinking or our times can you tell me some of the less good things or not so good things about alcohol +C: um a lot of times it will make make people stupid yeah you know people make dumb decisions and things like that we we usually try to be as safe about it as possible so like sleepover friends house and so you know we're not driving and it's mostly within our friend group so we're not worried about strangers putting weird things in our drinks but um definitely some of the ideas people can have when they're stupid when they're drunk can can be really stupid +T: hmm so you're trying to like you said not engage in really dangerous activities you're trying to stay put you're not driving you're trying to stay with people that you trust but yet it sounds like there's still some some things happening +C: sometimes yeah +T: can you tell me a little bit about that +C: well I especially don't like it whenever me or one of my friends like we drink too much and we hadn't up like throwing up and things like that that I don't that's not fun +T: yeah throwing up is never fun it's not and how often do you think that happened +C: for me that's happened to me once it was the first time I ever drank and it was it was a lot and you know what I was doing I was mixing all kinds of weird things I'm just kind of taking anything ever anyone gave me and that didn't end well but after that I have it but I do have friends that that still do sometimes so I'll end up like having to take care of them or something and +T: okay +C: it kind of put it down around my my fun +T: huh okay so on the one side some of the fun things associated with alcohol are people are just more relaxed sort of carefree and kind of let loose a little bit more on the other hand there's a little bit more I guess planning involved because you have to make sure that you're doing it safely or as safe as you can and then there can be some other consequences like throwing up or even if it's not you that sometimes you're stuck your your fun is sort of ruined when you're stuck dealing with a friend you drink too much okay any other not-so-good things about the alcohol +C: yeah people can get a little like sloppy I guess like they're all loose like with people and corners doing things that should be done in private and that kind of stuff +T: so you're kind of stuck being exposed to things you don't mean busy +C: yeah +T: got it okay all right well you mentioned a couple times that you've made a few decisions to try and limit the a dangerous aspect of the drinking why did you make those decisions +C: I just I you know have an aunt who is an alcoholic so I I see like the issues that are involved and I've seen movies and things I know that drunk driving is an issue so I you know I want to be as safe as possible in those terms and be in a setting where like we can let loose but still be safe like I someone's house or someone's parents home or something but so I like I know that there are dangers involved and I guess I want to limit that and still be able to have fun +T: okay yeah it sounds kind of similar to your your value of respect too so on the one hand you the drinking maybe helps with the belonging community to start if there's too much then +C: it sort of defeats the purpose +T: right and then with the respect one of the things you mentioned is really wanting to respect yourself and not sort of cross boundaries not sort of cross lines how do you think that the drinking fits in with that +C: in terms of what in terms of respect I think well in a way I do think that drinking is probably a form of disrespect to my own body because I'm not putting things I'm putting things in it that shouldn't be there and then but in terms of hot ways I am respecting myself I am I'm respecting myself by like trying to stay in someone's house and like trying to limit my drinking so I don't get to that blacked out like throwing up and everything and try to you know let loose but still be in control of my behavior so I'm not going to go with some random person I met in - I don't know where to do I don't know what and things like that +T: okay so you're sort of looking for that balance yeah how much you can drink to have some of the positive benefit but about crossover okay and what have you come up with it at this point do you have sort of a limit that you stick to or +C: usually well I start off by make sure that I make my own drink so I know what's in it how much is in it so that way I control how much I drink so I'll usually just you know get one of those cups and then make one drink and then I'll try to make it last as long as possible and I'll be like all right this is my one drink and I'm good in that way I still have something in my cup some people aren't going to be like oh here have some more like no I'm good I have mine and I'll still be you know having some to like let loose a little +T: mm-hmm and do you feel like that's working pretty well for you or you sometimes exceed that limit or or what do you think +C: for the most part it works pretty well because like I said people you know people come asking me trying to pressure me I'll be like no I'm good I have you know I still have so I'm like I'll get some later and then never end up getting anything but sometimes they'll be like hey let's take a shot and everyone's got it around like the kitchen or something ready to take a shot and then at that point I'll be like oh well maybe I can take one more and that's when I start you know falling into +T: okay +C: too much +T: so a portion of the time it's working well for you and another portion of the time maybe you like +C: I'd +T: like to make some adjustments to to make it a little smoother okay so kind of thinking along those lines how important is it to you to make some changes or make some adjustments to your drinking to sort of fit with your values and your goals for yourself +C: um I'd like to make sure that I you know in terms of respecting myself of my body I'd like to you know try to drink less +T: okay +T: like I you know it is nice to let loose and have fun but I'd also like it to be so you know I'm not damaging my body and I like my liver doesn't work by the time I'm like 22 +T: mm-hmm +C: and um you know have my friends on board with a similar mentality so we can kind of work at it together as a group as a community +T: uh-huh so kind of combined he has goals okay so you're you have a goal it sounds like of actually cutting back on your drinking how important is it to you to work on that goal on on the scale of one to ten where one is not at all important antennas it's the most important thing right now +C: I'd say about like like a six or a seven oh I like to work on it but you know if I get around to it I get around to if I don't I don't +T: uh-huh well why did you say six or seven rather than like a four +C: um because I still think it's it's important +T: uh-huh +C: I still you know like I said I don't want my body tried specially going to my school like I know how things affect your body and also affect your your social and your schoolwork and things like that I know that once I get to college it's not it's not gonna gonna work out being you know drinking every weekend and I'm like trying to wake up early and go to school take an exam I know that's not that's not feasible it's not a good idea +T: yeah looking ahead you can't keep drinking this way and reach the goals that you have for years now okay well how confident are you that you could cut down if you wanted to +C: I think +T: on that same scale from one to ten +C: I think if I made the decision I was going to for sure then I think definitely like a ten I know I +T: oh wow okay why did you say ten +C: it's just because I know that once I make the decision I know I can making the decision in the first place okay weather +T: okay and so you mentioned you know quite a few reasons why you would like to cut down have you thought at all about how you might go about doing that +C: um I'm thinking of maybe like trying to convince my friends without sounding you know dorky or something be like hey you know let's just stay in today like let's not go out or something or just be like hey I'm not like I'm not going to drink today and even if my friends do like being okay with them drinking around me not doing it and then then being okay with me drinking me not drinking and them doing whatever they want +T: so sort of trying to plan more activities that don't involve alcohol and then also trying to participate in activities without drinking yourself or maybe even drinking less than you're drinking okay does that sound like a goal you want to work on now or +C: I think so I think it's it's very feasible I think it's possible +T: okay um so I guess we'll talk about less alcohol activities and just making some notes to myself and then maybe I'm reducing the amount of drinking that you're doing if alcohol is involved okay so that's that goal sounds feasible you said would it be okay if we met in a couple weeks to sort of see how it's going +C: I think so that's good +T: does that sound like something you'd like to do okay well I really appreciate you spending the time talking to me and you know it sounds like you have a lot of really good goals for yourself really ambitious goals and going to medical school and you know becoming a psychiatrist or some some other form of physician you're really looking forward to doing well in school so you can get there and it sounds like you have a pretty active social life and a lot of friends who you feel probably would be supportive even if you cut down on alcohol and that you know there's a lot of benefits you see both to your body and your health you school performance and even some of the social stuff in terms of feeling a sense of belonging without having to deal with some of the gross consequences of drinking too much so yeah you know it really sounds to me like you have a good plan in place and as long as you're willing and interested in meeting again and be very excited to be able to talk with you about how it's going +C: I'd like to +T: alright great so I'll plan to see you then in a few more weeks +C: Thanks diff --git a/HighLowQualityCounseling/transcripts/high_007 b/HighLowQualityCounseling/transcripts/high_007 new file mode 100644 index 0000000000000000000000000000000000000000..37ffbe6db268341fb669279d936872735124be25 --- /dev/null +++ b/HighLowQualityCounseling/transcripts/high_007 @@ -0,0 +1,27 @@ +T: hi Lucy nice to see you today how you been going +C: yeah well thanks +T: great I'm just fully get started has anything changed with your medical history since I last saw you like any new medications or serious operations +C: No +T: great and is anything maybe worrying you about your teeth or your gums today +C: I think I might have a hole in my tooth +T: oh no what makes you say that +C: I can feel it with my tongue and it's a bit sensitive +T: mmm well let's lie you back I'll pop some gloves on and we'll have a little look Lucy it definitely looks like you need a filling um I'd love to help you figure out why you've got this new hole in your tooth do you mind if I ask you a few questions so we can try and figure it out +C: Yeah of course +T: great well here's a risk assessment form it's just a few questions that might help us figure out what the problem might be +T: great yeah it says here that you're drinking soft drinks in between meals what do you know about the effect of soft drinks on your teeth +C: I know it's not good for them +T: that's right um the bacteria in your mouth can use the soft drink to create acid that eats into the tooth surface and causes the holes the more that your teeth are coated in the sugar the more likely it is that you'll develop a hole did you know the one can of soft drink can have 10 teaspoons of sugar in it +C: I didn't know that so I shouldn't have soft drinks at all I'm not sure I could do that +T: yeah I understand it does sound like you're worried about getting holes in your teeth though there are a few options that you can do to help improve how you consume sugar would you like to hear about those +C: well I don't like getting feelings so that would be great +T: yeah probably drinking soft drink you could try drinking it all in one go instead of sipping on it or you could try drinking just at mealtimes instead of in between meals so does either of those sound like they might work for you +C: yeah I mainly sort of drink soft drinks in between meals though maybe I could just have them with lunch and dinner +T: great I'm in Romania to get a break from the sugar I sort of on a scale of 1 to 10 with 10 being the most how motivated do you feel you are to make this change +C: I don't like getting feelings so an 8 or a 9 +T: great and you maybe have any ideas that you could implement to help you avoid having soft drinks in between meals +C: I could carry a water bottle around with me +T: great that's a really good strategy and waters great for you too umm you can also try chewing sugar-free gum I mean is that something you're interested in +C: I might give the water bottle a try first +T: okay cool well look I'll put a little note in your file and the next time I see you if it's okay I'll check how you're going with avoiding soft drinks between meals +C: yeah that'd be fun and hopefully I won't have any holes next time diff --git a/HighLowQualityCounseling/transcripts/high_008 b/HighLowQualityCounseling/transcripts/high_008 new file mode 100644 index 0000000000000000000000000000000000000000..870fc7df017f40d178f37128265322675418048a --- /dev/null +++ b/HighLowQualityCounseling/transcripts/high_008 @@ -0,0 +1,11 @@ +T: so Jane it sounds like you're angry with your supervisor would what would I be right in saying that +C: well I think I'm pretty angry +T: all right look maybe to help me understand you know more about that anger I'm wondering if you could you know choose two or three pictures here that look like how you were angry at the time which which of the cards here that would show how angry you were okay don't I might just take a look at those okay it does look like anger doesn't it it's a pretty big anger so after you'd had that you know a big thing with your mum you you went to your room right +C: well she got really angry at me because on the way to my room my idiot sister got in the way so I pushed her out of the way she's just annoying so then I went into my room the only place that I really feel safe slammed the door and then mums favorite picture fell on the floor +T: thank you for sharing that with me because it really and being for being so honest about your anger because what it does is help I don't know if it's helping you but it's certainly helping me to understand that this is really big for you and it's a big expression but surprisingly you know anger anger's a good thing in a way because it's it's letting you know that something wasn't right and wasn't fair that he he just did change the thing without your permission without you knowing so in some ways you had a right to be angry but what happens what I heard you saying in as you were telling me what happened next what happened next was that your anger took charge and he it did more than what it's meant to do your your anger is just just to let you know that you're angry okay but what it did what I feel it did it just pushed you out of the road and said I'm I'm taking control here so Jane when you were angry did you feel it anywhere in your body +C: well my neck is really sore and its really paining and and my shoulders I just it's really like it's it just feels like I've been I've been hit by something +T: the end of the day that that pushing your sister over and yelling at your mum did +C: it's made it worse yeah +T: yes which is hard to see at the time I I do understand that but what I'm thinking is that if sometimes if we tell our anger look thank you you've done a good job it doesn't have to get so angry then because you you know you you're telling it that it's thank you you've done a good job you've let me know I'm angry now I'm going to deal with it from here +C: you have to help me with that a bit i think +T: we will diff --git a/HighLowQualityCounseling/transcripts/high_009 b/HighLowQualityCounseling/transcripts/high_009 new file mode 100644 index 0000000000000000000000000000000000000000..65d980f82edd577e71f7825cc17cd28eef32a050 --- /dev/null +++ b/HighLowQualityCounseling/transcripts/high_009 @@ -0,0 +1,21 @@ +T: hi I'm Amy the pharmacist so I understand you have some questions +C: hi I'm Mario and my doctor suggested I talked to a pharmacist about quitting smoking do you have the time for this +T: sure why don't you tell me a little bit about what you're thinking how soon you'd like to quit and why you want to quit +C: my cholesterol and my blood pressure are high my father and my uncle both had heart attacks when they were pretty young so my doctor's been telling me that if I quit I'll cut down on my chances of having a heart attack +T: that's correct quitting would be important for you and it will reduce your chances of having heart problems +C: so that's the situation I've tried to quit a couple of times before but it didn't work so what I was hoping is that you could go over the different options and help me pick the best one +T: hmm I'd be happy to do that first tell me exactly which products you used and more importantly how you use them +C: first I tried the gum I like to chew gum so I thought this would be good so I chewed about three to four pieces of gum a day but I was miserable and I started smoking after four days then I tried the patch a couple of months later I felt pretty good for about a week so I quit using it didn't think I needed it anymore started smoking two days later +T: based on what you've told me it sounds like you didn't get the full benefit of the product a few pieces of gum won't get enough nicotine into your body to make you comfortable you need at least nine pieces a day for it to be effective and it has to be used in a very specific way not chewed like regular chewing gum +C: I admit I didn't read the directions last time +T: as for the patch sounds like it worked for you you just didn't stay on it long enough we recommend 10 to 12 weeks and this gets enough nicotine into your body to help reduce most of the withdrawal symptoms while you work on learning to live your life without cigarettes you were able to quit for a week with it so it seems like it might be a good choice now but there are others as well +C: yeah my doctor said something about a pill I didn't like the taste of the gum much +T: well that's understandable but you should know there are new flavors that my patients say tastes better to be honest all the medications are effective it's just a matter of what you prefer you've already tried the patch there's also a nicotine lozenge a nasal spray an oral inhaler in tablet form we have bupropion which you've probably heard called zyban and there's a newer medication varenicline or chantix +C: yeah I've heard of those but I think I'd rather stick with the patch and this time I'm gonna make sure I keep it on long enough it +T: sounds like a good choice for you and given that you have some experience with it and you know that it works for you um how many cigarettes do you smoke a day +C: about a pack a day +T: okay so you'll want to start with the 21 milligram patch for six weeks and then the 14 milligram patch for two weeks and then the seven milligram patch for the last two weeks it's pretty easy to use in the morning of your quit day I want you to put one patch on a hairless part of your upper body and leave it on for 24 hours and the next morning you take that off you put another patch on in a different location you want to switch site so you don't get any skin irritation if you have trouble sleeping you can take it off before you go to bed you read the directions on the box and if you have any questions let me know +C: okay I'm gonna try it again and read the directions and stick with it this time +T: one more thing there are two parts to smoking so there are two parts to quitting it's an addiction to nicotine and a habit the patch will take care of the physical addiction and help with the withdrawal symptoms but you'll have to make changes in your behavior if you want to stay quit for good +C: yeah dr. Ward mentioned that to me and he gave me the card for this quitting line +T: that's perfect our stay quit line is excellent and convenient so let's talk about picking a quit date and we'll get you set up with a box of patches diff --git a/HighLowQualityCounseling/transcripts/high_013 b/HighLowQualityCounseling/transcripts/high_013 new file mode 100644 index 0000000000000000000000000000000000000000..9adf662063244a4109b9c8a33ef8d0a6f8b3cada --- /dev/null +++ b/HighLowQualityCounseling/transcripts/high_013 @@ -0,0 +1,29 @@ +T: there's great seeing you thank you for coming to diabetes clinic today my name is Mark Smith I'm a pharmacist I work with dr. Pham and I we run the diabetes clinic and we basically serve to educate our patients so that I can better manage their their diabetes and looking at your chart I see that you are pre-diabetic so what we're going to do now is kind of focus on nutrition mostly diet and exercise okay +C: dr. Pham already made me get a nutritionist I know what you're going to tell me so Kyle Eve +T: okay okay that's fine I'm glad you had the opportunity to talk with the nutritionist I'm she's a very nice lady and she has some very valuable information do you mind telling me some of the things that she discuss with you +C: it's the same stuff you're gonna tell me +T: okay well I will show you what I normally go through with my patients and then you can let me know if there's any information that you covered with the nutritionist or any of the material it's new to you then that would be great as well basically we feel that going over the nutrition aspect of diabetes and pre-diabetes is so important there's so much that we can do without taking medications and we've seen many patients that have benefited from making just minor changes to their diet that are greatly impacted their health in a very positive way so to start off I'm just going to ask you a few questions about what you eat to get a better picture of your diet so first what did you have for breakfast +C: couple eggs bacon biscuits great +T: okay all right and then what about lunch +C: turkey sandwiches and chips +T: okay chips and then for dinner +C: spaghetti salad bread +T: okay spaghetti salad and bread okay so tell me then what about any snacking that you do throughout the day like any snacks or anything like that +C: I don't really snack but sometimes ice cream after dinner may be free in between meals benign occasion not very often +T: okay and also what kind of beverages and things that you drink what are some of the things that you drink throughout throughout your day +C: or constant constantly feeling hydrated some thirsty so I drink sweet tea all day long +T: okay okay well thanks for sharing a bit of information within this patient this kind of gives us a better idea of what you throughout the day so now I'm going to give you some information or show you some information about nutrition okay +C: all right know what you're going to say I need to eat less I've heard it all before it doesn't work for me so good +T: okay all right so that's that's that's my ministrations but just just kind of bear with me so when I gather from your best far as that you know already you're fully aware of the things that you need to do in order to live a healthy lifestyle and take care of yourself however you seem to find it difficult and you don't think that it works for you is that that's kind of the fish that I'm getting so explain to me what are some of the barriers that you feel exists that prevents you from eating healthier and losing weight +C: it's mostly the money it's expensive to buy foods that are healthy and I just can't afford it consistently also like foods it tastes good I hope these stuff doesn't taste good and I just don't want it and also my kids want the good taste in food so they wouldn't even eat it if I made healthy food +T: okay okay then I understand completely that finances can be a potential issue and an issue especially when it comes to eating healthy more importantly picking out the right healthy foods for your kids to end and also to have good taste is also a priority to you so tell me about you know we're going to switch and transition from diet and talk about exercise tell me about your normal exercise routine +C: honestly I only have one I haven't exercised in years just don't feel like it put all the money to join again +T: okay okay and then what are some of the barriers you believe that prevent you from exercising on a regular basis +C: well kids they take a lot of time group and money like I said gym memberships or there's several close to my home but they're too expensive for me to get and I just don't have enough time the kids take a ball a day of the day and then work +T: all right and then what what ultimate benefits let's talk about benefits what benefits that you feel that you can ultimately gain by by seeking out more nutritious foods and incorporating exercise into a daily regimen regimen and an overall losing weight what do you think would be the benefits of doing all that +C: I guess it's good for you dr. Pham always gets mad at me and says I'm not healthy and always talks about my weight +T: okay +C: maybe +T: okay maybe yes yes ma'am well and and then those things are exactly correct on what I would like to do miss Fisher I know that you're pressed for time I'm not going to take too much of your time but I would like to schedule min and I and basically sit down with you and kind of go over some some helpful alternatives and basically look at some cost effective type thing since cost is an issue with you and then also look at some resources that we can channel into when it comes to exercise you'll soon find out that some of the exercises that you can do they don't even require a gym membership so you know if that's something deal at because you mentioned to me that time and money are contouring for you so we basically want to work with you together to see if we can get something that that better suits you you know and get you on the right track when it comes to your pre-diabetes and overall losing weight so would you like to come in and scheduling Pullman with us about a week from now +C: yeah I mean you can help me with the finances and Ty +T: yes ma'am yes ma'am I believe that so what what we do is we'll schedule a week from now and but it was it was a pleasure talking with you and I very much look forward to working with you okay all right yeah we good rest of the day okay all right diff --git a/HighLowQualityCounseling/transcripts/high_014 b/HighLowQualityCounseling/transcripts/high_014 new file mode 100644 index 0000000000000000000000000000000000000000..9bef8493dbd5a5f84677ad7a115c53e2ce86c499 --- /dev/null +++ b/HighLowQualityCounseling/transcripts/high_014 @@ -0,0 +1,25 @@ +T: hi I'm Andrea +C: until nice to meet you +T: nice to meet you so what brings you here today +C: well I just been feeling really stressed out lately because it's coming to the holidays and my teachers have decided to lower the class with everything these next couple weeks so it is overwhelmed with it all I had I have like feel like I have so much stuff to do and what are those personalities like for crafting a variant I can't with what I have to do and I wanted to well but I trust I'll be doing that and have the holidays I'm trying to prepare to my home Thanksgiving lots of stuff going on then and then boy is coming to visit me for Christmas +T: that's nice so hearing me say is that you're stressed with all this going on at school and preparing for the holidays that's that big it's really a lot on your plate +C: it's like if it was just the work if you find that I'm stressed about that too and I'm worried about me even think oh it sounds kind of silly but you know your boyfriend coming home for Christmas is kind of a big deal +T: for sure +C: and it's like I wanted to like my family but I I'm not excited you didn't put him to be bored you know I mean that's I shouldn't even be in my mind you know I should be totally focused on school right now it's just +T: so do you feel like you but obviously we're this far on this semester how well do you think you've done well thus far +C: yeah actually I've been doing a lot better in this semester and I think that because of it I wanted to want to keep to move on I want to get I like I'm over a cheer instance I like skip good grades but that makes the procrastination like I'm really good at working under pressure but I can't work under pressure with this up because if I don't start doing in advance I won't get it done and I'm trying to figure out how to just balance to you +T: do you think if you do what are some options that you see you may have preparing yourself to get the assignments done +C: oh I guess just I've considered you know being very turning off all of my electronics of when my computer I'll need it to do the whole market and doing like a to-do list and just really disciplining myself that you know I have to do it but as soon as I get my computer and like Facebook and gave you the things that distract me I keep finding myself putting it up and putting it off +T: have you tried anything that might have works in past - +C: well we recently had fire home and we did the whole fascinating and I fasted like my computer completely I was a lot more with internet at all and to really do anything with electronics and I think that just having that goal in my mind and because it was forgotten I was able to really just not do it and I did so much homework during that week that I've ever done so maybe just really sitting at one with God could help me to better I should I should do it it's just so much easier said than done you know because we're college students who want to go have fun and we wanted to be with our friends but I mean I've had to cancel all my plans and this is why purple holidays at lunch sometime a benefit just frustrating me the teachers you know I mean I know that they did all something followed but there's just so much to do +T: it's overwhelming that getting all your stuff inside working out strategies +C: I think that you know girls are always overachievers and we can't just chill and like even my fans always like why don't you just relax they're plump up your deal but I'm trying to think that but I don't like it's a big deal school some things ago because I'm not really talented with my music okay dance or any of those things but so many people are into it so school is like my gift I do good and I understand it so to not feel secure and that is kind of +T: so you put a lot of pressure on yourself when I hear saying it's cool because you like that - +C: hey I guess it is a lot of pressure I mean I remember in high school my brother was like the good pop and he's older than me he would come back with bad grades and I would come off straight A's I'm so excited you know tell me about your day Ethan Anthony was just like give him all these pitches he did so bad the whole time I always wanted to shine [Music] maybe I do need to just relax and know that the day-to-day thing +T: do you feel like you've done involve thus far the semester your classes +C: I think I've got some of my closest I'm not sharing because we don't really get product reports in them but both classes I do you know yeah I'm doing well and but you know there's so much riding on these next few weeks I don't do well on these assignments like it could totally mess up all that work so +T: so your primary concern really is for the speak you have to get done this week I remember me just said earlier about creating possibly the creating the to-do list or do you think do you think those things that you mentioned earlier would be good +C: probably just do it talk about it but I guess it's just nice to know that +T: completion with that and going the holiday do you feel like when you do how do you feel stressful week +C: toy was always really really relaxing so I think that'll be good it's kind of like a reward for getting through it but then I have I mean these goodies won't need a week and I feel like we'll be doing a lot in preparation for my boyfriend coming for Christmas so it won't be everlasting back for three more weeks of school and then like columns here and no it's like breach I mean it should be +T: so it seems like you have a lot going on this week but you seem motivated and now to complete it and you have the break to look forward to but you said it so that sounds like you you're almost there you're going to make it so it's good hearing from you [Music] diff --git a/HighLowQualityCounseling/transcripts/high_025 b/HighLowQualityCounseling/transcripts/high_025 new file mode 100644 index 0000000000000000000000000000000000000000..fa168a8256bbe431e3560e365e31bbd9032946eb --- /dev/null +++ b/HighLowQualityCounseling/transcripts/high_025 @@ -0,0 +1,21 @@ +T: hi Josh great to see you how's everything going with you +C: yeah fine thanks +T: great okay so before we get started are there any changes to your medical history such as any new medications you might be taking or any serious operation since the last time I saw you +C: no not that I can think of +T: anything worrying you about your teeth or gums +C: no not really +T: okay so what would you like me to do for you today would you like me to simply do a check-up let you know what I find and perhaps help you have a healthy mouth +C: yeah checkup sounds good +T: sure okay let's lie you back very some became one of your lower molars unfortunately Josh it does look like you're going to need a feeling I would like to try to help you so we can determine just how you got this new hole may I ask you a few questions so we can avoid it from happening in the future +C: can't you just put a filling in it and just fix it +T: it sounds like you're keen to get healthy I like your practical attitude the new filling will fix this hole but it won't stop new holes from occurring as I said I really would like to try to help you so we can avoid you having to get any fillings in the future on that note would be really great to try to get to know what you've been eating and drinking +C: look I know I've got a real sweet tooth I don't need you to talk to me about that +T: you obviously know yourself pretty well thanks for these helpful information +C: I know it's bad for my teeth can we just get this feeling done +T: you're right that it's bad for your teeth should I possibly give you any more information +C: yes sure +T: the bacteria actually use the sugar that's in your mouth to create acids and it's these acids that eat through the tooth surfaces to cause holes so you could say the more the teeth are coated in sugar the more likely it is that you're going to get holes if we're able to chat a little bit more about your diet I might be able to help you so that we can reduce the risk of you needing fillings in the future +C: or anyone I chat about my diet right now can we just get this feeling done +T: okay it sounds like you're not ready to chat about this today is that okay with you if we have this conversation at some point in the future +C: yes sure +T: okay great I'll make sure I make a note in your file and then if it's okay with you next time you come in we won't be able to pick up where we left off today you've got a lot in your mind and I don't really want to overwhelm you some people actually like to jot down the sorts of things they've been eating and drinking and bring it into the next visit or have actually seen some really great apps on smart phones where you can record this sort of information really easily it's up to you of course I'll leave it to you to think about you diff --git a/HighLowQualityCounseling/transcripts/high_030 b/HighLowQualityCounseling/transcripts/high_030 new file mode 100644 index 0000000000000000000000000000000000000000..def5fdff8bcaa68f86f1e0bc067e5f9a621fae80 --- /dev/null +++ b/HighLowQualityCounseling/transcripts/high_030 @@ -0,0 +1,56 @@ +T: great hello my name is Sara I'm the student pharmacist at what's a name and how can I help you +C: you can comment miss trans I'm just having like a migraine today so I'm coming in hopefully you can make any recommendation for me I choke fatigue cold and tired +T: all right when a scale one to ten how bad is your headache +C: it's about seven +T: oh I see you and a lot of pain right now +C: yeah +T: when did it start +C: um it start a couple of hours ago and it's it's getting worse +T: did you take any medications yet +C: um no not not at all not at all +T: so what makes it better and what makes it worse +C: so if I'm exposed to allow noise and then light I tend to tend to get worse but then if I you know I'm going to a room and dark room and no light no without noise and I'm it's getting better but still I'm still having like a you know really bad migraine +T: dude they do again those migraines select orphan +C: um only once once in a while is very rare I'm not really often at all +T: okay so before I recommend that medications to be and before I will I want you to ask you about your past medical history +C: okay +T: do you take any medications or do you have any medical conditions +C: I I have diabetes so I'm currently taking metformin twice daily other than that I don't think I take any other medications at all alright +T: alright do you smoke +C: um I don't +T: do you drink alcohol +C: occasionally +T: occasionally how much +C: drink one drink like maybe what +T: it's all right +C: yeah +T: no that's all right there's any allergies +C: not that I know no +T: okay so I will recommend medication this one it's called excedrin extra strength it has if the one tablet contains three different medications inside first one is acetaminophen it's a pain reliever and the second one is aspirin it's a pain reliever and it's also anti-inflammatory drug hours and also it contains caffeine +C: okay +T: and caffeine scanners constrict your blood vessels in your brain and also can relieve pain from from the migraine +C: okay +T: all right so this medication because of your your headache is very bad I would recommend you to take two terabytes +C: okay +T: by mouth every six hours but not more than eight tablets a day I say and you should not be taking this medication for more than 72 hours not more than three days and if you still feel the symptoms they're handing now after three days you should consult your doctor +C: okay +T: all right +C: okay +T: and the best way to take this medication is with water +C: okay +T: with a full glass of water and if you feel upset stomach you should take it with meals +C: okay +T: food okay +C: okay +T: usually this medication does not cause any major side effects however it make was obsessed Omikron or vomiting and you may feel a little bit nervous of shaking +C: okay +T: because of caffeine all right and then I would advise you not to drink any alcohol tourist medication because it may increase your risk for a stomach bleeding or a liver disease all right and you should not be taking any other medications over-the-counter like Tylenol or ibuprofen advil that personally don't take any of this because it already contains no aspirin okay because it contains a renter those products so you should not be taking too much of it and I would also advise you not to have too much coffee or caffeine in general +C: okay +T: all right because this product contains caffeine inside +C: okay +T: all right and also this medication does not have any drug interactions with your metformin so don't worry affect that's what I am concerned okay and you know so how so do we have any questions for me +C: um so so I just take two tablets every six hours for the cost of water +T: all right +C: perfect thanks so much +T: oh yeah oh you're welcome so you need any more help any questions you can always find me here +C: okay perfect thank you diff --git a/HighLowQualityCounseling/transcripts/high_031 b/HighLowQualityCounseling/transcripts/high_031 new file mode 100644 index 0000000000000000000000000000000000000000..f4d7bc1826b61edd82808d6aaf2f4804343b94a8 --- /dev/null +++ b/HighLowQualityCounseling/transcripts/high_031 @@ -0,0 +1,19 @@ +C: many people have told me if I quit smoking I'm gonna gain weight well food really doesn't taste good but they say it tastes much better if you quit smoking +T: mm-hmm +C: now the downside to that is I'm gonna gain weight +T: mm-hmm +C: that means a new wardrobe which I'd like to have but I can't afford +T: so right now you're seeing that it's a part of your life it's been a part of your life off and on for 18 years it's become a more important part of your life because you found yourself smoking at times that you thought I'll never smoke then +C: yeah +T: and your worry is that if you stop you will end up gaining weight so I'm hearing this kind of list of things that don't feel so positive about stopping I'm wondering what else might be on that list +C: withdrawal hmm they say it's awful being cranky +T: mm-hmm +C: and if I do go through this I just hope my friends understand and will support me and what I'm trying to do +T: mm-hmm okay yeah so added to the other other list is they're having to go through the withdrawal the unpleasantness of that +C: okay +T: what else might be on the not-so-good side about smoking and that's talking +C: um I think everything's on the bad sad about smoking but I'm just smoked so long I just can't imagine not going through life without smoking I know I've got to stop I'm having no health problems from cigarettes +T: mm-hmm +C: at present but when the doctor told me this morning what could be waiting for me in the future +T: mm-hmm +C: that made me rethink everything diff --git a/HighLowQualityCounseling/transcripts/high_036 b/HighLowQualityCounseling/transcripts/high_036 new file mode 100644 index 0000000000000000000000000000000000000000..a9e8cf44d9f826beaca49c5e9369de7f14a99bd9 --- /dev/null +++ b/HighLowQualityCounseling/transcripts/high_036 @@ -0,0 +1,30 @@ +T: so where you said you'd like to start Sal is talking about your asthma and specifically about your dog and how one is affecting the other +C: yeah my as was just been out of control lately and my doctor says it might be connected to Oscar +T: hmm so what can you let me know or or what do you know about your asthma and the things that affected or might make it worse +C: I've got allergy testing it's just the dust makes it bad I thought the smoking was the main thing that's cut down and then they said the drinking might contribute to it too so I got a lot of different things I'm working on so that's what I know the drinking the smoking and the dust that I got the scratch test for +T: right +C: and and that's what I know and that I take the medicine for it +T: okay and that your pet has never been mentioned as a concern +C: no I've had it for 12 years and now it's a concern I don't understand +T: hmm yeah and I I can see that you've already worked hard to make some changes you've almost quit smoking you're just down to your last couple of cigarettes and you're not even smoking those in the house and your house is totally smoke-free +C: does that work what the boy said yeah +T: okay and you have also thought about cutting back on alcohol and and I think you mentioned done done a little bit towards that +C: mm-hmm I'm a little I'm a couple down I used to drink for a night now I'm down to three at least +T: okay so now almost like that's not good enough like now you have to douse the dog and I mean and now what what's next +C: yeah yeah okay +T: so I mean there is certainly a lot of evidence that pets in the home and the dander from their fur can make asthma worse but I wonder what are your experiences with Oscar you know when he's in the house or maybe sleeping near you or you're around him what happens with your asthma symptoms +C: well we keep him clean like he's clean so all the dander doesn't really make sense but I have been noticing sometimes when he comes on the bed or just beside I wheeze a little bit but I think it has to do with um the hair the in my lungs cleaning itself up from the smoking so I don't know if it's that that's where I'm confused I don't know how this could be happening +T: hmm so it doesn't make total sense to you that that it's all Oscars fault and then that's the only solution +C: but the wheezing is something that I've definitely noticed a little bit +T: I guess I also wonder whether regardless of if your asthma symptoms are connected to Oscar that may be part of you feels like it's worth it because he's been such a big part of your life for so long +C: mm-hmm mmm I just want some medicine and I want to keep Oscar and I want to feel better about myself because I'm making all these changes in my life in it honestly feels like my my nose is just above the water +T: mmm yeah and and in the end you know whatever you whatever you do about Oscar about your asthma about all the other things that we talked about on that agenda setting worksheet I mean you are in the driver's seat salad it really is your choice +C: hmm ya know that feels good that I you know ELISA it is my choice I just feel like just about I'm not feeling happy about just all these different things that are coming up and I'm kind of sad about things and I don't know I don't know what to do +T: there's a lot of decisions and a lot of change with your wife with the new baby and and now thinking about looking after your health and wanting to be healthy for your wife and your baby +C: you know I want I want Giancarlo to grow up with Oscar so he has his friend when he's young too and I just it's a lot of stress and a lot of things you got to think about and I'm not feeling good about it +T: mm-hmm so what what would need to happen or how would you know when you win or if you ever did have to make a decision about whether to keep Oscar with you or not +C: yeah how would I know I don't know I think if my asthma got really bad and the medicine if she gave me the strongest medicine and I wasn't working +T: mm-hmm +C: that would be the way right now cuz I can't see I don't know how I'm gonna give this dog +T: oh yeah and it got the feeling that it's something that you want to think about that this is a really big decision and it's not one that you're gonna make in a hurry +C: no no it's something I got to just sit there and kind of put the pros and the cons on the table about but something's going on diff --git a/HighLowQualityCounseling/transcripts/high_037 b/HighLowQualityCounseling/transcripts/high_037 new file mode 100644 index 0000000000000000000000000000000000000000..d3dc118b748ed3083cd29aa05d827ad4342c9f73 --- /dev/null +++ b/HighLowQualityCounseling/transcripts/high_037 @@ -0,0 +1,29 @@ +T: hi my name is Arielle and I'll be your dietician today +C: hi my name is Emily +T: nice to meet you Emily what can I do for you today +C: well my doctor sent me to you because I have diabetes type 1 and I've been struggling with that blood sugar diet +T: have you been keeping up with your insulin injections +C: I have actually but I've skipped some a few times because I heard not taking them actually helps you this week +T: and you have lost weight recently correct +C: yes +T: I see well looking at your anyone C value of 12 tells me that your blood sugar for the past few months has been very high we want to try and get that value down to seven when you skip your injections do you notice anything different or do you feel differently +C: um get headaches sometimes and +T: okay those are actually symptoms of hyperglycemia or high blood sugar let's caused by a deficiency of insulin in the body do you know what ketoacidosis is okay when there is no insulin in the body the cells cannot get the energy they need to function to compensate that your body begins breaking down fat body this is what is referred to as ketoacidosis and this can be very life-threatening by leading to coma Oren's of your cases even death so those experiencing I'd usually have stomach pain nausea sometimes I have breath that's most fruity or like they say it smells like acetone or they have very labored reading what they call Kussmaul respirations and this is why taking your insulin injections it's very important so without it your body can't function +C: Oh I dunno about that I knew I was supposed to take them but I thought skipping with you here and there wouldn't be such a big deal +T: well your body is completely dependent on those injections as without them that glucose gets built up in your blood if continued hyperglycemia will develop which is very detrimental to your body and then it's not corrected quickly it will need to ketoacidosis +C: if there's so much sugar in my blood then why or whenever I should get my injections then wait +T: that's a good question my guess is that all the sugar it needs somewhere to go so your body gets rid of it through urine which is why you're always using the bathroom because you're gonna run up someone to fluid +C: we're going to lose weight +T: you're basically depleting your wash stores and becoming dehydrated +C: oh that makes sense now that explains why I'm so thirsty after I just get injections +T: exactly what we want to focus on is keeping your diet and insulin dosage in check also physical activity can help lower your blood sugar and help you lose weight and healthy weight what is your normal diet look like +C: well to be honest I pretty much eat whatever I want the whole carb counting is just really okay +T: well hopefully I can explain carb counting a little more in-depth for you with carb counting our goal is to spread out the consumption of carbohydrates throughout the day in order to normalize your blood glucose so in general 15 grams of carbs equals one serving of carbohydrates so this will make it easier for you and trying to determine how many units of insulin you need to take and after eat a meal so one unit of insulin for 15 grams of carbohydrates at d1 service or however your doctor tells me so how many nails and snacks do you eat today +C: I need three meals and snack appropriately throughout the day so it's a couple of times +T: okay so a starting point I would say aim for about 60 grams of carbohydrate or four servings at each meal and then between zero and 20 grams for each snack which would be about one serving of carb and also with each time you're getting your carbohydrate so at each meal make sure that you're dancing that out with some protein and fat as well so for example if you're eating like a piece of toast maybe put some peanut butter on it so that way you're getting your protein and your fat in there as well so do you know what counts as a carbohydrate +C: bring +T: yes but there are cards instance of other places you find think up like fruits starchy vegetables milk yogurt and sweets and generally the next Rishon table can tell you how many carbs are in something so I haven't had that for you and on this front and up it shows you the nutrition label and it tells you the total carbohydrates and it kind of helps you break down the steps and like how to do the math so in the total carbohydrates you wants to have sugar alcohols and fiber and because you don't completely absorb those those don't quite count in your total carbohydrate so this helps you do the math on that and it makes it a lot simpler and this basically just breaks it down for you completely on the other side I hat side I have listed the some examples of foods that may not have nutrition labels on them so like fruits like apples and bananas they don't usually come with nutrition labels but on here I have like what a serving would be and we come to cards I would be for that surgery it's like one small half would be 15 grams of cards so does this make any easier +C: sure does +T: alright well just be sure to keep track at the top calories and fats are consuming as they can add up really fast and lead to weight gain I also recommend staying active as I can how can you lose weight and lower your blood sugar just be sure to check with your doctor on what you can do and then you should take your is one before changing up your routine +C: I will check on that thank you for seeing me and explaining everything in such great detail I will give you my carb counting and another counting another chart +T: my pleasure I look forward to seeing you and our follow up where we'll check on your progress diff --git a/HighLowQualityCounseling/transcripts/high_038 b/HighLowQualityCounseling/transcripts/high_038 new file mode 100644 index 0000000000000000000000000000000000000000..7bde592f1332dee4298e03508ce46a4dec578caf --- /dev/null +++ b/HighLowQualityCounseling/transcripts/high_038 @@ -0,0 +1,57 @@ +T: what's going on what are you feeling right now +C: um I'm feeling disgust to Scully about what hope I can't do this like you can't do this +T: so so tell me what that feeling of disgust is what are you disgusted about +C: uh just my body like just I don't know I feel like eating that just makes my body feel you know gross +T: mm-hmm +C: uncomfortable I don't know +T: yeah well it sounds like there's some judgments in there right so it sounds like probably you're having some judgments like I'm feeling really bad yeah +C: yeah +T: that sort of thing +C: yes +T: but but you did say it more descriptively which is great which is you're feeling uncomfortable right now +C: right just eating that makes me feel icky I don't know just +T: yeah and I can totally understand how you get to there if you're thinking I'm feeling fat I'm going to get fat you know it's an easy place to get to okay +C: okay +T: but I feel like we're missing something too because I don't think it's just discussed I think there's another primary emotion in there what do you think that might be +C: well I feel like just looking at that I that cake I feel like I just want to run out the door I just I don't want to be here +T: sure so what what emotion do you think that is +C: being afraid being fearful +T: yeah +C: of what will happen if I eat that +T: I think that's exactly right that's what I'm seeing you know I see you kind of curled up over there you know you have a very worried face you know and you're having a hard approaching it I think I think that's absolutely right that you're feeling fear and I want you to know that makes a lot of sense to me you know when's the last time you've eaten cheesecake +C: I honestly I can't remember I don't know +T: I know it's been it's been a really long time he certainly didn't need it all through you know when you were really stuck in your eating disorder you know I used to +C: I used to like it I remember that but it was such a long time ago and uh +T: and so you've been avoiding food like this for so long that it totally makes sense that you're feeling fear +C: right +T: and you had said this is one of the hardest foods for you so that makes sense to me +C: right so just see it like as a big blob of fat +T: right +C: that was that it looks like to me +T: that's what what what is that it's a big Wobbuffet +C: no judgment +T: yeah exactly you know I'm not gonna let you get away with saying stuff like that all right +C: okay +T: so because that's just not going to be helpful right now so what I'm wondering is since we know that it's fear that we're dealing with maybe if we can do some opposite action to that emotion do you remember what I mean by opposite action +C: mm-hmm +T: what do I need +C: instead of wanting to turn and run away from the fear of eating this and just you know check out basically right you want me to go towards it and you know just experience what I'm feeling and not go away from it +T: right exactly so you know fears associated with that urge like you said to run out the door so instead of running out the door we want you to approach the thing that's scary which is this cheesecake right now right +C: right +T: okay so I see how hard it is for you and I honestly it's hard for me to watch and I wish I could just take that away but as you know the reason opposite action is so important is if you if I just take that fear away by saying no more cheesecake it's just going to make you more fearful the next time you come in front of some kind of food that's tough for you make it work yeah so by doing this hopefully over time your fear all go down okay +C: okay +T: so can we have the fear right now and still take a few more bites all right +C: okay +T: let's do it so how was that +C: it's difficult +T: yeah I can see how difficult it is +C: what I'm doing it but it's not football +T: exactly +C: doesn't feel comfortable +T: no I wouldn't imagine it would but you did perfect opposite action right there which is you are feeling really uncomfortable and I can tell that but you still did it +C: right +T: do you feel a little bit proud of yourself +C: yeah +T: yeah +C: a little bit +T: okay so this shows me that you can do it so let's try again let's take a breath and then we'll go back and do more opposite action diff --git a/HighLowQualityCounseling/transcripts/high_039 b/HighLowQualityCounseling/transcripts/high_039 new file mode 100644 index 0000000000000000000000000000000000000000..d2a77543b6b3bdd2097dbb5efeaa926424a598f1 --- /dev/null +++ b/HighLowQualityCounseling/transcripts/high_039 @@ -0,0 +1,38 @@ +T: hi George my name is Kaylee I'll be your nurse today I just want to let you know that everything we talk about here is confidential however I do have to let someone know if you're at risk of harming yourself someone else or this child abuse going on is that okay with you +C: yeah that's there +T: okay so George doing a little bit about why you came into the clinic today +C: well I have type 2 diabetes and I can't seem to find the time to exercise +T: okay would you mind if we explore this issue a little further +C: no that's okay we can do that +T: okay so why don't we start by having you tell me a bit about your day and what seems to be getting in the way of you exercising right now +C: well I live a very busy lifestyle and had work I've children I have John you know and then being a diabetic there's so many soft activities that come along and it seemed to have gotten control of everything else but it's just exercise I can't seem to find the time for it and it's very overwhelming and I feel this encouraged +T: okay so it feels like you're having trouble fitting exercise into your schedule and you're starting to feel pretty discouraged and frustrated +C: yeah I just found out what to do anymore +T: okay so how important would you say this change is for you to make in your life we'll try on a scale from zero which is not important at all to time which is very important to me +C: they've always talked about exercise being important to diabetics and I can see how that is important both to me and maybe it's a seven +T: okay pretty important yes and how confident would you say you are right in this moment that you'd be able to make this change and we'll do the same zero to ten scale +C: oh goodness um there's just so much I don't think I can make this change maybe a two - +T: okay so hopefully we can get that confidence up a bit and from what I hear you saying it sounds like you have been successful in the past making these changes related to lifestyle and incorporating exercise into your schedule is another really big change that might be really difficult for you to make +C: yeah it might just even be too difficult maybe I should have even come here today +T: well you know what I'm glad you did come in today it shows you're in a serious about your health and you really want to manage your diabetes better I'm sure was really hard to come in especially since you're not sure you if you really want to make this change right now +C: well I know how important it is for to keep my diabetes under control and how exercise can have an impact on my lifestyle and my diabetes but I've tried everything and I just can't seem to find a time +T: okay so it sounds like you know what can happen if you don't incorporate exercise so you know the risks and at the same time life is life is getting in the way +C: yeah like I said that it's I just don't know what to do I know it's important for my health +T: mm-hmm okay so from what I hear you saying you're having difficulty incorporating exercise into your schedule and at the same time you know the importance of exercise and the risks associated with not exercising and being a diabetic is that correct +C: yes +T: okay but you mind if I provided you with a little bit more information about the benefits of exercise +C: sure I think that would be beneficial +T: okay good so for a diabetic an exercise can help lower your blood glucose which is very important you can also help lower your blood pressure and the great thing is that regular exercise can also help improve your energy improve your sleep and strengthen your bones and muscles which one of these benefits do you think you would appreciate the most +C: well I would definitely love to have more energy it's very very overwhelming you're having to do all these things they're not advantage I feel so tired and even though I feel tired I don't get any sleep at night I find that I can't sleep so it would be wonderful to have the energy do the things to my day and be able to sleep at night +T: okay so it sounds like you're willing to make a change and you're getting kind of excited about possibly having more energy +C: oh yeah +T: okay so can you think of any ways you might be able to incorporate exercise interest go to area +C: well I Drive my kids to school every morning kiss them to go to school because I don't start work till like nine o'clock so maybe I could walk them +T: okay that sounds like an excellent plan how many times do you think you could walk them to school this week I assume they go to school every day +C: oh yeah they do um I Drive them to school so maybe I can try walking them to school five days a week +T: okay George that would be great that sounds like a really good plan do you think there might be anything that could get in the way of this plan this week +C: no it should be a problem I'm talking so late and the wife sleeps here in the house so I'll be fine +T: okay so great so the plan is to walk your kids to school every day this week and maybe you can keep track of this on a piece of paper just maybe take off every day of the week that you've done your exercise for the day this way you can keep track of things visually and you know you can watch your progress okay so if you have any problems during the week please feel free to call the clinic and ask for myself or another nurse although this is your decision ultimately we are going to support you along the way I don't want you to ever feel like you're lowering this and we will we'll play to meet in one week to see how things are going and hopefully we can follow up after that and get that confidence level up +C: okay wonderful I'm glad to have you as it's important that you +T: thanks so much for coming in today I really commend you for taking that first step towards change thank you George +C: thank you can we for your help diff --git a/HighLowQualityCounseling/transcripts/high_040 b/HighLowQualityCounseling/transcripts/high_040 new file mode 100644 index 0000000000000000000000000000000000000000..8163ae89db4d90e4182667c2c66e273a4f4b622c --- /dev/null +++ b/HighLowQualityCounseling/transcripts/high_040 @@ -0,0 +1,81 @@ +T: well cast our walls I'm really glad that you were able to find some time to actually get get together +C: well it's good to see you're finally where you been +T: yeah that's right I know I was thrilled to see that you've made an appointment on my calendar and you know you have this benefit as a health coach and we've just never been able to find time to get together I know you're always running around helping someone someone or whoever I hear about that raving about pastor wall it's great help +C: well I've got people that try to fit into the schedule to meet him for breakfast or lunch and around the work schedule and that keeps me occupied and trying to fit the schedule is +T: sounds like you're really running 24 7 +C: or 7 24 +T: that's happily so blonde glad that you took the time out to you know think a little bit about yourself and spend a little time that we could talk about how things are going for you you know you give a lot of your time to everyone else but it's also good for you too you have some balance and think about things for yourself also +C: is it really sounds like it so that's great that you decided to come in well thank you for letting me come you okay +T: so tell me about how things are going over overall I know you had mentioned in your email that you lost some weight recently +C: yeah dead wife quit feeding me know +T: your wife's foot feeding you huh well I'm sure if you quit feeding you you would find some other great way to eat +C: but that's all good little exercise helps on that and splitting meals sure meals instead of eating that big portion that the restroom gives you you know we split it that works +T: so you thought you've really found that when you want to eat you both order wasn't one portion and share it +C: most of the time +T: okay so that and then adding more exercise +C: more exercise yep +T: that's what seems to have worked for you +C: yeah exercise helps +T: well what kind of exercise do you like to do I mean you probably get enough exercise just running around between folks +C: well I do that but you know I roll out of bed then I run around the block three ties then it kicked the block under the bed and go back to bed +T: you do do you have to go for that early morning block block and monitor the neighborhood +C: bicycle League works +T: basically +C: yeah that works um +T: how did you get into that +C: had a bike there and that's a good place to ride so that's easy to do +T: ok +C: easy to do and +T: sounds like something you enjoy +C: yeah yep good check out the neighbors see what they're doing is why they're really awesome right +T: then everyone's waving down pastor Walt with their +C: 30 +T: latest thing that they're not talk to you about oh good well if there was anything about your health you're still thinking about now in terms of you know what's your next goal or what your next step or something you're thinking about +C: mm not really that I know about +T: so overall things seem to be going pretty special you are you +C: things are good +T: yeah so that's that's that's awesome it sounds like good a great place and sounds like the things you have implemented +C: their works +T: and working really well +C: it works +T: well on this scale of one to ten you know like we use that pain scale with people as nurses how confident are you that you'll continue on with what you've been doing as far as the portions and though bike riding +C: Oh probably seven +T: is that a seven or an eight +C: sure +T: so pretty confident that things will continue on it you can maintain what you've been doing and that's great you're not a zero +C: well yeah like Cyril +T: well what makes you a seven and not a four in terms of confidence +C: I guess that's just the way I am is just tough and it can be done in maybe do it +T: well because you've been doing it and you've been consistent and successful with it +C: correct +T: and what would it take to make you be a nine in terms of being more confident that it'll happen all the time +C: oh just another couple days on the bike a couple days out good +T: so what I'm hearing you say is that's kind of what you're wanting to get to is being able to global add a little more to what your schedule is and how do you see yourself doing that +C: well that's the child because if you go to meet people for breakfast at seven thirty eight o'clock +T: Wow 730 a clumsy +C: and try to ride a bike before and shower and stuff ahead +T: that means you're getting up pretty early +C: so you do it in the afternoon what a ton of degrees no that doesn't work either so evenings maybe +T: okay so of course the Florida whether you've got those hundred degree humid temperatures where you feel like you're hot then you get on the bike +C: right +T: island by the evening is it is it cool down some and we committed to taking off a little need me +C: on the rare occasion all day +T: huh so that it's kind of picking those days of window I feel like going out there do I feel like sweating right now on the bike +C: that's it +T: uh-huh so that seems kind of like your next focus on just trying to implement that +C: yeah a little more be good but +T: well it sounds like you know you're doing a lot to really think about your house and to have a balance between what you're offering to other people but also taking time for you do you do anything just do do anything just for you time just to you know be able to just have your own time to enjoy and mind +C: like grab a good book +T: mmhmm +C: yeah +T: grab a good book that's always a great way to +C: personal leadership +T: uh-huh +C: looks +T: and you find that that gives you +C: what yeah not one of those fluffy novel things +T: none of the fluffy Harlequins or whatever that the women like to watch read huh +C: yeah note those +T: leadership something that gives you some more tools to work with folks that have some depth to them well that sounds great if we could just perhaps maybe talking you know a couple maybe four to six weeks and kind of see how that bicycling is going for you and just know I'm here for you and +C: that's good so you're going to be here +T: yeah I'd love to continue to be your support diff --git a/HighLowQualityCounseling/transcripts/high_047 b/HighLowQualityCounseling/transcripts/high_047 new file mode 100644 index 0000000000000000000000000000000000000000..abac1338a2886273de2d061fa8b25fb3ab5f6abc --- /dev/null +++ b/HighLowQualityCounseling/transcripts/high_047 @@ -0,0 +1,41 @@ +T: we'll there's some things that have come up in in what I've seen so far I I just want to talk to you about your blood pressure it looks higher than I'd like and and obviously that concerns because there are some things that can happen with high blood pressure and I got to point out that the smoking in combination with the blood pressure concerns me and there may very well be cause and effect I'm sure the last thing you need is is somebody to to nag you but could we talk a bit about your smoking +C: yeah sure I'm comfortable +T: okay okay so you smoked how long +C: well 35 my first time I smoked was a I was 12 years old it progressed as I got through high school and I've been a regular smoker since about the age of 17 +T: okay so about half your life you've been a regular smoker +C: yep +T: okay about how much you did +C: well oh it's kind of buried over that span of time but I'd say right now I'm about about half a pack a day +T: okay okay the most important thing I mean I've got slides will and statistics and all kinds of scary things I can say but the most important thing from my perspective is what your thoughts are about your smoking where you at with being a cigarette smoker +C: well I am aware that it's it does have adverse health effects and down the road I perceive me at making a change in my behavior and and knowing that the health consequences associated with with smoking but that day is not today I don't feel like I really use you know when it started off as I mentioned as a teen it was more of a social thing +T: sure +C: and acceptance my friends were doing it I got to college I was open and open to more people who were were smokers as well and it seemed to be more accepted and I've just been you know continued that uses of as an adult +T: yeah +C: you know it's it's for me it's now become much more of a habit and just a routine as much it is is the I feel like the the nicotine in the effects of the the cigarette itself it's very much part of my daily routine this is part of your life this is what you do +T: yeah and you know I know it's it's you know the cost and have gotten increase in over the last few years with with the cigarettes but uh but like I said at this point in time in my life I have a trouble seeing myself quit I'm a little bit concerned about you know I've had friends who tried to quit as well some successful some haven't been as successful ones that you know have quit they've noticed they've gained a lot of weight and and that's kind of concerns me in my age ranges what kind okay so you're doing a lot of good thinking well what what I heard you say and clearly you're a guy who sought through some things about your health what I heard you say smoking has some negative consequences and I don't want those things to happen but today's not the day I'm not gonna sign up and say today all all quit cold-turkey right you know appreciate that I would like to know will more about what you know about potential negative consequences when you think about what happens to smokers even half a pack a day what consequences are we concerned about +C: well my grandfather had had emphysema +T: chirp +C: which is you know a direct cause of his smoking non-filter cigarettes for 35 plus years +T: yeah +C: that concerns me +T: yeah +C: you know shortness of breath I noticed you know I still try to do some limited and exercise and and sometimes it's very labor intensive for me when I'm exercising that's a concern you know the health of my family my wife you know being exposed to secondhand smoke is mostly concern you know we're looking at starting a family soon and and I know that behavior will need to change when when that when that time comes but I guess you know in terms of other health concerns you know you know the more unpleasant ones the the complaints from the family members about the smell of me +T: yeah yeah it's our that the the social pressure is a rough +C: you know and now you know I with with different places and businesses outlawing you know smoking in side restaurants and bars around our area it's become much more of a challenge maybe publicly +T: so these real big health problems some of which your grandpa has emphysema certainly lung cancer another risk that people take and then you look at what's going on in your own health already a little short of breath sometimes not having the lung capacity that you'd like to have social pressure exposing your wife you know I I wish I could say that's not a word but I think you're doing some good thinking I do think part of why all this hassle about smoking publicly has happened is because if your wife's exposed certainly it's the two of you had children if your children were exposed there are some real health consequences to people who are around you when you're smoking and already some some sense of some symptoms you've had with so it's you're breathing all right are there any other you mentioned breathing and people's negative reactions your fear for your wife's health are there any other things that I should understand that you don't like about being a smoker other concerns +C: you know uh I mean I guess it's in terms of my health you know the my teeth the yellowness of that the whitening of teeth and the appearance that I have you know the I guess there's one thing on the surface that's of concern you know really I think that the respiratory issues that we talked about you know +T: sure +C: the lung cancer those were pretty much my primary big ones you're not concerned with but you know the the routine that I have with the smoking is it's so ingrained in my lifestyle that it's just really hard for me to fathom being of stopping +T: yeah +C: you know I've not really made a strong effort in the past to to quit you know if I've sampled some of the nicotine gum from friends who've tried it +T: right +C: and didn't care for that it was found it you know not an equal replacement for the real thing +T: yeah yeah +C: and I think that's kind of worrying +T: okay so so when you weigh things you just say man I'm concerned about weight gain this trick I know the gum didn't seem so great what else do you know we'll about sort of small steps people could take who don't want to get emphysema or lung cancer or have this thing progressed are there any small step you're telling me you're not really quit cold-turkey +C: well I think I mentioned in the beginning when we were talking at you know the the volume of cigarettes that smoke is kind of varied over the years there was a time in my early 20s where I was pushing close to a pack a day including trying to reduce the amount great is is one I guess more tangible a realistic option and in terms to losing it +T: absolutely +C: rather than cold turkey although I've kind of heard mixed messages that maybe cold turkey is the best way to go or not so I'm not really clear on what would be the best strategy to apply +T: well you've taken an important step will one of the first things I say to people who say I can't stop cold turkey is could you consider cutting back that's a huge step that is significant it's not perfect but I'm not in the business of perfect patience will I'm in the business of people taking small steps and this is this is a big one and I want to congratulate you I do know some things about other steps will and and even it sounds like quit cold-turkey isn't a step today but I do know some other options some other options to lay out potentially would it be ok if you and I talked about those other options that you could just file away for when you're ready +C: sure I'm always open to some suggestions and advice when it comes to this absolutely +T: great diff --git a/HighLowQualityCounseling/transcripts/high_048 b/HighLowQualityCounseling/transcripts/high_048 new file mode 100644 index 0000000000000000000000000000000000000000..9c9315211fb6677ffff328db34fb6495c78130f8 --- /dev/null +++ b/HighLowQualityCounseling/transcripts/high_048 @@ -0,0 +1,42 @@ +C: I'm feeling very stressed out lately a lot of tension couldn't tell me more about that I just feel like nothing I do is good enough I work really hard I try really hard but I'm still having a really hard time +T: so what I hear you saying is that you're feeling really stressed and kind of stretched out too thin +C: I am stretched too thin I'm trying so hard but I can't live up to my dad's expectations I really love him but it doesn't feel right or what it should be like my friend's parents support them +T: and what do you wish things would be like +C: I like to have more free time I have lots of friends and they get to relax and hang out after school and I don't get to do any of those things I like to do that or spend time with my boyfriend my dad has always pushed sports if it's not volleyball it's another sport and I just want to make him happy +T: that sounds exhausting so it sounds like you're feeling this contradiction of pleasing your dad and meeting his expectations but you also want to enjoy yourself and be young is that right +C: yeah +T: so that must be really frightening to be so confused about your dad's expectations and I also imagine you feel pretty frustrated with them yeah I am frustrated with them +C: if I don't please him it makes me feel like I'm not good enough +T: what do you think your dad wants you to be like +C: well he wants me to be in really good shape make the best of grades graduate with honors so I can get into a really great school and I know he just wants the best for me and I want to make him happy +T: I can really hear you really love your that don't you +C: yeah which is why not living up to his standards is so hard and +T: so it's this feeling that only a part of you is acceptable and that doesn't leave much room for you to be human does it +C: no it's like he wants me to be perfect perfect like those women in the magazines +T: yeah and if his love for you is based on picture what's the good at that +C: you're right it is no good I can't ever be good enough for him I can't ever live up to his expectations and we have this college visit coming up I feel like college is too far away is too far to the future I feel like it's too much pressure and I'm not even sure if that's where I want to go to school I could visit at any point but it's this weekend my boyfriend was going to take me to a concert that all my friends are going to I want to enjoy my life not worry about the future my dad said we had to go now even though he knows about the concert this weekend what should I do it's not where I want to go anyway but I can't tell my dad I could never tell him that's not where I want to go I want to be a kid I want to enjoy my life I just don't think it's fair why do I always have to live up to what he wants me to do what should I do should I tell my dad I don't want to go +T: so this is the conflict it's really hard for me because I want to give you an answer and I really wish that I could give you the answer you want I really mean that +C: but that's why I'm going to therapy I thought you were supposed to tell me what to do +T: well I don't mean to be evasive about this but I just I want to know what do you think you should do in this situation +C: I don't know why can't I just be like a normal person and tell him I don't want to go why do I tell him things I really don't mean +T: and so I catch that the real deep puzzle is you feel this what should I do sometimes it's sad for me to notice how hard you are on yourself about yourself and I really appreciate you sharing this with me well +C: yeah I'm hard on myself because I need to be but I hate how I always have to live up to such high standards +T: and so the thing that comes to mind is me asking what do you wish I would say to you +C: I wish you would tell me what to do I feel like there's a part of me that really wants to please my dad but in order to please him I don't feel like I can be myself there's just a part of me that feels lost and unsure of myself +T: yeah I really hear that and to me at the same time you don't sound too uncertain +C: oh really +T: yeah judging by the tone your voice it sounds like the thought of doing what your dad wants you to do is more uncomfortable than it is for you to actually tell him how you feel +C: I just wish you would listen that he wanted to know how I feel he just wants me to be the perfect daughter but he doesn't even know the real me +T: and so you sort of feel this I want my dad to like me for who I am +C: yeah I'm not the straight a size zero perfect girl and I can never be good enough I can never be smart enough or skinny enough and +T: when I think I'm hearing you say is that you'd like to feel accepted for your dad +C: yeah that's what I want how can I do that do you think I should say something to him +T: well I feel like this is a really private thing that I couldn't answer for you but I'll definitely try to help you come to your own answer +C: it doesn't matter how much I want him to accept me you wouldn't like the real me I could never live up to his expectations the thought of even saying anything is terrifying because I know he would be so disappointed would it even be worth it to say something to him +T: I'm really not sure it's an awfully risky thing to live and you'd be taking a chance with your relationship with him and you'd also be taking a chance with yourself +C: yeah it really is risky I'm never in control of anything sometimes I feel like the only thing I have control over is +T: that sounds really upsetting I think what I'm hearing you say is that by controlling food is the only way that you feel it you can make a choice for yourself +C: even just talking about it right now is making me really tense because it's making me think of everything I ate today counting the calories is one of the only things that makes me feel better because it's something I can control +T: so you're feeling anxious at the moment and like your only relief is in controlling what you eat +C: I guess that's the only thing my dad can't control that it's just mine I don't think that's right I wish I didn't have to be so hard on myself and I could eat like everybody else does +T: so it's quite clear that the problem isn't just with your dad or your relationship with him but it's also at you as well and in this question of how can I accept myself diff --git a/HighLowQualityCounseling/transcripts/high_049 b/HighLowQualityCounseling/transcripts/high_049 new file mode 100644 index 0000000000000000000000000000000000000000..5a8a633748857b64aa53acfd60ba840ce609a356 --- /dev/null +++ b/HighLowQualityCounseling/transcripts/high_049 @@ -0,0 +1,58 @@ +T: hi Alex my name is Tony I'll be your nurse for today how are you doing +C: I'm okay I guess just waiting for the stitches to come out it would be nice +T: okay tell me a little bit more about this firefight +C: okay story time you rate this so proud my girls having a fantastic time looking off on fleek and ish and then this girl like she has the nerve to stare at me from across the room it gives me this kind of it come on like this and then she comes up to me she bumps into me she spills my drink and she comes up and then she's like there man so I'm like excuse me so obviously I pushed her she pushed me kind of thing and yeah one thing led to another all right so it's a blur from that point on but all I know is that cops showed up I'm here and I have this to deal with fantastic great +T: okay from what I'm getting here is you were intoxicated at that point in time and then you had a confrontation with this girl which led to the bar fight and +C: I was more than toxic it Oh smash oh you should have seen it but like this type of thing doesn't happen often so I don't want you to be sitting here and referring me to some AAA because yo I'm not an alcoholic +T: okay so it seems that you can't offend that they feel offended you refer to me +C: yeah I'm not an alcoholic no I'm +T: okay because it labels you guys mom +C: yeah exactly +T: over yeah all right of all we do have some time right now if it's okay with you I wonder if we could talk a little bit about your drinking habits +C: yeah sure no +T: I do you what is drinking you for you would have +C: yeah well you know being 25 that's what we do like we get together we'd hang out we get a couple of drinks it's me and my girls we do this all the time and I love this it breaks the ice when we go socializing so meet new people kind of thing you know girlfriends circle it's it's fantastic and it definitely relaxes me after a stressful week and my weeks are so stressful is I need this you know so I mean yeah but just so you know I do drink responsibly and I never drink and drive and I don't intend on doing that +T: okay so to me this is our drinking is your way of relaxing with your friends is your way to socialize and it breaks that I guess right it helps you socialize and you know I'm I also wanted to say that experience I was responsible of you to be drinking and not driving +C: thank you +T: how does it affected your life +C: who has it well I mean now that this happens I do have it because of that bar fight and he's gonna be disappointed so I guess you could say that my relationship with Henry it's been great fantastic but he says that when I drink it's like I'm not myself it's like somebody has never met before and obviously you can imagine the arguments the fights and oh my god all that stress it's just I love him so much but you know but it does stress and that's like I don't forget to make it it it's just +T: so for my understanding drinking it helps you socialize his friends it relaxes you it's you know here we have just you know it breaks that ice for you on the other hand it's causing that a lot of arguments of do you and your significant other Henry +C: yeah +T: and it's causing a lot that that all those arguments are completed you a lot of stress in your relationship this manager +C: yeah I mean we're engaged you look pretty this is well I don't like you put it that way I mean I'm worried because what's he gonna think of me later on the link once again I tell our children all your mom is an alcoholic she drank this and they go into fight I don't want I don't want anyone to ever think of me that way but at the same time I mean I don't want to quit cold-turkey I mean you must understand how hard this is for me to even be here and talk about it but I love him so much I mean I would do anything for him and he's gonna be so he didn't even say I don't know how can I face him +T: this seems like a little Brady lucky died to have someone who loved him that much +C: mmm boy seriously he's not gonna find anybody that loves him as much as I do trust me on that it's not gonna happen +T: so what I'm getting here right now is that if you just want to quit +C: yeah +T: yeah and it's just partly because um but this alcohol is the leading to the arguments with Henry and it's necessary relationship +C: yeah +T: I noticed over a year there and I know you don't really like like the idea of it but what do you know about it eh like what's one shift of light on that +C: it's a place or alcoholics go to discuss their problems and like I said I'm not an alcoholic +T: mm-hmm well you're right there for multiple walks of life and they share their drinking stories and everyone just kind of helps each other through this journey if you can so prayer together +C: okay +T: I don't even want to join eight at this point in time +C: okay +T: mom's but hypothetically speaking would you ever consider joining it +C: if this is what I have to do to get my guy back and I'll do it +T: mm-hmm okay well on a scale of 1 to 10 I'm 10 mean like for sure and 1 being not really sure about it at all what would you say where you are on the scale with 20 an 80-acre know that you +C: put it that way and everything I told you I would say 6 yeah +T: why would you say sticks instead of say that's really I mean you're really adamant about not doing anything +C: well it's all about it's all about Henry at the end of the day it's it matters to me if I want to keep disengagement and I will do anything for that man so of course this is what I have to do this to do this is him live including his relationship with me and it's so much more important to me than drunk in a bar I'll tell him that +T: yeah so right now we're sitting at a six what needs to happen stated maybe we can jump that to an eight or nine +C: um you know like flexible hours maybe if that isn't even an option um also maybe there's maybe if there's a place nearby somewhere like nearby my house I'll be great so off to waste gas its expense I already go to work and it's far anyway and um like I guess I guess it has to do with attitude as well I don't want to sit there in a circle like this and somebody judging me because the way I look and my drinking habits and all of that so I guess I'm just looking for a good vibe you know I don't want to be judged not labeled +T: yeah all of these are like really understand aborning it's just of course you want something I mean you need to be close to use you don't have to commute so far and +C: yeah +T: we all have very busy schedules +C: yeah +T: the fish is very busy sniffle and Emily makes sense and of course the environment I mean if you're not happy they're just an even and learning and if you're not comfortable in it and it's very hard for you to +C: yeah +T: you know to be in that environment +C: yeah +T: well actually today I was wondering if it's a great view I can give you this for sure it's just for any medium you're really close to your location where you live +C: okay +T: and my number is also on then you can always give me a call if you have any concerns and also I just want to thank you today for sharing your stage of drinking and I know it's not you know easy to just tell me no this is a very sensitive subject down so I want to +C: thank you thank you for listening to me no one has actually sat down and talked to me about anything and I feel like you shed some light on an issue so thank you you're very really good he's alive +T: they're very welcome and if it's okay with you perhaps maybe we can schedule another follow-up meeting I'll tell you about like two weeks or so +C: yeah sounds fine +T: yeah that's okay two weeks work there +C: two weeks okay something diff --git a/HighLowQualityCounseling/transcripts/high_052 b/HighLowQualityCounseling/transcripts/high_052 new file mode 100644 index 0000000000000000000000000000000000000000..99ca920f6f9bca449fba04a30441dca473cacc33 --- /dev/null +++ b/HighLowQualityCounseling/transcripts/high_052 @@ -0,0 +1,52 @@ +T: look Carl how are you doing today +C: oh good good area I'm doing well thanks for asking last week you were talking in therapy +T: yeah I mean and I thought a lot more about it this week after I mentioned it last week but a joke I was telling you about Jill my coworker and you know she was kind of bothering me in the past couple weeks but really this this past week was like the worst right so she's not doing her paperwork and the thing is is that she has to do these reports in order for me to do my reports so if she doesn't have hers I can't do mine and then I can't get mine out in time for the next person to do their it's a mess the whole thing's a mess and it's just it's annoying me +C: so her work slowdown would not be efficient work is affecting your work productivity +T: yeah yeah it definitely is and it it's one of those things that like you know has it gives me a bad a bad evaluation you know like it if I'm not eating my stuff in in time then it reflects negatively on me you know and it's it's all kind of she's she's the first level you know and then all the other levels are kind of dependent on her turning things in on time so she doesn't then I don't then the next person and so forth +C: and it makes it seem like you're not doing your job +T: right yeah and my boss doesn't like it my boss's boss doesn't like it so forth you know and I try to explain to them you know she's the problem but it doesn't always I don't always have the time to go up and tell them like here's what's happening or it just somehow it doesn't come out +C: you don't always get the opportunity to tell people that are important at your work about the situation +T: yeah and that's pretty annoying too because you know it's one thing if people get mad at me but then I'm able to tell them why I'm not doing my job like I'm supposed to but it's another thing for them to get me into me not realizing my fault you know +C: you have an explanation for why the works that get done +T: yeah I did I do that's the thing but I can't always get it out you know I can't always tell the person that's has the complain about and yeah I mean I tried talking to my my boss and I tried talking other people too you know but really hasn't gotten anywhere +C: so you're feeling stuck with this whole thing +T: yeah yeah I mean I talked to Jill a little bit about it too you know and I tried to ask I tried kind of gently reminding her you know like such-and-such needs to be turned in by Tuesday at 12 o'clock yeah I didn't want to be real abrasive you know but I I tried to remind +C: it was a polite approach +T: yeah yeah and it didn't didn't really seem to work because it's still happening +C: your attempt to fix the problem hasn't really worked the way you wanted +T: no it really hasn't and and that's just I feel like I've tried everything that I could try you know and even like I came home and I was talking to a friend about it and I was trying to think of other solutions right you know I was trying to think like what else I could do what else I could say who else I could talk to things like that you know and I mean my friend you know he was listening in staffing had some good suggestions but it he didn't know what to do either like cuz he doesn't know the way the company so like I got nothing +C: you're not getting help you need for this +T: yeah not at all feeling pretty lost with it and then I wish it was just like a clearer way to do things like this is what you should do now and I don't see anything +C: some sort of clear plan +T: yeah yeah but I yeah I don't I don't see a way to go about it I mean I so I right so this is the way I lay down my mind I tried talking to the people above me mm-hmm didn't work out the way I thought it would I tried talking to the people below me so to speak just lower on the before me in the process that's what I mean and that didn't work out which it's just Jill and I talked to her and that didn't work so like there's nowhere else I could turn +C: the options are exhausted +T: yeah that's what it seems like to me +C: and this is frustrating for you yeah it is and I've been trying to Rack my brain you know like what else could I do you know like maybe if I could maybe if there was like a committee or something that I could go to you know and be like well this person's not doing what they're supposed to be different but there's not a committee like that or even if there was like a person you know like a resolution person or whatever but there's there's nobody like that +T: there's no other Avenue +C: that's what it seems like to me yeah and you knows I'm even trying to think like I don't know should I write a letter to somebody maybe but I don't even know who or what +T: you've thought about a letter but who would you send it to +C: yeah or like just something else that I could I can do instead of going to this person though that person that didn't work could I could I call us somebody is there anybody else in the company that you know might handle stuff like that but I mean there's there's HR people but that's I I can't really see where they could come in I don't know how Human Resources could deal with something like that +T: you don't view them as a potential solution +C: wonder me if there's like a but there's I mean I'm thinking now that there's got to be something or somebody or somewhere that I could put in like almost like a complaint or something like something's out of my hands and I don't know what to do about it look there's got to be something and now that I'm saying this I'm thinking that there's got to be +T: some other resource you haven't tried yet +C: yeah yeah and I mean now I'm trying to think back to my training you know initially you know what I think now that I'm now that I'm thinking a little bit harder about it a little bit differently about it I'm thinking that there's like man I forget what they call it now but maybe like a complaint but it's not the right word but maybe a complaint box or like suggestions or something and I think if I remember correctly those suggestions and those complaints get brought up at every staff meeting which we have like every other week +T: they're discussed at this regular meeting +C: yeah and I'm I'm thinking now I mean nobody really uses it but I'm thinking like maybe that's an avenue that I can use you know and like maybe that'll get brought up and maybe that's something that then might actually work +T: this could be another option for you +C: yeah it could be and then if it does work it'll get thrown and rather if they do read it it'll get brought up at the staff meeting where everybody's at my boss my boss's boss Jill everybody's there and maybe that's a way for it to come to everybody's attention that deadlines being missed affect other people in ways that you don't really know about +T: so everyone will hear your complaint and maybe react in a way to help you +C: maybe yeah I think that's I mean that's gotta be the way to do it and maybe that's the best way ever I really think yeah I mean after saying all that after going through that I really think that that's probably the best way to do it and if it if it doesn't and I guess I could find another way but I really think that's the best way to do it +T: you feel as though you found an option here +C: yeah yeah and even if that doesn't work then it'll be brought up and maybe it'll allow me to talk to my boss further about it and maybe he'll understand really where I'm coming from but this will at least be a start to something you know how to make me a lot less stressed with deadlines and stuff +T: you are frustrated with all this +C: yeah but maybe maybe after I do that you know put in the complaint or suggestion +T: mm-hmm +C: maybe I won't be as frustrated I'm gonna feel a little bit less frustrated now even thinking if there is another opportunity +T: it feels better now as you're contemplating and another potential Avenue here +C: yeah yeah +T: well this might be a good place to wrap this session up that feels like the right move for you +C: yeah +T: and well schedule so I see you next week and we can pick up from there +C: sounds good +T: all right cool thanks Carl +C: thank you diff --git a/HighLowQualityCounseling/transcripts/high_053 b/HighLowQualityCounseling/transcripts/high_053 new file mode 100644 index 0000000000000000000000000000000000000000..d5a6340612494b3ee74342843e991bd7ddda5211 --- /dev/null +++ b/HighLowQualityCounseling/transcripts/high_053 @@ -0,0 +1,60 @@ +T: yes there it goes okay hi I'm Sheila I'll be your pharmacist today um first can you describe by your name and birth date +C: um my name is carb and my I am 57 years old +T: okay that's good enough I just wanna make sure I have the right person and so I have three things for you today is that when you're expressing +C: yes +T: okay I just wanted to take a minute and go through these with you all right okay great I was like - these are results for you we have the Lance's insulin which is your long-acting insulin and then we have the metformin catalyst cannot look like what you've been picking +C: yes that's women taking +T: okay great and so I'm how do you be using these +C: uh my metformin I take twice a day and then the insulin I just take in the evening +T: okay great and then on this it says 48 units are you still taking that much or +C: yes for me +T: okay and have you noticed any side effects or any problems with these but I can help you in +C: no the doctor says my diabetes isn't under control +T: okay all right well it looks like they decided to add another influence and so what this is is novalog which is also called a smart insulin looks like um this one is one that you're gonna actually I should rephrase that and what did your how did your doctor tell you to take this +C: I guess I have to take that on before I eat carbohydrates +T: right okay great and um why did your doctor amasses +C: um because my diabetes is on control teas done +T: alright okay great so um you're right you're going to use this with meals and you're going to actually try to get before you eat so that may be a little bit difficult because you're going to estimate how much carbohydrate you're going to eat before you actually eat it so it might be a little dicey at first um try to help you with that um what did your doctor tell you to expect with the medication +C: um that the same thing that you said I'll have to do a certain amount of units for each amount a card +T: okay now with insulin there's some things that we'd like to that sometimes can be a problem too like hypoglycemia have you experience animal +C: yeah I have a little bit +T: okay how have you been managed genius +C: uh I eat like soda or drink soda sorry or like glucose tablets +T: oh okay great and usually keep something on you then okay it's going to be even more important now that you're going to be doing it so basically you're going to start with the one unit for 15 grams of carbohydrate and that might be a little bit abstract for you so I don't know if you've ever done carb counting before so I got you some information um this is just a general like nutrition facts thing that you would see on a food label +C: okay +T: so they make it really easy for you guys it just says right here a total carbohydrate so this is per serving though so I wanted to draw your attention to the top where it says it's serving size is you might have to do a little bit math here like on this one a serving size is one ounce but there's four servings in there bad +C: oh +T: if you ate the whole bag you would have to multiply this by 4 +C: so that'll be four carbs rather than one +T: umm right for a unit right because this is almost 15 or +C: 4 units +T: right so you would use for a units of insulin to cover a full bag of it so that's how you do the math +C: okay +T: now unfortunately this is more of a general average and since you're just starting on it it's probably not going to be realistic so what you're going to want to do is monitor this monitor your blood sugar and any type of like thing you can sense that you have when you first start this is um mainly a really like a range and some people leave one unit for like 9 grams and cards and some people need one unit for like 30 grams of carbs so it's really going to be dependent on how sensitive you are to insulin +C: so I might have to go up +T: yeah you might have to go up or down just depending on how you react so what I would suggest is keeping like a log with you I don't know if you're logging your blood sugar reading and like a paper log or if you're just keeping it in your letter +C: in my meter yeah +T: yeah it might be good idea to have like a moment of madness you just when you get started so you can kind of figure out exactly how many units you need per amount of carbs just as far as what you respond to yeah +C: okay +T: you know this is just another little thing about when you first start getting used to counting carbohydrates just grant information for you so um I know you've been on the Lantis and it's an injectable how have you been doing the injection +C: um just in my belly that's that area punching the pan now are you using like the same area on your abdomen or do you kind of use different sauce I rotate it between each side +T: okay now that we're adding another influence you're going to be adding three more injections a day perhaps so I gave you a little chart here there are other places on your body that you can inject other than your abdomen so it might be a good idea because you really do want to rotate by Senora tation okay um so you're pretty familiar with how to use a syringe then +C: yes +T: okay you have a sharps container at home to secure the needles great okay so just to refresh they're only going to be using a couple of units at a time with this so I'm each each mark on here is a one unit and it goes up to 50 so pretty easy at least it's not done by twos or anything +C: right +T: okay um so we've gone over a lot of information and just to make sure I didn't leave anything out we've come through a lot of stuff here um can you just tell me how you're going to use these +C: okay yeah um well my old medications I'm going to continue taking so I'm going to take the metformin twice a day and the nighttime insulin at night and then with the new one I'm going to take one unit for 15 grams of carbohydrates but rotate site so that I don't get any atrophy and then I'm going I think it's a good idea to keep that logbook and monitor my route post levels in case the doctor will need to adjust the dose of that +T: I think it's actually great and yeah I just wanted to maybe ask another question about um you know what kind of exercise habits we have or how is your blood pressure been I noticed that as far as what information I have it was a little high which is something it concerns us with diet medication so I would have even +C: um well I have the back pain so I can't exercise that much and lately I just haven't been going to the nutritionist as often as I should +T: okay what kind of barriers are standing in the way of that +C: my job I'm a principal I'm pretty busy this time of year +T: okay um as far as your back pain and what is the root cause of your family you know if it's like something that maybe a chiropractor or massage might help there's the low impact exercise maybe a hope it for you I don't know maybe you can bring it up your doctor or two or Long's we're gonna be getting on something like just walking or like a stationary bike or even swimming if any of those are things that you can implement it'd be a really good improvement come and anyone needs much insulin - +C: oh okay +T: one other quick little thing is that um so insulin and your amount of exercising and activity kind of go hand-in-hand so if you start to exercise more all of a sudden you may need less insulin so once you get started on this and you know how much you're going to use per how many carbs it may change with you come around which is a good thing yeah but just keep in mind because you may have more hypoglycemic events if you don't alter +C: it watch it but maybe I won't have to use as much +T: yeah exactly so what other questions you have for me +C: um I just had one question I don't know if you'd answer this or the doctor but my eyesight oh if I get this if I use the insulin and get better control well my eyesight get better or shot getting is worse +T: um it should hopefully stay blind not get any worse I'm not sure if it will repair at all I don't think it will but it's best to stop it now you know I stopped their progression so the better control you have the better it should be as far as not getting worse but I've definitely something it's gonna be important - especially your occupation so so yeah getting under control - great a great thing +C: okay thank you +T: all right well thank you very much and give me a call if anything comes up I have some more information for you here which is very much just what we've gone over but that we can write all right +C: thanks diff --git a/HighLowQualityCounseling/transcripts/high_054 b/HighLowQualityCounseling/transcripts/high_054 new file mode 100644 index 0000000000000000000000000000000000000000..de72ab7e821abac76738d3796597e196c93ba49c --- /dev/null +++ b/HighLowQualityCounseling/transcripts/high_054 @@ -0,0 +1,55 @@ +T: all right before our are you today +C: I'm good how are you +T: I'm pretty good sons outshining makes me happy +C: definitely very warm +T: thinking that wait so why are you here today it'll be a any specific reason sir +C: Oh my doctor said I had type 2 diabetes so I don't really want to go on medication so +T: oh that's actually very common today with medications doing it by a natural healthy lifestyle so she said you have text red beans did she tell you anything about that or I will level are we right now with the understanding of what type 2 diabetes is +C: well I know I had something to do with the insulin but she didn't really understand +T: well I'm here for you so what type 2 diabetes is is in your body that working called your pancreas secretes this insulin excrete hormone called insulin and what the insulin does is takes up the glucose that's in your blood it brings it into yourselves that they use for energy and in your case your body is still producing insulin but it's just not either producing enough or it's having trouble getting it into the cells for various reasons or you're producing it it's just not working your body loses insulin resistant right now so do you know why your cells need the glucose +C: err +T: yes exactly it's due form of energy and your brain needs a minimum level of glucose to function along with all your other organs so by not getting that insulin or by not getting the glucose into yourselves there's some sense there's starving going to ketoacidosis a lot of complications can happen with that so it's very important to maintain blood glucose and control your Sugar's with a type 2 diabetes +C: so that's why I've been so tired recently +T: yes that's a very good cause of it so yeah that's perfect so well let's talk about your daily routine in your diet and see how that plays into it right now so what do you do on a normal day or what times would she be okay +C: well usually I just start breakfast eggs bacon +T: okay +C: that for lunch they'll usually say like some deli meat bread +T: hybrid wait girl in purple and +C: then for dinner on like pasta or some kind of poultry +T: okay so have you ever considered maybe trying to buy like different made whole grain bread or whole grain pasta +C: yeah I mean we don't usually do it +T: okay okay so you know that you need to not control your blood glucose levels right to maintain the healthy lifestyle so what are your goal is to try and do that or why why would you want to do that +C: well I don't really do much exercising my husband you know sometimes their dog so +T: yeah +C: okay +T: so and then the exercise that's going to help by reducing the adipose tissue around your cells which will make it easier for the insulin to pick up the glucose and bring it into your cells so losing weight is always a key part in maintaining diet or helping to control diabetes and even if you're not necessarily using weight doing the exercise one really help you gain more muscle mass which what is the bad news and both is just another word for fat is it late with that around yourselves adipose tissue is that too soon yeah so okay so we've gone over some brainstorming ideas so let's pick some two or three things that we can really focus on so for next time maybe we can hopefully see a little luck because um before I said the doctor happened to give you a glucose meter do you know what that is or +C: know that when you pick your finger +T: that is what are you prick you maker yes and that will tell you what your blood glucose is so remind me at the end of thing and we can give you one of those if that sounds like a good option and then we can start having blood glucose readings and that will also manage your blood sugar that's a way to +C: how about help +T: well that will let you know where your blood glucose is so say in the mornings generally your blood who was this putting much lower because you've gone all night not having anything to eat you're gonna start the day fresh but at night it's kind of obvious that you've got all day you're eating you're tired your body's gone through a rough day your blood Sugar's public we're generally much more higher so if we have glucose readings say next time when you come in we can say see where you're at see if they're generally starting to decrease of what we're doing is helping or not and then you can go from there always and hopefully that will help so you won't have to run the medicine +C: okay what would be a good range question +T: usually we want to try and keep your blood Sugar's under 100 and especially in the morning waking up not having anything in your system I know 100 be a good number at night of course it's going to be a little bit higher so 120 80 would say we're trying to keep anything under there and you know what if you mess up and they're higher that's okay because things happen you may have wanted to go to a party that day eat a cake you know anything so things are going to fluctuate but if we come back and you generally have lower glucose that's as much that's very good sign much better for your body so so okay so I'll call these pretty serving things what do you think we can what are like two or three main things that you choose that you will focus on +C: okay well I think testing is pretty important then I could definitely try to exercise more because I haven't really been doing much of that +T: right right +C: and then I maybe the whole grains too +T: yeah and you always don't have to switch by it over either we can say go to the grocery store this time by white bread the next time I buy whole wheat bread or make your pasta half white half wheat things like that under sandwiches maybe one slice of white bread once it's we brighten everything up whatever work for you and also does your husband eat well or +C: I mean we pretty much the same nothing right cooking +T: okay so that's perfect do you think it's a good support +C: I can try to get +T: yeah exactly and you know what maintaining your health and maintaining his health is just going to better the both of you anyway so it's always nice to have someone to help support you and what you're doing and going on the walks +C: okay +T: and if instead of staying or going on a walk everyday maybe you can go every other day with him but it's a learning process so you don't have to jump into everything right away as long as you're taking the initiative now and trying that's always what's gonna help so if it goes wrong it is okay so let's go back and summarize what we've decided you know some be the three goals that +C: we've shared more pool greens more exercise +T: okay perfect and do you what times do you think will work good for testing for you or do you have an idea of how you'll like keep a journal maybe or +C: so I can keep the journal I'm more of a morning person +T: okay +C: Chuck Tesla +T: in the morning and then you'll know what you are for the day you go from there they said that sounds good to me so you seem very motivated and excited like you want to get better and that's always a good sign +C: I definitely want to stick around a long time for +T: I agree that's yeah it's a mingle a lot of people healthy lifestyle so okay do you plan on coming back and see an appointment for next time or +C: yeah that's a really good checkup +T: okay does three months okay and that way we can give you a long time because well look at your anyone see again your anyone see is a measure of how sticky your blood is basically and so it's a three month measure so you would take it two or three months it'll tell you how much sugar and stuff on to the red blood cells of your body basically so we can see if it's higher or lower it'll tell how you're doing and so +C: okay +T: that would be a good indicator where you're at next time I see you +C: okay +T: so thank you for coming in today Jamie diff --git a/HighLowQualityCounseling/transcripts/high_055 b/HighLowQualityCounseling/transcripts/high_055 new file mode 100644 index 0000000000000000000000000000000000000000..80f99122e3d770e1649ccd24890ac97d78ebc6b2 --- /dev/null +++ b/HighLowQualityCounseling/transcripts/high_055 @@ -0,0 +1,36 @@ +T: you in summary the minnesota state mankato security report states that you were stopped on Stadium Road last Friday cited for driving under the influence and then you are transported to detox plus you're only 21 years old is the report accurate +C: I guess so I don't really remember much like those a week ago so I was kind of drawn to +T: ok behavior like this could get you suspended doesn't that concern you +C: mm-hmm I mean not really I'm gonna be 21 in a couple months I'm potentially alone the cops came to me a minor I mean I'm not a heavy drinker like like my friends or anything I don't get wasted at all and I just hey be careful I just won't get caught I'm just trying to find like a normal college student +T: what were you thinking when you got into your car after having six beers you could have caused an accident and killed somebody +C: whatever I didn't know I called my roommates for a ride you sleepy so idea home somehow and this is name of my fault I can ride all the time but I didn't do anything +T: you need to take responsibility for your actions do you keep partying like this your problems will only get worse you're likely to face costly legal citations for grades health problems getting kicked out of school and disappointing your parents you don't want that to happen do you +C: no no like I said this is my fault like are we done here have class in 15 minutes +T: your behavior is now a Minnesota State University expects of its students if you want to be a student here you'll need to show that you're able to follow our rules do you think you can do that otherwise you'll be suspended +C: look I really like corn I miss you and I gilja sand you you're making some really good points and i'll think about them okay +T: okay well your sanction is you'll be placed on university disciplinary probation and you'll have to attend an alcohol education seminar that will cost you one hundred and fifty dollars also disciplinary action is progressive and cumulative meaning that any further violations will result in suspension for one semester or longer +C: $150 are you serious I can't pay that all right I'm done with those I'm good +T: in summary the minnesota state mankato security report states that you are stopped on Stadium Road last Friday excited for driving under the influence and you're transported to detox plus the report lists your ages twenty Dillon what is the accuracy of the report and can you share with me some details leading up to the incident +C: I guess that sounds that sounds right I mean I was kind of drunk and it happened like a week ago I just I drove over to my friends house just to go watch the game and you know we're having a couple beers and X and O the Vikings accountabilities in pretty big so we drank a little bit more than usual and I mean at the end I had to get home and I couldn't find a ride so I just rolled +T: you decided to drink more than you intended because you were disappointed at how the Vikings were playing and when your roommate couldn't give you a ride home you decided to drive yourself home did I get that right +C: yeah that's exactly how it happened I mean I'm a normal college kid I had to drink in a house and buddies I mean it wasn't a big house party or anything that got busted +T: yeah I understand that your intention would have a good time while watching the game with your friends you didn't think about what could go wrong when you drink alcohol underage because you were at your friend's house not a big party and you made an effort to be safe by finding a ride home +C: and I tried to be safe I mean I tried to call her roommate but I am getting in trouble anyways +T: dawn you told me what brought you here today what do you think the problem really is +C: um let's say I have a drinking problem I think I probably have more of a like getting caught problem I mean my friends they drink like fishes and I they don't ever get cotton and you got me over here and I get caught and left +T: sounds like you attribute your current situation a bad luck if that's what you believe and you don't attempt to make any change in your behavior what consequences might result +C: I guess I got some more problems with police in school and I really don't have like the time or the money for any of that +T: how important is it that you avoid future problems with the police or school villain +C: it's just super important because just just going to detox alone was was awful the experience I don't want to do that again and my dad said if I get suspended from school I'll have to have to go work on my uncle's farm in Iowa and that would just kill my social I don't see any of my friends and I mean it's already bad enough like my parents took my car away when I got the DUI +T: yeah what would you be willing to do to prevent going to detox again and getting suspended +C: well yes I I guess the easy one is I want to drink so much and I try to avoid situations where I'm more likely to get in trouble so probably I don't want to drink so much +T: on a scale of one to ten how confident are you that you'll be able to follow through with that plan with ten being very confident +C: I guess I would say like I don't like over halfway is so maybe like a sex +T: what steps could you take to move that six or seven or eight +C: I could probably I guess well it's the big thing would be like kind of where I drink so like drinking like if I'm only like in my apartment so then I'm not risking myself to drive very like if I go out to a party waiting to like I'm 21 to drink maybe find stuff to do that doesn't revolve around drinking like I'm guessing like a town this size there's got to be more to do the just drink +T: in what ways might your life be better if you succeed in making the changes you mentioned +C: um I mean I guess the big one would be like I went I won't be hungover all the time like I would make it to my 8 a.m. then well even even when I make it to my ATM's now like I just I sleep like I wake up I'm like oh my god what's going on and then I get to my 8 a.m. and I'll just sleep through and then I'm this just about everything that's on the test so I think if I if I reprioritize what is important to me it probably helped me succeed I mean in high school I had a 3.5 GPA is I know I could do it here +T: College is all about making choices can you tell me about your beliefs and values that influenced your decision making and how do those beliefs and values align with the decisions you plan to make about drinking +C: um I mean education is really important to me and and also my family talking about it and I really I really want to be an international journalist to be on the news like I mean I have the face for it so I guess if I reprioritize mind if I read prioritize what I need to do like and I won't drink so much I probably want to be disappointing my parents and I'd be able to get a really good education +T: thanks for coming in for participating today your sanction will involve being placed on university disciplinary probation and attending an alcohol education seminar that will cost $150 RS +C: Oh what is the seminar diff --git a/HighLowQualityCounseling/transcripts/high_062 b/HighLowQualityCounseling/transcripts/high_062 new file mode 100644 index 0000000000000000000000000000000000000000..a316ff4dac3e13bd2eafa67d9687ac637cbbd026 --- /dev/null +++ b/HighLowQualityCounseling/transcripts/high_062 @@ -0,0 +1,74 @@ +T: understand your boobs a little down lately +C: yeah I'm not feeling so hot +T: can't tell me how long you've been feeling down +C: yeah you know it's been a while extended like probably six months +T: six Ross okay tell me how many times you've felt this way in your life we've got periods of feeling down like how many of those +C: you know it's really the maybe second +T: the second time +C: yeah okay +T: how long did the first time +C: last year +T: so I'm gonna ask you some different questions about what's going on or it could be going on do you feel like your mood is depressed most of the day nearly every day +C: yeah +T: you do here are feelings of hopelessness emptiness I'd like that a little bit okay two other people see you as being sad yeah do you feel like your interest in pleasurable activities has decreased mustard a nearly every day you still have some how about significant weight loss or weight gain +C: yeah I don't fit in my clothes I've got about 15 pounds +T: is that unusual for you have you had any difficulty sleeping too much too little +C: the lime soup a lot +T: you feel like you're restless how about feeling of being slowed down any symptoms of feeling tired or losing energy coming fatigued +C: yeah +T: you feel that way how about inappropriate guilts or feelings of worthlessness +C: sometimes +T: sometimes +C: yeah +T: nearly every day or +C: yeah +T: have you noticed it's been more difficult for you to concentrate or being more indecisive that's right now have you had recurrent thoughts of dying or committing suicide any suicide attempts +C: I'm just really sad low energy not great +T: no how long has this been going on +C: for about six months +T: about six months +C: yeah +T: so I'm gonna ask you a few questions which ones resonate with you which of these items resonate with you that you're experiencing and which ones maybe don't apply okay do you feel like that your moods been depressed most of the day nearly every day like feelings of sadness hopelessness things like that +C: not every day I mean a lot +T: how about have you noticed a significant change in your interest in pleasurable activities most of the day nearly every day has your weight change significantly either losing weight or gaining weight +C: yeah +T: yeah +C: I barely have any clothes I can wear it about 15 pounds +T: is that what kind of weight gain unusual for you how about having trouble sleeping too much or too little +C: if they're like I'm up in the middle of the night or I'm sleeping you know like 10:30 yeah I'm sleeping a lot +T: I mean hours do you notice yourself either being more agitated or more slowed down in terms of your movements +C: slowed down so that's actually my husband said something about it +T: how about symptoms of fatigue or losing energy +C: I just feel like I I feel like a waste of space like I'm not living up to my potential like I've let my parents down I've let my husband Alan look guilt +T: you're having thoughts of ending your life +C: it's good to see you I was like last night I was thinking about when I was going to come in and I was thinking about like things that I wanted to talk to you about and I've really been concerned about a lot of things but you know what I mean it's you don't know what I mean cuz I would even set it yet am i saying but I'm really you know I'm getting a lot done I'm getting a ton done around the house I'm not sleeping very much you know I've been up you know all through the night but I had this where did I put that list where I could it but I have whole list of things I wanted to talk to you about tonight but you know my husband wanted me convinced I'm here and what is it that he wanted to talk to me about +T: well I wanted to talk to you about something we talked about earlier session which was a time it sound like a few months ago +C: yeah yeah I totally was it's so different from now I mean it's amazing now I love this feeling +T: you don't feel anything at all now +C: right now no I'm not I'm not I mean life is beautiful are you kidding me oh well I guess you could say that in the end I you know get it but I'm totally getting off topic what were you saying +T: well my sister questions about that that period of time in your town +C: is that significant I mean do you really mean +T: I'd like to find out what's going on there +C: okay +T: yeah that's okay +C: no that's fine that's fine +T: I know these things can be hard to talk about +C: it's okay so what was it that you wanted to +T: well remember we talked before you said it was a time it sounded like a started about a year ago +C: oh yeah +T: we were kind of down like now you're you see my good little off +C: oh oh you mean like my summer yeah right it was less no it wasn't it was last year about this time but then it lasted to the summer it lasted but women you know it was at six months and that was miserable I do not want to feel like that again and I mean I felt like that before I've been a couple times I think but you know like can I just tell you I am so productive right now that right back then I was not I definitely was not I thought it was such a different type of feeling I was like lying around on the sofa all day I was you know oh my god it was sleeping all of it I hate everyone meets right now it's fantastic I mean I categorized all of my photographs from when I was a baby through graduate school and I've got them and all these look good anyway what was I saying - I was talking about +T: is normal enjoy playing with your kids +C: oh yeah yeah +T: you just not through that time +C: that was horrible no +T: and you mentioned that you weren't sleeping too well do you have any weight changes during that time +C: definitely you know closer to 150 back Bettany about right now 15 and that's great but ya know I gained a lot of weight I do not want to go back to that again yeah I'm like 115 right now I went to Bloomingdale's last night do not tell my husband but they were having the most amazing sale I think I spent too much I mean I probably +T: spent a lot +C: but it was on sale and the stuff is gorgeous I mean if he saw it he really could not complain because I was meant to have it again seriously these sweaters are beautiful +T: so this symmetry which how you're feeling now sounds really opposite way you felt six months ago +C: oh yeah yeah yeah completely but I mean this is good so during that time so I'm going back down back to that time for a second did you have feelings of worthlessness +C: yeah but I mean I could probably guilt ya +T: can tell me about how the symptoms the presence of the symptoms like the frequency duration for example during that time period was that most of the day nearly every day that you felt this way did you have any trouble concentrating or making decisions +C: yeah +T: having a thoughts of suicide this is back this information is very helpful thanks Ian diff --git a/HighLowQualityCounseling/transcripts/high_063 b/HighLowQualityCounseling/transcripts/high_063 new file mode 100644 index 0000000000000000000000000000000000000000..663d7fd676ad1610b0d95ba308023949b031e75f --- /dev/null +++ b/HighLowQualityCounseling/transcripts/high_063 @@ -0,0 +1,134 @@ +T: at least how you doing today +C: I'm doing well thank you +T: doing well what's going on +C: I have family coming into town and I have to go to the airport to pick them up +T: so you have family flying in +C: yes I get very anxious about having to cross the bridge I have to cross the Ben Franklin Bridge and then get over the bridge that goes to the airport by the stadium I think that's a Gerrard Point Bridge don't wanna yeah that's two levels there I have to do that both ways and then call you in coming +T: both ways you have to do it across four times +C: yes +T: so what kind of feeling is just bringing up for you +C: I get very anxious even or thinking about it right now +T: so you're anxious right here with me +C: yes yeah +T: so I want to try to scale this we talked about this before with cognitive therapy so let's say that 10 is really the most anxious you're felt about crossing bridges right and one is no anxiety where would you be right now right now +C: probably an 8 it's worse when I'm at that point of that day but right now I think just knowing that I have to do that yes +T: and what's it on that day +C: yes +T: all right so but even now how far away is the until they +C: oh it's a week there's we coming yet +T: so even now a week out loses it's Nate this is really hurt +C: No +T: so for your job and local travel you don't really have to cross any +C: ten minutes to work everyday and bang so 20 minutes I went shopping centers and everything that's just within the vicinity I don't have to cross any bridges +T: right so no snow bridges yeah thanks probably planned it that way it's good I don't know +C: it worked out well okay all right coming up pick up the family you will be crossing so let's look at this in each stage okay so I mean you're clearly anxious now as you mentioned let's go to trying to move forward a week to the day that they'll be fine at what time they find it +T: it's gonna be a four o'clock flight +C: so about what time would you have to leave - +T: I would have to leave probably at 3 o'clock because it's only about 20 minutes to the airport really +C: really +T: but I would like to leave earlier they're probably taking up time by the time they land and to go through you know they're getting their luggages they probably won't even come out till maybe 4:30 but I'd like to make sure I'm there at around 3:30 4 o'clock +C: all right so let's go to the best day it's good that day and said that afternoon +T: okay +C: so you're still at home and let's say we're about 15 minutes before you have to get in the car what are you thinking then +T: I have to do this to to get up and go they need me to be there this this week it's my parents coming in and they're elderly so I don't want them to be stuck at the airport there's no one else that actually can go pick them up so I have to get up and go and pick them up so +C: that's going here +T: that is what's going through my mind that you know there's nobody else that can do this I mean it's cheaper than there's nothing I can't probably can't even afford to get a taxi for them because you'd have to cross that's from Philly to into New Jersey so that's gonna be very expensive I can't afford that when all I'd have to do is pay $5.00 for the tow and maybe gas up my car for $10 or something but hey I'll be thinking about it I have to do this and I'm not really doing it you know it's something that I can save money that way and I don't want to leave them stranded definitely someone else can I mean baby lost they're not familiar with there but in Philly the airport is crazy to me +C: it's a big place a lot going on so so you're sitting at home in 15 minutes before you eat in the car and you're thinking I have to do this but your reasons are positive like you to save money and protect your parents from having to be there alone so ones things I do come in +T: um just the thought of the bridge there it's just I could drive off the bridge you know they can fall off usually what I do is try to stay in the middle lane I can't do more miles an hour and I just I'm shaking I have the radio on and windows down because I can't swim so for any reason I'm to fall off I mean that's it for me I even have a little metal one of those so I think it's an instrument that you used in the house for I don't know pliers or something is something real hard that I can hit the glass with it sits right there on my door so I'm all ready I planned and I have that I planned ahead of time I know what I'm gonna do as soon as I approach the patient but I still feel anxious +C: you're anxious before you leave and you're and you're starting to think about the bridge at that point we already think about it +T: yes +C: how about when you get your car you start driving toward the bridge say a prayer I'm still anxious I turn on the radio the closer I get to especially the toll points and I know it's at me and you see those lights flashing last exit before you know +T: you know you're going over one +C: yeah I have no there's no turning back there's no turning back +T: so before that when you can still exit what's your anxiety level +C: before when I can still Excel yeah it's probably still high it's about the other than the high nor so it's still high but +T: it's not maxed out yet but every lap +C: it's gonna be +T: yeah I think it's pretty bad at that point +C: and how about when you cross through the that's an inside the tendon okay +T: yes yes +C: so your specific fear as you start to cross this is the bed Frank want to be the first bridge right you can do across is that your car will go off the bridge +T: yes +C: and when does that so that's a 10th anxiety when does that anxiety start to go away +T: as soon as that getting close to getting off the bridge and now leaving that little sigh of relief there's a little release there and I know that I've been able to manage those two three minutes of cross that into how many minutes it takes actually of crossing crossing the bridge and I start feeling a little bit of relief but then again I know I have to do my back exit and there's another one coming by that so starts all over again all +C: right Sonia crossed the second bridge the drug point fridge you go to the airport as your anxiety dropping those points +T: Oh as soon as this I'm descending from the Gerrard Point Bridge there's less you know it's almost reduced I'm not coming you know really low it's almost going yes it's not Muskaan +C: yes +T: and when you start thinking about that you're gonna have to cross them again +C: as soon as I'm exit I'm getting back on 95 going north and I know here we go again and cars that zooming by and you know +T: as you're not going to really +C: know I'm that person into the middle lane doing 40 miles an hour yes +T: all right so you're you're doing everything you can to keep your car on the bridge but you're still feeling anxiety like you're gonna go off the bridge +C: yes the whole the whole time until you start really descending +T: exactly +C: and then you feel like you've made it +T: yes especially when there are those big trucks tractor trailers coming +C: does the air +T: yes yes if it's also in bad weather or at night it's worse because on the bridge especially the top one you kind of see the sky and there's nothing else you see so it's like you're gonna fall off yes +C: so in the lower level it's not as bad +T: all the lower level coming back it's not as bad because you're kind of like protected here and there so it's not as bad but going is definitely worse yes +C: are you aware of any time a car will gone off the bridge +T: I hear all the news once in a while you'll hear something happen or sometimes in movies you see things happen I think it's possible +C: it's possible do you think it's a high risk +T: no maybe none of that um Girard bridge because I I noticed I was checking it the other day I had to go to the airport and I was trying to measure the distance between the metal poles just to see if a car could fit there really and I think a car could fit there but you know it just depends on the angle you were hit or something or if you flipped so yeah done some thinking she's +C: done some calculations geometry right and you've concluded that it's not really likely but it could all right so but either way your anxiety is maxed out on each bridge now when you get home I mean get your parents back to you take them back to your house +T: yes +C: and you feel them +T: I don't even recall all the anxiety know why it was such a big deal anyway I don't think about it at all +C: all right so you when you arrived home you're down to one +T: yes yes +C: all right so going back to the the first stage like when you're getting ready you're thinking that you have to go +T: yes +C: and it would save your parents money +T: it would save me money how it can be the one calling the can but if people want to pick them up and save them from being stranded at the airport than being in a land that they they're not familiar with an area they're not familiar with so make sure that they're safe +C: how important is their safety to you know very important yes +T: so it clearly it sounds like you picked them up before +C: yes +T: so picking them up is it's worth all the anxiety +C: it's worth but yes it's +T: tough +C: it's still something that bothers me that I have to do yeah it's worth the inside +T: that's worth it but you wish that you could do it without anxiety +C: yes I wish there was another route that I could take any bridges at all that's not known yet defined yeah +T: and how long have you had that anxiety we try to approach it +C: as long as I can remember that I know maybe even that when I was younger but perhaps as a mother and you know someone as I got that life was important I mean prior to maybe marriage and kids +T: all right developed along the way somewhere it's been with you ever since +C: yes +T: so I'd like to do what kind of therapy we call a refrain and actually you've kind of already done it but I want to make it a little clearer so you suffer things I D and you suffer it to protect mostly protector your parents +C: yes +T: so as you're going over the bridge you're thinking about the automatic thought we talked about these before right the thought that kind of pops in your mind is I'm gonna fly off the bridge +C: yes +T: so that seems pretty unlikely all right that's not something that maybe as you talk about geometrically maybe there's some way your car could find the bridge with physics now maybe could happen but it seems like it would be do you fairly like +C: yeah +T: so you could challenge that and this isn't the refrain part but you could challenge that on that thought which with a statement and adapt a response like it's pretty unlikely I think it's going to happen alright that might help a bit to keep applying then the chances are vastly in your favor I could sing how many cars you cross that bridge I'm a fly off the bridge alright heard of plan out for those bridges but the other you know the refrain part is that you're you're doing this you're willing to take on the bridges and have this anxiety for the betterment of your parents for their safety +C: yes +T: so in this whole equation of crossing bridges and anxiety and you're really really the good guy in this you're you're willing to you're willing to suffer and overcome a fear to make sure your parents are saying yeah I mean and you've thought about before like before you leave you think I only have to pick a month but you've never really connected it to want to be in the good guy here +C: well yeah +T: okay does that make sense +C: yes it does it does yes like here go my guess my family size my brothers and sisters appreciate that yes +T: yeah you've overcome it before to pick them up and when you pick up again you'll you'll overcome it again and you'll suffer but I the difference here is that that reframe I want you to apply that reframe when you're feeling that anxiety issue get ready to leave and as you're trapped with the bridge that you're really you know you're doing what you feel is right for the good of your family +C: yes +T: all right so the automatic thought that's gonna come in in is you're gonna fly off the bridge okay that's what that's what the exoti is about Miss Spears and the reframe in this case the reframe adapter response is I'm doing I'm doing this for my family and the probabilities preloaded like the bridge that's a separate thing but the reframe is I'm no I'm the hero of this I think that's a great way to look at here to hear of this situation +C: so think of that terms at the beginning of that day or they went up to hold +T: the whole day yeah yeah just kind of go over that should rather than like something you must do because really you don't have to do it strictly speaking right I know you feel you have to do it but you're willing to do it you're willing to sacrifice and suffer to do it +C: okay +T: and I'd rather that be the theme that you're getting is a positive thing that you're that you're willing to do it has to be done it's uncomfortable you'll survive it it's uncomfortable I focus on that kind of reframe then focusing on the very low probability that you're the risk that you're going to fly off the bridge so it's very low low risk +C: okay look uh make +T: sense and +C: make sense and make sense +T: so it's not so much being forced to do it me forced into an extra situation you're voluntarily in brave and I know it's hard it's hard for you didn't use your say it's a 10 on the anxiety to get that's that's the highest score right so it's hard for you but the way to look at it maybe would be you're doing has to be done you to flee go your family they need you have you ever had any close calls on a bridge or anything +C: um when it there was that day when there was a lot of thunderstorm and there was wind so I could literally feel the car shaking on the bridge and there was a day I think I was coming into Delaware I had to stop and call those they say if you need help crossing the bridge and I stopped and call them but they talked me before they talk to me for about half an hour or so and then they told me that it would take another hour for someone to literally be able to come and get me and this was like that I was leaving here it was self probably around 10:00 10:30 class was over I was on the bridge and it was late at night raining and I just I couldn't do it but after a while I think I calmed down with their conversation and I was able to just take it easy in that middle lane she always managed to overcome +T: yeah and that might be another a good automatic thought or adaptive response to that on that thought is that I've always managed overcome this and it hurts but managed overcome it +C: yes +T: I kind of taken charge like that and being assertive that might help reduce that automatically +C: ok +T: you think if you try that this time is you +C: that's thinking in that positive way I've done this before and then that can do it again +T: yeah +C: all right all right +T: so I'll see you again in two weeks which will give an opportunity +C: to pick them up from me you're quite a bit +T: and then we'll see how things start with that and we'll move from there +C: okay +T: all right thanks sweetie +C: thank you very much diff --git a/HighLowQualityCounseling/transcripts/high_064 b/HighLowQualityCounseling/transcripts/high_064 new file mode 100644 index 0000000000000000000000000000000000000000..671cd632d25cb5a3f124d1bb98843b73de1163f1 --- /dev/null +++ b/HighLowQualityCounseling/transcripts/high_064 @@ -0,0 +1,75 @@ +T: so I'm hearing the good part about drinking is that it keeps you calm and I'm also hearing the downside about it is that you started wanting spenders and your family get a bit concerned it must be tough so what is that like for you +C: a little bit down and or Danika really pick-me-up is a good drink +T: yeah so you kind of use it as a way to shift your mood a little bit yeah okay and so what what do you what would you like to do what would you like to change +C: I don't like the way that makes everybody feel when I get overly intoxicated so I feel like I need to just find another way I need to stop +T: okay so you noticing that it's kind of a little too long and so you want to find an alternative means of coping or trying to relax +C: yes +T: okay and what are some alternatives +C: well my buddy from work told me about some places that might be able to help me with some some strategies around giving up drinking +T: yeah +C: thought about going back to church +T: so on a scale of zero to 100 how important do you think it is for you to make this change +C: I know it's it's it's clearly above 50% I feel like if I don't stop just now end up in a grave somewhere so I need to take this +T: okay so around 50 and on a scale from zero to 100 100 how confident are you in making this change +C: I've tried before maybe a day or two and then something really bad happened or things got tough and I just went right back to drinking +T: the good side of it is that you understand that you need help and I think that's awesome really really good for you to have that insight so I'm hearing that you're not that confident okay so from from 0 to 100 where are you +C: I'm gonna be in less than 50% because I have been way too long without drinking uh sometimes when I work I think about getting off just to have that one +T: so in terms of importance you're around 50 in terms of confidence it's less than 50 so I'm hearing that it's important you know that it's important for you to make that change but in terms of confidence you're not that confident okay so what do you think it would take to help build that confidence +C: well I live alone really have anybody that comes and shakes on me so +T: yeah +C: maybe if I had somebody you know take your time to check on me +T: right right +C: find out how I'm doing every now and again that might keep me encouraged +T: so I'm hearing that you you would like someone to help keep you accountable and also to help encourage you and motivate you towards making this change and and this is the reason why you mentioned your belief system before and if I if it's okay if I may ask your permission what the people at your church be some of the people that you can turn to for some of the the accountability and you know help motivate you to change +C: I guess that's what church is for I've been in church since I was a little boy I don't know that that's where you go to get right so all of you are the right people +T: right so I hear you say I want to get right and I kind of hear that willingness to want to change can you tell me 103 best reasons for you to make this change +C: she's always telling me I don't need to drink she doesn't want me to hurt myself I see how makes me feel when I drink I'm usually in the rut I feel good terrible again I just want to do I want to go out and achieve some things in life change this +T: okay so some of the things I'm hearing is that you might want to do it for your mother and I'm hearing that you would want to achieve this you're maturing on in life and so for you and what's another one +C: just thinking oh maybe I'll grow healthier tonight some that drink as much quartz I drank it all +T: yeah +C: people you know they don't drink and they seem to be really healthy +T: uh-huh +C: so maybe I maybe I can be that one day +T: walk me through a day of drinking for you +C: well not working +T: okay +C: I wake up in the morning and I usually try to fix myself some some breakfast but I end up drinking a little bit because I keep a little something +T: okay +C: but by the middle of the day I find that I'm really loose after having a few drinks and I say a lot of terrible things I don't recall it in in particular but I've been recorded and friends have told me you know things that I've said under the influence and it really rowdy anything I'm taking out nobody when I'm when I'm drinking then I get kicked out of places +T: yeah yeah +C: I can drive and +T: yeah +C: it's just not it's not the way I want to live it's I feel too dependent upon having the right drink +T: yeah +C: it can't be empty and +T: some hearing when you wake up you've had a drink in the morning right before breakfast +C: yes +T: and by that time you're calm and you're loose and anything you just get a little belligerent okay it's causing you to get kicked out a lot of places you know and I'm hearing them you're saying that that's no way to live and so you no longer want that yeah and the good the good thing about what I'm hearing is that you have friends +C: yes +T: well care enough to notice what's going on and bring it to your attention by recording you +C: yes +T: and so when you see yourself +C: I feel I feel bad sometimes we make fun of me because my buddies dream today drink yeah but not unlike me I'm the worst on everyone and they can take it in to have one beer be done and me I'll just keep going everybody goes home and you know it's just me +T: and something your buddies have in common right +C: yeah but they I think they're just seeing me in a different way when it went out I've hurt so many people +T: yeah +C: and I just don't want to do it anymore they told me I mean oh and I believe our new home +T: yeah +C: everybody's saying that he helps or I must I must in Galax +T: yeah and so help is available I have a few substance abuse places that I'd like to refer you to and maybe some hey have you heard of alcohol Anonymous meetings as we mentioned before support group and your church as you mentioned so these are the avenues that you said you would like to go into +C: I mean sounds alright I don't want to feel like I don't have control +T: right +C: I don't want to feel I don't want to drink I want help I just don't want to feel like I'm trapped in one particular program I mean they do make community do these guys helped me to find strategies +T: absolutely absolutely it definitely helped me with strategies and you know a lot of affirmation and helping you to get there control that you said that you wanted these are definitely some and great place is to go into to help you get your life back sound like what I'm hearing you say +C: yes good +T: okay so we've talked about where you are in terms of wanting change we talked about where you act as far as feeling confident in change we also discussed a little bit about the reasons why you want to change the three reasons you mentioned your mom you mentioned for yourself you mentioned your health in the session we also discussed some avenues that you may take in terms of getting that support that you want we talked about your belief system a little bit we talked about church we talked about referrals in places that you may be interested in so you talked about a lot and I want to hear from you how is this going for you how how was the session been going for you in the past the last session that we had before +C: I mean our key I came back because the first time I spoke to you you didn't judge me +T: yeah +C: you didn't tell me I was some scumbag whose side of the road you told me I needed a clean up because I'm a junkie so I came back and you've made it very easy for me to speak to you and that's the only reason because everybody else talks to me but they they talk down to me and I don't like that and not feel ashamed of myself but speaking to you telling me I understand I can get man up and I can do something different nothing regain my self-confidence +T: yeah well thank you I'm glad that you have had a wonderful experience in terms of speaking with me today and I'm glad that you've also decided on what you want to do in terms of making those changes for your life and I'm glad that I can I can be a partner in helping you to achieve those things I really really appreciate it so if there are any goals that you would like to achieve for our next session or in the future +C: I just want to be I want to I want to not drink +T: yeah +C: at all yes between now and our next session I would think that would make me very happy +T: Wow +C: I warned them I want to have something to talk about +T: yeah yeah wonderful session okay we'll go ahead and schedule those referrals diff --git a/HighLowQualityCounseling/transcripts/high_065 b/HighLowQualityCounseling/transcripts/high_065 new file mode 100644 index 0000000000000000000000000000000000000000..220f491f3410ed7a8e379eeced4e674b753a0716 --- /dev/null +++ b/HighLowQualityCounseling/transcripts/high_065 @@ -0,0 +1,85 @@ +T: hi nice cute +C: you two +T: so why don't you tell a little bit about yourself +C: so when it was Kelsey Harris I am a student here I'm a senior double majoring tiger balm on campus I play a sport I do collectivities home very busy around campus from with your lineup I was born and raised here so I like beyond my family a lot +T: just sounds like you're really busy all the time yeah +C: yeah you can say that you got home a lot +T: um actually no not really I only live a couple hours away but my parents come here not frequently but enough that i get to see them so you say they play basketball +C: yes +T: yes +C: yes so walgreens whopping two-year like what you decide +T: well I've been struggling with some anxiety issues lately and I can't seem to figure out why I just I've been having some like anxiety attacks and panic attacks just wasn't like the last couple months and I thought him just go away on their own and like they think has come on at night sometimes or at first I thought they were centered around like papers and normal collops things but then like I had one were fall break whenever I didn't have anything to do looking to be here +C: have you so you see that it has nothing to do with schoolwork because you said you have a really cool place and you don't think I hadn't anything to do it back +T: I don't think into this and I mean it's a big school of constant thing so it's my senior year or two and I had to pop up until now so I I don't know I can't really figure out what could be causing it +C: how are things at home with your family +T: I'm dinner going well my little sister actually she's a freshman in college this year so my parents are at home with the emptiness and trying to figure out what i'm going to do with their free time and call me a lot i went off a lot but I mean everything's fine I see my grandparents pretty often my sister is going well +C: that's good so so you and your family are going well +T: we're we ever pretty close +C: how I was like the social life like how are things at school you know with your friends and ball how are things going +T: socially everything is going well too just trying to keep everything balanced it's a but I mean I feel like I'm doing a pretty good job of it +C: you get very clean school and stuff +T: yeah and i will say that senior year brings you know the senioritis around sometime so it's hard to get some motivation in there but um I mean schools would well like I I'm happy with my grades are socially I'd say that I mean my friends are still there like I love my friends I'm i feel like i do the same things that is nothing different going on +C: okay +T: socially I +C: just just get anxiety attacks just randomly +T: yeah +C: do you notice any pattern maybe when things id attack occurs +T: so I had probably five or six within the past month a couple of them happen at night only who actually most only the only one happy birthday but I wasn't like around anybody see any patterns with that at a loss +C: but he had any strange or reoccurring dreams +T: um actually I have they're just been like weird dreams that it's like I don't know it kind of plays on the future a lot but then like whenever i wake up i can't remember like specific details from it like you have you had a dream where you it feels so really you wake up and you Cameron really what just happened +C: yeah that's usually how you know it works a lot of people put a note pad next to their their bed and the second they wake up they write down what they dreamt about so they don't forget and like it's just something that people do but maybe that's something that you can try oh my good yeah so you say your sister her brother +T: sister +C: just left home why she going to school +T: she is in school at Spelman in Atlanta so she is having fun hopefully studying oh no she's not playing sports she just ran their students +C: she's a regular student +T: yeah +C: you know how many thousand things on your plate like you did +T: yeah I was I don't know cuz every time I talk to her she's like like they have a lot of going on down there Nixon is it Lana like it's my Burlington North Carolina so I talked to her I'm like when you ever study I don't really you know every time I talk to your do it comes you too jealous but we should +C: yeah okay so when you have anxiety like wouldn't have these attacks like what are you feeling +T: I feel like scared I feel almost like a pressure like I can't breathe you type of thing but more like a scared feeling +C: do you feel helpless +T: yeah +C: yeah what do you thought +T: well the first time it happened like I never had before so I didn't know what's going on and I was like in my room just about a little bit not doing anything in particular so the first time it really scared me and then you know it took me a few seconds just like started reading my guardian graduate and then a house wine so I think the more they happened I hope they will just call myself down and just keep going few minutes later and not think about it but I don't want them to keep all right well +C: that's good that you're about to keep my calm yourself down and that's good have you talked to any of your friends about it +T: no +C: it's the first time you're talking about it +T: yeah I've seen any doctor like I don't have a weird thing with like taking medicine everything I want to be supplied with always like home +C: just type in it +T: yeah I feel dependent on medicine +C: yeah I feel the same way uh okay so how would you toss the team looking this year how's the basketball team looking +T: really good um I want to seniors on the team so everybody's looking up to me so it's a little bit of pressure but i like i like it it's different you know our team's different +C: yeah +T: it's it's hard to compare this team to like other years and I mean it's kind of like unknown going into it just like you have a heavy patient because there's young you know two layers yeah we were going you taking my captain girl you'd say that oh just stepping into whatever goal the coaches want me in want me to 70 keep me like I'm trying to be a leader like vocally and it's different for me because I'm not used to being so vocal about it +C: so you feel a pressure a little bit this year +T: I can just always pressure there but I guess it's like a little more pressure just because he had a lot of the +C: yeah +T: one of the few seniors +C: ok so +T: the pressure is good though no yeah +C: yeah actually I agree um and then so with school are you feeling any pressure there +T: um I guess not I think about it I mean I am a little bit um so like my GPA is it's pretty good I have a like 33 I'm pretty close till you at 36 Soleil I'm trying to keep it up like a 35 the rest of the year and we depart of zoo but doesn't aiming for yeah so yeah yeah but it's all like a pressure go myself like nobody's really like telling me I have to do it just for or else but it's just something that kind of doing +C: so are you are you a leader in your sorority any kind like you have actually there +T: well I'm the treasure in my sorority but we we had a lab new members come in last year some kind of like showing them the ropes kind of likes taking steps back you know like them starting to read some things so it's not really that much pressure in that +C: but it sounds like you a lot to do +T: yeah +C: Billy today +T: yeah I think I'd rather do that then have so much free time +C: yeah +T: I'll have to do is probably sleep it like egg sleep or watch TV you know or Netflix +C: oh okay so I want to hear more about you know your family like tell me a little bit more the relationship you have like with your sister and be with your grandparents look if you have +T: so my parents are from Greensboro my grandparents on both sides actually still live in greensboro so they're 20 mins away if that they all come to my games pretty much every home game if season tickets but I don't create my advice he said tickets but my family so uh I mean we're like I really close I don't know like I don't go see them like very often maybe like once a month but I try to go see them at least once a month or once every other month version like that but I see them so much because they come to my games I was like +C: yeah +T: yeah +C: yeah yeah +T: yeah well yeah this is why don't I go home that often either obsess my parents quite a bit to my sister like I thought it like she's a freshman in college so she's having fun um I'm seven actually just had laser their homecoming this past week so I know she's been busy so yeah oh my mom's birthday last week president again yeah we're pretty close +C: yeah and I guess +T: no I think about it I love it gradually +C: yeah we have to face the real world pretty soon I think it's just been like all facing the reality of the fact that you're gonna be graduated +T: yeah I mean I kind of have a plan of what i want to do blood change changing you know it's just like funny hearing some people you know like have their first job offer sounds like +C: is that stressing y'all +T: not yet but I feel like it might I probably will in the spring right now I'm still like I still feel like really invested in elon so I still feel like I'm here yet so probably in the spring out I have to like start +C: configuring out +T: yeah +C: well I hope everything goes +T: thank you diff --git a/HighLowQualityCounseling/transcripts/high_070 b/HighLowQualityCounseling/transcripts/high_070 new file mode 100644 index 0000000000000000000000000000000000000000..d99086ba9da9379c5a80e58a89c47b5b2518e09b --- /dev/null +++ b/HighLowQualityCounseling/transcripts/high_070 @@ -0,0 +1,128 @@ +T: hi Michael it's good to see ya well glad you came in today when I douse up +C: well I came back here because I had to I had to make an appointment so I could get my prescription for my blood pressure medicine refilled and they wouldn't do it it wouldn't refill it it's a drugstore unless I came back here so +T: you're you're angry what +C: well I'm not angry at you but I'm angry at the situation and I gotta come back in here take time off from work just to get that prescription filled but but you know you do what you got to do and +T: well I appreciate your bringing that up that is does sound frustrating but by coming in it gives us a chance to to sit down and and and talk and see how things are going with the medication which is what I'm most concerned about I know we started at about three months ago or so and I am real interested to hear how you're how you're doing on +C: well uh yeah whenever I get my blood pressure checked at the drugstore it looks like I'm that it's working and that respect but it does seem to take away all my energy you know +T: kind of fatigued +C: yeah yeah my I got no get up and go if you know what I mean +T: so kind of has taken the wind out of your sails +C: absolutely yeah +T: how long have you noticed that +C: oh I don't know I at least since I've been on this medication at least that long +T: yeah doesn't sound like it's working well too working too well for you have you tell me about how you're taking the medication have you taking it very regular +C: oh yeah I take it I take it just like it says take it on the bottle you know I take it every morning when I get up +T: okay so you've been pretty consistent and taken +C: the all yes +T: anything else going on in terms of symptoms no just this overall lack of energy which I know my wife doesn't particularly care for +T: your wife coming a little bit more about how it affects the relationship between the two of you +C: well as I say I get up and go got up and went and there's not much going on between the two of us like there used to be +T: so sexual performance is not as good as it as it might be +C: nope but I think it's because of that damn medicine +T: so does this sound like something that you want to continue or should we talk about possibly other other options for you it sounds like it's kind of affecting your life negatively well +C: yeah yeah but you know I I'm worried about my blood pressure because my my mother had a stroke not long ago and I know it was so they told us it was because of her high blood pressure so I don't want that to happen to me +T: so you're concerned about having a stroke +C: well yeah I mean would you be you know it sort of runs in families I think +T: yeah so taking care of your blood pressure is is very important to you +C: yeah yeah absolutely +T: again it doesn't sound like this particular medicines working out too well for you if it's okay I could talk to you about possibly changing the medication so on the one hand we'd be keeping your blood pressure under control but on the other hand we wouldn't be causing these types of side effects hopefully would that be okay +C: well are you talking about on more medications or just a different medication +T: yeah so uh I think probably it sounds to me like probably changing medications at this point as a start we can always add another medication later if that becomes necessary +C: yeah well I'm not real interested in adding any more but if changing it it would keep my blood pressure down but not take away all my energy than I might that give better idea +T: so you'd at least be willing to try a change and and see how that goes +C: yeah yeah I know well +T: if it's okay I can tell you about a group of medications that I I like but if but first if it's okay that they give you a kind of my rationale for using that medication to start with so you know one of the things you'd mentioned to me was some of the financial concerns and the medication that you're on is pretty dirt-cheap and for most people at this dose particularly a low dose because you have mild hypertension most of the time it doesn't have many side effects obviously for you that was different does that make sense +C: yeah +T: yeah so the medication I'm thinking about is something called an ACE inhibitor ACE inhibitors are very very well tolerated and occasionally people will get a dry hacky cough with them but it's fairly rare but there's very low risk of side effects in terms of sexual side effects in particular and most people as a matter of fact it's one of the the drugs that actually helps your heart beat a little bit stronger and better and many people don't have any kind of a decrease in their energy so how does that sound +C: yeah it sounds though it sounds like a good idea if it still controls my blood pressure but doesn't take away my energy it sounds like a good idea +T: okay so what other things can you tell me about that might affect your blood pressure +C: uh-oh uh-oh my work is sometimes stressful and some of the people I work with kind of drive me a little batty occasionally and I I don't know if it I don't really know if that it causes my blood pressure to go up or not but it certainly could I guess +T: so there's some stressors at work +C: yeah +T: and if it's okay I'm going to write down some of these things that as we talk through them so what else can affect blood pressure that you know of +C: um well you know just mostly from watching TV shows I guess I am aware that alcohol and I drink some a moment that alcohol has some effect on blood pressure I think it might even say so on the label though I'm not sure +T: it can't it can't anything else you can think of +C: no +T: well sometimes sometimes weight can be an issue and explain this little tool to you this is for what it's worth called a agenda mapping so it sounds like there's a number of things that you know of and then we can talk about that affect your blood pressure you mentioned stress and an alcohol and we talked about weight certainly you know blood pressure medication can affect you there and I would say another big one might be exercise does all that makes sense +C: well yeah +T: so we could we can talk about a lot of these things with which one might you want to talk about and if we need to we can set up for appointment and talk about this more if we run out of time but +C: well um exercise I'm I actually like to exercise +T: and tell me about the exercise that you're doing +C: well I play golf and walk the golf course +T: so you carry your bag or do I drag it along on a pull cart +C: my wife says that that doesn't count as exercise but I say try it yourself it is exercise +T: it is exercise it is exercise Michael look at your your weight when we came in +C: yeah +T: and you were about 160 or so yeah which is actually according to your BMI body mass index in the in the overweight range how do you feel about that +C: well I don't think I'm overweight +T: yeah you don't look terribly overweight but according to the the charts there it's in the overweight category so you're actually getting you into the normal category would be about a loss of about 15 to 20 pounds +C: 15 or 20 pounds +T: yes 15 or 20 pounds +C: I haven't weighed that since I was in high school +T: I understand I understand but you know I'm not saying that we need to lose 20 pounds sometimes just a loss of 10 pounds can make a tremendous impact on your on your blood pressure +C: okay +T: so 10 pounds sounds like something that might be negotiable +C: 5 +T: 5 is the number +C: okay +T: let's go you do with thigh +C: okay I think I can do 5 +T: all right so if you were to want to lose 5 pounds how would you go about it +C: I'd probably go back to the gym +T: as that worked in the past +C: yeah I mean I used to go to the gym and work out a lot and uh I've done it for a while but I guess if if I'm I'm sure I could lose 5 pounds if I wanted to +T: and that would actually kind of take care of two of these things right your weight and your exercise both of those would have a really positive effect I think on your on your blood pressure +C: okay well +T: so we've talked about changing your medication stopping the medication you're on changing you to this ACE inhibitor and then perhaps looking at the weight and going getting back to the gym and starting an exercise program is that about right +C: well what would it take for me to not have to take the medication at all +T: at all +C: yeah I mean if I did enough exercise and lost enough weight would you not what I not need to take the medicine +T: I I really wonder if you would I think that's an excellent question and if you're motivated to lose that kind of weight I'm with you I can't leave I this good I can lose five pounds well it may it may take more than five pounds to get the desired effect on your blood pressure that's really getting back down into that normal weight range if you will in that one 35 to 40 range probably +C: I I just want to make sure I understand if I if if I lose uh five pounds and I do it through exercise that I could you would recommend that I try going without the medicine for a while too and see what happens +T: I don't think I'm ready to go there yet Michael but it sounds to me like you want to get off of your medication +C: yeah if I can yeah +T: well it there it's a blood pressure rate that you are right now blood pressure number that you are right now I probably wouldn't recommend that that that's going to take a plan for us to work out over probably a period of months so that you could one lose a little bit more weight to exercise really regularly we might want to talk about the alcohol um can I ask you how much your you're drinking now our regular basis +C: two or three beers a day +T: two or three +C: yeah +T: it is okay I'd like to share with you a little bit of information about alcohol and its effect on blood pressure Merryn research has shown that for men more than two drinks a day and for what more than one drink a day really can significantly impact your blood pressure negatively it raises blood pressure how does that how does that sit with you +C: you're saying two or three +T: more than two more than three +C: okay so two is still considered aa safe and regard to blood pressure +T: that's what most of the research shows +C: okay I'll do two +T: you'll do two okay and you said that you did two three every day +C: most every day yeah sometimes a little more on the weekend I guess +T: can you think of any ways to maybe cut back on that to where you wouldn't be getting as much alcohol in your system on a regular basis +C: oh yeah I guess I could you know I mean uh I you know I don't I I don't have a drinking problem so I could take a day or two and not drink at all if but if if two a day doesn't hurt my blood pressure um I think I could go with that +T: so two a day um keep in mind too there are significant amounts of calories involved and alcohol particularly beer +C: I suppose I could drink Light beer +T: light beer doesn't appeal to you +C: might as well not drink beer at all you drink Light beer but I suppose if I suppose I could do that +T: scale of zero to ten zero being not willing at all to do that ten being very willing to do that where do you think you +C: probably about it I +T: why did you say a five and not a three or four +C: just because uh you know doc habits are hard to break you know and it usually don't drink Light beer and so it would be a change it would be something different but uh well you know I'm willing to give it a try +T: tell me the good things about cutting back on alcohol and maybe switching to light beer talking about the good things +C: well I did you know obviously a good thing is I'd probably lose weight which is what we're trying to do here +T: so you'd lose weight +C: uh and there there may be other things about alcohol that has something to do with blood pressure that I did not understand but but I suppose it would help keep my blood pressure down and my weight low or if I didn't drink as much beer or if I drank light beer and so that's the good side the bad side is I don't like it as much +T: on a scale of zero to ten zero being not very important and ten being very important how important is it for you to to get better control of your blood pressure +C: very important I put that up really pretty high I'll give that a nine +T: so in terms of making a change what are some of the things that you'd be willing to do in order to make that happen +C: well you know I'm willing to do the things but most of what we've just talked about +T: which are +C: um drinking Light beer drinking no more than two beers a day going to the gym again and sticking with a different medicine for a while +T: okay so to recap changing your medication you're willing to go to the gym and exercise switch to light beer and keep the beer to a maximum of two a day okay now only you can make that decision Michael I can't do it for you is that somewhere that you're willing to go +C: yeah I think I'm willing to do what it takes to keep my blood pressure at a level that doesn't concern me and if this is what it takes I'm going to give this a try +T: so one more scale in terms of your readiness to make to do this zero being not ready at all and ten being ready where would you fall on that +C: six and a half +T: six and a half and watch six and a happen and not two or three +C: because I know when I walk out of here that if I keep doing what I'm doing I I'm either going to have to live with the blood pressure medicine that takes all my energy away and I don't like that or I'm going to have to let my blood pleasure get real high and I know that can cause all sorts of bad things to happen +T: so you're really worried again about the health consequences of not keeping your blood pressure under control +C: people keep telling me that high blood pressure causes all sorts of bad things to happen so yes I am concerned about that +T: so if it's okay I'm going to put this in your record that we talked about well we're certainly going to switch your medication but you're going to be working on losing some weight going back to the gym cutting down on your beer usage and switching to light beer is there anything I missed +C: five pounds +T: five pounds that's the number now I'd like to see you back and about let's call it a month let's see back in a month +C: I'm the five pounds going by then +T: my pounds will be gone and we'll see how things are going and probably talk about this some more and see how successful you've been with this plan and then we'll go from there diff --git a/HighLowQualityCounseling/transcripts/high_071 b/HighLowQualityCounseling/transcripts/high_071 new file mode 100644 index 0000000000000000000000000000000000000000..c1a67988d763cdc960dd6dc2609c3ce788b997eb --- /dev/null +++ b/HighLowQualityCounseling/transcripts/high_071 @@ -0,0 +1,140 @@ +T: hello Becky +C: hello +T: my name is Jenny ponds +C: nice to meet you I +T: good to meet you and I hear that you met with dr. Johnson and you were looking at your concerns about wage is that right +C: yes +T: okay and how has that been for you +C: very frustrating +T: uh-huh +C: I've been trying to get my weight under control over 15 years boy but +T: it sounds like you've been working at it but this the years go by it gets pretty pretty frustrating +C: yeah +T: and and how um is your weight affecting life for you what's life like sort of where you are +C: um well it crepe lot of pain I'm having problems with my knees recently had knee surgery me so it's really I know the physical pain has shown up that's that's the newest thing you know before it was about what I felt you know what I might look like now it's about how I'm feeling I'm older much older and the pain in my body the sluggishness +T: so as the years have gone by it's it's it's becoming more and more of a problem +C: yes +T: yeah yeah okay and any other sense of how it's affecting the pain course is a very noticeable you know subject but anything else that you experience +C: um like things you're able to do we able to do the same sorts of things well some of that I attribute to age but +T: oh yeah right the cardiovascular as well yep +C: yep yep so the biggest one that motivates me is the pain right now because get you away from it +T: and you're in you know that if you lost some weight that then you'd have less pressure on those knees in you can be you +C: can get around towns would make it too hot you know it doesn't take much just to to feel that difference unfortunately I'm going in the wrong direction +T: yeah well it sounds as though you feel pretty strongly about this that you've been your back in here really wanting us to help you get something going +C: yes +T: so first off I have to hear a ruler rubens and if if you might indicate if you wish from a scale of 0 to 10 just how strong your conviction is about this being a problem you know just as you're describing it the pain and the concerns about your cardiovascular you know all of the ways that it's affecting your life okay from zero that it's really not that much of a problem to 10 this is a serious problem that needs to be addressed +C: okay +T: so where would you put it +C: well I would say that hmm intellectually I'm probably at a nine and physically I'm in the tab +T: hey all right +C: yep so physically my body telling me every day +T: why you say +C: my mind just this needs to be +T: and on what what do you think your mind is you know what the concerns are that your mind has are the are any doubts or anything +C: well I'd say that that it's less because I because of a frustration because it feels like I ok I'm not committing to doing what needs to be done to get rid of the pain and take care of the body so it just doesn't feel like my intellect not knowledge but intellect +T: or emotional baggage with your body +C: yeah or otherwise wouldn't I be doing it +T: yeah it's very close though +C: it's much closer than the business much closer than it's ever been I mean intellectually have been that's what I've been stalling with cuz I've known what to do or thought I knew what to do and I would tinker with it but I didn't make the commitment and now my body says you gotta get it or you're going to be down to the count +T: yeah absolutely um and nine so that's really quite high too +C: okay +T: attends the top of the scale with your body but nine with you not just your thoughts and feelings about it so what makes it a night and not a seven or an eight +C: um the fact that something on my mind every day +T: hmm +C: and I know that making the choices is coming up for me I just haven't made the break through like I'll I'll realize that I've done something that was a good back right after the sack yeah I need to realize it before the back and then like could make the change uptake +T: yeah that sounds like that's a source of frustration +C: oh yeah +T: yeah yeahs +C: out of an internal fight +T: yeah yeah if I could share a perspective that i have about giving what goes on with our mind and our body you'd be interested +C: yo head okay +T: well and this is just my theory but I really has a sense that you know we've got an appetite center in their brain right I'm part of our brain that regulates it might be getting messages about how much energy we have available probably a lot of other things too but basically that's monitoring our body to make sure that we're getting enough nutrition I think one of the challenges as we gradually gained weight and that's what happens with a lot of us know is that over time we gradually gain weight and then we look and we say well this is you know 10 15 20 pounds more than I want to be now but up here okay this this Center in the brain is doing its job of maintaining all those new cells okay you know it's going you know our job two days make sure that everybody gets fed and so we're working against something that's quite automatic in there you know the appetite that we have you know the appetite that we have when we have carb cravings you know I my sense of it is is that that's just something very very automatic Amanda but I also know that it's possible for us to especially someone with a strong conviction that you're demonstrating you know to to really start making some changes so maybe we'll explore for a moment if you like some of the things that you've tried and maybe your sense of what some of the things you you know might might like us to look into it now +C: so i tried the you know looking at diets and of course any of that stuff always leads to putting on more way +T: yep +C: I've turned changing diets I've had major life changes where I'm not working anymore thinking that I would now have all this time to exercise +T: and it's actually a more sedentary +C: yeah especially because they have here i am the less i can move around cuz it's so painful +T: so kind of a vicious cycle +C: oh yeah and I was having got diagnosed with severe apnea sleep apnea and learning about all that impacts and now I've been on using machine for about five weeks and I feel the difference both emotionally and physically and they say it takes three to six months to even really i could feel even better than when i'm feeling now so this is definitely the time to make this change they say the lack of sleep to sleep apnea impacts wait +T: I think it does +C: so it's possible that was contributing to my you know to my weight gain +T: yeah absolutely and then even just the factor that the apnea causes you to feel very tired during the day +C: oh I told them a larger gym +T: yeah you don't have that energy to beginning of the doing things +C: oh just just the diet just so diet and I you know I five books I don't always read them with all the things to get all to try to change my mind around I've television shows about and it saved a lot of research wow I've done I've done the lazy persons research but but I you know I've been tuned into it and I've tried writing down what i ate didn't last very long +T: can they keep it rising on us +C: no no I think once i got realized how much i was eating i stopped writing um but yeah well that's really +T: about it right on that i might share +C: uh-huh +T: if you're interested a book that i read a while back called why french women don't get fat +C: oh +T: and our goal isn't to be like french women but there are some things in in the in the diet in or lifestyle in that country that are different than the lifestyle in the united states and seem to contribute to better fitness and not quite so much overweight in the book she is a high school student exchange student going to the US and she encountered chocolate chip cookies and brownies and things could put a lot of weight on her and the amount of time look what just happened that must be must be youtube doing that I've all guys folks um and when she got back to the to France she'd gained a lot of weight went to her family doctor and he suggested that that's the first step getting that making a food log +C: mm-hmm +T: and then the perspective that he used was was to just find what he called the offenders we'd like one or two things that oh hi you know concentrated Swedes or concentrated fat and I see a not happening here then what what comes up driver when it I +C: ice cream +T: ice cream yep +C: ice cream +T: yeah ice cream I think pretty much is at the top of the list for all of us you know I swear that ice cream when I have it it just goes right to my hips you know it doesn't pass go doesn't go like two hundred dollars it just goes right there so have you had you looked into that as a possibility if so i might try to cut back +C: oh yeah at times i have but i struggled a little bit recently and I um I was gone through ice cream consistently over a couple we carry then guess what my week when I just get so single-minded in focus that's when I go into the grocery store that's all I go for that's all I can think about +T: mmm yeah I think it's really got that reward circuit in our brain down yeah yeah yeah yeah well is that something you'd like to cut back on +C: Oh a little +T: ill so you'd like to be I love I got ice cream okay +C: and let the point one I I don't forgot to say no never but I'm at the point where saying just don't need it I mean I could go for two but buying it out of the grocery store it's not working for me it's not allergies +T: only you're thinking not getting into the house +C: yeah I keep it out of the house +T: haha not come thank you a very good idea you are not shutting down will not let this happen I've already been with apple support it looks like YouTube needs a talking okay so ice cream is the goal +C: yeah +T: okay +C: a leather go +T: all right and in what would you say your your specific goal would be about ice cream that you really like to not have it in the house is that your main thing or +C: not having a now yeah that's that would be huge to having it cuz that's really where I'm breaking down is when I bite it and I gallon put it in two days you know +T: yeah and that's so easy to do because it's not filling you know and you know we it turns to liquid in our stomach to everybody +C: I mean it for breakfast +T: oh sure +C: yeah +T: oh absolutely yeah that is one of the strategies I used once I just have a little in the morning and burn it off you know and all that's doing is lighting that fire in there I don't know something ya +C: got extreme hung up +T: okay so the goal is just not have it at home +C: okay yeah +T: and how confident would you say you feel and again we're going to go back to as if you roll the clock 0 to 10 0 and 0 is you don't feel at all confident and 10 as you feel completely confident that you will be able to make this change if not having ice cream in the house and maybe we'll say Joanna for the time of you know an estimate of help for how long +C: um +T: week two weeks +C: let's say two weeks +T: yeah +C: so I'm going to have to find a healthy choice to get when i get those urge for that ice cream and then instead of walking in the store going to present food i'll keep the ODI go the other way and pick up fruit +T: yeah it's funny when I think it's hannaford here in Calais the ice cream is over that way and the produce is over the head okay no it's like making a right turn instead of a left turn +C: it's an interesting it sorry +T: yeah it's the right and it's the right way you go yeah young you could have a cup am i right yeah all right thank you let's take the right turn out of the right right whatever nothing yet +C: um so uh do we could be the challenge to we could be a good challenge +T: so why would you put your confidence 0 to 10 and i'll let you make a mark to feel like +C: i'm gonna say a seven right now +T: um +C: just just because i can think of go right lots of cash registers between there and the foot the frozen food so if i get out before that +T: um +C: that would be good it would certainly if i die that was thinking about the pain and my loss of mobility can write that I hereby your ruler I can remember that if I go all the way the other way to the frozen food so I go left I'm going to have pain if I go right come on much better chance of feeling better +T: okay +C: and +T: and that brings up an idea I might be able to help you with maybe next time we meet if you like +C: okay +T: and that is of course we'll check in and see how it was not going fun also there's a process called thought mapping that's a method where you walk yourself through step by step going into the store how you're feeling anything to do with feelings about ice cream and and you can rehearse in your own mind +C: uh-huh +T: making the right turn instead of the wrong turn +C: peddling visualization like athletes do +T: yes exactly and part of that yeah the way that they visualize they want to do that I left then I hi pole vault oh and they by picturing themselves doing it they actively Prix the performance improves +C: yeah +T: same story here +C: okay I understood that +T: so we might we might plan that or it sounds like you kind of got a sense of how it works +C: yeah I'm familiar with visualization I'm good at all which is I think pretty close to mind mapping so so you think about it down the painful way and then you replace that with thinking about it with a healthier +T: yeah yeah it's a little bit of a but if if you already it sounds like you've already got a sense of how visualization works on and you might be able to just decide say I mean what it makes sense to you even as you're young either in the car about to get it go into the store that you're visualizing yourself or maybe at home before you go out you know whatever makes sense to you you could even experiment a bit on your own +C: oh yeah +T: it works yeah yeah and visualizing now so I'm ever visualizing the fruit you know and having kinds that you really like you know and if you like variety you know one make it as enjoyable as possible but you are so wise to come up with that idea of substituting something you know putting having something else in place of because when we just take something away something else in the brain goes 0 or you're taking my you know it didn't +C: ya +T: I'm going to have this instead this is much better +C: yeah +T: and I should check the time for measures when we are I get 15 minutes +C: I hackathon and over here +T: we are on not seeing oh yes we are i think we can stop ok so i will look forward to seeing you in a couple weeks and +C: yeah +T: wish you well +C: thank you very much do we have to attract a great plan going here ok diff --git a/HighLowQualityCounseling/transcripts/high_076 b/HighLowQualityCounseling/transcripts/high_076 new file mode 100644 index 0000000000000000000000000000000000000000..92dae09ed9758a32ed42acb264919abf94fb7198 --- /dev/null +++ b/HighLowQualityCounseling/transcripts/high_076 @@ -0,0 +1,273 @@ +T: good afternoon miss Joe knobbly my name is +C: afternoon +T: my name is Jessamine all knobbly and I will be leading you through our nutrition and education and counselling meeting today +C: okay +T: just a little bit about myself I am a Nutrition and Dietetics student at Loma Linda University and we'll be sitting for my Rd exam next June +C: fantastic +T: so I just want tell you know I got into this field because I just really wanted to enhance and improve people's health through making advantageous dietary choices so +C: that's great +T: before we get started would you like a bottle of water +C: I'd love to have a bunch of water +T: okay +C: thank you very much sure yeah can I start drinking now +T: yes go for it so in today's session I would just like to hear about some of your personal goals why you came to the session today obstacles you may be facing in regards to nutrition and just figure out some ways to overcome challenges that you may be facing +C: okay well number one I'm really really happy to have this opportunity to sit down with you and discuss my really horrible eating habits especially by you know recently I have been actually struggling with wanting to lose the weight I would say for about a good six seven months now and all that I have seen so far is that I've been basically actually basically fluctuating between 199 and 206 sometimes even 208 the struggle today has been the frustration level of when I get on this okay I'm going to get on this quote-unquote diet and I'm going to lose the weight something amazing happens I actually end up painting I'm tired in the morning I'm stressed because we started this whole new business that we have here and I'm totally out of control I feel that I'm totally out of control when it comes to eating I think a lot of it has to do with not eating quote/unquote properly or systematically +T: okay so for you I just threw a lot at me so I'd like to go back and recap some of the things that you were saying to make sure that I'm understanding everything clearly +C: okay +T: so in January 2010 you started a meal plan that was very strict and you were able to maintain it for a few years +C: no few months +T: few months yes you think a few months and then you started to travel and you know kind of things kind of went a little bit astray from there +C: yes +T: you went from this strict dieting all-or-nothing kind of plan do not really knowing how to make food for yourself or compose a meal for yourself because you were +C: let me was you know it's interesting you say that because that meal plan that I was on that diet plan yeah what's called a no decision +T: yes it's a +C: no decision diet which means you don't have to make any decisions about anything this is the prescription and you live with that prescription you'd be alright anyone else I kind of denied it +T: so you almost kind of missed out on the education portion of how to eat when you're on your own +C: yes +T: which is what in the long term we want to achieve is for you to be able to make healthy food choices when someone isn't there to tell you what to do you're able to critically think for yourself and regardless the nutrition +C: yeah +T: so some other things that you mentioned was that you're just feeling frustrated and kind of out of control in regards to your weight-loss initiatives which I can which is very it seems very frustrating if you want to be losing weight and you're not not seeing it and then you said that you were tend to be eating more so those are all very frustrating things and not and then you also said that during your day you're not really eating consistently +C: at all +T: you're kind of all over the place and kind of looking for more of you know consistent meal plan day in which you're not you know starving and then overeating later +C: I do the kind of like keeping it's like I wish I had one person walking behind me this fear you whatever that says okay mealtime here it is it was like preparing it here it is you know so that because I just eat such a stressful and such a work living environment +T: let's talk about where you get most of your meals from +C: I would literally stop at the supermarket or I would stop at a 7-eleven or I would stop at a couple of times I didn't know a lot of times i stopped at Dunkin Donuts right that pick up the donuts or at the other daughter shop I would pick up because it's fast a lot of times I'm eating out and it's not you know the best thing in the world +T: okay um so I'm hearing that you get most of your meals from outside of the home +C: yes +T: and not typically cooking meals and kind of go for those more convenience convenience meals that's easy yes so how would you feel about going over some tips for when you're dining out that if that's if you're very busy and like that's the option that you're doing right now I'm just making some little tweaks because cooking at home may not be an option for you at this moment +C: that's very true probably I would say yes +T: so making little changes +C: yes in regards to the restaurant is the way everything changes +T: yes are some some tips that you can implement when you're at the restaurant +C: okay +T: so some of the things that I would like to talk about so when you're ordering food from a restaurant you want to stay away from words such as like fried or just like also deep fried and kind of go for those words like royal bake and steam +C: okay +T: so recently you told me that you went to a restaurant and I have the menu printed out here and I would give you a copy of that +C: yes +T: and and you told me that you ordered the New York strip steak +C: yes +T: and you had bread and butter for your meal +C: yes I do +T: so just looking at the options here we do have a fresh fish option at the top +C: yes +T: and it says it's simply grilled with olive oil or you could get it pan-seared baked or blackened with lemon shallot butter +C: mm-hm +T: so I would probably say maybe to stay away from the lemon shallot butter noise and maybe steer towards that simply grilled with olive oil or the maybe the baked or +C: a boy in this use +T: you could do the pan serve but the other ones are better option +C: okay +T: so that's um - +C: I would have enjoyed the tilapia for exam +T: okay so +C: that's what I like to eat that they were Chilean sea bass I would have enjoyed that too +T: so that's an opportunity that you would be +C: yeah +T: you enjoy billing to go change +C: yeah +T: so going for those terms and maybe doing like maybe a fish option every once in a while as opposed to doing a steak +C: yes +T: okay some other tips so when you're ordering if you want to order a salad instead of ordering the salad and getting kind of like a Caesar dressing or something like that they typically kind of put a lot of dressing on salads so maybe ordering it on the side is a better option because then you can be in control of how much you would like to add on to the salad +C: okay +T: and typically going for maybe like a balsamic dressing is good or you could do a balsamic and olive oil dressing +C: mm-hmm +T: typically most restaurants will have that option +C: yes and I like both stomach vinaigrette +T: so also in regards to restaurants portion sizes are typically very large and you had mentioned earlier that you know sometimes you just don't know when to stop eating or you tip you think you're hungrier than you are you just eat a lot at once +C: yes +T: when you give that example with the bread +C: yes +T: so a good tip is to kind of ask for a to-go box in the beginning when you get to the restaurant +C: mm-hmm +T: after your meal comes and just put half of the food in the box and you don't open the box can't get home it's kind of bang for your buck too right because then you can either other real later +C: yes +T: and you could if you do choose a healthy option you can take it to work the next day and you'll have a lunch option for you here at the office +C: yes +T: um also when it comes to salads you really don't so here they have the chopped spinach salad for example there's bacon egg radishes mushrooms and warm bacon dressing just because a menu item has all these things included does not mean that you have to get it with all those things in it +C: okay +T: so you can easily tell them oh can I have the chopped chicken it's chopped spinner salad without the bacon +C: right I don't like bacon +T: so that is something that you could ask for for that side because I mean spinach is great mushrooms are great radishes are great egg is great you can always take out egg whites I mean the egg yolk if you don't want the egg yolk or anything like that so a lot of restaurants I think analogies are accommodating because they want to have your certainty they want to have your business +C: yes +T: so they're gonna try their best to make the customer happy +C: yes +T: so for me personally I often ask for changes in my in my orders unless they specifically specified please do not make changes on to the order or we can't make a change for this order I typically change majority of my orders +C: hmm +T: because the foods that you eat or the foods that are commercially made are not necessarily the healthiest +C: yes +T: they're made to appease the palate +C: right +T: so they usually have lots of fat and you know sugar and sodium and those kinds of things added to it to appeal to a wider variety of individuals +C: mm-hmm +T: I have a little handout here so we can talk about some like portion sizes +C: okay +T: so a fist would be considered like a cup of rice or pasta or fruits or vegetables it's about the size of your fist is one serving +C: now that's cooked rice oh +T: yes good right the palm of your hand is about three ounces so that would be for fish meat or poultry that's about the size some people say like a deck of cards it's about 4 ounces +C: hmm +T: it's around there and then if you're gonna have nuts of reasons a handful is about 1 ounce there's like a little handful so one thumb would be one ounce of hard cheese or peanut butter and you said +C: Wow I love cheese you know +T: and then for your thumb is a a teaspoon of our thumb tip is a tea spoon of cooking oil or margarine or butter and sugar +C: teaspoon +T: as a teaspoon why don't you try and start setting some goals for you in regards to some food we do +C: okay +T: of what would work +C: that seem so you go one +T: so what is what is one goal +C: that you want you would like to accomplish for what's the eating out that I want to accomplish for eating out +T: yeah so would you um what a goal be that you want to choose grilled options +C: well I see +T: what you mean okay are you willing to do that choose grilled options +C: you know it's sometimes that would be a goal +T: so how do you feel about journaling +C: hate was difficult to do but it was very exciting +T: mm-hmm +C: because it is making me it helps me actually meet that objective +T: okay so that seems like something that we could +C: yeah I usually get up with you already six o'clock in the morning +T: would you have time to journal that +C: yeah I can make the time for that +T: okay so um how many of these a week would you say you could draw +C: I can technically journal every day +T: okay so why don't you give a range of times so why don't we say four to seven times a week in the mornings for we can say until our next session so we can go you can go back and recap how the journaling is going for you +C: what am i generally I'm gonna do it in the morning +T: generally how you're feeling physically maybe the food reflect on the food choices that you had made the day before maybe set some you said you like setting little objectives maybe little mini goals for yourself for the day things like that +C: that is easy for me to choose actually +T: okay that's great so why don't we just make sure we're doing that let's say seventy-five percent of the time you're eating out +C: okay that is really very doable for me +T: okay +C: because I do it every lunchtime when I go that's exactly +T: what I do we try and good ideas living by kind of like an 8020 percent rule so eighty percent of the time you're making healthy choices twenty percent of the time you can kind of you know feel like you're not as restricted because it seemed like in the past being on a very strict diet doesn't work in the long run because that's not how life works +C: yeah +T: and things are thrown at you and you have to be a little bit valuable to your different situation +C: yes +T: so those are some good goals now I would like to talk a little bit maybe up some physical activity +C: yes so I would love to be accused might cost me too much money +T: yes so I'm understand that you do want to become more physically active and you've had experience in the past being physically active what do you feel has prevented you from from being physically active is it time is it being tired +C: it's actually both time being tired +T: okay you know what kinds of physical activity do you enjoy doing if you were to do physical activity what do you like doing +C: I would I'm looking +T: biking swimming activities +C: I love swimming +T: okay +C: I would I don't mind actually gonna get a treadmill on the place I don't I do enjoy those things because they do we find me when I do it I don't just like I'm tired +T: you start that's difficult he's very different getting there +C: yes yes +T: okay so um okay so starting is difficult but just remember that any little changes you're making are are good even if it's going to the gym for just a little bit in 20 or 15 20 minutes or just walking outside of your house and you know after work or in the morning around the lunch break just going outside getting some fresh air how do you feel about maybe parking further +C: I do that +T: okay +C: you know it's interesting but I don't do it all the time +T: so maybe we'd like to set a goal for that so what about well what what seems good for you how often do you want to do it every time +C: what +T: would you like to park far +C: actually get all the time for a while I did and then I stopped I'm gonna park like the closest I can +T: so even that alone will give you a little bit more +C: that's physical activity +T: exercise so maybe parking I don't know an exact distance but parking further away if you're going to the grocery store if you're going in and out of places just walking more in general +C: yes but I get the idea though +T: typically once you start something you kind of like and start seeing results +C: yes +T: so that's where your motivation +C: yes yes +T: so your motivation lies and seeing results +C: yes yes +T: okay so then something to remember is that results don't come overnight and that's hard +C: yes +T: to have to stick to something and constantly remembering that and maybe that's something you could write about in your journaling too I'm saying that results literally writing results don't happen overnight +C: mm-hmm +T: because if you do stick to a plan over time you will see results yes we exciting for you +C: yes +T: I'm the greatest so maybe getting up in the morning and going on the treadmill how often would you be willing to do that sure we +C: you know +T: it's realistic a week realistically +C: I mean I would love to do is float accent +T: four times a week so for how long do you think you can even go on +C: I always wanted to be on the treadmill for about 60 minutes +T: 60 +C: yeah it feels good when I'm on threatening for 60 minutes +T: do you think that would be realistic for your schedule and now that we're saying that we're gonna be journal +C: you start out you mean you know +T: okay so why don't we start trying with 20 minutes +C: okay +T: so for 15 or 10 minutes or 50 Matt what works best for your schedule +C: well +T: what is realistic +C: I have to tell you that I have tried the 10 and 15 minutes and it doesn't do much at all it doesn't feel like I have done much you know I mean +T: over time +C: I guess it depends on how I'm using the treadmill +T: mm-hmm and over time it will help but you also have to couple it with your with I don't is +C: I put down 20 minutes +T: 20 minutes +C: doctor for 20 minutes or day for four days a week +T: mm-hmm +C: excuse me on the treadmill and I can start without doing the incline or anything just to get myself back into doing it +T: okay +C: getting used to it +T: yeah it's going through the motions so yeah well it becomes kind of second nature +C: right right +T: they say it takes about like 27 or 30 somewhere around their days to develop a habit +C: I really that's interesting point +T: I'll have to get you the exact number later but yeah so for it to start feeling second nature so it seems like you are really you want to make you're you're preparing to make the changes right so +C: yes +T: you know you know that you want to make the changes and you feel ready to make you feel ready to make these changes +C: I actually do yes I mean I'm was really really happy when you approached me to have this this meeting I really was and that's why I was sharing with you the details +T: mhm +C: it's almost like going to confession and because because I don't feel good about where I am I really don't +T: maybe one last thing I can mention right now +C: um +T: his water +C: is why it's I like water and I it's easy for me to drink water is because my throat got used to actually taking in that much water it's not a five-piece to be a fight than to begin +T: yeah +C: you know +T: that's like me to drinking water for me is a struggle and I have to make myself do it but I know that I'll feel rejuvenated and I'll my body will function better and let my metabolic processes happen like they should and get my food and digestive system going so they're very I mean we're made up of mostly water so your thought you brought he needs that +C: yes +T: and just keeps you more alert when you're dehydrated do typically more sluggish and you're less more likely to make poor nutrition decisions +C: yes yeah +T: so just drinking water so why don't we you said you've done it in the past right how do you feel about drinking five bottles +C: I honestly would not mind at all especially if I started exercising I think +T: so you know it's really cool as they have apps now +C: though +T: that you can track how much water you're drinking I'll have to drop +C: and you give them out to anyone that for you +T: mmm-hmm yeah and you can track how much water you're drinking out of there and there's other web sites or apps like MyFitnessPal that you can track what you're eating and it will track all the calories and things like that for your day so why don't we go over um why don't we recap some of the goals so I just wanted me to say your understanding you know what we went through and some things that we talked about +C: okay let me tell you what they are +T: yes please +C: okay so the first thing he said is how about if I did some journaling and he said to do it between four and seven times per week in the morning and then I should actually indicate also in my journaling how I feel also he said to reflect on the food choices that I made for the day the day before and that should be part of my journaling +T: yes you should be noting some goals for the rest of the day so I want to drink five remember to drink five bottles of water +C: and I last part of my journal +T: things like that just was kind of like reminders for yourself +C: okay the second thing there were five things all together the second thing was we talked about restaurants because I eat a lot +T: mm-hmm +C: and he said that I really should choose always put in my mind that I should be choosing Royal Baker steamed 70% of the time but if I go with the 8020 rule it would be good I can do 82% of the time I should be doing good choice since 20% of time it can't be bad choices that's okay because many minutes so that's basically what I remember you say +T: well I also want to reiterate that it's you know there's no good food and bad food right there's no such thing as good food bad food that's when we we come to pick like portion sizes right +C: Oh +T: so food is food +C: yes +T: but we want to have more you know plant-based foods and we meats and low-fat dairy and whole grains and things like that +C: um +T: and fruits and things because of all the health benefits that they have +C: yeah +T: and then we want to you know for sweets and other other treats and desserts we want to keep them as treats and desserts and by doing by keeping a portion the size small we can also you know continue our goal of weight loss +C: okay +T: because we don't want to you know deprive you and then all of a sudden oh I want to binge eat all this food +C: right +T: so and you know there's you know events and parties and things like that that you kind of need to be you know okay with you know living a little bit +C: yes +T: so that's it +C: okay that's very good points and I noted those things the third thing is the physical activity he said that I should really begin if I do like and enjoy using the treadmill for example I ought to consider maybe 20 minutes to start every 29 to 30 days chances are you will develop a habit +T: I don't remember the exact timeframe but it's somewhere around there +C: okay +T: maybe keep it as a goal just to get there just to get to that +C: oh yes yes +T: mm-hmm +C: even if you go into the office +T: yeah +C: so that's very logic number five the fifth thing you talked about is which was more of an educational piece and you said it was all about calories and you said that what I should be considering is taking in about what would be 500 less calories per day and if I did that it would equate a loss of one pound per week +T: yes +C: and and don't forget to increase your water intake by basically take the five bottles that I basic I was saying that I used to do so start drinking more water and drink water is because carbohydrates attached themselves to water and it is a good idea to reduce carbohydrates are important for the body but at the same time a lower intake of the carbohydrates would probably be helpful in weight loss +T: well it will have to be helpful with water I mean it will result in water weight loss but that's not really fat loss so that removes water weight will come back when you drink a bunch of water again so that's not really the weight loss were looking for we want fat loss +C: okay +T: you want a decrease in fat and increase in lean mass +C: so I mean how are you gonna lose the fat the yeah the fat loss +T: through your diet and just exercising well and +C: better choices you write coochie which is basically I always think Roy big steam right +T: yes because three 3 diff --git a/HighLowQualityCounseling/transcripts/high_077 b/HighLowQualityCounseling/transcripts/high_077 new file mode 100644 index 0000000000000000000000000000000000000000..40b7cc44cd997bd9ad4275e0544000f030465547 --- /dev/null +++ b/HighLowQualityCounseling/transcripts/high_077 @@ -0,0 +1,76 @@ +T: hi-oh Vina how are you doing today it's good to see you +C: I'm just tired +T: just tired yeah you know we did some pre-visit planning with you and your phq- which is a short depression screen was actually positive so we asked the nurse to give you a little longer screening tool which is a phq- and that actually did come up with a score of which is in the mild depression range so how does that how does that feel +C: well I knew I felt different I didn't know I was depressed +T: but you knew something was something was wrong +C: I didn't feel like myself or have it and feeling like myself no +T: tell me a little bit more about not feeling like yourself +C: when I just go to work and I come home and I sleep I wake up in the morning and I'm still tired I just have no energy +T: so you sleep a lot but even though you're sleeping you don't wake up rested no not at all doesn't sound like good quality sleep +C: no I just have no energy I don't want to do anything but just sleep +T: how long has +C: that been going on hmm I guess a couple months or months yeah +T: what else is going on +C: w-well you know I been drinking more I'm a drink socially but I find myself that when I come home you know I have a glass of wine and then I just go to sleep +T: and that's worrisome to you +C: it is cuz I don't usually drink that often during the week so it's increased yeah yeah +T: I can see where that would be bothersome to you what else what else is going on with +C: you well you know my mom died a year ago so Mother's Day is coming up so you never think about mom a lot I miss her a lot +T: that anniversary is is close +C: yeah +T: that's particularly hard when those anniversaries come around for the passings of our parents that's a that's a very difficult time I +C: yeah and I took care of mom so that's hard because for a long time well she was sick and she died from cancer so I took care of her so for a long time that's all I did was take care of mom and work that was so now that she's gone it just kind of brings up everything all over again +T: it's kind of a hole in your life +C: yeah we were really close +T: I'm really sorry for your loss and thank you for sharing that with me I know that's I know that's very difficult so it sounds like your sleep has really been affected you're not getting good quality sleep you're really fatigued yeah I'm just kind of going through the motions it sounds like during the day and then how's your appetite been +C: I'm not really eating that much you know so I have energy you know before I would come home cook dinner or you know meet some friends after work but I don't want to do that I just come home and have a glass of wine just go to bed +T: so you used to be more socially involved than you are now +C: yeah don't do anything now a little T; more isolated +C: yeah just working come home and sleep +T: so if there was something that you could do about this what do you think you might like to do +C: well I don't want to stay like this this isn't Who I am you know just sleeping all the time this is I don't want to stay this way +T: kind of feels like you're stuck yes point +C: yeah I just don't want to do anything or go out my friends anymore and just work and come home and sleep I don't want to do that +T: it's kind of the same old routine um I wonder if it would be okay if we could talk about some of the options that are out there for folks that have some mild depression +C: okay +T: like you would that be alright most of the time we typically think about medication as a as a possible answer so no medication at this point ation +C: no +T: all right then I think as important certainly perhaps more important than medication is counseling and getting you to talk with someone about your feelings on a regular basis and getting some feedback on that +C: I'm okay with that you know when Mom was sick you know she was in hospice care so she had cancer and the nurses and the doctors you know had our family talked to someone you know about what we were feeling you know +T: so that was the face pretty good experience +C: yeah yeah to talk to someone that understood what we were going through sure +T: something else might be exercised another possibility would be a natural product there are some things over the counter that I think for mild depression may be appropriate and those that's another thing that we could talk about if you wanted to learn a little bit more about those +C: may be something natural exercise I don't have energy I don't want to I just don't feel like doing anything so I know I'm not going to exercise right now but if it's something that's natural you know I can maybe try that +T: okay if it's okay let's go back to talking about the counseling for a minute and then we can hit some of those other things too okay so um is there a counselor that you know or that you have a relationship with this lady that worked with you during your mom's death is she you don't want us out in the community +C: she was really nice for me yeah I liked her +T: so it sounds like you're pretty ready to do that could you say on a scale of zero to ten ten being really ready zero being not ready at all how ready would you be to do some counselling +C: maybe like a six or seven +T: so a six or seven why a six or seven and not a four or a five +C: well because I don't want to stay like this and you know I've already talked to her before she was really nice so I wouldn't mind going back to her and she told me you know when I saw her last time if ever needed I could come back +T: so it sounds like you've got a connection there already that's really good yeah um does that sound like something you're ready to do then and maybe make a plan about that yeah I can definitely check with her and see if she can see me again okay yeah +T: well that's okay then it would be all right if we talked a little bit about the exercise I know you said that didn't really sound like an option for you at this time and that's perfectly fine only you can make those decisions Alvina but if it's okay I wanted to give you a little bit of information about exercise and its effect on the brain okay exercises is again a number of studies has been shown to be as effective as prescription antidepressants okay I didn't know that yeah it actually raises serotonin have you heard about serotonin yeah I asked kind of the happy hormone yes so um it actually raises serotonin and also something called BDNF which is well it doesn't really matter what it is but it helps actually your your brain actually grow and help repair itself so exercise can help in lots of ways by improving serotonin and decreasing stress certainly and in actually improving the quality of sleep how does that sound at this point +C: well if I try to exercise and if I call her to talk to her again does that mean I have to run the medication +T: right now we can try that absolutely again those are yours to sit your decisions and I'm I'm here to really support you in those so if those sound like things that you might be willing to do I'm I'm all for it well I'll try then let's go on the medication +C: okay I have some friends they exercise and workout that I could probably call and exercise with them +T: so you have some friends that are already involved in an exercise program yeah is that something you talk with them about and that you possibly could get into that group +C: yeah I have friends that run and friends that go to gym I have some friends that walk after work +T: so it sounds like a wide variety of things that you could do yeah which of those tend to interest you most +C: well then also you know my church on the weekends they have exercise classes too so yeah but I think I guess I don't have energy really to exercise but I'll try it but I'll definitely call the person I had talked to a mom passed away and I'll do that right away +T: very good well I think it sounds like this is important for you to to feel better and it sounds like you're really ready to kind of make a plan how do you see this fitting into your life at this point again kind of getting back to the counseling and and the exercise +C: well when I saw her I could see her after work so I can call her and see if I can still see her after work for therapy and exercise I mean I can do that you know after work or on the weekends my friends they exercise various time so +T: yeah let's talk a little bit more about that you're say on a scale of if we can do use another one of those scales zero being confident that you could start an exercise program zero being not very confident at all in being very confident tell me where you are in this exercise thing +C: honestly maybe a five okay and I'll try it it say if I have to do that so I have to go on medication then I'll try it okay that +T: sounds like a pretty strong commitment yes I'll try it +T: okay and tell me a little bit more about your plan for exercise at this point +C: then well you know my friends have been calling but you know I'm just sleeping all the time so when they call them sleep so I haven't really called them back but I know I can just return their calls and just let them know I'll want to meet up with them and you know at least maybe just start walking +T: I think that's a great decision you have a couple of friends in mind that you could call +C: yeah real close close friends that live not too far from me yeah so tell me how to +T: tell me about a plan that you would think could perhaps get you going with with the exercise +C: well I probably shouldn't come home I probably would need to call one of my friends and make a plan to maybe walk after work and take a change of clothes and maybe drive to one of my friends house after work and change with her +T: it would be difficult to do it in the morning you don't see that happening +C: no because it's so hard when I get up in the room so tired that I can't I can't say doing in the morning +T: you think it would be easier to do it after work +C: cuz I'm already out yeah as long as I don't come home so I come on Monica's sleep come home it's over yeah yeah all right +T: well good it sounds like we have a plan for the counselor and when you check out today I will put this in your record and that will want to get in touch with the counselor that you work with when your mom was going through okay her passing in the grief situation and then I'll want to depend upon you to call your friends and then get involved in the exercise program +C: okay I'll try that +T: all right and if it's okay I'd like to call you in a week to one see how you're feeling and to the exercise is helping you may really find that after you give the exercise a good trial you may actually look forward to it because my hope is that will actually help you feel better and improve your mood and then I would also like to see you back in two weeks just to check on things now we've talked about exercise apartment we've talked about medication not being on the table at this point but I want you to know you know you can call anytime and I will work to get you in and that might be something that we need to do if our plan is not working okay \ No newline at end of file diff --git a/HighLowQualityCounseling/transcripts/high_078 b/HighLowQualityCounseling/transcripts/high_078 new file mode 100644 index 0000000000000000000000000000000000000000..33326e524a69bdb8ba525ea233721e65102805f7 --- /dev/null +++ b/HighLowQualityCounseling/transcripts/high_078 @@ -0,0 +1,111 @@ +T: hi Michael it's good to see ya well glad you came in today when I douse up +C: well I came back here because I had to I had to make an appointment so I could get my prescription for my blood pressure medicine refilled and they wouldn't do it it wouldn't refill it it's a drugstore unless I came back here so +T: you're you're angry what +C: well I'm not angry at you but I'm angry at the situation and I gotta come back in here take time off from work just to get that prescription filled but but you know you do what you got to do and +T: well I appreciate your bringing that up that is does sound frustrating but by coming in it gives us a chance to to sit down and and and talk and see how things are going with the medication which is what I'm most concerned about I know we started at about three months ago or so and I am real interested to hear how you're how you're doing on +C: well uh yeah whenever I get my blood pressure checked at the drugstore it looks like I'm that it's working and that respect but it does seem to take away all my energy you know +T: kind of fatigued +C: yeah yeah my I got no get up and go if you know what I mean +T: so kind of has taken the wind out of your sails +C: absolutely yeah +T: how long have you noticed that oh I don't know I +C: at least since I've been on this medication at least that long yeah +T: doesn't sound like it's working well too working too well for you have you tell me about how you're taking the medication have you taking it very regular +C: oh yeah I take it I take it just like it says take it on the bottle you know I take it every morning when I get up +T: okay so you've been pretty consistent and taken the +C: all yes +T: anything else going on in terms of symptoms no just this overall lack of energy which I know my wife doesn't particularly care for +T: your wife tell me a little bit more about how it affects the relationship between the two of you +T: well as I say I get up and go got up and went and there's not much going on between the two of us like there used to be +T: so sexual performance is not as good as it as it might be +C: nope but I think it's because of that damn medicine +T: so does this sound like something that you want to continue or should we talk about possibly other other options for you it sounds like it's kind of affecting your life negatively +C: well yeah yeah but you know I I'm worried about my blood pressure because my my mother had a stroke not long ago and I know it was so they told us it was because of her high blood pressure so I don't want that to happen to me +T: soyou're concerned about having a stroke +C: well yeah I mean would you be you know it sort of runs in families I think +T: yeah so taking care of your blood pressure is is very important to you +C: yeah yeah absolutely +T: again it doesn't sound like this particular medicines working out too well for you if it's okay I could talk to you about possibly changing the medication so on the one hand we'd be keeping your blood pressure under control but on the other hand we wouldn't be causing these types of side effects hopefully would that be okay +C: well are you talking about on more medications or just a different medication +T: yeah so uh I think probably it sounds to me like probably changing medications at this point as a start we can always add another medication later if that becomes necessary +C: yeah well I'm not real interested in adding any more but if changing it it would keep my blood pressure down but not take away all my energy than I might that give better idea +T: so you'd at least be willing to try a change and and see how that goes +C: yeah yeah I know +T: well if it's okay I can tell you about a group of medications that I I like but if but first if it's okay that they give you a kind of my rationale for using that medication to start with so you know one of the things you'd mentioned to me was some of the financial concerns and the medication that you're on is pretty dirt-cheap and for most people at this dose particularly a low dose because you have mild hypertension most of the time it doesn't have many side effects obviously for you that was different does that make sense +C: yeah yeah +T: so the medication I'm thinking about is something called an ACE inhibitor ACE inhibitors are very very well tolerated and occasionally people will get a dry hacky cough with them but it's fairly rare but there's very low risk of side effects in terms of sexual side effects in particular and most people as a matter of fact it's one of the the drugs that actually helps your heart beat a little bit stronger and better and many people don't have any kind of a decrease in their energy so how does that sound +C: yeah it sounds though it sounds like a good idea if it still controls my blood pressure but doesn't take away my energy it sounds like a good idea +T: okay so what other things can you tell me about that might affect your blood pressure +C: uh-ohuh-oh my work is sometimes stressful and some of the people I work with kind of drive me a little batty occasionally and I I don't know if it I don't really know if that it causes my blood pressure to go up or not but it certainly could I guess so there's some stressors at work +T: yeah and if it's okay I'm going to write down some of these things that as we talk through them so what else can affect blood pressure that you know of +C: um well you know just mostly from watching TV shows I guess I am aware that alcohol and I drink some a moment that alcohol has some effect on blood pressure I think it might even say so on the label though I'm not sure it can't +T: it can't anything else you can think of +C: no +T: well sometimes sometimes weight can be an issue and explain this little tool to you this is for what it's worth called a agenda mapping so it sounds like there's a number of things that you know of and then we can talk about that affect your blood pressure you mentioned stress and an alcohol and we talked about weight certainly you know blood pressure medication can affect you there and I would say another big one might be exercise does all that makes sense +C: well yeah +T: so we could we can talk about a lot of these things with which one might you want to talk about and if we need to we can set up for appointment and talk about this more if we run out of time but +C: well um exercise I'm I actually like to exercise and +T: tellme about the exercise that you're doing well I play golf and walk the golf course so you carry your bag or do +C: Idrag it along on a pull cart my wife says that that doesn't count as exercise but I say try it yourself it is exercise +T: it is exercise it is exercise Michael look at your your weight when we came in yeah and you were about or so yeah which is actually according to your BMI body mass index in the in the overweight range how do you feel about that +C: well I don't think I'm overweight +T: yeah you don't look terribly overweight but according to the the charts there it's in the overweight category so you're actually getting you into the normal category would be about a loss of about to pounds +C: or pounds +T: yes or pounds +C: I haven't weighed that since I was in high school +T: I understand I understand but you know I'm not saying that we need to lose pounds sometimes just a loss of pounds can make a tremendous impact on your on your blood pressure okay so pounds sounds like something that might be negotiable +C: +T: is the number okay let's go you do with thigh okay I think I can do all right so if you were to want to lose pounds how would you go about it +C: I'd probably go back to the gym +T: has that worked in the past +C: yeah I mean I used to go to the gym and work out a lot and uh I've done it for a while but I guess if if I'm I'm sure I could lose pounds if I wanted to +T: and that would actually kind of take care of two of these things right your weight and your exercise both of those would have a really positive effect I think on your on your blood pressure +C: okay well +T: sowe've talked about changing your medication stopping the medication you're on changing you to this ACE inhibitor and then perhaps looking at the weight and going getting back to the gym and starting an exercise program is that about right +C: well what would it take for me to not have to take the medication at all +T: at all +C: yeah I mean if I did enough exercise and lost enough weight would you not what I not need to take the medicine +T: I I really wonder if you would I think that's an excellent question and if you're motivated to lose that kind of weight I'm with you I can't leave I this good +C: I can lose five pounds well +T: it may it may take more than five pounds to get the desired effect on your blood pressure that's really getting back down into that normal weight range if you will in that one to range probably +C: I I just want to make sure I understand if I if if I lose uh five pounds and I do it through exercise that I could you would recommend that I try going without the medicine for a while too and see what happens +T: I don't think I'm ready to go there yet Michael but it sounds to me like you want to get off of your medication +C: yeah if I can yeah +T: well itthere it's a blood pressure rate that you are right now blood pressure number that you are right now I probably wouldn't recommend that that that's going to take a plan for us to work out over probably a period of months so that you could one lose a little bit more weight to exercise really regularly we might want to talk about the alcohol um can I ask you how much your you're drinking now our regular basis +C: two or three beers a day +T: two or three yeah it is okay I'd like to share with you a little bit of information about alcohol and its effect on blood pressure Merryn research has shown that for men more than two drinks a day and for what more than one drink a day really can significantly impact your blood pressure negatively it raises blood pressure how does that how does that sit with you +C: you're saying two or three more than two more than three okay so two is still considered aa safe and regard to blood pressure +T: that's what most of the research shows +C: okay I'll do two +T: you'll do two okay and you said that you did two three every day most every day yeah sometimes a little more on the weekend I guess +T: can youthink of any ways to maybe cut back on that to where you wouldn't be getting as much alcohol in your system on a regular basis +C: oh yeah I guess I could you know I mean uh I you know I don't I I don't have a drinking problem so I could take a day or two and not drink at all if but if if two a day doesn't hurt my blood pressure um I think I could go with that +T: so two a day um keep in mind too there are significant amounts of calories involved and alcohol particularly beer +C: Isuppose I could drink Light beer +T: light beer doesn't appeal to you +C: might as well not drink beer at all you drink Light beer but I suppose if I suppose I could do that +T: scale of zero to ten zero being not willing at all to do that ten being very willing to do that where do you think you +C: probably about it I +T: why did you say a five and not a three or four +C: just because uh you know doc habits are hard to break you know and it usually don't drink Light beer and so it would be a change it would be something different but uh well you know I'm willing to give it a try +T: tell me the good things about cutting back on alcohol and maybe switching to light beer talking about the good things well I did you know +C: obviously a good thing is I'd probably lose weight which is what we're trying to do here +T: so you'd lose weight +C: uh and there there may be other things about alcohol that has something to do with blood pressure that I did not understand but but I suppose it would help keep my blood pressure down and my weight low or if I didn't drink as much beer or if I drank light beer and so that's the good side the bad side is I don't like it as much +T: on ascale of zero to ten zero being not very important and ten being very important how important is it for you to to get better control of your blood pressure +C: very important I put that up really pretty high I'll give that a nine +T: so interms of making a change what are some of the things that you'd be willing to do in order to make that happen +C: well you know I'm willing to do the things but most of what we've just talked about which are um drinking Light beer drinking no more than two beers a day going to the gym again and sticking with a different medicine for a while +T: okay so to recap changing your medication you're willing to go to the gym and exercise switch to light beer and keep the beer to a maximum of two a day okay now only you can make that decision Michael I can't do it for you is that somewhere that you're willing to go +C: yeah I think I'm willing to do what it takes to keep my blood pressure at a level that doesn't concern me and if this is what it takes I'm going to give this a try +T: so one more scale in terms of your readiness to make to do this zero being not ready at all and ten being ready where would you fall on that +C: six and a half +T: six and a half and watch six and a happen and not two or three +C: because I know when I walk out of here that if I keep doing what I'm doing I I'm either going to have to live with the blood pressure medicine that takes all my energy away and I don't like that or I'm going to have to let my blood pleasure get real high and I know that can cause all sorts of bad things to happen +T: so you're really worried again about the health consequences of not keeping your blood pressure under control +C: people keep telling me that high blood pressure causes all sorts of bad things to happen so yes I am concerned about +T: that so if it's okay I'm going to put this in your record that we talked about well we're certainly going to switch your medication but you're going to be working on losing some weight going back to the gym cutting down on your beer usage and switching to light beer is there anything I missed +C: five pounds +T: fivepounds that's the number now I'd like to see you back and about let's call it a month let's see back in a month +C: I'm the five pounds going by then my +T: pounds will be gone and we'll see how things are going and probably talk about this some more and see how successful you've been with this plan and then we'll go from there \ No newline at end of file diff --git a/HighLowQualityCounseling/transcripts/high_079 b/HighLowQualityCounseling/transcripts/high_079 new file mode 100644 index 0000000000000000000000000000000000000000..64250de7fa5b5c08f142064c2e3a2d7a371ef464 --- /dev/null +++ b/HighLowQualityCounseling/transcripts/high_079 @@ -0,0 +1,65 @@ +T: morning page +C: hello how are you +T: it's good to see you up and about how are you feeling after your last little hospitalization +C: well it was pretty scary I'm I'm definitely improving but I don't feel as well as I think I should um the COFF is a lot better but my breathing is still not what I think it should be right now +T: so you're you're still struggling to breathe some +C: I guess you could call it struggling I just when I walked to the mailbox or up the stairs I get out of breath easily +T: exercise tends to make the breathing worse +C: it does seem so yes +T: so you're better but not quite where you want to be and +C: I'm definitely not where I think I should be I feel like I should be better by now usually after a cough or bronchitis I'm able to breathe easily and it's not like that this time +T: so you usually bounce back pretty quickly but this time is taking longer and that's a that's a real concern to you +C: it was when I was with you in the hospital you gave me a little oxygen in the beginning and I just never thought I would be a person that would have to have oxygen that was scary too +T: so that the oxygen piece is something that scary it almost feels like ear were really really sick when you needed oxygen C it does I never picture myself needing a I guess I'm scared of needing an oxygen tank and carrying it around with me and having the tubes in my nose um that I just don't see myself needing that I always think of myself as being healthy +T: and now it seems like you may have some real or some permanent damage +C: that's what it seems like +T: Paige would it be okay if we talked a little bit about your disease process +C: sure +T: you know with a flare-up of bronchitis like this you very well may have done some damage to your lungs the good news is as you continue to heal I mean we have a spirometry today which is that breathing test that you did we compared that about six months ago it is quite a bit worse now a lot of that will get better with time but also a lot of that kind of depends upon whether you continue to smoke or not +C: oh this one we're going to talk about my smoking huh +T: well Paige we don't have to talk about anything you don't want to talk about um those are going to be decisions that only you can make I can't make you quit and so that's just going to have to be your decision I I want you to know though that I'm here to support you and even though we've talked about smoking cessation and some things that you could do in the past you've been kind of resistant about that I wonder if having this bout in the hospital has done anything to change your mind +C: well I think I need to seriously think about it again I just evidently my health is on the line because it it was just a really bad experience for me +T: so bad experience mm-hmm so if we look down the road maybe five ten years and you decided not to quit smoking what do you think that would look like for you +C: probably not good I would see me not being able to breathe at all and again just my biggest fear would be needing oxygen every day all day that +T: oxygen is a pretty strong motivator for you isn't it yeah well so it sounds like if it sounds to me like if if you didn't quit smoking that you feel like your overall health might really be at risk +C: yes +T: where does that where does that leave you C I need to start considering it more seriously than I have in the past if I want a different outcome if it's +T: okay at this point Paige it's great and but let's talk about it's okay what's something called a decision balance so and involves four things to think about it's almost like writing it on a page but we're going to do it in the air or whatever so what are the good things about smoking that you like if you didn't side to quit what are some of the negatives about smoking if you didn't decide to quit and then if you did quit what would be some of the good things and then what would be some of the negative things if you did quit so tell me if you would what are some of the good things about that you like about smoking if you continue to smoke the way you are +C: okay um I like the taste I like how it feels in my throat I love the social aspect of it I have smoking friends I have non-smoking friends and just when I'm with my friends that smoke it is just a lot of fun it's just something we do as loud as that sounds um and I love it with my coffee first thing whirring a lot +T: so some of the good things are the taste we regularly with coffee and how it makes you feel and then it sounds like there's a big social component to smoking for you there is tell me about then what would be some of the negatives if you continued to smoke and didn't quit +C: my health that would be the number one things that are negative about smoking the snow and my clothes my hair and that it's a lot of people that are surround myself with it's not socially acceptable anymore and that does make me uncomfortable +T: so some of the negative things would be it's a impact on your health right the the smell clothes and so forth and then there's a lot of kind of social pushback +C: yes there is +T: with cigarette smoking I see what else +C: well you know my husband Dan recently stopped smoking and was it yeah he's done quite well but now it's seems like he's righteous and I'm an addict and he says things like you could just do it if you'll just do it you know what those cigarettes are gonna do to you why don't you just stop I tell them I've stopped a hundred times and I'll stop when I'm ready but it you know that's put a strain on things +T: it does sound like he's concerned about you and and concerned about your health and that he loves you +C: I know it just doesn't feel that way sometimes but I know that he would be supportive because he wants what's best for me +T: but it's on the other hand it's it's hard to put up with some of that stuff and I think I think it shows a lot of inner strength in you to put up with some of that even though it's kind of a pain +C: well thank you I'd like to think so +T: so what would be some of the positives some of the good things about quitting based on what you told me here today +C: even if I have some permanent damage you encouraged me to believe that if I stopped that I could get better and definitely avoid the oxygen tank that would be the biggest positive the second positive was that Dan and I would have a little more peace in our home and get along better and he would see that I you know want to be on the planet my clothes would smell better my hair would smell better a car would smell better I wouldn't have to worry about you know sneaking somewhere when I wanted to smoke and it wasn't socially acceptable in the situation I'm in so there are a lot of positives okay +T: so again on one hand there are a lot of good things that you enjoy about smoking and on the other hand there you've given me quite a list of things that if you did quit there would be a lot of ways that your life would be better so where does that leave you now +C: but I just really need to do this and to concentrate on the good things and just be ready to stop I just need to stop +T: sounds like you're pretty committed so honest let's talk about a scale then on in terms of being ready to quit zero being not ready at all and ten being like yeah I'm really ready to quit where are you on that do you think +C: I'm gonna say an eight +T: an eight why an eight not a five or six +C: it all just goes back to this recent event and the fears that I have or where it would be I'll go back to your five to ten years from now and that's just not +T: not a pretty picture no no it's not tell me some of the things that you are aware of that can help you in this quest +C: well I'm very familiar with nicotine gum and nicotine patches I do wear the patch and they work very well for me um especially at work because I'm not allowed to smoke at work nor but I want to be smoking at work again with the people that I'm with um and that's really about all I've ever tried or called Turkey and that just never will I never want to offer you mm-hmm +T: do you know about the NC quit line +C: I've heard the commercials on the radio but I've never looked into it +T: would it be okay if we talked about that for a minute sir this is a fantastic program page they have a lot of information but the great thing is you can actually have your own personal smoking counselor and you can call them or you can leave a message with them to call you but there's a tremendous amount of support there and that's been a very helpful thing and the great thing for me is they will actually call me and give me kind of follow-up information on how you're doing mmm how does that how does it sound +C: sounds very intriguing sounds like it could be helpful yeah not just depend on Dan with my journey yeah +T: so he's just uh sounds like more support right you wouldn't feel you wouldn't feel alone in this battle right yeah so I heard the nicotine patches and gum and then possibly the Quitline anything else that you've heard about or that you might be interested in there +C: well I do know Dan um had a quit date is that something I have to do +T: again decisions that only you can make H and but if it's okay I can tell you a little bit about the research about the quit date okay um most of the research shows that if indeed you can kind of look at your calendar and see a time that would be better to quit them than not it's really helpful to have a quit date and to tell as many people as you can about that this is the day I'm quitting again it tends to garner that social support and increases the commitment level how does that sound +C: well that makes sense why it would be better than just today will be the day +T: is there any time that would be better for you to get a quit date than another day +C: we do have some plans coming up so I think a week from Monday socially would be better that's the day a week from it yes +T: would it be okay if our office called you on that day to just begin to give you a little bit more support let you know that we're with you sure that would begin so let's go back to another one of those scales scale of to in terms of your confidence about doing this zero being no confidence being they have a lot of confidence about my ability to quit where would you be on that scale +C: I think with everything we discussed today I would like to leave on a and that's how I feel that's tremendous it is tremendous good good feels good feels I could still be a little weary +T: but it feels good +C: yeah but it feels like you have a play on this time good as what I feel better +T: well congratulations I think that's probably the biggest health decision that you could possibly make in your life particularly in light of what you've just been through so right I think this is a really good time and I have I applaud your courage doing it takes a lot to to make this decision so good for you +C: well thank you +T: so I will call you and we'll give you some information about the Quitline when you leave you can take care of the patches and and gums instead of over-the-counter and if it's okay let's schedule an appointment and two to three weeks out and get you back and see how things are going \ No newline at end of file diff --git a/HighLowQualityCounseling/transcripts/high_082 b/HighLowQualityCounseling/transcripts/high_082 new file mode 100644 index 0000000000000000000000000000000000000000..c153ce8cf44c96f7a6d432d30bd4407df36a576c --- /dev/null +++ b/HighLowQualityCounseling/transcripts/high_082 @@ -0,0 +1,41 @@ +T: hi gene I'm dr. sabe nice to meet how can I help you today +C: well doctor I made an appointment with you finally because I was diagnosed over three months ago with the pulmonary disease COPD yes and although I didn't call right away I really need some help in quitting smoking right so I thought well this is my first step so it's time to do something +T: something okay so you've been diagnosed by this progress brother just diagnosed that and and how are you feeling right now +C: I'm I'm really scared because I don't feel well I haven't felt well for a while I'm getting coughing fits even when I'm on the telephone with customers +T: it sounds like you've been smoking for such a long time and then this diagnosis was given to you and now that's really causing you to be afraid and frightened +C: mm-hmm I I don't know what I'm going to do about it okay +T: no have you thought about when you want to quit +C: fine I'm giving myself six months six months and and that seems like a long time away but I have a feeling I'm going to fail at this point in time I don't even have % faith in myself +T: 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 under confident that you'll actually be able to do this and your word about failing +C: I don't know what to do I've tried to quit smoking I've had I've taken pills I've taken the patch I've gone through therapy nothing's helped I finally I went to the doctor I was actually in the hospital they took me to the hospital for a week that's the longest I quit +T: so you've been able to quit smoking but only when you were in the hospital +C: I had no choice I have no choice and then next day I was back to smoking again what I smoked okay +T: 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 this could you tell me what is good about smoking for you +C: it's part of my life it's I started smoking when I was at home my parents smoked all their friends smoked it was on television everybody looks so grand smoking and all dressed up and and fancy clothes and had me be having a drink in their hands and having a nice meal I didn't really think about it's just an extension of me I guess it's good for my nerves right I mean I feel like it is I know when I've got a package in my pocket or I know if I'm going through some stress I say oh I'll have a cigarette and think this out sure +T: so gene I want to make sure that I understood what you've told me of what do 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 feel sophisticated you feel like a movie star in fact the way you talk about it seems like that's what it makes you feel like is that right that's right okay is there anything I missed +C: um I enjoyed it just it relaxes me it's great after a meal yes um free mm-hmm we all just do it it's a little group of people my family right the people I work with we go out in the courtyard have a cigarette and talk that's how you make friends a lot of people would like a little group now we're all a little bunch of us +T: so it's hard for you to quit smoking when everybody else around you're smoking and it's so easy to go and take a break and have a cigarette +C: I I never thought of it that way but probably you're right now +T: you've told me what is good about smoking for you ah can you tell me what it's not so good about smoking for you +C: well it's bad for my health and it's scaring because I don't feel well I haven't felt well for a while I'm getting coughing fits even when I'm on the telephone with customers +T: is there anything else that's not good abouts looking for you +C: um it's expensive really god expensive and I smoked sometimes cigarettes a day and I'm starting to buy a different makeup because I'm starting to really age starting to get lines in my face and wrinkles and my skin is getting really clogged up and I'm spending a fortune on cosmetics +T: okay so let me make sure I've understood this piece as well so they're not good things on the not so good things about smoking for you are the effects on your health the effects on your physical appearance on how you look and the amount of investment that you do making in makeup and in getting your nails done etc and then the cost of smoking yes so so let me ask you this given everything going on in your life right now on a scale of to where is the most important thing to do and one would be the least important thing to do how important is it for you to quit smoking +C: it's for me for my health and for the money and everything I said I would say it's or out of that I should quit smoking +T: definitely most important +C: yes a hundred percent one of the most important things +T: let me ask another question and follow-up to that again given everything going on where is the most confident you ever felt about anything and one is the least confident how confident are you that you will be able to quit +C: um I'd say or percent confident sorrowful yeah I'd like to say more but um +T: okay now help me understand why you said and not something like or because you mentioned that you don't even want to quit +C: well I'm I guess I'm still a fighter and III it's starting - I'm starting to realize it and I do feel pretty good that I came to see you it was a step and a couple of people who care about me actually gave me a pat on the back that I came to see you so this was big step so I guess yes it wouldn't have been as high maybe last week okay +T: so you've said to percent what would it take to build that confidence to about % +C: maybe if I could come to see you again or maybe some ideas were suggested maybe if there was a group or something I I don't know but I need some help +T: so if you got help that would help you say that you went from % to % +C: I think so because I feel a little better that I just came to see you today okay discussing things helps me I always feel better when I get things out okay +T: so Jean I really want to congratulate you on taking this very important for a 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 is 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 notice 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 +C: in other words think about it more don't don't just do it automatically +T: that's correct and writing it down helps that process +C: yeah I think so because and when I get the urge I could maybe fight it and maybe wait till the next urge and maybe mark that down that I didn't go right away when something went wrong and yes I can try that +T: okay and I can give you a little card that can help you keep track of it and then if you can bring that back to the next appointment it could be something we could discuss okay anything else +C: no that gives me something to work towards until I see you next week +T: excellent well thank you so much for coming in today and thank you for seeing me doctor you're welcome \ No newline at end of file diff --git a/HighLowQualityCounseling/transcripts/high_083 b/HighLowQualityCounseling/transcripts/high_083 new file mode 100644 index 0000000000000000000000000000000000000000..459adb5463fb385c8cc338417b30524575a07721 --- /dev/null +++ b/HighLowQualityCounseling/transcripts/high_083 @@ -0,0 +1,34 @@ +T: able to come in it's just great you know we haven't seen you in like six months how have you been girl +C: they've been doing a little better yes +T: we'll talk about that you know it looks like on here that your ac is down a little bit I think it's down to about ten now yeah so you've really been making some progress tell me about how it's been going +C: well I do exercise a lot more I exercise a lot more yes I have my little portion controls they don't have too much of a certain food I make sure that you know I have my insulin at the right time the right amount +T: so it sounds like you've really been doing a couple different things that have been working for you it's exercising more which I want to hear about and you've been really looking more at your portion sizes yes you know those measuring pieces we had talked to talk some time about yes and then the third one is Oh taking your insulin at the right times okay I'm really the schedule on where it is yes does that seem to be making you feel better as far as the insulin or what do you noticing +C: um I'venoticed that well I'm very sure we discussed this before when I used to go out I used to just kind of check my blood sugar and make sure that it was low enough to have whatever I kind of wanted to okay I see right yes well now I mean I still go friends of course but as you should as I said um but one like once I go out now I kind of I tried looking for something like if my friends are gonna have a candy bar or something I try looking for maybe a granola bar or something that's a that's like sort of like a candy bar but it's a little healthier and I know that it won't rise my blood sugar that much +T: so you've been looking for other alternatives so you still feel like you're doing one but they're doing I'm looking at the carbs a little or seeing where it would be with your sugars +C: yeah like I mean of course I'm teenager I still love candy or whatever but +T: nobody can stop you from having candy completely exactly +C: but you know I still try go to go out and have fun I mean even though my friends do eat whatever they kind of want I just I take better better care of myself I eat something healthier it's something that'll make me feel more energetic instead of like a little sugar rush and then just crash later on +T: so you know how you feel when you get that sugar rush and cry yes that feeling hasn't been something you've enjoyed in the past yeah so you've you've been feeling a little more even keel it sounds like how that's going so talking about the exercise piece you say you've been exercising more what have you been enjoying +C: well now that I'm in school I mean I tried out for the basketball team yeah hey yes +T: oh I know you said you're really looking forward to that +C: yes and it's a lot of fun I enjoy it the workouts are pretty harsh but I like it I have fun I enjoy it and you haven't been feeling as though your sugar that you want to crash during checkouts +T: you've been able to manage while you're out with your energy level +C: yeah I mean I always keep some fast-acting sugar on me just in case super I'm glad crash +T: and that had added something you've had to use or haven't had to use during exercise also know how good deal good so you've been able to kind of go into it with the right sugar level yes so that you haven't bottom doubt +T: well with all these things that you've been working on so well what what's your main goal right now what's something that you're you know really trying to be focused on for you +C: well my main goal is well I've lowered my ac a little bit but I'm trying to get it to where it's really actually supposed to be so that sure myself healthy you know +T: so so keep moving in that direction we've got it from a from a down to a which is a huge success in the time period that we've been looking at and maybe let's try to move it down even a little further to you know nine to start and move down to an age exactly okay so that's that's that's great so the bigger goal is getting the ac down a little and then these smaller pieces are your what you're doing to make that happen yes so how important is it for you to have an ac let's say eight in the next six months on a scale of one to ten kinda like that pain scale we use where would you put yourself on a scale of one to ten just how important it is +C: I would actually have to say about an eighth +T: it's an eighth Wow so it's not a two or three it's an eighth +C: my goal I want I really want to reach my goal I want to be able to feel good and you know I want to make sure that I know that I'm healthy and that I know I was the one who did this for myself +T: but you said it wasn't about your mom it wasn't about dr. Smith but it was about what Elizabeth wanted yes so what would it take to move you just a little bit higher up to a nine as far as importance what would have to happen +C: I'm not really sure actually I mean it's really important to me but I do have you know has to have school and sports exactly you know I have to worry about other things too +T: we all have a lot of things we're juggling and to be honest I don't think anyone can ever really be a ten in terms of importance because we have all these things that we have to manage and sometimes they're higher up and sometimes they're lower up depending on the day or even the minute so I'm that same kind of scale of to where would you put yourself in terms of how confident you are that you can bring down your ac - what did we say at within the next six months how confident are you that you can make that happen +C: about a actually +T: Wow yeah wow that is awesome so tell me about that +C: well I'm really comfident because I mean if I was able to get my blood my ac from to and only a couple of months yes I've believed that I can do the same thing again thank you what I'm doing up +T: soreally just continuing to do what you're doing you've already shown here in the last few months that you've dropped it substantially and I'm sure you were really excited to get to see that score you know to see what the number was really gonna be +C: yeah it made me feel really good I know that I'm doing better and that I'm healthier so +T: did you have a sense when you came in did you have an idea of what you thought your number might be +C: I did actually because I know that before I wasn't doing as well as I I could and by pushing myself I knew that you know what I know it's lower I know that I did good and I've been taking care of myself I know it's most definitely lower okay +T: so you could feel confident coming in at hey when I see that number I already know the work I've been doing so it darn well better be lower because yes we're not put into this so that makes sense it sounds like for you just continue to do what you're doing continue on with getting onto the basketball team and you know continuing on with those things you're playing out with your with your insulin you haven't been in the hospital now for over months so I mean that's you know that's a huge progress in success as far as keeping yourself stable and feeling good and enjoying high school yeah so how bout we check back again you know an hour another days and just kind of see where that the ac is then yeah and kind of go from there and you know if you have any questions or you're not sure about something by all means you can stop and that's what we're here for okay thanks Liz it's great talking to you today it's great down you too you \ No newline at end of file diff --git a/HighLowQualityCounseling/transcripts/high_084 b/HighLowQualityCounseling/transcripts/high_084 new file mode 100644 index 0000000000000000000000000000000000000000..acd8fac2bc858c6424f264d35c6f8224dccc0fa4 --- /dev/null +++ b/HighLowQualityCounseling/transcripts/high_084 @@ -0,0 +1,30 @@ +T: little bit of information as to why you're here but but maybe you can go ahead and just tell me +C: yeah well my wife basically just said if I don't get um final stop drinking then she's leaving +T: Wow okay so she's doing pretty tough stance on it +C: yeah yeah she said you know she's told me for a long time that she doesn't like it and our kids have said they don't like it she's never she's kind of threatened it but I think she needs it this time I don't +T: okay all right so pretty important to you I mean she's taking the stance on it your kids have said similar things and now you're here I mean it's gotten point that you've you agreed to go ahead and go into treatment she's saying not just get treatment she's saying quit I mean Jesus she's being pretty yeah she just wants me to stop pretty out of about it okay so what do you think +C: well I'm thinking that I've worked hard my whole life and I should be able to to drink if I want but you know I don't you know I never been arrested you know I've got I've done really good with the money that we have you know we live a pretty good life she gets to do what you wanted I get to do what I want and this is just something that I want to do so you know I and it's been that that you know I've been drinking since I think we met yeah we can vary it a long time oh so I don't know what I I'm kind of like I know what the big deal is really and all right I don't want to quit +T: what's always you feel you know I mean it's like you know you work you you're responsible you do what you think is expected of you and so it kind of feels a little unfair to you know you're a man you're a head of the household you know you're doing your duty and it feels a little unfair to have people trying to dictate your behavior and telling if you've got to give this up +C: yeah I don't like it people tell me what to do yeah no no usually I just usually if someone tells me what to do like tell him to back off wouldn't what to do and so but she's serious it's time so I don't know what to do +T: so all right all right well so I guess that's kind of the that's the dilemma I guess you know on the one hand she's uh she's very out of it she's very concerned and is making her expectation very clear on the other hands you know you're being asked to give up something that you don't particularly want to give up um what do you think what do you think she's what you put why do you think she's so concerned +C: well she says she's worried about my health you know cuz I have high blood pressure you know worried about because my dad died of a heart attack at a really early age so she's afraid I'm just gonna I'm just gonna drop dead you know I outlive my dad by so many years and I you know and again it's my life yeah so yeah +T: yeah certainly it's you know people can tell you what they want right you know and but all ultimately it's up to your choice what you're gonna do so you know she she can threaten you and she can she can tell you that you know if you don't do this she can you know she's gonna leave and she can leave you know it sounds like you really don't really don't want that +C: but but you know everybody's got their choices to make in this situation +T: okay so she's concerned about your health and has pointed out that you have a you know your father so he drank and +C: that's but I was really little okay when when he died so I don't know +T: so you're not sure if that we died of heart attack okay you know so you're not sure if that played a role in his heart attack or not I probably did probably crank song but so you're not sure about how well you know he died did it earlier and she points that out as evidence that like you've got media genetic predisposition to having health related problems associated with drinking +C: yeah the dollar I've said I should quit drinking the dog or they know okay you're not convinced but with the dog don't exactly that years ago I need to quit drinking and +T: okay so it almost seems like evidence to the opposite they told you to quit drinking years ago and here you are it's still alive then +C: I pretty much do whatever I want when I yeah you know surely no life because the way it's been I've given everybody wrong yeah of everybody okay Wow +T: okay so you feel like you know you beaten the odds so else you can say the live +C: yeah you can say that okay max I'll work my way up I'm working my way up and once really high up my confident for a retiree okay huh you've always thought I would do it +T: so it's kind of you know the state you know you have this determination you're the kind of person that you know you you do what you trust your gut and you do what you think you should do and you know you work real really hard and you and you've had a lot of success in your life is right it seems like in your in your job and and and with your family the fact that you're a married man with kids and you know you've raised them up and you know I think there's no denying that you had a lot of success in real life in it and and you know and you know better than anyone how hard you had to work could she be back so +C: um and she doesn't get she doesn't she wasn't I don't think she recognized how hard I worked for it to have what we have okay you know and I wish she just let me live the life I've always wanted to live you know and then part of its drinking I like drinking so okay +T: okay all right so she's got all these concerns about it how do you and you mentioned your kids have some concerns - they talk about it I mean what is your sense of and it sounds like so far you feel like well I've beaten the odds and I'm this kind of guy like I'm always a kind of guide it sort of pushes the envelope and you know has proven a lot of people wrong over the years and so you're very skeptical when anyone tells you that drinking is going to kill you like yeah is it it's almost like if somebody tells you that you're gonna say you know you're not gonna believe that I mean you just don't believe that's the truth +C: well I would yeah because it might kill other people but I'm not going to let kill me +T: okay okay all right so what so what if anything in what they're telling you do you believe it turns out like a possible negative effects that I may have obviously it has not killed you you're standing here right now yeah okay so as it killed you but do you think but have you seen any do you think there's anything to anything any validity to what your wife is saying your kids and the doctors with regards to having a negative effect on your health or otherwise I mean just just very honestly if you sit there and you look back and kind of go well and is there anything that you think that is going on that that it's valid right now +C: if I if I tell you what I'm really thinking are you tell my wife but +T: no no I mean confidentiality is such that no I want you to know I'd never feel comfortable talking I do not assess us but you know +C: I think you you I think you kind of get me kind understanding so I really you know my um my son's in AAA okay and and you know when he went into his treat treatment and he really was hard on me like he said that he blamed me for him you know get you know going down that path and and and I really felt like maybe I could have done more he and i were really close now we're not as close because he I can tell you this doesn't like to be around me as I drink and my daughter is she sent me a letter a while ago saying that she loved me and that she didn't want me to die and wanted my kids to be around her but her kids to be around me but she um she didn't want him around as much because cuz she didn't like it when I'm drinking so well so yeah I've had I've had those couple things that that maybe go maybe maybe that maybe I need to rethink this yeah and then I'm always one way and that's really like I still want to lose her I just don't +T: well you know gosh I really appreciate the Jew did you feel comfortable sharing with me to know who those things with me and and I can see that you know this has been very painful and I just I can't commend you enough for being willing to put yourself out there and come in and trust this process it's not easy to do so I really appreciate the fact that you've done that thank thanks for talking again together I'll be hopping your straight shooter or I really appreciate that +T: alright okay thank you very much thanks easy \ No newline at end of file diff --git a/HighLowQualityCounseling/transcripts/high_085 b/HighLowQualityCounseling/transcripts/high_085 new file mode 100644 index 0000000000000000000000000000000000000000..259698a2d99af93bfa4bea28f8e4ffe6868839bb --- /dev/null +++ b/HighLowQualityCounseling/transcripts/high_085 @@ -0,0 +1,38 @@ +T: why miss Clark my name is Alan Lyme I'm a social worker at the Family Health Center +C: dr. Sheila asked me if I would spend some time with you today +T: I'm really glad that you here I'm just curious as to why he would send you to me +C: well I came to see dr. Steele last week because of increasing stress and anxiety that's kind of getting the best of me and in the course of my appointment with him he was asking how I was dealing with that stress and I mentioned that my one or two glasses of wine a few nights a week is turning into more frequent in maybe three or four on some nights and he had some concerns about that and and felt like maybe you could help me with stress or something +T: yeah so he he actually see me because he went to him for increased stress and he's concerned that your alcohol consumption may be a part of that increase and prior to prescribing you anything you want to make sure that you had someone to talk to about that +C: I suppose okay I saw you filled in one of the pink sheets might take a little bit he told me to fill that out and bring it with me +T: okay thank you so you say here that you have four or more drinks in one week you mentioned that you may be increasing that a little bit as well um and that you have one or two drinks in one setting typically yeah and maybe monthly you have more than that what what's what kind of drinks do you have what do you drink we need to drive +C: winewith my meals um you know again one or two typically and more frequently three or four so my stress is increased +T: so starting to increase this times drink a little more okay well based on what you put here you give it gives you six points on this scale scale ranges from zero to forty so six points will put you in what we consider an at-risk zone so if it's okay with you lots to talk a bit about that okay okay so that was sunset run zero to forty it's not it's not a super high risk but it certainly could be a risk for maybe increasing stress maybe some physical Emmas related to alcohol well could start to show up if you were to increase your drinking from there or you can stay there this is a typical standard drink size over here I'm not sure whether that fits your description of a glass of wine a lot +C: I fill the glass up so maybe a little more than +T: yeah maybe the little space that it's upside to drink drink and a half each one so that also increased a little bit more so perhaps maybe drinking more than you indicated on here and for women you healthy woman your age no more than three drinks in one setting is considered to be lower or no-risk and / in one week so in total how much total in the week and what you say here is that even on this sheet you're perhaps already drinking more than that mmm +T: so what do you make of all that +C: well that news to me you know I thought red wine with your meals is supposed to be healthy and you know no more than seven in a week that seems kind of prohibitive +T: yeah it seems it seems a little less than perhaps you've been drinking with what you consider to be healthy drinking and certainly there's this conflicting information out there about what's healthy what's not healthy imagine the increased stresses what because we're concerned or to seal as your stresses increases and if you were to prescribe you anything maybe some interaction between the two but also build and serve them I would think so if you would what is it that you like about alcohol +C: well you know it does at least in the moment temporarily reduce my stress and I you know like a good glass of wine I don't don't drink the cheap stuff I like the expensive what +T: so you like the taste of it mm-hmm and it does help to lower the stress signal which is for that time you're drinking one of those not so good things about alcohol for you +C: um well you know the nights that maybe I have a couple more glasses than I should I wake up feeling kind of yuck and of course part of my stress is finances and I mentioned I like the good stuff and so if I'm drinking more than I'm increasing my financial burden yeah +T: so your financial stress may be increased by the fact that you're drinking +C: yeah kind of defeating the purpose there the drinking to do stress and increasing stresses +T: so the one hand it lowers it on the other hand it's increasing kind of a seesaw teeter-totter effect then what do you make of that give them that on one hand it lowers and the other had it increases and now it's increasing even more +C: maybe I need to find some other way to deal with my stress +T: yeah imagine you've had some thoughts of that what have you thought of trying well I've exercised in the past and that helps right now my schedule is kind of out of whack and I just really don't know what to do that's why I came to see dr. Steele +C: I thought maybe he can prescribe me something that would help me you know when I'm feeling overwhelmed and he may be able to I'm not saying that he cannot +T: I'm just imagine that he's concerned that if you continue to drink on the level that you are drinking that whatever he prescribes you there may be an interaction with the to imagine that she's concerned I'm not completely sure so you've had some success in the past with changing behaviors and if you were to decide to make any changes here it sounds like you could drop all that to make those changes how important would it be for you on a scale of through i below the visual here with that if zero is not important ten is very important to do something about your drinking +C: way mm-hmm well I mean if if it means that it's increasing my stress and or he's not going to prescribe me anything because of my drinking then it's fairly important maybe about a +T: mm-hmm let's put it up there why do you choose a or a or +C: well again I've got to get things under control you know my kids are depending on me and I've got to go to work to help ease this financial stress and +T: so you know all those responsibilities there's a lot riding on your decision in what to do this what if anything will bring up too late online on that scale +C: um well the you know the risk that you mentioned about the drug interaction I certainly can't afford to you know have any more stress +T: yeah so so you choose to lower your stress rather than increase it and if lo and your drinking would have that effect that something be willing to do right now how confident are you that you could do something about your drinking +C: I'm pretty confident and you know probably about a seven or eight +T: okay so it's pretty hot up there again and what if what if anything would you choose to do would be to cut down with a bit to quit +C: just in case but you know I like I said like a good glass of wine I don't want to quit altogether I'd be willing to try cutting that but you know if it's going to if doctor seal would agree to prescribe me something for the anxiety and it meant that I had to not drink at all I'd be willing to do that at least for a period of time +T: so you'd be willing to stop altogether that's what was indicated by the physician okay so so based on that how ready are you to do anything right now whether it's to cut back whether it is to quit +C: well again you know if I can get something to help me manage if maybe I can find some other way to deal with the stress then then you know I be pretty ready I again maybe about in on that scale maybe an eighth okay so that's that's pretty hot there as well +T: it sounds is that you'll be pretty motivated to do something about this right now given your responsibilities given your children relying at this point and just on on lowering anxiety in general it sounds and that's one of your goals as well well I'm pretty confident that once you decide to do whatever it is you decide to do you'll be able to follow through that based on your experience in the past of of making behavior changes imagine some things that you can draw upon what's one thing that you could do imagine you thought of some things might help to lower your stress +C: well I you know the the exercise but again that's that's kind of difficult to fit in right now hoping that dr. seal will prescribe something for me to take when I'm feeling particularly overwhelmed and maybe just having somebody to talk to to bounce some things off of +T: one of the things we can't offer here is for you to come in and talk to one of our behavioral health specialists may be able to help you talk talk through this there's a terrible stress and sound like responsibility there and we can make a point for you if you like before you leave today dad talk to someone that'd be nice right it also has some information here if you're interested some a pamphlet on alcohol and and how what healthy limits are and how it may be affected by medications that you took as well and I wish you lots of luck it sounds as though you really committed to making this shift in this change and imagined doctors still wanna fight with you and see how you do with your with your change within a few weeks again I look forward to speaking to in the future all right thank you very much you're welcome \ No newline at end of file diff --git a/HighLowQualityCounseling/transcripts/high_090 b/HighLowQualityCounseling/transcripts/high_090 new file mode 100644 index 0000000000000000000000000000000000000000..ba9679c4bc4bbc43341b16dd09d7e054af1e2b0a --- /dev/null +++ b/HighLowQualityCounseling/transcripts/high_090 @@ -0,0 +1,48 @@ +T: um I'm gonna do it +C: okay i guess i guess something happened over this past week i I've been looking for a new job since i left my last one and I found I found this really good job on the internet but the problem is that the job is working with kids and they they have to do a drug test in order for me to get the job and it kind of like it made me think is made me think a little bit more about something that I've been considered for a while which is kind of just giving up giving up we'd forget like I've been thinking about it for a while but a guy also kind of think about the way the way we'd really helps me in like if I'm ever feeling like really really anxious about something um I mean we'd kind of as he chill out hub sort of relax and I just don't know if I'm ready to give that up yet +T: so the marijuana has real value for you but you don't want to see going +C: yeah yeah it does it's a it's like a way to self-medicate in the way and +T: at the same time you would like this job +C: yeah so I could see how this would be a you know pincher +C: right yet I'm just kind of like it's put me in a difficult spot like I definitely I definitely want to get that job but you know if I cut it if I cut out smoking like I don't know what else I would do like if I if I started to have a panic attack or if if I was really like anxious about like anything that I'm worrying about I got all I don't when I did Cubs +T: have you been treated for anxiety before +C: um I I did therapy for a little bit but it was like I don't know back then it was kind of like when anxiety was just starting so it wasn't too big of a problem so I like I click there because it was really doing that much yeah +T: you take the marijuana for any other reason other than to help with the anxiety +C: I mean like if i'm bored or maybe if i'm like hanging out with buddies like I don't really have a reason not to do it like until now but it wasn't like like I really use it whenever I like feeling really anxious about something +T: so and you may not be able to answer this question but if you didn't have any anxiety would that change your motivation to use marijuana +C: if I didn't have like any kind of anxiety um like it would simply kind of tough to give up because like if I'm hanging out my buddies they offer it to me like that's that's all that's pretty chill but um I don't like I really I'm really looking forward to this job and like the benefits of having that job without weighing the benefits of just like smoking smoking my money's so +T: so you're excited with the job +C: I am yeah it's it's almost kind of a dream job +T: tell me about it +C: well it's working with its working with kids with autism and the school so look I would be kind of like a almost like a personal ta in a way so like it's a part of an inclusion program so when the kids are going into the class like I would either sit with them or like maybe back behind the class and kind of like help them out in case something comes up and it's like since my brother as autism that's like it's that's something that I've always really kind of wanted to work with +T: so sounds like a real passion for this type of work and and really the big obstacle here is this marijuana +C: it is it's like a catch- too because it's like I know the job would be great but it's like it's a it's a big step for me to take that job and it's it's going to be super it's gonna make you super anxious you know it's going to be like it's going to be a lot of anxiety taking a new job so it's like if I have to give up the marijuana and then like not have another way to cope with anxiety like to get the job it's that's a good like a catch- +T: yeah it's a predicament yeah you're kind of weighing both sides of this right now I'm wondering do you have you think you have like a physical craving for the marijuana +C: yeah I mean no not really +T: so you're really using it recreationally and as an anti-anxiety agents +C: yeah pretty much +T: so if you were I know you didn't have great success before in therapy we want to combat anxiety but if you were being treated for anxiety and working that job which seems like you would really like do you think you would be able to stay away from marijuana +C: I think if the therapy really worked I would be able to UM like it's just so easy now just to kind of light up like that's an easy fix and like I don't think therapy is gonna be that instead so like you know it it would be tough I think if I had real confidence that the therapy would work I could do it but I mean it would have to it would definitely have to work like I just as well as as smoking you would need to see results yeah yeah definitely +T: would having the job that you're passionate about reduce your anxiety +C: after a while like after I got use of the job but like just starting the new job would make me kind of anxious and then like it would be tough not to not to smoke while doing that like I don't I I don't even get why they drug test anymore because like it's it's been decriminalized being legalized in so many places and there's so much research saying it's not that bad it's kind of like it's really upsetting that the place that I really want to work as that policy I think it's really silly +T: you're frustrated marijuana is illegal yeah it's yeah at the same time it's the reality you're living it right yeah it's I think it will be legalized and like in the state in a couple years but until the end like I mean I can't wait that long to start start working so +T: until then you still need to address this dilemma +C: right yeah these soil problem +T: so you have choices here right you can continue to use marijuana and take the job right and that seems like something that has some advantages for you but some some disadvantages right because you would really like that job +C: yeah and i was it's it sound sympathetic to be like no I don't want to take my dream job because I need weed like such it was stupid +T: so what do you think you are in terms of making this change you feel motivated to take some steps toward it +C: I don't like I'm I'm so kind of on the fence because like if I if I have to give it up for the job I could do that but I would definitely need like some other way to get rid of all this anxiety like whether it's therapy or whether it's like something else I yeah i would i would definitely need like a substitute if I got rid of it for good +T: so you definitely say you definitely need it so you can't give up the marijuana unless you have some other available alternative that would help with that anxiety right that's that's key to you to make this change yeah but at the same time that would be ideal because then you could take the job +C: right yeah I mean I mean if I really thought that I could like it's some kind of treatment that was as good as weed yeah I mean I could i get them maybe quit and especially the house to get this job especially +T: so with anxiety reduction your chances of stopping marijuana increase and then you could take the child that you want yeah yeah I've been notably the best best outcome is that the outcome you would most want +C: yeah i think so i think i could give up wrecker like doing it my buddies recreationally I could yeah I'm just light up a cigarette +T: so here's what I'm thinking and let me know what you think about this when you come back next week right what if we start looking at this anxiety if we start you know I start treating this anxiety you know I see if we can get it reduced and kind of work from there because maybe when you start to feel if that works and that anxiety starts to abate it sounds like it'll just be easier for you to stop the marijuana usage yeah what kind of time frame are you on terms of taking this job +C: I mean the job it has a high turnover rate so like even if I like I need to apply this week but if I don't get in more likely another position like it will open up like within a month or two +T: and when would they drug test you +C: um it would be like a right after I apply so if I applied and then did the interview that's when they will give him the paperwork and I have to give you a drug test when was the last time you spend more on +C: just a couple days ago to +T: see what I'm getting at +C: yeah yeah it's a yeah so I like I wouldn't be able to do I wouldn't be able to make it this application but I would like to be off it by the next one +T: so you're fortunate in the sense that the turnover is high right because it gives you opportunity to apply later on so do you feel like you could invest in that plan let's work on the anxiety see what happens with marijuana see if we can reduce your usage of it or have you stopped that all together and then kind of move toward this job +C: yeah yeah I could deal with that +T: alright so the next time you come in we'll start talking about the anxiety and let's see what we can do about that move from there all right yeah it sounds good that's good thanks Scott thank you \ No newline at end of file diff --git a/HighLowQualityCounseling/transcripts/high_091 b/HighLowQualityCounseling/transcripts/high_091 new file mode 100644 index 0000000000000000000000000000000000000000..1de4baa8519a09c94717e5759731c721b9ea4115 --- /dev/null +++ b/HighLowQualityCounseling/transcripts/high_091 @@ -0,0 +1,32 @@ +T: so brings you here today +C: well my doctor made me come said of my diet is bad and my cholesterol level is up so high that I've got to change the way I eat and honestly I don't really feel like doing that so he said I had to come talk to you and hopes that that's going to help +T: ok so what's nothing to me is that your doctor saying you have an issue a health issue at your cholesterol and nearly an allison issue of this present time cycle +C: right right it was actually I feel pretty good they do a test on me and says mom not healthy because what I eat them I don't know it doesn't bother me +T: ok so you sound a little we're very resistant to change +C: I like french fries I like fast food I don't want of time to cook you know this is the food I eat his burgers it's what's my lifestyle and he says I got to stop eating french fries sometimes pizza I like sausage and a breakfast I eat almost the whole pound of bacon log bacon bacon on my eggs bacon on the sandwiches I like bacon on the cheeseburgers the doctors like mr. Hendricks you have to stop eating bacon wait a minute I don't know about that french fries +T: so this is the first time you went to the doctor he makes an account with your high cholesterol okay so how long +C: it's been going on for a while I mean every time he was like yeah I think you how to change the way ye na ma alright and then I keep eating it the this time he's dropped the heavy on me and he said you're gonna have to do this and he showed me pictures of cholesterol problems and told me facts and stories about people that's didn't stop eating the bad foods and cholesterol levels where they ended up not so I don't want to die +T: okay so what do you thing to do to help resolve the issue +C: I'm kind of hoping some other options i'm changing my food +T: have you considered exercise +C: we didn't talk so much about that he was so focused on the food but I'd be willing to exercise if I can still eat my fries +T: okay will sound like you have it this semester issue the food thing you are not great to give up but exercising to be a possible Avenue just to lower your cholesterol levels ok so how motivated are you today start like a rigorous exercise routine +C: the lord I kept glycerol was six maybe a seven even okay +T: so what could you do this week to start now once you've in this office today to have lower your cholesterol +C: follow the hunger but how odd probably willing to talk to somebody about an exercise program +T: okay have you know participant in an exercise program before +C: no +T: okay knows me a lot of work and I respect your decision that you are not ready to give the food but you have a decision to make good choices it is your choice to do with you +T: is it D but this is too much for you like you're incapable of this this is beyond you you can now show your dad +C: I can do it but I don't know if I'd be happy +T: so how would you know if you're not happy until you try it +C: I got a feeling I wouldn't be happy but I'm wrong +T: okay so you say motivated like a or a mm is that the highest like today that you've been or wish your motivation +C: I'm lowering operators after my last doctor appointment +T: okay it is promised been going on for how many watts or +C: yeah probably three to four years three or four years okay he's noticed it's been a while since my cholesterol hasn't started to come down +T: okay so this is like neglect for the three or four years pretty much but you are little motivated now +C: yeah he scared me all about with the health reports he was giving me +T: okay when's next time you go to the doctor +C: he wants me back in a month +T: okay so cuz you're a little motivated he said I'm six or seven we can maybe establish a pan for you so we listen good a doctor your clothes will be lower than what it was just this present month that'd be good sorry the plan sorry your plan \ No newline at end of file diff --git a/HighLowQualityCounseling/transcripts/high_096 b/HighLowQualityCounseling/transcripts/high_096 new file mode 100644 index 0000000000000000000000000000000000000000..2a3543df792f10c24d87a61662caf692fe44c45e --- /dev/null +++ b/HighLowQualityCounseling/transcripts/high_096 @@ -0,0 +1,24 @@ +T: good afternoon miss fish I would like to personally thank you for taking time out of your busy schedule to talk to us regarding smoking cessation we're basically going to go through a few questions that will help both of us get a better understanding about your current smoking status and I'm going to just take some notes here as we continue to talk okay first of all how long has you have you been smoking and at what age did you begin to +C: think I was that's about years years okay okay +T: and in those years had you ever trying to quit +C: yeah I tried once when I was pregnant but it just didn't work okay I know I hear it's not worth even the time to be honest +T: okay well that's fine I mean what you definitely deserve some applause for you know your willingness to quit in it as you know smoking is a very difficult habit to quit especially for a time I paid like years so what were your reasons behind wanting to quit in those previous tips +C: really is one one main time and is right for it right when I got pregnant the doctor kept nagging me my mom kept nagging me they just kept saying how bad it was for my baby and finally I just got tired of fighting the battle and I quit +T: okay okay then and then what did your physician tell you about more of the specific dangers in continuing to smoke +C: he really didn't say anything just that it was bad +T: he just said it was bad okay so if I understand you correctly miss Fisher on you saying that you have been smoking for years with several attempts to quit in the past but ultimately no long-term success okay both your mother and other family members along with your physician have told you several times on that you need to quit but neither of those individuals everyone into the overall specifics about the actual dangers of wanting to quit smoking is that does that sound about right yeah pretty much okay +T: okay so let's kind of take it one step forward um and those are tips to quit in the past what was it that you know made you start back smoking again +C: well I needed it to get through the day it calms my nerves I crave it I want a few of kids but they're stressful stressful and I just can't make it without one +T: okay okay then well that's that's quite all right in this fish I mean we have we have a multitude of patients that mentioned those particular reasons specifically right there also you know as you know I mean but I would say that we've had also great successes working with those patients and ultimately getting them to quit smoking so there's there isn't any lost hope with that so let's let's move into talking about your reasons for wanting to quit should you should you desire to do so what will be those reasons for wanting to quit if you decide to do so +C: I still think it's a lost cause but I'm not sure I guess something on TV it says it's back to health my doctor said is bad for my health my mom says it's bad for my health so I guess it's bad for my health I've smoked for so long I don't notice anything to me it's what gets me through my day +T: okay then get you through the day okay well well tell me this what was the longest period of time that you were able to quit in the past you know since you mentioned the previous quit attempts +C: guess the pregnancy so about nine months or so I started back pretty much day one after my baby's born +T: okay why are you able to quit for nine months that's it that's it that's a pretty big accomplishment miss Fisher if you think about it that's pretty much close to in close to an entire year you know do you does that make sense that that's a pretty long period of time you know one whole year why don't you +C: definitely think about it +T: okay I mean and I can and I believe it's safe to say that was a pretty tough decision considering the fact that you've been smoking for years right one okay and so basically the fact that you are willing to take it upon yourself in the meantime to quit while you're pregnant that speaks volumes of you you know so that would that would basically lead into my next question you on what would have been the worst thing that could have happened to you if you had quit me smoke if you have started to quit smoking for good after your pregnancy +C: yes there's nothing bad +T: nothing bad okay okay what Mina in my opinion I believe you're you're exactly right no as you well know I mean the the the journey to quitting smoking is very difficult but if you think about it you yourself you were able to quit for almost a year now you were able to quit for nine months so just as you were able to quit during your pregnancy for the sake of the kids you know you can use that same sort of energy to want to have the desire to quit for the sake of your own health in order to see your kids grow up to be you know healthy individuals also okay and that's and that's really something to think about so I guess my next question for you miss Fisher would be more like a scenario question so if you can kind of roll with me on that on the scale of one to ten how important is it for you to consider thinking about quitting smoking sooner rather than later with one being not important at all or ten being the utmost and most important +C: five okay well well +T: why a five and not a three or four +C: I guess you pointed out I did it for nine months cold turkey so maybe I could do it again for longer in this time for my health they're not for my babies okay +T: alright that's it and that's a great point that you bring out to me miss Fisher on I believe this gives us some some great foundation you know should we decide to move forward with this to with the smoking cessation if it's okay with you I would really like to schedule another interview with you or another point we can actually sit down and go into further detail about about these other barriers that people face on there when they're smoking and also share with you some of the great benefits that that can come of quitting smoking on would that be something that you would be interested in yeah okay well that would be great I mean I would like to thank you again for coming by and we can schedule you an appointment for advocate I was saying about one week does that work for you yeah time free okay and in the meantime I like to come and hand you this tobacco log right here this isn't it this isn't an attempt to help you quit rather it would help us identify some specific triggers and identify triggers that you may face along the road to quitting smoking okay well thank you very much and you have a good rest of the day okay nice meeting \ No newline at end of file diff --git a/HighLowQualityCounseling/transcripts/high_097 b/HighLowQualityCounseling/transcripts/high_097 new file mode 100644 index 0000000000000000000000000000000000000000..f6a72723d5250fc75bed6877bea5b125f2d5029d --- /dev/null +++ b/HighLowQualityCounseling/transcripts/high_097 @@ -0,0 +1,7 @@ +T: so now I want to talk to you a little bit about some of those answers I said we would get back to okay so firstly I just want to just summarize kind of way you said that you've tried smoking cigarettes one time didn't like it you've had a few drinks a few different times over the last year at some parties and you also got a ride from someone who you knew was smoking marijuana did I get all those ready right yeah okay all right so I want to say that you know it's a good thing that you seem to not like smoking seem to have decided that you don't want to smoke I hope you would continue to you know to decide that you don't want to smoke it's also really good that you don't use anyone else's prescription medicines I know it's really tempting in high school with your busy schedule and you know just trying to use things to help you study to help keep up with your busy schedule so it's really a good thing that you that you've also avoided doing that but it really it is concerning about your drinking so i just wanted to hear a little bit more about that from you so could you just tell me a little bit about your drinking +C: well it's not really that big of a deal it's just on the weekends i have a couple of beers and i think the main thing was the homecoming when I just got a little scared because I didn't remember parts of that night so and like my friend they threw up so it was kind of scary +T: okay so just to clarify so it sounds like when the one hand you know you kind of drink to fit in at your friends I'll do it that you felt kind of would help feel a little bit more comfortable in this date but on the other hand just being afraid of some of the consequences and seeing friends get sick or kind of a negative for that well well I am concerned about your drinking you know just so you know we used to think that people's brains were done developing by the time you were but now we know that they develop well into your s and alcohol really can have an effect on developing brain cells probably that time where you didn't remember everything you did that night we call that a blackout and that's usually an indication that there's some subtle effects of the alcohol in your brain cells so so again that that's concerning not to mention that often people do things that they later regret when they're drinking so so just to think about all that and really I would recommend that you not drink at all until you turn okay so I mean just to think about that but if I had to have you put on a scale of to being not at all interested being very interested where do you think you'd be as far as your interest in stopping drinking right now +C: that sounds like a good idea probably like nine or +T: okay good so now I just want to talk also about driving with the friend who was smoking marijuana yeah I mean just to make sure you understand it a lot of times people may seem fine but really they're not especially with the the skills you need to drive safely so so that's something that you one to avoid here +C: I'll just call my parents next time I need a run +T: okay yeah i think you know I've known your parents for a long time and I think they'd be understanding and willing to do what they need to do to come get you so good okay what do you have any questions no I think that's good okay so what I want to do is have you come back in a couple months and just check in to see how you're doing with with not drinking so let's see how that goes and you'll come back in a couple months and we'll we'll see how that way okay so good \ No newline at end of file diff --git a/HighLowQualityCounseling/transcripts/high_098 b/HighLowQualityCounseling/transcripts/high_098 new file mode 100644 index 0000000000000000000000000000000000000000..e1088a7e57c59936b11afff3e8954b3f95ed6564 --- /dev/null +++ b/HighLowQualityCounseling/transcripts/high_098 @@ -0,0 +1,59 @@ +T: so I don't know how much you know already about sort of my role here and why you're even here so I thought I'd start by telling you a little bit about myself basically my job is to meet with all of the students I meet with everybody about once or twice a semester and just talk with you a little bit about how things are going different behaviors that you might be engaging in and thinking about any changes you might want to make for your life if you decide that you do it's not my job to change you I couldn't even if I wanted to that's not my role at all it's really to help you think about you know how things are going for you and how you might like making changes or moving forward that sound okay all right so why don't we start by you telling me a little bit about yourself +C: sure um as you know i'm andrea i am a junior i'm in the marching band i plated center sacks honey yeah i'm also in the little bit of a band geek i play you know the wind ensemble and the Jazz Band things like that +T: wow you really are involved in music yeah when did you start +C: I started playing about years ago actually Wow yeah I start on the violin first and then I went on explored a little with the piano clarinet finally found the tenor sax hmm yeah +T: very cool I've always wanted to be good at music it all right so it sounds like you're in band and a few other musical ensembles any other hobbies you have or things you like to do for fun +C: um you know just hanging out with my friends or go to the beach things like that it's kind of everyday sort of day okay +T: tell me a little bit about your family uh well I have one older brother he's about eight and a half old years older than me my parents and I have dog +T: cute what kind of dogs the golden retriever oh nice okay big boy very fun +T: alright and how are things going in school for you +C: I'm pretty good grades have been pretty alright I still like three point seven ish okay +T: great so you're doing well what sorts of goals do you have for after college or after high school +C: I'd like to you know I'd like to of course graduate high school hopefully go to a nice Ivy League school or I mean that might not happen and then I'd like to go on become a doctor study psychology you need to come at psychiatrist or something okay you +T: have some pretty big dreams yeah it's great that's really exciting to think about that and you're going to be looking forward to the future and those things all right well one thing I'm going to ask you about is um you know different people have sort of different things that they really value in their life whether it's you know their cultural identity or their family or their friends or job or hobbies things like that so here's a little sheet that goes through just some basic values that might be more or less important to certain people like belonging or sense of community again cultural identity or family friendship modesty religion respect self-determination and spirituality so when you think about yourself which of these are kind of most important to you in terms of your life +C: um I think a sense of community and belonging okay I think those two and um respect +T: respect okay can you tell me a little bit about why you picked those three +C: yeah well I think community and belonging I kind of related them um you know how I said I was in the marching men I really you know I really enjoyed being in like that team setting of you know being with other people and all working to work together towards that one goal mm-hmm and then in terms of respect I I kind of view that as one of like my major like rules like I I really do think respect is important to respect myself or respect those around me so okay I place great importance in that +T: okay great so sort of being a part of a group and being a part of a team gives you a sense of belonging like you said a sense of purpose in the way and then the respect is really sort of all-encompassing and not just authority but respecting yourself respecting your teammates or your bandmates and other people around you okay that's great all right well one of the things I want to talk to you about sort of relates to belonging and your friends so what kinds of things do you like to do when you get together with your friends +C: um sometimes you just you know go to the movies go to the beach like I had said sometimes we just get together someone's house play some board games and hang out mm-hmm and +T: when you're hanging out with friends is there ever alcohol involved +C: yeah sometimes +T: okay can you tell me a little bit about how alcohol fits into sort of your social scene uh well it's mostly just for for parties or party settings it's kind of to get things going and getting loosened up as they say mm-hmm and +T: so when you go to parties most of the time there's alcohol there okay and how often do you think you would say you're drinking +C: I'd say um on a not busy month for instance i'd say about like two weekends out of the month to three +T: mm-hmm so about half the time you're drinking and half the time you're not can you tell me what's different about the days when you choose to drink versus not to drink +C: the days that we drink or mostly like I said their parties so it's more of that whole partying and dancing and you know having everyone have fun and then when we don't it's a lot more relaxed it's a lot more hanging out playing board games watching the movie it's not yeah so it really depends on what the activity is whether or not alcohols get down there +T: okay and do you notice a big difference or can you tell me about the difference in your enjoyment level at say a party versus and that you're playing board games +C: I think of them as as different i think you know night in playing board games and things it's meant to be relaxing so it's nice to have like that kind of breather versus with a party it's a lot more energetic it's a after at all it's very draining mm-hmm but in the moment it's quite fun to dance and have +T: okay so there's sort of pros and cons em yes okay what are the things that you like about drinking or like about alcohol +C: um it's you know when we drink we we tend to have more fun because I guess we're not you know everyone's drinking together we're a lot more loosened up and relaxed and not really thinking about stresses or things like that but it can be when it's too much drinking it can be can be obviously bad +T: okay so sort of in the the too much drinking or times can you tell me some of the less good things are not so good things about alcohol +C: um a lot of times it will make make people stupid yeah you know people make dumb decisions and things like that way we usually try to be as safe about it as possible so like sleep over a friends house and so you know we're not driving and it's mostly within our friend group so we're not worried about strangers putting weird things in our drinks but um definitely some of the ideas people can have when they're stupid when they're drunk can can be really stupid +T: hmm so you're trying to like you said not engage in really dangerous activities you're trying to stay put you're not driving you're trying to stay with people that you trust but yet it sounds like there's still some something's happening yeah can you tell me a little bit about that +C: well I especially don't like it whenever me or one of my friends like we drink too much and we ended up like throwing up and things like that that I don't that's not fun +T: yeah throwing up is never fun it's not and how often do you think that happened +C: for me that's happened to me once it was the first time I ever drank and it was it was a lot and you know what I was doing I was mixing all kinds of weird things I'm just kind of taking anything ever anyone gave me that didn't end well but after that I have it but I do have friends that that still do some time so I'll end up like having to take care of them banging okay it kind of put it down around my my fun +T: uh-huh okay so on the one side some of the fun things associated with alcohol our people are just more relaxed sort of carefree and kind of let loose a little bit more on the other hand there's a little bit more I guess planning involved because you have to make sure that you're doing it safely or as safe as you can and then there can be some other consequences like throwing up or even if it's not you that sometimes you're stuck your fun is sort of ruined when you're stuck dealing with a friend you drink too much ok any other not so good things about the alcohol +C: yeah people can get a little like sloppy I guess like they're all loose like with people and corners doing things that should be done in private and that kind of stuff +T: so you're kind of stuck being exposed to things you don't mean this video yeah got it ok all right well you mentioned a couple times that you've made a few decisions to try and limit the a dangerous aspect of the drinking why did you make those decisions +C: I just I you know have an aunt who is an alcoholic so I I see like the issues that are involved and I've seen movies and things I know that drunk driving is an issue so I you know I want to be as safe as possible in those terms and be in a setting where like we can let loose but still be safe like I someone's house or something a parent at home or something but so I like I know that there are dangers involved and I guess I want to limit that and still be with a half one +T: ok yeah it sounds kind of similar to your your value of respect to so on the one hand you the drinking maybe helps with the belonging community to start if there's too much then it sort of defeats the purpose and then with the respect one of the things you mentioned is really wanting to respect yourself and not sort of cross boundaries not sort of glass lines how do you think that the drinking fits in with that +C: in terms of what in terms of respect I think well in a way I do think that drinking is probably a form of disrespect to my own body because i'm not putting things i'm putting things in it that shouldn't be there and then but in terms of how ways i am respecting myself i am I'm respecting myself by like trying to stay in someone's house and like trying to limit my drinking so I don't get to that blacked out like throwing up and everything and try to you know let loose but still be in control of my behavior so I'm not going to go with some random person I met mm-hmm into I don't know where to do I don't know what and things like that +T: okay so you're sort of looking for that balance yeah how much you can drink to have some of the positive benefit but without crossover okay and what have you come up with at this point you have sort of a limit that you stick to or I +C: usually well I start off by make sure that I make my own drink so I know what's in a and how much is in it so that way I control how much I drink so I'll usually just you don't get one of those cups and then make one drink and then I'll try to make it last as long as possible and i'll be like all right this is my one drink and I'm good in that way I still have something in my cousin so people aren't gonna be like oh here have some more like no I'm good I have mine and i'll so be you know having some to like let loose a little mm-hmm okay and +T: do you feel that's working pretty well for you or you sometimes exceed that limit or or what do you think +C: for the most part it works pretty well because like i said people you know people come asking me trying to pressure me I'll be like no I'm good I have you know I still have some like I'll get some later and then never end up getting anything but sometimes they'll be like hey let's take a shot and everyone's got it around like the kitchen or something ready to take a shot and then at that point I'll be like oh well maybe I can take one more and that's when I start you know falling into okay too much +T: so a portion of the time it's working well for you and another portion of the time maybe you like I'd like to make some adjustments to to make it a little smoother okay so kind of thinking along those lines how important is it to you to make some changes or make some adjustments to your drinking to sort of fit with your values and your goals for yourself +C: um I'd like to make sure that I you know in terms of respecting myself of my body I'd like to you know try to drink less okay like I you know it is nice to let loose and have fun but I'd also like it to be so you know I'm not damaging my body and I like my liver doesn't work by the time I'm like mm-hmm and you know have my friends on board with a similar mentality so we can kind of work at it together as a group as a community +T: uh-huh so kind of combined he has goals okay so you're you have a goal it sounds like of actually cutting back on your drinking how important is it to you to work on that goal on on the scale of one to ten where one is not at all important and ten is it's the most important thing +C: right now I'd say about like like a six or a seven oh I like to work on it but you know if I get around to it I get around to if I don't I don't uh-huh well +T: why did you say six or seven rather than like a four um because I still think it's it's important +C: uh-huh I still you know like I said I don't want my body try especially going to med school like I know how things affect your body and also affect your your social on your schoolwork and things like that i know that once i get to college it's not it's not gonna gonna work out being you know drinking every weekend and I'm like trying to wake up early and go to school take an exam like I know that's not that's not feasible it's not a good idea +T: yeah looking ahead you can't keep drinking this way and reach the goals that you have for yourself okay well how confident are you that you could cut down if you wanted to I think on that same scale from one to ten +C: I think if I made the decision I was going to for sure then I think definitely like a tent I know I +T: oh wow okay why did you say it's just because i know that once i make the decision I know I can do it making the decision in the first place okay weather +T: okay and so you mentioned you know quite a few reasons why you would like to cut down have you thought at all about how you might go about doing that +C: um I'm thinking of maybe like trying to convince my friends without sounding you know dorky or something be like hey you know let's just stay in today like let's not go out or something or just be like hey I'm not like I'm not going to drink today and even if my friends do like being okay with them drinking around me not doing it and then then being okay with me drinking I mean not drinking and then doing whatever they want +T: so sort of trying to plan more activities that don't involve alcohol and then also trying to participate in activities without drinking yourself or maybe even drinking less than your drinking okay does that sound like a goal you want to work on now or +C: I think so i think it's it's very feasible i think it's possible okay +T: so I guess we'll talk about less alcohol activities and just making some notes to myself and then maybe I'm reducing the amount of drinking that you're doing if alcohol is involved okay so that's that goal sounds feasible you said would it be okay if we met in a couple weeks to sort of see how it's going I think so that's good does that sound like something you'd like to do okay well I really appreciate you spending the time talking to me and you know it sounds like you have a lot of really good goals for yourself really ambitious goals and going to medical school and you know becoming a psychiatrist or some some other form of physician you're really looking forward to doing well in school so you can get there and it sounds like you have a pretty active social life and a lot of friends who you feel probably would be supportive even if you cut down an alcohol and that you know there's a lot of benefits you see both to your body in your health your school performance and even some of the social stuff in terms of feeling a sense of belonging without having to deal with some of the gross consequences of drinking too much so yeah you know it really sounds to me like you have a good plan in place and as long as you're willing and interested in meeting again and be very excited to be able to talk with you about how it's going like all right great so I'll plan to see you then in a few more weeks hurted thanks \ No newline at end of file diff --git a/HighLowQualityCounseling/transcripts/high_099 b/HighLowQualityCounseling/transcripts/high_099 new file mode 100644 index 0000000000000000000000000000000000000000..066d39e41929becad5fda946074a05c2543e4289 --- /dev/null +++ b/HighLowQualityCounseling/transcripts/high_099 @@ -0,0 +1,80 @@ +T: for coming in um so I'm not sure how much you know already about sort of what you're doing here if it's okay I'll give you a little rundown so basically we're here I'm just going to talk to you for a little bit about sort of what your goals are for your life get to know you a little bit better and talk about some different behaviors that you might be engaging in it's not my job at all to judge you or to try and change you you know basically I'm going to talk to you about how things are going any changes you might want to make in your life how I could help you with that and just what I can do that's going to be most beneficial for you that's not okay all right so I guess just to get started can you tell me a little bit about yourself +C: well my name is Laura I'm years old and I'm a senior in high school +T: okay and what kinds of things do a plan for your life +C: well hopefully go to college get you know get enough grades to go to college that's great do you have a plan as to where you might want to go or um I'm not sure yet might be a few schools in the area I'm looking maybe to apply out of state oh alright being away for college cool +T: yeah so kind of keeping your options open yeah definitely great and you have an idea about what you might want to study or yeah maybe I'm pre-law oh wow okay that's exciting +T: yeah all right cool um what do you like to do for fun +C: well um on the weekends I like to hang out with my friends maybe go like a party or go to the mall to shop or if there's like a school related event we'll go to like a football game or something like that yeah I like to have a good time +T: yeah and you have a lot of friends or a few close people or +C: um I would say like a moderate amount I'm not really really popular or like I have no friends um I'm like normal alright that's a good way to be right yeah alright +T: so um it sounds like in general your things are going pretty well for you how are your grades right now um they're pretty good a zombie's so +C: I'm doing okay okay +T: well one thing I want to ask about is you know different people have sort of different values or things that are important to them they might you know be really close with family or really have you know their friends as being something particularly important I'm going to show you just a few things on this sheet and if you can look more so there's things like belonging community cultural identity family friendship modesty religion respect self-determination and spirituality which of those do you think is sort of important to you +C: um family definitely a friendship and belonging +T: okay what's important to you about your family +C: well I I love them so I want them to think well of me and I want them to be accepting and love me okay and you have brothers or sisters yeah I have one sister okay great and how about friendship +C: friendship I've grown close to many people that I care about so I would like them to be accepting of me as well great so being a good friend and having people who are good friends too is important and then what about belonging you mentioned that one - +C: yeah just a sense of like fitting in and like being accepted you know yeah not +T: wanting to be part of a group yeah kind of okay great all right well one of the things I want to talk about is you know you mentioned that you like to go out with friends and party and that sort of a thing and I'm curious when you're at the parties do you ever have any alcohol +C: um not much maybe like one or two drinks at the most +T: okay can you tell me a little bit about how alcohol fits into your overall social scene +C: um I pretty much just have a drink just just have it like so it looks like I'm drinking even though I'm not so maybe people bug me about drinking or something +T: okay you're kind of getting pressure from other people who are drinking and it feels easier for you to hold a drink +C: have one they're pretending you have it okay and do you think that this is most weekends or occasionally +T: how often do you think that you are one or two weekends of the most very much so +T: one or two weekends a month you're in a situation where there is alcohol yeah okay and what sort of situations are you in +C: well just I guess at a party or something someone's house uh-huh or even if it's not a party like a small social gathering maybe there'll be like a few beers around mm-hmm so mainly just kind of hanging out with friends pretty much +T: yeah are you ever places where there are parents around or are mostly just just with the kids +C: mostly just with us but sometimes I'll go to like a close friend's house and like I'm close to her family as well so well I'll just hang out +T: and what about driving +C: um like drunk driving +T: yeah do you ever go anywhere in a car after you've had any alcohol definitely no I've never drunk driven and I've never been in a car with a drunk driver +T: so that's something that you've sort of made a decision about that sounds I know that's extremely dangerous okay what do you know about how that's dangerous +C: um well alcohol definitely impairs your judgment so I mean driving under the influence of alcohol can lead to like crashes and accidents and things like that so I'd rather not be in that situation so +T: you're really trying to be safe and and make sure that you're not putting yourself in those situations that's great you know it's it's tough to do sometimes and I really commend you for being able to to stick with that yeah so you mentioned you pretty much will like hold a drink or maybe have a drink or two what do you thinks the most alcohol you've ever had in in one day +C: no more than two drinks okay so the the absolute most yeah those two okay and +T: what kinds of things do you like about alcohol um +C: I've never really been drunk so I can't really say that I like that being or not but it's just I I mean you're just in a good mood +T: mm-hmm so it just kind of makes you feel relaxed yeah okay relax okay anything else +C: um no not really like I said I don't drink that much so I I wouldn't be able to tell you okay and +T: any not-so-good things about alcohol +C: um definitely yeah I mean what about parties is stuff and it's getting a little late some people that drink like drank too much they start throwing up or they get hurt or they're really loud and obnoxious and that's not fun for anybody +T: so you've seen a lot of other kids you had some consequences and decided that's not for you yeah +T: got it I can understand that any other things that you can think of +C: um no I mean I've never you know been friends with anybody that's got into like a serious accident and stuff it's just very like obnoxious thing +T: okay well so you know as someone who's not yet it is underage drinking is something that's not legal and it is something that is considered pretty risky so I'm wondering what you think about that just in terms of how it fits into your life +C: um I know it's definitely risky but I mean I guess we still do it uh-huh +T: so it's kind of something that here it's just there it's just there okay and I'm curious you mentioned you know your friends are important to you and your family's important to you sort of fitting in as important to you and how does alcohol play a role with that +C: um well definitely not in my family life because my parents don't really condone okay alcohol use but friendships I mean when I'm hanging out with my friends that were at a party or something there's usually alcohol involved okay +T: so from your family perspective the drinking is not something that fits very well yeah and with friends you feel like it's easier to hang out with alcohol or maybe you wouldn't have as much fun or your friends wouldn't like you as much +C: I guess I mean this is just there okay so it ties in with the whole blogging okay +T: well when you think about your drinking and sort of looking forward and five years or ten years how do you think that drinking might fit in with your life +C: um it probably will have a very small role if any mm-hmm in my life considering I have big plans for my future okay +T: can you expand on that a little bit more what do you mean +C: I mean I don't think I would be you know drinking as much your going to parties as much if I'm studying for school or in college or trying to get it off things like that okay +T: so the alcohol is something that might make it harder to reach your goals yeah definitely so when you're sort of looking ahead how often do you think you might be drinking say when you get to college +C: um maybe less than I am now I mean I don't drink much anyway so maybe like one drink every once in a blue moon okay +T: so you sort of have a plan to cut back on your drinking eventually how might that go +C: well I mean I guess right now I would try to stop in highschool and once I get older maybe just like socially once in a while but not anything bigger +T: yeah you don't feel the need to make any major changes but you feel like you could make some adjustments that doesn't get ya that's a good word okay how important is it to you to make some adjustments to your drinking on a scale of one to ten where one is not at all important not something you're thinking about and ten is the most important thing +C: maybe of five or six and +T: why did you say five or six rather than like two or three +C: because um it's not something I do not care about at all but it's not something that's just constantly on my mind that I want to change about myself okay so it is something you have thought about yeah +T: yeah okay and how confident are you that you could make a change if you decide you wanted to on that same scale +C: um I'm pretty confident but I can considering that I'm not really an alcohol user say I'm not really into that whole scene so it's not going to be difficult for me +T: so what number do you think you'd say um on the scale +C: one through ten favorite quit or not yeah maybe like an eight or nine okay and +T: why'd you say eight or nine rather than even like five or six +C: because like I said it's not a big part of my life so it's not really types of people okay all right well kind of keeping that in mind +T: it sounds like you do have sort of a vague plan to make some adjustments in your drinking at some point yes and it's moderately important to you it's something you would like to do because you have these big goals for yourself and you actually feel very confident that you could be successful with it what sort of goal do you think might be good to set for today +C: um probably to stop maybe next party I go to not have a drink at all okay +T: do you feel pretty confident that you could just stop completely +C: yeah I mean I can just tell my friends my parent my friends aren't really that pressuring it's just like outside people that I don't really know that well oh so I could just tell them hey I don't feel like having a drink today +T: what might be some benefits of falling through with that goal +C: um definitely I'll have like all my senses there and I'll be aware of everything that's going on uh-huh anything else um health concerns I guess I know alcohol is bad for your health and so that would be one okay so +T: it's it sounds like you're actually pretty comfortable with setting a goal of not drinking any more at least at the next party and seeing how it goes yeah okay do you think it would be alright if we met again to kind of check in on how it goes and see if it's working out for you yeah that would be okay alright great and then +T: it sounds like some of the benefits you're expecting are health benefits having an easier time with achieving your academic and career goals and just sort of not having to deal with some of the consequences that your peers do right okay well very good is there anything else that you think would be important for me to know +C: um how would you advise me till I get maybe my friends to stop drinking oh +T: that's a great question so a lot of times kids who are trying to cut back it's harder if their friends are still drinking and one of the easiest things is trying to have more activities that don't involve alcohol but of course that's harder if you're not the one planning so some of the things that can be useful if you're at a party say and there's already alcohol there and there are other kids that maybe aren't your closest friends some of the things that I would recommend since you're interested are you know carrying around a different drink that looks like it has alcohol in it so you know even carrying an empty beer bottle or beer can or you know if people are having a mixed drink just having the coke say without any all mixed into it often having anything in your hand is a good barrier for people who are trying to offer you alcohol because you already have something in it kind of prevents them from trying to stuff something else in there do you think any of those things might work for you +C: yeah for sure +T: okay what about in terms of talking to your friends about it have you thought about how you might approach with them or is that something else you'd like some tips about about telling them about your plan too I need to stop drinking I was just planning on playing them that I don't really want to drink anymore that wasn't me uh-huh no your friends would be pretty comfortable with that yeah I mean now it's my closest friends for sure okay great any other concerns or questions anything else I go but no I think I'm okay okay so then like I said I'll try and see if we can meet up maybe in a few weeks and see how it's going and then if things are going great then fantastic and if you run into any stumbling blocks and we can maybe problem solve together okay great that's sound okay yeah all \ No newline at end of file diff --git a/HighLowQualityCounseling/transcripts/high_110 b/HighLowQualityCounseling/transcripts/high_110 new file mode 100644 index 0000000000000000000000000000000000000000..16087ddcc72d5a465b9a52a373eac65e49493d2a --- /dev/null +++ b/HighLowQualityCounseling/transcripts/high_110 @@ -0,0 +1,49 @@ +T: I can great to see you today nice to see you too so I understand your smoker and I wonder if you would talk with me about your smoking? +C: sure I'll be +T: all right and so can you describe for me your pattern of tobacco use? +C: uh it's sort of sporadic I mean it mostly revolves around either i'm drinking with friends or or when I have you know emotions that I don't know how to deal with whether it's anger frustration or sadness or loneliness or pretty much any emotion that couldn't feel good yeah and +T: so how many cigarettes would you say that you have you smoked each day? +C: uh like I said I'm sporadic I don't smoke the same every day but on average maybe a half a pack a day I mean it could be none one day and then the full pack another day and so but maybe on average a half a pack +T: okay and how soon after you wake up in the mornings do you have your first cigarette? +C: uh you know it's not right away from me normally I in most days it will probably when I'm in in the car and the way to work you know and just it's one of those places where I'm in a car and start the car and light a cigarette and you know follows right afterwards +T: well it seems like you have a lot of awareness of your triggers for smoking +C: uh yeah you know I don't I don't I think crave it in a way that I think maybe most people do all the time I just have situations for sure that that I by smoking you know +T: okay and how long have you been smoking? +C: I had my first cigarette when I was years old +T: and has your pattern been the same since then? +C: uh you know what varies a little bit but but it's mostly been like that you know I never smoked a lot more than I do right now or really even a lot less it's mostly been mostly about same on average +T: and so are you interested in stopping smoking? +C: uh yeah I mean I I I quit all the time frankly I I've thrown away you know half full packs and and and swear I'm done and then I think I'm done but it only lasts for for a few days and then you know either I'm out with friends drinking all right I I get upset and then and then without even thinking about it I go and buy a pack on I'm a smoker again yeah +T: and so those times when you decide to quit what are your reasons for quitting? +C: uh well i think i'm stupid for smoking you know i mean i think everybody knows that it's horrible for you and do awful things to you and your lung cancer and kill you you know and then i have asthma too and so put it on top of that and I you know more recently I've seen family members die lung cancer and it's awful a horrible way to go you know and so it seems more real and I I don't want to do that to myself I wouldn't want anybody I care about to smoke and yet somehow I keep doing it to myself you know I I sort of can't believe that I choose to do it and yet i choose to do it without thinking all the time +T: but it seems like it really fits in with your lifestyle with the friends that you spend time with and +C: yeah we we all work nights we all go out afterwards we all drink and smoke and you know I I don't think i could really imagine being out of them and watching them smoking me not doing it to you know I just it would do all it takes is being around it you know and I'm smoke with them +T: yeah well it sounds like it's really it helps you to connect with them and part of socializing +C: well yeah I mean yeah I don't they don't pressure me to do or anything it's just being having it all around me you know and having a drink in one hand you know like it's it's like it couldn't be any other way you know just being being around it and and and and people spoken and I'm I'm gonna smoke with them too +T: it also sounds like when you're really feeling bad or feeling negative emotions that it's the one thing that you know you can go to and for a little while anyways it helps you to feel better +C: uh yeah I with any kind of emotion that I don't know how to deal with it just feels like a ton of pressure inside of me and and and smoking two cigarettes like pushing the pressure release valve you know like I just but I feel relief and I don't feel nearly as angry or sad or frustrated or whatever and and so it does what I mean it to do I guess +T: let's stop here so we can discuss what you have seen so far consider the following questions how do you think this conversation is going so far? how effective is the assessment? are there other questions you want to ask? what have we learned so far about Kens smoking pattern and history? what are your initial thoughts about potential tobacco cessation medications and counseling strategies? let's see what happens next and so right now in this moment can you talk with me about you know how ready are you to quit? so on a scale from one to ten one being not ready to quit it all and ten being you know you would set a quit date right now where are you? c at huh you know I would say maybe six or seven i would say I'd be I'd be happy to be done you know I'd be happy if I didn't ever smoke again I just I just don't really believe it's going to happen I guess you know I like I said I quit all the time and now it's even sort of a joke that that me Quinton's like not quitting at all it just means I'm out t um okay well did you know though that um people who quit without any sort of assistance using any tobacco cessation medications or counseling have a four percent chance of success of quitting in the long term +C: you know I that sort of discouraging I guess that no one can get away from it you know but I guess I'm not the only one +T: um but there are some cessation medications and aids that can really help you to successfully quit +C: what a kind of things you're talking about +T: well there are things like um the patch or the gum so nicotine replacement therapy there's also other medications as well as counseling where it could really help you learn and practice some strategies to help you stop smoking especially at those times when you're really triggered or you have some real cravings they'd have to be really good techniques +C: i think you know I but like i said i don't i'm so convinced that i'm done each time that I quit and then and then I start again and I don't even think about it you know there's whatever technique would have to uh has a lot to overcome I think in my case +T: so so then that leaves me to asking you about your confidence level so if you could rate yourself your confidence level about your ability to quit on a scale from one to ten one being not having any confidence at all and ten being yeah I know I can do it this time where are you at with that +C: uh you know i would say maybe you two maybe a three out you know I I don't know you know I can go like I said a day or two without smoking but I've never gone for good you know I all I need is you back in that situation again either upset or out with friends and I'm right back and so I just I have a hard time believing I have a hard time even imagining a world in which I really wouldn't wouldn't go to smoke when uh when times get tough I guess +T: yeah well and so can you talk with me a bit more about the reasons why you would really want to be quit? +C: so there's health reasons +T: yeah um is there anything else that really you know is one of the reasons why you would want to quit? +C: uh you know i just i don't i don't want to live this way where I do things that to myself and I wouldn't do to anybody i love you know I wouldn't want any any loved one to smoke you know and but somehow I I do it to myself you know and and and and I'm trying to start exercising you know doing some running in some hike in and and and then I get short of breath and I cough and I'm worn out if I smoked a lot the day before and and I'm not sure you can choose both smoke and ends being in good shape you know I just I just I don't I don't believe in me making that choice I guess to be healthy and +T: so it really does sound like for you quitting smoking would be an expression a self love +C: i would i would have to love me more i guess to get there like I said I would I would I would want anybody I loved and not smoke and so if I I chose to not smoke if I was actually be able to do it I think it would have to be because because I cared enough about me to do it +T: yeah and so your confidence you said is that a two or three why not a one +C: you know because I do go days a time sometimes without smoking I mean as long as I'm not in a situation that sort of forces me to do it you know as long as i'm not out with friends drinking or as long as I don't have some situation gets me upset than I don't I don't feel it has control over me you know just in those situations where there's nothing else I can do you know but smooth +T: well it sounds like quitting smoking is really important to you but that you know you don't really feel confident and you're not sure about what strategies are out there to help you and I'm wondering if you'd be willing to meet and talk with one of our tobacco treatment specialist who can we tell you what your options are get you connected to resources to help you quit would you be willing to do that? +C: you know like I said they gotta have something pretty special I mean I outside of them coming to the bar with me and not going to figure it out of my hands I'm not sure what they can do but but I I don't want to keep Quentin I want to quit one more time and it'd be it'd be it you know so we'll give them a try +T: yeah well in like you said you know you've quit many times before and for multiple days and that is a real success and I know that because you ended up going back to smoking that it doesn't feel like a real success but certainly being able to stop for hours or days at a time is really an accomplishment and I hope you can feel that +C: well it feels like something maybe I mean I'm better off having a few days often then smoking a pack every day but but i don't i don't think you'd really quit until you really quit you know like i don't i don't think my quit and I know you really want to quit I don't I don't know that there's anything better I could do for myself if I could actually do it +T: okay so if I connect you with them with the tts you'll um follow up with them and talk with them about it? +C: I'll give them a try +T: in our next meeting we can check in and see how things went for you +C: all right +T: okay well wonderful great talking with you it's good talking you \ No newline at end of file diff --git a/HighLowQualityCounseling/transcripts/high_111 b/HighLowQualityCounseling/transcripts/high_111 new file mode 100644 index 0000000000000000000000000000000000000000..fdbaf8b19d2ec562fb3f7cae807c812665582630 --- /dev/null +++ b/HighLowQualityCounseling/transcripts/high_111 @@ -0,0 +1,18 @@ + +T: Jeffrey tell me what you'd like to talk about today? um press all you can call me Jeff the time +C: um I don't know there's just so much going on right now hey I lost my job two months ago and I don't know I was like taking care of myself so much better and it's just I stopped going to church as much and it's been really tough because my wife and my two kids aren't living with you right now so I'm just trying to get my just kind of get trying to get myself together right now and so I mean you're the first person I've seen it for days I just don't know I just don't know what to do +T: okay so right now what you have so much going on that you're just feeling totally overwhelmed you don't even know where to start yeah thinking about trying to control your diabetes just seems like one more +C: yeah I did likely from like a bun on a job like how can I think about you know check my sugar and I regular basis I'm trying to just get out of bed you know and not sleep till pm like I've been doing you're even feeling a little bit depressed right now yeah yeah it's not helpful +T: so it sounds like you mentioned that you had been going to church and then you also said that your wife and kids you're not with them right now so sounds like the people that you had in your life that men were a source of supporter there aren't there for you +C: yeah hmm maybe that are there hurry i don't i don't know i mean that's part of what I'm scared about is you know what if they aren't there like one thing that was really cool his on Wednesdays me and a few my friends would walk the Bible study instead of driving and it was fun and one of the friends was named Cheryl and whenever I didn't go she'd call up would be like so you know she'd always get me to go and just I didn't want to let them down i also really enjoyed it so we just talked about work I have a job now but I mean we just I don't know we just talked about life you know it's really good +T: so that group is really helpful to you not only just to kind of chill out and have a good time but also you actually had some exercise +C: yeah exactly get into n out of them had diabetes as well so sometimes we were just Chad you know see if people were you know just taking care of themselves get into the clinic doing whatever they needed to do so I missed that you know +T: okay so that was a really helpful thing for you in managing your diabetes and you're feeling a little bit lost not having that +C: yeah yeah I just I just I don't know I just it's just it's just tough because you not only do i miss my friends but i also miss being a good husband and being a dad and and being able to provide and just I mean I had to get fluted the church food pantry you know two weeks ago and you know it shouldn't be like that i should be able to support them and to you know work hard go to or come on you know cook dinner help with the homework i mean i'm not doing any I have no structure in my life right now you know I I mean I could add sleep in till pm because who cares you know +T: it sounds a little bit like you're feeling a change that you can't fulfill this role that you it's not so much ashamed +C: it's just embarrassed you know it's like I I I mean even just saying this I'm kind of like hope you know that you don't judge me or whatever because I did I can't even it's hard to even just say this I don't want things to be like this you know it's hard enough sometimes having diabetes and being embarrassed around that but throw all this other stuff on and it's too much I just don't even want to acknowledge it +T: really you know you're really frustrated because they fell anything's going on in your life that you feel like you don't even have control +C: exactly exactly yeah i mean at least i had control as far as going to work going to charge um taking care of my family i mean those are three things that helped having those in balance i could focus on my diabetes because it was as part of my routine and i got ready for work you know like those just part of my routine +T: so in the past we were able to have the structure and also the support of people around you it's sort of added more daily basis it was easier for you there's a lot easier +C: yeah it wasn't easy but it along or I just felt like I could deal with it +T: okay so even though you're really overwhelmed right now and everything just sort out of control and you're feeling really really hope it sounds like you may have identified a few things to think about in trying to figure out where to move forward all right did work in the past right now \ No newline at end of file diff --git a/HighLowQualityCounseling/transcripts/high_116 b/HighLowQualityCounseling/transcripts/high_116 new file mode 100644 index 0000000000000000000000000000000000000000..8b948e6dcf000d013466c82124e72550bdc62ed2 --- /dev/null +++ b/HighLowQualityCounseling/transcripts/high_116 @@ -0,0 +1,37 @@ +T: so Rose thank you for coming in today can you just start off I tell me a little bit about yourself +C: oh yeah i'm a student right now at U of L will not right now i'm taking a little break from school um i live at home with my parents and I I work out I mean right now I'm not doing too much but on college +T: it's your typical college student +C: yeah +T: well it sounds like you're really really happy about your life I can tell with your facial expressions and things like that you seem pretty content to be taking a little bit of time off from school right now and you know that you live with your parents sounds like you really enjoy spending time based off what you're what you're telling me +C: oh not really I do like my family a lot but i kinda want to be back at school I mean I guess I'm kind of friendly person um but yeah I don't know I like starting out of my family for sure I always like to call you home for Christmas and summer break all that kind of stuff but I'm kind of aggravated because here I am my junior year i'm really excited as it gets missing year and graduate and now i have to take another semester because i had to take out this one and I'm really grateful that my parents are like you know letting a little bit them but they are making me look at the same time um so yeah I I got sick a little bit and they asked me to come home and I thought that you know I can get better and i I just I don't want to take any more time off really I want to stick to my age and a graduate on time like everyone else my age so it's aggravating I that I am grateful that I have a family like them I guess +T: so it seems like you're kind of conflicted about what's going on you know I'm hear you say that you got sick and it wasn't really big deal but it seems like your parents may have been your opinion overreacted +C: yeah +T: kind of pulling out of school was causing you fall behind what you would like to be +C: yeah i mean everyone gets sick i mean i don't think it's important for me to stay home for that reason you know they may to always be concerned about my health I feel like I think they're a little overly concerned +T: can you tell me a little bit more about what you mean by sick what kind of symptoms and you have what did that lead to +C: well I just kind of always been more easily able to like colds and stuff and it always kind of got worse for some reason for me i'm not sure why but I you know I just it just kind of happened and so I expected it when I got to college of living has lots of random people in dorms and I knew they'd be like freaking out on it and they of course were finally by sophomore year and it wasn't getting too too sick you know I guess some days at work a couple days of school you know every other month or something but junior year I don't know I guess they thought I was getting more stressed dollars I don't know I'm kind of guessing here but um yeah so my symptoms i guess like you asked we're kind of getting the common cold i guess but i would just get really exhausted and sometimes like everyone so i won't be able to get out of bed but +T: so it sounds like you're really confused about why your symptoms even began +C: yeah i mean just I feel like I'm a pretty normal +T: I know that you really discuss that working out was it really important part of your life it's safe it can you tell me a little bit more about that? +C: well I want to be a personal trainer that's kind of where I am right now like that's why I wanted to stay on my agenda because after school I have to do like a few more years of school getting my masters I'm really excited about that like I mean I've been reading like magazines for training like since I could remember and it's all about you know being fit and being excited about being fit and having like I energy that kind of stuff which is hard when I'm sick time high energy but I always going to work on my own fitness lifting weights and running and doing extra classes just to kind of build my core that kind of stuff so you know I I think that's kind of why or got so much it's really important to me and one day I'm gonna have to encourage you with the workout so I need me they'll love it myself so +T: well def don't want to be hearing that is this this is probably one of the biggest parts of your life and you know what you're saying and I don't even frustrated but you've been unable to do this inject home +C: yeah +T: because of the illness and your parents concerns you know you express that you really like to work out every single day how many hours a day on average would you say that you work out? +C: I mean they encourage like what I read is like four arms but like I really want to be a great trainers I'm you like five or six so I know it seems like it I'm like +T: you're like time consuming it is +C: yeah I mean I like a friend come running with me around smile but a sort of certain point they don't want to keep running with me or like workout me good so you're not a little socializing but I mean it's what we want to do with my life so I have to get used to it one day i'll be doing it for like hours a day +T: so well it seems to give a lot going on with your life I mean taking that amount of time during a day to run I know it would be very exhausting so I can completely understand that getting the cold may seem pretty doable to you I know that you were referred here by your primary care physician dr. hafer and I know that your parents were just really concerned with not only the amount of exercise that you were doing that maybe also some of your other eating habits yo Mike us try to talk about tonight you can't be a little bit why you think that they're concerned about that at all? +C: I mean compared to like my siblings on Michael little thinner so I guess that's probably what they're thinking but I need a workout I want to be fit but I I really watch what I eat you know I mean that's what they disease I'm een and you know I'm not just magazines for more than that it's Boca soon yeah videos and come on part of many blogs and that kind of stuff you know what I hotel my own but you know they just really encourage watching +T: how much fruit you have how much about how many vegetables you have how many you know how much mean you have? +C: and so my parents had concern when I have very little meat and when I'm you know when I'm just consuming fruits and vegetables so that's really where they're concerned I guess they want that's must be what it is I mean they think I don't consume enough of anything so they tell me but I mean if you look at like these agendas that I have been following other people survive you know by that most the time so I mean so when I guess +T: I'm hear you say is that you're really you're following with the magazines and what the internet what all the other fitness experts are saying right it seems like your parent ships aren't fully understanding that that's just the regimen in the lifestyle that that industry village drives for and they don't follow themselves so +C: I mean they're not going to understand that they've never been really concerned about it I've always kind of encourage them to kind of comment down the heat but you know it's something that yeah I've read these things I and I want to be competitive one day as a trainer and getting other people to be competitive too so I they think us here original question was what was it again I'm sorry I kept rambling I'm nothing +T: you're doing fine you can continue on as you were we can sort of his head in the direction of I know you really discussed a lot about fitness and working out as one of your really important aspects of your life will you have some of the other important aspects of your life? +C: um well like i kind of said my family and i really do care about them and so they're very important to me and my schoolwork is very important to me i really try to do well Matt just try to focus my time on that and I also do a couple hours of work everyone everyone's valid during the week at the library so I try to put those hours there just because I need to make the extra money to pay for you know I'll do all the things that I following magazines and my groceries because the campus foods one of the most i joined by our groceries absolutely +T: well it sounds like you are incredibly busy as a college student John sleeping +C: yeah +T: it's something that I think would be very beneficial for the next week before we meet again it's I would like for you to try to do your best to journal kind of document maybe how your day goes you know in the morning what are you doing in the in the afternoon what are you doing it at night time where you're doing just just breathe little notations you know seven o'clock i'm doing this eight o'clock i'm doing this not every single hour but as often as you can remember I'm and I'm likely to bring that in next week for us to discuss that way we can kind of see how your schedule is going around real quick +C: yeah +T: that sounds like we're going to do for training sometimes +C: good +T: all right well I'll see you next weekend are good next thing \ No newline at end of file diff --git a/HighLowQualityCounseling/transcripts/high_117 b/HighLowQualityCounseling/transcripts/high_117 new file mode 100644 index 0000000000000000000000000000000000000000..b922a350310f7aaa47427982752041b829e2c26c --- /dev/null +++ b/HighLowQualityCounseling/transcripts/high_117 @@ -0,0 +1,44 @@ +T: hi William I'm Heather I'm so glad to meet you +T: hi Heather thanks for coming in sure how was your trip over +C: it was okay i had trouble finding the place at first +T: but you know first time coming here you made it I made it right fantastic and it looks like you brought some paperwork with you C and I didn't I filled out the form +T: thank you for all of that how was all that for you it's a lot of papers a lot to fill out +C: I I wasn't sure on some of it what to put down so I'm hoping you'll help me with that +T: fantastic well thanks so much for going through all of that e note was a lot to ask and I'm so glad that you're here and that you made it and we can most certainly go through any of that that would be useful for you today okay and I'm wondering if maybe at first before we get started I'd like to check in with you and just see if there's any questions things that you've been thinking about or wondering about since you first heard about our program that might have brought you here might be on your mind +C: um-hmm that's a good question well I not really I know a little bit about the program actually because I was a client about seven or eight years ago and didn't really things didn't turn out well so I'm interested to know how things might be different and I'm I'm just not sure I'm just not sure with my situation if you can help me out or not +T: sure so you're back with us again and thinking about gosh this time might be different for you and may be wondering what that might look like +C: I hope so yeah yeah +T: anything else that might be on your mind or even thinking about or wandering about? +C: well I have I don't know if I'm getting ahead of myself or not but I have a little bit of a record for some misdemeanors when I used to drink and so I'm I just really feel like I'm not good for much I don't know who would want me for it to work +T: so they're really wondering right now if if if work is possible for you +C: yeah +T: do you think it is well I hope that through our work together you'll be able to decide that for yourself hmm and my hope in our process is that that we could be partners and thinking about that together and what what work might look like for you in your life and how it might fit in for you how does that sound +C: okay I thought you might just tell me what to do and I had to do it I'm so this okay I'm I'm ready like I can do that +T: so thinking about for yourself what you know could be possible is almost a new thought for you right now +C: it is usually when I'm at home I'm pretty depressed and thinking this is the rest of my life and it's not something I'm it just doesn't make me happy when I think of it like that so to think there might be alternatives or choices interesting i'm not sure what to do with that +T: honestly and something brought you here today it did +C: yeah +T: what was it that made you decide even with all of that sort of thinking about at home? +C: i'm not sure if this is possible or this this may not work out for me +T: and yet there was something that brought you here +C: well I consider my chair all day and watch TV shows I get to watch the old days and its really nostalgic and I'm in my mid so I'm thinking I could be doing this for another or years is that really okay for me my son is he's an adult he still lives with me but he's he's capable taking care of himself and I just can't imagine myself sitting in this chair for the next years and just deteriorating and I don't think I would last years i think i would ask maybe eight and I'm not ready to go +T: so there was a moment in time when you were sitting in your chair watching your oldies that you thought is this what the rest of my life will be like em hmm will there be something you know that be something more and also you know it's part of the time it's like yeah this is it you know you made your bed be happy with it and this is this is all there is in that's it then this other part is not too sure if that's okay +C: you know I'm not really sure I want to be there yeah not as comfortable but then the end then there's a third voice that says he can't do anything and so it's just like I just feel really confused and kind of tied up in knots and I thought well I'll give you our try again it can't hurt I might get mad but why not +T: well I'm really glad you're here William and I look forward to finding out much more about what it is that's most important to you and what you want your life to be like in it in the future and you do know what's best for yourself you have those voices that you said that tell you what you do like and what works for you and and the voice that sort of says I'm not sure that this is what's best for me you have a lot of things kind of rolling around in your +C: I do it's an just spins around in there it's really really hard sometimes yeah how exhausting that must feel mmhmm yeah and confusing and aggravating and depressing and anxiety-provoking and just all of that honestly it was kind of hard to come in here because I just like I'm feeling kind of hopeless about the whole situation so um but I like I said I just thought I can't hurt and even just talking about it in this moment +T: I noticed that you got a little tense and sort of it's almost like those wheels are turning again just considering it as the coaches are tracking +C: it is I just think I'm i don't know i feel kind of dumb it's just like what am i what do i think i'm doing but i'll try not to be negative i'll try to think more positive it's just kind of a habit +T: I guess and you have some hope for your future that things can be different for you I hope so I'm sure what that looks like yet don't know what it looks like +C: yeah +T: so what do you think if the two of us together um could potentially start exploring that journey a little bit some of the things you mentioned just in our brief interaction right now have been that you that you have a son that lives with you that is really doing okay and so you're able to start thinking about yourself in your life and that maybe you're a little concerned about what the future might bring and what some of the things in your life that you're dealing with your criminal history for instance might potentially get in your way and how could you how could you get around that what life could you have for yourself at home it's more than sitting in that easy chair watching your oldies mhm so if we may be delved into a bit more of that sort of what you're thinking about working how does +C: that sound sounds really good I I haven't worked for years and or maybe eight but it's been a long time and things have changed so much I just know it won't be easy but I'm ready for that you seem like a pretty nice person to talk to so I'll give it a try +T: you're ready to at least explore it huh so um would this be a good time for me to share a little bit maybe about how our program might have changed from the last time +C: sure I'd yes please +T: so how I see things is that I sort of feel like maybe a guide or a partner with you in your journey towards work in thinking about work from where you are now maybe feeling a little bit confused or not sure about what the future may bring and then to bringing you forward to however that looks for you in your life and hopefully to that place where you really want to be where you're doing something that that fits for you and feels good and that we it as a program have some resources that we could potentially utilize together our first step would be of course today to take your application for services and then after that I would be able to look at whether or not you're eligible to work together on this journey and if so we would be able to figure that out together what that path looks like so how does that sound to you? +C: it sounds pretty good I'm how long does this take +T: that's a great question so you really you really want to know what the path forward might look like yeah what to expect what to expect +C: yeah I really like to know what to expect that's important to me and everyone's journey is different working +T: oh you and I together can potentially plan that mm-hmm we can talk about there are certainly certain time frames in our program around eligibility our first step is the application and then we have some time frames and together our hope is that we can even improve on those time frame um so I guess it's kind of a wait and see well know when it happens how long it takes absolutely but the first step is just to get started and how about if we along the way maybe kind of check in with each other around expectations and time frames would that be useful? +C: hmm mm-hmm thanks +T: yeah yeah totally so if you'd like to get started would you mind if I take a look at your application paperwork and just make sure that there isn't anything that I may have a question about +C: okay thank you very much for bringing fun like I said I \ No newline at end of file diff --git a/HighLowQualityCounseling/transcripts/high_118 b/HighLowQualityCounseling/transcripts/high_118 new file mode 100644 index 0000000000000000000000000000000000000000..50050b1f4dbc7cee3dbcce31edea5948e0b6e1de --- /dev/null +++ b/HighLowQualityCounseling/transcripts/high_118 @@ -0,0 +1,47 @@ +T: William it's really nice to see you back again +C: hi yeah I'm glad you're here and as I know as I had mentioned on the phone when I set up the time that you have we have found that you're eligible to or the services here and so that means that we can get started and really map out a plan okay and our guidelines are that we need to we need to have we have days to develop that plan and there's a lot of different ways that we can go about it and think about it and will kind of start that process today how does that say? +C: okay yeah sounds good +T: um in before we get started on the specifics of this I'm wondering if there's anything that you're concerned about today or things that you've been thinking about in relationship to that? +C: Oh since our last meeting you know it was really interesting because part of the time I was really enthused and part of the time I was really scared and I started just kind of throwing around ideas and but at the same time one thing we didn't really talk about too much last time was some of the this I've got some pain of my ankle my car doesn't always work my son has a mental illness and I hate to say this but I I for the pain i use medical marijuana and so i just wanted to be upfront and honest with that +T: yeah so there's a few other things +C: but you know just that things are still spinning in my head +T: yeah so that you've been thinking about it a lot and about some of the issues that may come up and actually I what I what I put together here is in looking at your paperwork I kind of pulled out some of the things that are possible for us to talk about and I you had indicated on there that you had medical marijuana so I've got that I walk the whole issue with the pain okay on there it does sound like the that thinking about dealing with your son might be an important one for us to consider in this too +C: mm-hmm it is he has his ups and down for sure mm-hmm create a lot of stress so yeah right and makes it up makes it hard to think about being able to take care of that and and go out and do other things too +T: yeah you know you mentioned in your in the paperwork that what you you wanted some help sort of thinking through a work goal or the possibility of work at all +C: yeah like that's it's just like making that decision and really working on it the when I went through also I pulled out a few things and here's what i came up with from that +T: and you mentioned last time about the criminal history that you had a little bit of concern about the misdemeanors were there that were there you also have talked about in your that you were on the SSDI and that you had you know for your for the injury based on your injury and the disability and sort of thinking about maybe some benefits thinking about that in relationship to work and has another thing we could discuss so another thing that was on there was the education and you mentioned about the not having a GED or finishing up high school and that's certainly something we can talk about and how that might affect work you mentioned the that there had been some issues with alcohol addiction and certainly that is a topic that we could talk about and how that might you know might play in with the work and then the pain management and the sort of follow-up to the injury and what what that is what that is or what concerns you have about that and as you just mentioned you the issue with your son and how what your role in taking care of him or how much that puts on the family stress mhm and all of those are areas that we could start with and I'm also wondering if there's something that you feel is more important to start with in terms of initiating this journey towards figuring out what your goal is +C: well one thing that's really big on my mind and maybe it's wrapped up in here is that all the work I've done was physical labor work and I can't do that anymore so there's been a whole shift and so I'm feeling really sort of lost about what what's of it what are the odds available i don't even know with physical work there's a ton of things that a person can do +T: yeah +C: and i just can't do that +T: so that's certainly possibly the exploration of what kinds of work that aren't that aren't physical in nature recognizing that you wouldn't be able to do the kind of work that you did previously bright and really thinking about that and certainly there's some resources that we have for helping in that exploration and looking at there are a lot there are other options out there are ya okay for someone my age you think? +C: yes okay yeah I do +T: it's just learning more about that +C: yeah okay looking through them so okay you know and what I want to say is we can end up touching on we may possibly end up touching on all of these things during the course of our our planning process and it's really about figuring out what is the most important thing to you to start with and what you have the most concerns about or what you think would help you most in that decision-making process what do you think well all of this +C: yeah you're right it all plays a part but I gotta say this pain that I have in my ankle is constant it's always there and it's just sometimes it's worse than other times but it affects my sleep it affects my outlook and then I use some marijuana to help kind of ease that the severity of that pain but the pain is still there so it you know I can get up and think my day is planned this way or this way and I may not be able to get past that that lounger the recliner man to be because of that pain and I'm so I've that really scares me is that going to keep me from working and i don't know if i told you but I've got like nails and and plates are not nails with screws and plates in my ankle and have to use a cane and people are going to notice right off the bat when they see me that there's something wrong with this guy +T: and so it's already it's pretty obvious and it also sounds like that pain is really taken up a pretty big role in your in your life and it feels like a pretty big barrier right there +C: sometimes it's all I can think about +T: yeah +C: is that playing yeah +T: well how about we spend some time really talking about what what that pain management might look like what what you've been doing and and sort of how you see that playing out in your work that be that's not okay? +C: definitely +T: tell me you mentioned the marijuana and you mentioned that you um that you know that you have a cane and have some adaptations and tell me what else you're sort of doing to manage the pain right now +C: well like the other day I tripped and I did something to my ankle I don't know exactly what but I have a like a boot you know and somebody hurts your ankle they can put a big boot on it so I've got a boot that helps keep it stable I've also got a brace that helps keep it stable it's hard sometimes one of the wound might open up and become infected so then there's doctors appointments and that kind of pain and it's not very pretty what else have I been doing just not I try not to overdo it but sometimes that's kind of hard because I tend to push myself sometimes i take i don't take any of the heavy duty meds i've had addiction in the past i know and they don't make me feel good anyway so that's a good thing I'm not hooked on some of those really heavy-duty prescription medication so I will take over-the-counter ibuprofen and tylenol things like that I think that's about all I can't think of anything else yeah you know I just do +T: I want to affirm how much you know about yourself that you made decisions about how manage this based on not wanting to get yourself in trouble with addiction again? +C: I I really that's a you know I really takes a lot of courage to do that and to sort of live with the pain and figure out alternatives well I always tell people I one drink away from jail so you know that's a pretty good deterrent +T: yeah yeah so that stays at the kind of the forefront to the top of your head to like oh boy and if the stress gets too much that could be a problem +C: yeah yeah +T: it's true yeah you know one thing it sounds like the pain management is probably the place where might be useful to start because that might be the most the right up front the thing place to start so we can do that and we can talk about there are alternatives out there and and different programs and different situations that have been useful for others in your situation in terms of managing pain so maybe we will send me to a shrink maybe they'll shrink that ankle +C: yeah i just know he'll say it's all in my head sometimes +T: and so it sounds like you've had some experience that +C: oh I'm being told that it's it's just in your head and it's really that really makes me mad +T: yeah because you really know you know what it is and you've been living with it and working with it and trying to find a way to manage it for a long time +C: exactly yeah +T: right don't want somebody telling you +C: yeah +T: that you're making it up +C: yeah +T: well I can assure well that that we that we can find alternatives to that +C: okay I'll be curious about that +T: yeah okay well how about we go ahead and set that up and we'll start there and we'll keep these others and what I want to let you know is that if other things come up that we need to cover we can put them on this list to to make sure we'll check in about these okay it's time we meet and figure out what if you know where what we want to work on that day okay start with the pain +C: okay sounds great thank you +T: mm-hmm \ No newline at end of file diff --git a/HighLowQualityCounseling/transcripts/high_119 b/HighLowQualityCounseling/transcripts/high_119 new file mode 100644 index 0000000000000000000000000000000000000000..945f23b15d95a432b306f29c8afd8233c1b106ff --- /dev/null +++ b/HighLowQualityCounseling/transcripts/high_119 @@ -0,0 +1,64 @@ +T: wondering if you would be willing to share with me what you picked +C: ok I'd be glad to and I just have to say it was really hard to choose the top three and I actually stuck in a fourth +T: it's important to you there is a lot +C: that's important to me and I am +T: let's see do they seem to be in order when I tell you about them? or just however you'd like to start +C: okay +T: um wanting to start with family and it says to have a happy loving family +C: I'm going to kind of family is very important to me having a happy loving family that is kind of a it would be a nice goal but a family that's that gets along well a family that is there for each other and support each other maybe not always happy and loving but you know still there for each other that's really important to me +T: it's a really a family that is kind of your rock and he family is very different than maybe the words that are on this card and yet family really called out to you family did you know that's basically the only people +C: i talked with two is why one friend that comes over once in a while but really all during the week and its family so I don't know you know where I would be without them and and it's just so it kind of blends in with us next on the responsibility I Myers my ability to be responsible has increased so much when it comes to family and I really want to keep that going I I feel like I have a I have to prove something to my family that because I wasn't responsible for a long time and in fact I still have plenty of times I'm not responsible but it's other you know I try I'm trying my best to show that I can be responsible does that make sense? +T: so family and responsibilities are tied together for you and responsibility is something that you haven't always been as you would like and yet you've grown in your ability to be responsible possibly partly because of your family +C: well especially with my son he started working so I'm there to take him to work and pick him up so that kind of gets me going during the day whenever we have a family gathering I'm always the first one there and I used to be the last one and so I try to be really punctual and be there for my family when I can i really think i'm kind of the black sheep of the family though i'm not i'm not really worth it a lot so maybe I this is why this is kind of hard because it's almost as if I'm going over and above just to make a point that I'm responsible and then sometimes I just feel like I'm not responsible to anyway I'm just talking in circles +T: so sometimes how they interact with you you don't always feel what you're trying to show them +C: or I don't always know that what I'm yeah I don't know what they're thinking about me so I tend to make things up +T: yeah and because of what you're thinking you sometimes then really try to act responsible and hope that they will be able to see what you're trying to show +C: ya want them to accept me more because I just felt I haven't been all that accepted +T: and you keep trying +C: I do I do yep +T: yeah so this is do these really fit together for you so tell me about the others that you pay +C: so i picked cleanliness it's real important to me because like i said before i am i pretty much in my chair watching TV a lot of the time or on the internet or something however it's i don't want to sit in my house all day and have it be a stinking mess with garbage all over the place so I'm a little bit sort of OCD about that you might say I have to have make sure every surface is clean all the time and I vacuumed once a day even though it really hurts on my ankle I get up on a vacuum I have a cat so I make sure the cat box is scooped and if anyone comes over my place is always it's immaculate and I take a lot of pride in that +T: yeah so it gives you pride to be able to show something you are able to do even it's even if it's sometimes difficult ' +C: mm-hmm sometimes I wonder if I go overboard but you know that's okay it's my house right I can do what I want and you feel good about it +T: you said I do you feel pride mm-hmm I do you know you dirty a dish you clean it and put it away that's that's what you do and if it's difficult and others notice +C: mmhmm yeah I've had family come over every so often and they're like wow this place is amazing it's spotless so yeah I feel good about that +T: so you mentioned that somehow that also connects with family it's not only for yourself it's also sometimes for others possibly being able to show them that you're responsible in your own dwelling in what you're able +C: i am and even though i only get twelve hundred dollars a month or or something in social security my rent is about you know I barely can make ends meet I have to sell things all the time I have a clean house I'm proud of and I do what I say if I tell family I'll do it and I want the best for my son who has had lots of rough times so may I never thought about like that before +T: your boy true changes us when you start talking about the right that you have and what you're able to do with what you feel like might not be a lot +C: yeah I was kind of defiant you know some people wouldn't be able to get by as well as I've been able to I think so and then I had that humor because I think I'm really funny and creative and it's important that's really important to me to keep that perspective and to keep that kind of at the forefront or else i could just sink into a deep dark hole that side of you oh +T: so in thinking about family responsibilities and cleanliness there's that sense of pride of something bigger than yourself and you're really working hard here and yet you've got this this hammer that sort of fits in there with all of that no tell me more about how you see humor fitting in in your life with all of these things that seem to be so almost serious mmm really focused well and understand +C: i'm thinking about work along all this time too so because of my creativity and my family tells me i created more that i say i'm creative but my family tells me i'm creative and i we play games okay so i don't know if +T: you've seen this game but it's some draw it's like words of friends but you draw pictures and you have the other person +C: i guess what it is it's not easy to draw a picture on an iPad because of the the stylus makes such big lines but boy I can draw some really cool pictures on there and my family takes screenshots and they keep them because they're so cool and then later they'll they'll show them to me and I'll be like wow I really did that so the humor is that they're kind of funny some of them like one of Elvis it was really funny and I just felt like the family you know gave me special record gives me special recognition sometimes they really noticed they notice that have this special ability +T: mm-hmm and it touches them in a way that you want to touch them +C: hmm I'm not sure what I could do with that but you know and same with humor just ice I kind of see things from my ionic perspective the and I can't even give you an example right now but I just I just think of really funny things when they pop out of my mouth and and I give I get positive recognition from my family that way +T: so you really have a connection with your family through the actions that you take in your life to show them that you're a responsible person and these relationships with her family are really central to your life right now they are the people that you interact most with and you have pride in yourself so that respect of yourself and being able to show your family what you're really able to do in your life how you're able to keep things clean and presentable and have that sense of pride and yet it seems that your humor and creativity is something that really is almost a more powerful thing in being able to show who you are and getting special recognition for in your life who you are as a person and maybe a part of you that you have yet to fully discover or to show the world who you can be what do you think of all that feels pretty good +C: I'm a little embarrassed +T: yeah hmm so haven't really thought of yourself in that way +C: I'm usually more negative about myself huh I've got more going for me than I thought this is the best of +T: William mm-hmm han couldn't couldn't keep it here this this is important to you this humor the humor yeah keeps me going that creativity yeah keeps me going it's almost like that that light ahead that hope that you were talking about +C: oh yeah yeah +T: I don't think some people realize how important humor and their life is and it's very very important to me clearly as you see the path ahead and thinking about work and I know you mentioned that when you were considering your values you were thinking about work at that time +C: mm-hmm +T: how if at all do you see possibly utilizing these core values family responsibilities cleanliness and humor in thinking about what your life could be like with work it work? +C: huh well right off the bat I thought of crime analyst because most work environments you know they want you to keep your workspace clean I have to tell you I had a job a long time ago and I was driving around and I would spit sunflower seeds out and just made a mess on my truck and my boss didn't like that I was young I didn't know what the big deal was but now that I'm older it's like +T: okay that's a really important a site to bring through the workplaces having a clean workspace or being like remembering that cleanliness is important in the workplace being a good work partner +C: yeah right because other people don't want to be tripping on on my clutter and +T: of course responsibility because if your employee there's always that expectation that you'll do what is asked of you or that you'll do what you say you'll do and you know you can do that right +C: yeah I think I can and I'm not exactly sure about family but humor when I think of humor and working I think of getting along with coworkers and you know that's that's an important aspect to work to is being able to get along with others and I can do that most of time sometimes I'm not so great at it my humor can be a little bit biting so I might need to watch that sometimes +T: yeah so you really think about others and how they interact with you +C: mm-hmm +T: and who you are as a person that's those are all important things for you +C: it's important for me to know or to have them think highly of me +T: well thank you very much William for taking the time and really thinking about your core values and you mentioned this it was difficult to pick um and you shared a lot about about who you are and and sometimes it may be a little uncomfortable and thinking about those those things that are really most precious to us and I just really wanted to thank you for that opportunity to really get to know you about her and I hope that I hope it was useful for you and that we can use it together in our work figuring out what the path ahead might look like he'll work in your life how can I remember these what do you think when you when there are things that you want to remember in your life how does it work for you how do you typically remember things I think I need to write it down so i'll write it on a piece of paper +C: sure +T: keep it with me +C: yeah +T: yeah something that you can maybe take no doubt +C: mm-hmm +T: how do you think you might use it? +C: well that's a good question Oh ideally when I'm in a situation where I think I'm not getting along well or if I think things aren't going so great just in general or I'm really thinking negative about self is when I could pull it out and look at it and get a reminder so that's something I'll have to keep in mind i'm not sure how much i'll do it but i'll at least it's there and it's a start +T: it's interesting to consider who it might be something as a reminder to yourself about what a really responsible person and that humor is also important to you +C: yeah +T: those things that are most important the guiding principles in your life +C: yeah yeah \ No newline at end of file diff --git a/HighLowQualityCounseling/transcripts/high_120 b/HighLowQualityCounseling/transcripts/high_120 new file mode 100644 index 0000000000000000000000000000000000000000..606960d92d60fd074f65553150558f1f93237832 --- /dev/null +++ b/HighLowQualityCounseling/transcripts/high_120 @@ -0,0 +1,26 @@ +T: so what brings you in today lalamon +C: my son's behavior is just what you won't listen to any others he goes out whenever he wants to go out and his father and I are just fed up with it and his father's already said it since he turns people call along so they're coming getting distorted putting in jail +T: in frustrating because you have no control of the house +C: well yeah T dislike these it was kids running the whole house +C: yeah we don't like he doesn't want everything +T: so you wish you had that pants and power where you can be able to get your son to do the things that you and your husband would like for him to do +C: well yeah I wish I had that power but he's not all this things to do to us he's already decided that he said said he said I was then they all do whatever I wanted so what's the point what's the point of even trying +T: sounds like you've given up on yourself to be able to use those parenting things to try to get him to be able to listen to your house he's gotten physical +C: yeah would especially with my husband swing at it first came in it can be kind of scary to live in a house with a adolescent male getting physical when he's upset yeah it is scared because I don't know how he's gonna react and you might be just fine today and tomorrow just for no reason he's exploded and a lot of weather can hit me take off what did he just tell me home so yeah I don't know what to do +T: and you tell me something well one thing I am here is that you guys are working really hard to try to get your family back on track and get your son back to the place where you guys can have that a better family family environment +C: well all the things we try they don't work tries it didn't work and he tells me something I try that work +T: one good thing is you're willing to trust them to something you really try some new things because you're open to that you've tried and you kind of said you gave up a little bit but what you just said that I heard was that you are willing to maybe pick up and try some new things that might be helpful +C: well if there's anything because I think we tried at all so feeling kind of doubtful that there's anything else I don't think about nothing else is work so why would people go ahead and tell me the best that that works to begin with +T: well the good thing is we know things that don't work so we don't have to do those things over again okay so if you had to rate it on a scale of one to ten how how important is it for you to try to strengthen your parenting skills with your husband? +C: I guess one being I'm not doing anything else I've done everything else I can do and me know we really you to try they really need to check well it used to be more for now it's probably about five or my husband is probably +T: about you want right something's going through this for a really long time and just feeling like you're the point where you want to be loved but you did say a five and you know that does leave room for hope so why wouldn't you say a two or one like your husband? +C: cuz I because he's my son and I haven't given up and I care about him and and I think I know he can do better I just don't know how +T: so you are very hopeful for your family and for your son just would you be willing to continue to work with me to to learn some of those things maybe I can be helpful for you to try to find some things that might fit for your family +C: well I willing to try mm-hmm +T: we got to get him in here and see if we can get you to on the same page but at least you're willing to say that you're willing to try +C: yeah I have good luck with the elbow +T: wow so you would be willing to come back in here next week and be able to sit with me and they kind of go from there new ways to work with your family and not try those always over again +C: yeah +T: yeah we can pops up another water problem +C: okay +T: okay well then I'll see you next week \ No newline at end of file diff --git a/HighLowQualityCounseling/transcripts/high_121 b/HighLowQualityCounseling/transcripts/high_121 new file mode 100644 index 0000000000000000000000000000000000000000..5236177f6e039cc4225ba7253c2fd64800b04de7 --- /dev/null +++ b/HighLowQualityCounseling/transcripts/high_121 @@ -0,0 +1,151 @@ +T: Hi Emmy. I'm Denise. +C: Hi. +T: I'm one of the advocates here at the center. +C: Nice to meet you. +T: And how are you? How are you today? +C: I'm fine. Thanks. Well, strange, feeling strange for this but okay. +T: Yeah it's something really different for you? +C: Mm-mm. I have, I have not done this before. +T: Well why don't you tell me a little bit about what brings you here today. +C: I'm not even sure. I I heard, about this place and that you work with women who are, having trouble with their relationship and are confused and so, I thought I'd give you guys a call. And so, I'm, thank you so much for taking the time to see me. +T: Yeah. So you're, you've heard a little bit about the program here. Would it help if I just explained a little bit about what, what my role might be today +C: Yeah. +T: Yeah. +C: Yeah. Cuz I don't know what to do. +T: Yeah. What I want to reassure you of is that i'm not here to try and tell you anything that you might need to do or to try and give you advice or any information at all. I'm here to help you in whatever way is useful to you. Just sorta sort out what's going on and what if anything you'd like to do differently. So, this is really up to you. What you would like to explore today. How does that sound? +C: That sounds really hard because I'm not sure I'm very good at sorting things out myself. +T: Yeah, so right now you're feeling a little overwhelmed with everything that's going on and you're not even sure where to start. +C: Yeah, that's a good way to put it. I'm kind of confused about what to do next. I have a little baby at home, so I don't, I can't think, anyway most of the time. +T: Yeah. So now anything, any kind of decisions you make or anything that you do, effects both you and the, and the baby. +C: Huh, uh-huh. And, and my, boyfriend. It, it affects him. Which is why I guess I'm here, is to talking about him and me and the baby and how we work together. +T: Yeah. Well, if you're interested or you're willing, why don't you tell me a little bit about your story? +C: I don't know where to start. He and I had been together for about a year. And I got pregnant right away and we, just had this baby a little while ago. And, and before that I was working and, he and I, you know, we're on and off here and there. We, we get in fights and he disappears for a while and then he comes back. That's kind of what the years look like. And I've just been getting more and more confused on what to do, and recently I did something really that didn't even look like him. He looked like a different person, and it freaked me out. And it freaked the baby out. And, quite honestly, it freaked him out, too. He didn't, he said he, he didn't know what happened and he felt he said he felt out of control. +T: So the, in the history of the relationship over this year, it's kind of been in and out in a way. And that there have been some incidents where you've had some arguments and separated for awhile and gotten back together. +C: Uh-huh. +T: It does sound like something pretty significant happened that sort of Freaked everybody out. +C: Mm-hm. +T: And all, all of you. The baby and you and him and, and was kinda scary. +C: Mm-hm. Mm-hm. Yeah. He, he came home. I was, a friend had come over, a, a man friend. He doesn't like me to have men friends. He came over to help me with my resume. Cuz I'm starting to think about going back to work. And he had a weird look in his eye and so I kind of, you know, sped up and I kind of let my friend leave but soon as, right after he left, he he kinda just got this dark, scary look and he pushed me onto the ground and and it was just different than anything that ever has happened to me or to us together and. It, he just got this weird kinda like he was possessed by something and he said he didn't, he would never do that again. He is such, he is a really good daddy and he really helps us out a lot. +T: So in a way it doesn't, it didn't even really make sense to you or to him, because on the one hand he's really good, good with you, and good with the father, I mean good with your child, and on the other hand it was like what is this? Something really different. +C: Mm-hm, mm-hm, yeah and he's, he's he really helps us out. And I didn't know what to, to do with that. So that's why, that's, I guess that feeling that I have had since that happened has prompted me to call somebody to figure out what to do. +T: What, what are your thoughts right now about some of the options out there for you to do, if, if anything? What are, what are you thinking about? +C: I haven't talked to anybody for a year, really. +T: You've gotten pretty isolated. +C: Yeah. Yeah, I haven't. My parents live pretty far away, and, I guess he's kind of, my boyfriend's kind of I guess the word's jealous. He just really cares about us. +T: Yeah. +C: And so I haven't had a chance to really talk to people about what some ideas would be that wha, what could I do? I used to work, and I was kind of looking forward to working again. He's he's sorta made it clear that, that I don't need to work because he's gonna take care of us. He brings home diapers. +T: Mm-hm. +C: And gives us some money when he's around. And so, we really don't need it most of the time. +T: Mm-hm. So you had been kinda thinking about maybe going back to work and doing, doing some of that on your, on your own. And, and yet he, he doesn't really, he's expressing that he'd like to be able to take care of you and- +C: Yeah. +T: And when he's there he, he does take care of you? +C: Yeah, yeah. And yeah he does take care of us. He's a, he's he makes sure that I have enough money for, you know, for the basic needs in the house, and he pays the rent, and you know, but when I, when he's gone and I run out of money, it just kind of, that's when I think, God I just wish I could take, do a little bit by myself, I'm just not sure. +T: Yeah, yeah. +C: How to go about doing that. +T: Yeah, because that leaves you in a real bind, when you're, you're there and you don't have what you need. +C: Mm-hm, mm-hm, and I, yeah, and I don't know who to talk to about that. +T: Yeah. +C: I try to call him sometimes, and make up. You know, and say sorry for the fight that we had. And sometimes that works and sometimes it doesn't. +T: Yeah. So you kind of find yourself when you're in that bind trying to find ways of, of getting, getting what you need met, and, yeah. +C: Mm-hm, mm-hm, mm-hm. Yeah. So I don't know to do this. I mean I don't know what to do next. I'm not very good at it. +T: I just wanna say we, we can go over some things that are potential to talk about to really focus on that might help you. But I just want to let you know that this is, I really appreciate, how hard this is to be able to talk about it and it's, it's not an easy situation and you're definitely not alone and I really appreciate your willingness to talk about it. +C: Thanks. It's really hard to. +T: Yeah. I know. There are lots of different things that we can talk about that are, that, that many women in very similar situations find themselves. And things that we can talk about and focus our conversation on that might help you just sort of sort out and figure out what, if anything, that you want to do differently or how to, what your next step might be. +C: Okay. +T: And, and, some of those that we work with are like talking about the relationship. You've mentioned a few things about your, your relationship and how it kind of goes in and out and it's, can be really good and then he can be gone for a while, and just sort of sorting some of that out about where you are with that. We can certainly talk about resources, about the resources in the community that may be there for you or in terms of your own understanding, but also if you are in need of additional help we can talk about those. +C: Oh. +T: We can talk about safety planning, I mean one of the, one of the important things is to try and help you find a way to make sure that you feel good about keeping yourself and, and your baby safe And we can talk about that. We can talk about finances. You mentioned you were thinking about going back to work but that you were relying on him right now. +C: Mm-hm. +T: We can certainly explore that a little bit more. Taking care of yourself, which- +C: Yeah right. +T: Yeah, yeah. For many, many new, new moms, that's hard under any circumstances, to find a way to take care of themselves and keep themselves healthy. So that's certainly something we can talk about. And also, just the whole issue about taking care of your child, and, and your, your mothering, your parenting. How you might, how you might, focus on that and, in this situation. +C: Mm-hm. +T: Or there might be something else that you feel is really important to deal with right up front just to start with. +C: Mm-hm. +T: What do you think? +C: Well, it, it's it's funny, as you're showing me this, I, I've been thinking that all I've been doing is focusing on the baby, and being a good mom, and and, and yet, I'm also trying to think about getting a job, and I don't know how those two, fit together. And even as I'm just saying that out loud, I'm not even talking about taking care of him, which is weird that I'm not even. When I look at this, these circles I, I'm looking at mothering and children and finances and that seems to be important, yet I'm spend, I spend so much time thinking about him all the time. And right now I'm not. +T: Mm-hm. So maybe y, y, you spend a lot of time already thinking about your relationship and really struggling with w, w, what it, where, what it means and where it is. +C: Mm-hm. +T: And now you are kinda think well maybe I oughta think about some other things and see where I might go with those. These things, if, if, a job and taking, learning how to be a better mother and might be might help the relationship so that might be. So it might be a way of focusing on how, how you might be able to take care of yourself. Get, get a job or look at the possibility of doing that, and the same time trying to incorporate your, taking care of your child. Tho, those things might help you and might free you up to figure out then what to do about the relationship. What to do about the relationship. +C: Yeah, what to do about the relationship. I'm not sure what to do with the relationship. +T: Mm-hm. And, you know, you, you're the only one that, that really will know about that. About the dealing with the relationship. About what, when the timing is right for any decision that you make, one way or the other. +C: I don't even know what to think about that. I don't know how to. +T: Yeah. +C: I don't feel like I can make any decisions. +T: Yeah. Well, and it sounds like you'd like to think about making some decisions in other areas and, and, when you think about. Was that, was that right? Would you like to focus a little bit on just the possibility of getting a job. Is that something you'd like to talk about? +C: Yeah.And how to balance that with being a mom at the same time cuz that sounds really hard. +T: Well, you mentioned earlier that you had kind of been thinking about going back to work- +C: Mm-hm. +T: When, after the baby was born. What, what thoughts do you have about how you might go about balancing that and, and, and thinking about, thinking about that? What have you thought about? +C: Well, I guess I think initially that I would need his help more. He would need to help take care of the baby. He didn't do that now, so I don't know, and it'd be kind of scary, that, I don't know what that would look like. So I would have to find some other help to get, to be able to go to work, even just part time. +T: Mm-hm. +C: So, I've got to get some child care or something. +T: Yeah. So you might have to explore some other options for the child care and, and other ways of taking care of the, the baby so that you would be still okay about going back to work. +C: Yeah. +T: Yeah. +C: Yeah. Somebody I trusted. +T: Yeah, yeah. +C: And I'd have to figure out, just the timing of that and a job that would fit a schedule where I could still, breastfeed and help her with her naps and make sure that I'm there for bedtime and all those important times. But make enough money that it was worthwhile to do it. +T: To, yeah, to be out and working and paying somebody. That sounds like a lot. +C: Yeah. +T: It really does sound, though, like you, you're really deeply committed to taking care of your child and providing the kind of structure and, and, and things, the basic needs, and really taking care of your child at the same time. +C: Mm-hm. +T: Yeah, yeah. +C: It's very important to me. +T: Yeah. +C: I didn't think I was, I wanted to have children and then we did so I would like him to be a daddy in that, wow, just realized I was thinking about him not being around as a daddy and I'm not really sure what to do with that. +T: Yeah. +C: But the babe, the baby is the most important thing right. I didn't realize that, I'd spend so much time thinking about him all the time. And when is he gonna be back and does he love us and why the heck did he do that, that weird thing and why does he care about these other things that he cares about. +T: Being jealous and not wanting you to have friends. +C: Yeah, why does he. And it has nothing to do with what I'm thinking about now, which is the baby and, huh. +T: But it's, you've mentioned that a couple times now that it's, that it sort of surprises you. They way you're thinking about it and the way you're approaching it. Like, you, you're recognizing or seeing that you have spent a lot of time really agonizing over, over the relationship and, and why things are happening in the relationship, or what it really means. You've spent a lot of time there. That kinda surprises you that you might be thinking about it differently. +C: Mm-hm, agonizing. I guess that's what I've been doing. I feel like I've just been hoping and wishing and it seems like all my focus is always. So, when the baby's crying, I'm, I'm worrying about him, and, and and I so the baby crying is, is just, it's hard. But but if, just now talking about it, letting go of worrying about it feels kind of freeing. That I could actually think about why the baby is crying, as opposed to why is why is he not returning my calls or why did he give me that look when I, you know, talked about getting a job and things like that. It's not, so. Interesting. +T: So, you're realizing too, how much it really takes to focus attention on the baby and to be able to do it and it's like I, I, I it's hard to do both. +C: Mm-hm. +T: It's hard to really think about doing both. +C: I need his help with that. +T: Yeah. +C: I don't need to be worrying about him too. I don't understand what safety planning means. +T: Well, one of the things that we, we look at is trying to help people who are in, in a situation similar to you. Where, where there might be some, where there might be some fear about something that could, that might happen, or you know. And I know you said he, he, he had indicated that he wouldn't do it again. But sometimes it really helps people to feel, to have some plans in place for what you would do if anything came up and how to get you and your baby safe if that's what needs to happen. So if he kinda got that weird look in his eye again which, actually, I've seen before, but he just never really did anything like this before. +C: Mm-hm. It just went farther this time. +T: Yeah, okay so like if I recognize, if I saw that look, what to do? Is that? +C: Yeah, +T: yeah and, and, and sometimes that ties in with, you know there might be places that you can go to, to get safe. There might be steps that you can take to, to really keep yourself safe. Or make sure that the baby's safe. Or people to call, or thing, just things that you can do based on what your life is like and what you, what resources you have available to you. +C: Mm-hm. +T: Is that something you're interested in really exploring? +C: Sounds kinda freaky to think that I would have to keep myself safe from somebody that says he loves me and, you know, loves the baby. Sounds a little strange. +T: Mm-hm. Some ways it just seems like it shouldn't have to be that way. +C: No, it shouldn't have to be that way. But it, I didn't expect him to do what he did either, so. That kinda came out of nowhere. +T: Yeah. It really took you by surprise. It's something that you're just trying to figure out where. How does this fit and what, what does it mean? +C: Yeah. +T: And what do I do with it +C: Yeah. +T: How do I, how do I respond to this +C: Yeah. +T: Yeah. +C: It doesn't seem real. So I guess, thinking about, thinking about that kind of makes sense ahead of time. +T: Yeah. Well, let me see if I, if I got it all, and then we can make some decisions about where to move from here or how to take the next step with that. And I wanna make sure I, I understand a little bit about your situation. +C: Okay. +T: And, this, first of all, this is the first time you've come in. This is the first time that you've had something that really happened, this incident that happened where he pushed you really, prompted you to, to take some steps. Because it's scared you. +C: Mm hm. +T: Mm-hm. You have this relationship that's been kinda off and on and but he's been very supportive and helpful in terms of giving you, meeting your basic needs and the baby's basic needs and wants to take care of you. +C: Mm-hm. +T: And, and there are times when it's really good. And there are times when you've been less sure. And this is, this incident has also made you kind of think about that. +C: Mm-hm. +T: Some of the ways that you've been thinking about or, or thinking about it now kind of surprises you. But you're looking at thinking about the possibility of maybe working it out to go back to work a little bit. So that you can have more financial independence, if you will, or be able to take care of yourself for those times when you need to. +C: Mm-hm. +T: And you're starting to toy with the idea of maybe it might be useful to have a really good plan to keep yourself safe. Did that kind of get it all? +C: That, yeah, that kind of captures it all. I'm not yes, yeah. I don't know. I don't know where to start. +T: Mm-hm, mm-hm. +C: But I guess that's why I'm talking to you. +T: Yeah, yeah. So, maybe we can, we can take that next step and, and and. When, when, when we get together again and we can do that. We can just take the next step and start looking at some planning for both of those, in both of those areas. +C: Mm-hm. +T: For keeping yourself safe. And, and for, you know, looking at the possibilities. Cuz there are options and resources out there should you choose to, to, to make the decision to go back to work. +C: Mm-hm. +T: There are some options for you. +C: So, there's like a good, somebody can help me work on my resume or something like that? +T: Yeah, there, there are other options for, for, for a variety of things and we can make some, have some discussions about that. +C: Okay, okay. +T: How does that sound? +C: That sounds good. That'd be nice. +T: Well, I, I really appreciate again your coming in today. And we will follow up with this conversation and in you, you will have, \ No newline at end of file diff --git a/HighLowQualityCounseling/transcripts/high_126 b/HighLowQualityCounseling/transcripts/high_126 new file mode 100644 index 0000000000000000000000000000000000000000..80cfa5bad4f5a7a453a9d58bac5917dc0405f897 --- /dev/null +++ b/HighLowQualityCounseling/transcripts/high_126 @@ -0,0 +1,33 @@ +T: hi Jerry how are you doing today +C: good how are you +T: I'm good things just wondering how you've been doing since you at the hospital +C: um yeah that's what I've had are we laughs from my depression but I've been doing go with it for the past few months and I've been on some antidepressants and I've been having some going to group therapy so that's been helping me a lot and then I kind of smoking a lot but some pad a lot Ollie asthma flare ups and shortness of breath +T: so you're making some progress so in a group therapy improving with your depression but you're experiencing some symptoms from your asthma you do a bit more about that +C: yeah that's what I can't really run as far and like this when I'm going for a little walk from anywhere I kind of have short power beyond shortness of breath and I just get fatigued really easily I just kind of noticed that how about longstone function like they used to +T: okay so you're getting some shortness of breath and fatigue really easily would it be okay with you if we talked a little bit about your smoking today +C: um I didn't really come in here for a terminal had that much time so i don't know i was just like to get back on with the appointment +T: okay I mean I totally understand that that's a difficult subject to talk about and it's completely up to you I just would like to talk about it with you because I do think and have some magnificent on your health today I'm worried about how it's affecting you in your day-to-day life would it be okay if we talk about your health issues and we can kind of slowly talk about it get into that will take a while we keep making a squeaker as long as you want this is your time and we're here for you +C: okay i guess i'm going to talk about it for a little bit +T: ok so in your everyday life how else has being affected you other than the shortness of breath and the fatigue that you've been experiencing +C: um well I'm around my my knees often and my my brother hasn't really want me to washing her unless I like stopped smoking because she gets all the second hand smoke and my my dad died from lung cancer so they kind of suspected that was from smoking so that kind of scares me +T: okay so that's a negative aspect of smoking for you is that you can't be around your niece and that your father has died from smoking so let's talk about maybe some of the positive things that smoking guys for you +C: um that's what it kind of helps with my depression it kind of relaxes me I feel like if I stop smoking it would probably make me relapse and i would start having the suicidal feelings again and also it's kind of like a social aspect where I kind of hang out with my friends and +T: okay so now let's talk about the opposite side we're going to talk about the pros and cons of stopping smoking so what would be some of the negative things if you stop if you decide to stop smoking +C: um I guess I want to be able to hang out with my niece as much as I would like to I might follow along the same path as my dad and I mean I'm sure my lungs would probably get worse if I keep smelling my asthma probably get worse +T: so your eyes one would get worse you can't be with your niece is often and you would be going along the same path as your dad which is ultimately death so let's talk about the positive things of stopping +C: I know I would say a lot of money I would probably have less symptoms my asthma unless short of breath and how you see my knees were and I prod us have an overall better life as much smoke smell my clothes +T: so after we kind of talked about the pros and cons ultimately you have a lot of pros to that you enjoy about smoking it's a social aspect and you enjoyed in a house with your depression but also there's the opposite side where you can't spend as much time with your niece as you want to expect your health it's expensive there seems to be a lot of negative things that you described um well how do you feel about that but there's kind of this discrepancy between the two +C: um I mean it's a really hard decision but I feel like my house is like the ultimate matter +T: so I think like that comes first but again I would just be really hard to stop them like you know in this habit well I definitely applaud you for considering it because I know it wasn't something that you claim to come here to talk about and this was on your schedule but it's definitely important to your health and I'm just like to ask you on a scale of to with being not ready to change at all intending but you're ready to change right now right this second where would you lie on that spectrum +C: well after listen all those pros and cons i guess i would say around a six or so +T: ok so y is and not a two or three +C: I guess it made me step back and kind of realize that I might be following the same lifestyles my dad I could probably end up dead like him from lung cancer and I mean one of my made things that I enjoy like in life is watching my knee so I feel like it would be best for me to style +T: so why a six and not and eight or nine +C: how do I haven't really thought about that much before so I feel like it will take a little time for me to get there but her dad it's just breaking the habit will probably be the most of calls +T: so six is a great start and I definitely think that that's something that we can work with together on do you know of any thing that will help you quit smoking? +C: um I guess I could hang out with another different group of friends or just maybe kind of stay back if they're smoking and try to find something else to do I could also maybe do something to like exercise to kind of get my mind off smoking or do something they'll be beneficial to my health +T: yeah so exercising did different group of friends that maybe isn't it revolved around smoking with that there's also group therapy that I know you do for your depression which is also awesome to help people stop smoking and we can give you some pamphlets and give you a number that we can set you up with have you ever considered nicotine patches +C: um no I haven't really thought about it but now that you mention a hug I'll probably look into it +T: okay so let's get you the number and we can discuss the nicotine patches are an alternative for you that would work we can schedule an appointment or in the next two or three weeks and see the progress that you've made and I really am glad that we had this conversation and it seems like you're readily ready to quit so that's awesome +C: yeah thanks for talking to me +T: yeah of course \ No newline at end of file diff --git a/HighLowQualityCounseling/transcripts/high_127 b/HighLowQualityCounseling/transcripts/high_127 new file mode 100644 index 0000000000000000000000000000000000000000..55ae5c3e1a6c4384a8d0e215622c58adcf5cddc9 --- /dev/null +++ b/HighLowQualityCounseling/transcripts/high_127 @@ -0,0 +1,51 @@ +T: hello my name is Tenzing I'm a certain nurse from Humber what is your name +C: Angelina Jolie +T: hi Angelina how are you doing today +C: I'm doing good just I'm having a hard time dip finding time to exercise +T: I see um before we talk about that I want you know that whatever we talk about today is going to be kept confidential +C: yeah +T: so let's talk more about what brought you in today +T: i have type diabetes and i know i need to exercise to help man to my diabetes but i just cannot make time for it i wish i can find ways to manage my time +T: mm-hmm so you wish to make time to exercise so you can manage your diabetes +C: yeah +T: um what are the benefits of not exercising to you +C: won't look and I just I don't see any benefits of not exercising +T: and what are the costs of not exercising +C: it will make my diabetes for is to a point where I have to start taking medication on say +T: okay so what are the costs maybe of finding time to exercise +C: mm i would have to make time out of my busy schedule and cut down on things that I like doing my family's like watching soccer I'm see okay and what are the benefits of finding time to exercise if I exercise little hot marriage and will keep me from taking medication and see +T: so let me see if I understand this correctly so you recognize that exercising is important to control your diabetes and to prevent yourself from taking medications to prevent diabetes um so you also mentioned that to exercise you have to cut down on your family time which is also valuable to you exactly okay son how long will just say from now would you think that you know you take make this change let's say probably within a monk okay so and how on a scale of zero to ten like how important is it for you to make this change and zero being not not not important at all and being the most important +T: I would see having nine out of ten +C: okay and why is it nine another two or lower number +T: because like I said it is really important for me to manage time to exercise so that my diabetes can be managed and controlled +T: and on the same scale of zero to ten how confident are you in being able to make the change +C: I soon I'm probably at eight at a time +T: okay and so would I be correct in saying that it's very important to you so it's nine out of ten to make time to exercise to stay healthy and mainly to avoid having to take medication to manage your diabetes and your confidence level is at eight out of ten and being able to make this change +C: yeah +T: okay so looking back is there a reason that you haven't been able to make time talk to sighs +C: hmm I just have a very busy schedule with work with kids and also my wife works awesome so it's really difficult to find coming to exercise not only understand +T: okay so how would you like for things to change +C: I would like to have more time to exercise at the same time spending time with the plan is important to me +T: I see so what kind of things did you do to control your diabetes in the past +C: being physically active whenever possible I see +T: that's good can you probably give me an example like the activities you did and when was the last time +C: I used to take my I used to go to the park with my kids um go play soccer with them but then these days they're on I palatal its best everyone that was about a couple of months ago I see and how likely are you able to find time to exercise now I'm sure that I'll be able to make time because if I try my best because my health is important to me +T: mm-hmm and what makes you feel that now it was a good time to try something different +C: I think it's important to make change before it's gets gets to a point I have to that we use with medication +T: mm-hmm so we should like to discuss some of the things you can do to make time to exercise +C: I could take the stairs inside an elevator and watching the brushy brushy store +T: well those are some great alternatives instead of going to gym you save a lot of time so did you we want to know did you want to know more things or ways to find time to exercise +C: yes I feel like that'd be really helpful +T: okay so since you mentioned that spending time with your family was something that you really value ah you could probably and watching software he said you could you know put a treadmill like a exercise machine near your TV Here I am so you can exercise and watch your movie or software with your family and what you can also probably plan outdoor events or outings with your family something that your kids would enjoy so that they can be off their iPads and technology +C: yeah +T: those are something you can do maybe go jogging with your family +C: yeah yeah I think those are some really doable strategy sagging contribute to my daily schedule +T: mm-hmm so now that we have had this conversation um how do you feel about you know making time now to exercise +C: mmm now that I have different ideas on how to exercise I feel more comfortable or capable of finding time to exercise +T: and would you like you know other maybe more sessions to follow up +C: yeah that would be really helpful +T: sure and when would you like that for probably +C: um next month +T: okay sure see you next what then and I really appreciate you showing up today and making an effort to come here to discuss your condition and you know what making time to exercise for your diabetes +C: thank you +T: thank you for your time \ No newline at end of file diff --git a/HighLowQualityCounseling/transcripts/high_128 b/HighLowQualityCounseling/transcripts/high_128 new file mode 100644 index 0000000000000000000000000000000000000000..43c99b2d6dbcb543c92b3d6abfbceec584b89dce --- /dev/null +++ b/HighLowQualityCounseling/transcripts/high_128 @@ -0,0 +1,68 @@ +T: Brooklyn hi it's good to meet you I see you've made yourself comfortable +C: yes j yes +T: so thanks for coming you today it's good to meet you Emily yes so would you like to tell me why why you came here today +C: I made me don't know what +T: hmm dunno +C: what what you know I don't get myself +T: mmm so your mom made you come here today +C: yes she thinks i was on computer too much that i did not agree that right +T: she's your mom thinks you're on the computer too much spending too much time why have them here yes and you don't think +C: that's true I do not think that this truth I do not +T: well tell me a little bit about what you like to do on the computer +C: let's watch gameplay videos of Minecraft where the role play mmm that's funny roleplay +T: yeah something a little bit about that do you have a character that you roleplay +C: yep I don't play let's go that night they really gonna and Jesus which would be a cat girl OMG and she has red eyes that aren't stairs a pretty long brown hair a black hoodie shirts and black high top converse and she's a dark angel dark angel princess +T: do you think Lily the dark angel princess you think there's any of that character of you do you see yourself in Lily +C: yeah she like me except like some characters is like her well anything like how she she loves but dislikes her mom doesn't mean exhibit my dislikes she like really hates her mom cuz her mom and legs for a twin sister more than her mmm female they really like the same +T: so it sounds like there's very similar stories to you Lily the character on my breath yes and you also said you like to YouTube +C: yes and I'm watching other people and they make them for us people to watch and half now and not her videos she saw just pull magical gig cats and puppies mmm can't can I can tell you a thing for kick ass +T: well you say cheerful funny so it's a lot of fun yes +C: mm-hmm and she makes funds yeah what's it with a cat pun like guinea and her shedding is a cat-tastrophe +T: yeah so I'm talking to you gee what I hear is your mother thinks you're on the computer too much yep you don't think that's true you seem to be enjoying yourself that around here yes does your mom know that you're having fun when you're on the computer +C: I don't know I mean I think she wouldn't know he doesn't actually throw ups me I get upset and very annoyed because I have to post my video +T: mm-hmm so your mom interrupts what are the race some of the reasons that she interrupts you probably from you throw something away go to track and one where she was nows on the opposite side of the house and let's I think that's the main one so your mom asks you to throw away things unnecessarily do something that +C: she I know she can do because my foyer oh brother can do it and she's she couldn't do this +T: mm-hmm so she doesn't need me mmm just like a little much hmm he has more energy so do you usually spend time on the computer alone in your room or where's the computer in your house +C: I usually keep it in my room mm-hmm my bed with a cat hmm +T: so when your mama drugs you you said you have to pause the game when you get frustrated +C: cuz I'm coming like times in one out she knows she's seen +T: it all if you can imagine why your mom's doing that what do you think would be her reason for interrupting you so that hard way see but doesn't have to get up mmm because you have to tell me hmm I understand watching well it's frustrating yes well it sound like you care what your mom thinks +C: when she says my hair is next that hurts my feelings +T: mmm +C: because she's supposed to be MERIS follow us dogs news I am I have to say I need you here it's pretty fabulous too +T: yeah so your mom interrupts you when you're on the computer um and she ever taken your computer with you or tried to stop you from playing with appear +C: yes she has one time like I didn't need you I shouldn't screw you cuz she ain't on my gummy bears mmm that's a reason j omega versa which is something all of your moment no you get mad mmm my brain turned up you I wasn't in control mmm oh gosh possess me think that's it that's what happened and that happened and then I can use my computer my phone my kindle mmm nothing come in watch TV for three days no electrons for three days yeah night watching TV can you wash them as I didn't want to read all the books at around ten times how many new books so I literally had nothing to dip closer lost all my pencils like a drop +T: so how did it feel when you couldn't play with your xbox you couldn't play with your computer you couldn't look under candle you couldn't play with your phone you can watch TV it sounds like you were left without most of the things you enjoy the most yeah how does it feel +C: it felt like as much to explode or die at any moment and I asked if I have my electrons back mmm I've been a second day +T: mmm couldn't wait ain't no because when you have notebooks like all the books you have our books are very red don't want to read anymore because like you just think of the whole story three head all right just don't let the book in general you look like fences for drawing hi there's nothing to do you will explode mm-hmm do you have any ideas of things you could do or alternative ways to spend your time how did you handle that those three days without your computer +C: I did not handle the I have a pencil just as wasted my time I think she could draw since I have the hunger games series now but an earlier in the year I can read I can't read though stop going to bring back +T: so you have three days without your electronics how are you able to do your homework +C: well um i think it was around left school hmm i don't think i have homework i think is on friday and then well it's difficult to find things to do +T: well I've met quite a few children who have trouble finding alternative ways to spend their time besides electronics most of us are on our phones or on the computer or emailing each other I'm sure you have texting I'm sure you have a lot of homework you have to get done on the computer typing paper and only you can decide what interests you oh it's essential I used to come here mmm so it's necessary right if you want to be a game developer you feel like this is a learning experience for you to get used to play on computer so that you can actually bring it into your professional life later hmm there's your mom realizes +C: I've said a billion zillion convoy like in front of everyone doesn't be getting it up and I go up I don't nothing baby younger i dead +T: mmm so you told her many many times yes attention was missing well she didn't work mmm sipping yeah so it sounds like you you feel like she's not listening to you she's always on her fault she could have no face bone why should people calling people up up mhm she have to go to schoo +C: l said I was a dead bad days away +T: oh thanks Emma told Anthony so when you get home from seven hours of school five days a week plus you like to chill with your computer that's your way relaxing it sounds like yes and also I heard you say that you see your mom on her phone all the time so eats the fact that she's playing on facebook and texting while she's telling you not to be on computer seems very hypocritical to you +C: yes it makes me feel function +T: mmm you're angry yes so back to when you you had those three days about electronics you shared that you're reading books or you look back and you wish that you had had certain books during yes let's just say you had a chance to go back those three days and take fun things to do with you bit work relays your phone that weren't related to watching something on TV or netflix urn will get youtube or your kindle let's just imagine that we could go in time and take some fun ideas for things to do this in those three days in fact if you wouldn't mind I could share something with you that I've shared with other kids who have trouble thinking of things to do would you like to show you +C: sure +T: okay so here's a list and every person has their own preference for what they think is interesting your hobbies and that's what's amazing about how different we all are so no no see the dirt just there's something on that list it popped out you something looks fun something that you can't stay I'm doing this is just a general list of things that people do with your time reading and drawing listen to music +C: mm-hmm +T: do you have another way to listen to music besides your computer hunt down CDs +C: mmm +T: who's your favorite artists do you like listening to rap music pop music +C: I listen to all types of music but I think if I parties cheers one as a favor I would pin 's evanescent around +T: do you like spending time listening to music what about some of those other activities is anything else interest you that maybe there's something you've never tried before +C: me okay I like petting cats +T: well it sounds like your mom is concerned and getting on your case about being on the computer all the time not spending time with your really is this sound about +C: right and I know the good thing she doesn't want me on computer that's all I know mmm what +T: do you imagine she wants for you when she takes your computer way just imagine +C: oh she wants me find something else to do hmm how it worked then I realize air I did those things that I have my face makes me like you looking ideas with you what to draw no movie game mm-hmm I still need those movies +T: so your mom wants you to do things other than planned right here and you think you already do other things besides playing on computer yet hmm well you've shared with me that your mommy com so if you decide yourself to come see me let's just imagine what would you like to do in this time with me here for the next weeks how do you see us sharing your time together what would you like to do any sessions with me pet cats +C: mm-hmm +T: dead cats minutes we can pet cats do you have can I better have you written by elegance +C: mm-hmm +T: pit cast session pet cups it's all very great idea yes okay well thanks for taking a look at that sheet of activities um maybe you just hold on to that for next week and take a look at it and see if there's anything that interests you and maybe take it take a marker and circle it and we can take a look at exploring some different activities is that something the light interest you +C: okay +T: we'll have a good week and I'll see you next time you're so going to meet you +C: ok \ No newline at end of file diff --git a/HighLowQualityCounseling/transcripts/high_129 b/HighLowQualityCounseling/transcripts/high_129 new file mode 100644 index 0000000000000000000000000000000000000000..25c7807c6b58bc83cbde60cf4c7016ea85444790 --- /dev/null +++ b/HighLowQualityCounseling/transcripts/high_129 @@ -0,0 +1,38 @@ +T: welcome Jane I'm Stacey how are you today +C: fine thank you +T: that's good to hear is okay if we just go over a couple of your details +C: yes that's okay +T: okay so from the forms that you've filled in earlier today we found out that you're a year old female you have bad knees and have been recently diagnosed with rheumatoid arthritis you have recently sustained a tear to your right shoulder culturally you're from a Fijian Indian background you work part-time and have lived in Australia for years you mentioned earlier that you also assault Carol for you to disable children is that correct +C: yes that's correct +T: I appreciate how difficult it must be for you to look after your children by yourself now tell me what brings you here today +C: my doctor recently suggested I should lose weight and exercise more in order to take pressure off my knees and joints I know I need to lose more weight and my diet can be unhealthy at times and I don't exercise as much as I should I also find that my knees ache from cooking in the kitchen all day for my family and cleaning the house every other day you say your doctor suggested you to come here today but did you want to come here as well I think with my doctor making a point of me coming it bought it to my attention more I know I'm more a little overweight and maybe I should improve on my on my health for me and for my children say the doctor mentioned that excess weight was not helping the pain either +T: you said that your doctor mentioned that you should come here today that perhaps maybe I can help you some of these issues if you were to change or improve any area of your life where would it be +C: I guess to try and lose more weight and take the pressure off monies I'm starting to feel uncomfortable in my clothing and finding that I get tired when i walk small distances and big need to feel frumpy and heavy on my feet and I'd like to be not so puffed out when I walk small distances being on my feet so long makes my joints ache as +T: well it must be difficult feeling that way and uncomfortable hopefully I can help you with this how important is it for you to change your life right now on a scale of to +C: I would like to say about I think I'm ready to make a change in my life I'm always doing things for other people um I've been listening to my friends and they say I should start looking after myself more +T: that's good to hear that your friends are looking after you how confident are you being able to make a change in your life honestly +C: I'm not sure I've tried to lose weight before I lose a little and then put it back on usually when I'm busy +T: your stress +C: I'm not set on the fact that exercise can be effective for me when I exercise my knees hurt and I don't want to lift every ways I understand how difficult it must be for you to lose weight and put it back on again +T: but you did say that you could lose weight how did it make you feel at the time +C: I felt Gordon was proud of myself and I went out and even bought a new top +T: so it sounds like that when you lost weight you felt better that's great and why do you think exercise may not have worked or being so effective for you +C: I'm not quite sure maybe because I wasn't doing the right things or getting the right advice you could be right can you see that maybe at the time this is why am i noticing improvements I know it should have probably seeked out more advice from a professional again it was just the timing of it and I thought I could do it myself +T: I'm sure you could do it by yourself but a little assistance and some knowledge never hurts what do you think changed that made you potentially put the weight back on +C: I think because I stopped walking on the treadmill I wasn't really caring about the amount of carbs i ate at mealtimes and in my culture we eat a lot of rotor which is our form of bread we ate this with most meals I don't really do anything else but take occasional medication for the pain +T: okay it's important for you to recognize that amount of bread that you're eating probably wouldn't have helped and also the fact that you stop walking on the treadmill would lower your capacity to burn that food which an along one would affect your rheumatoid arthritis now that you say it +C: I probably knew that it's just Bernard recently to find the time and to get back on the treadmill I work part-time and my children take a lot of my time up so it's really difficult and I hardly get a minute to myself that's completely understandable +T: from what I can gather your main issues preventing you from exercise include time and family obligations basically +C: yes it's stress for loving to be the sole carer for my family I love my children but they can be hard work it must be but +T: you can see in order to lose weight and improve on your symptoms diet modifications and some sort of exercise need to be implemented into your daily routine yes that make sense +C: but do you really think that this would help me +T: of course it would but you'll need to be committed to your own personal improvements look at how committed you are although it is hard work looking after your family that's true I see your point what do you think it would take to change your mind about participating in physical activity +C: maybe being able to do exercises that don't take too much time up things I could do at home or it would be great if I could in of my children sometimes +T: okay so if you were given a program that was realistic with time and easy completed at home do you think you could do this +C: I think I could give it to go I want to improve my overall fitness I would also like to feel comfortable in myself and reduce the aches and pains in my body great +T: so it seems as though you have put a lot of thought into your overall goals what if i say to you come back and see me in two weeks do you think in that time you would at least attempt to start the program provided +C: yes i think i could give it a real girl and try to make it a priority for the next two weeks +T: on a scale of one to ten how confident are you that you'll be successful +C: i'm going to say nine out of because nothing certain that's an interesting way to look at it +T: hopefully we can get you to by the end of it hopefully so I can see you're willing to make an effort let's say we meet here in two weeks then hopefully it's hopefully you have some competing exercise of sessions and progress to show me I try my hardest that's all I ask for i'm looking forward to helping you through this journey Jane it was nice to meet you +C: you too \ No newline at end of file diff --git a/HighLowQualityCounseling/transcripts/high_142 b/HighLowQualityCounseling/transcripts/high_142 new file mode 100644 index 0000000000000000000000000000000000000000..3ee8bdacb1683dd5d3b1fd1df2ec7f6bef744960 --- /dev/null +++ b/HighLowQualityCounseling/transcripts/high_142 @@ -0,0 +1,36 @@ + +T: okay nice to meet you Rachel cause your day going +C: it's good it's a little exhausted from life that's about it +T: okay before we go any further isolation Oh yuck about their genius with with minutes together today I have a couple topics I'd like to discuss but before going where it is there anything you'd like to you +C: well I'd be minutes I only have minutes to spare +T: okay so we will be done is there anything like today +C: oh wow so my family doctor keeps telling me that I need to exercise because I type diabetes but I just don't understand why like I'm so busy with life and see how we feel sexy vibes +T: I completely understand your you have a busy lifestyle how are you going to fit exercise into that lifestyle +C: yeah +T: so can you tell me about your day from when you wake up to +C: sure well I wake up in the morning and i work a -hour shift at the factory then it comes home I have to cook for my husband clean the house make sure clean before i go to bed and then sometimes my kids come on the weekend or during the week because they're so far away they're not the university and just spend time with them I guess +C: okay so seems like you have a busy lifestyle and your doctor wants to include exercise into the lifestyle +C: yeah +T: why do you think your doctor would like to add to your heavy or your busy workload +C: he keeps telling me you need to be healthier it will help manage my diabetes and like I just don't understand why there's so many people my age most of my friends don't even exercise of their healthy like why do I have to exercise to be healthy +T: okay I hear you so on one hand you've gone all your life all day you've gone years and you're still you leave you're healthy and you don't think you need to add exercise or anything else like that but on the other hand to your doctor is telling you that exercise would help your diabetes and exercise will help you so what do you feel are some of the advantages of God working out are not adding exercise to hear +C: well not on the exercise I'm already like so exhausted by the end of the day so if I'm exercise to it i will i'll be even more exhausted so that advantage is that of a little more relaxed compared to when I will exercise and also like I get to spend so much time with my family if I don't exercise if I prepare an hour two hours of exercise and I will never get to see the kids see my husband spend time with them do activities with them and yeah +T: it's good to see that you really enjoy spending time with your family and spending time with your kids do you can you tell me about some of the important things in your life +C: well my feelings a huge part of my life I love spending time with them my husband and I are always together after work we don't we try to not separate and do our own thing you try to play together and then my kids are my daughter goes to University of Waterloo and mentor mostly University of Western so they're so far away from us I came to spend time with them like every single day i want to so when i get to see them i try to make the most out of it +T: that's really good to hear so your would be seriously you're proud of it proud of you too can and you enjoy spending a lot of time here of course yeah and you'd you cherish the time you get to spend with your weakest and me because you made it so get them to fit into your already hectic lifestyle yeah advantage of these people exercise +C: wow maybe I could influence else will be a little lower or maybe I want to keep important at all all four could maybe do some weight at the same time and +T: I think you'll be a good stress reliever when I run of the track down and also maybe I can include the heart center you can spend some time at the gym together and all the weekend +C: I can have a kid and we can have a little family care to the gym but if you don't they'll be exhausted and I've done so luxurious way that I'll be tired by the time I'm done at the gym +T: so it's my understanding that you feel like exercising with other than we needed extra help by reducing or eliminating your insulin insulin dosage it could help you lose weight after the stress reliever you can come out really take care I've been in your children we have attended at it but you're still worried that he was really diving not how to continue on today after telling some strategy diseases including your +C: maybe I could go like an hour or two before I was terrified to love is when I come back home all I just showered like that a lot that we don't have to worry about me doing anything after I'll just worry about getting epson experience part of the video +T: so you would change the time you go to drinks or the lines which one you want to go +C: yeah +T: and from what you're saying earlier you want to include your family and your husband or their bed we were straight the new year it support system comes with him any company any reason trying to see like +C: well i'm still looking they're always here to support you through anything about happening or motivates me once more like maybe if they come along with really likes you can do it motivation and support me and we can put together a movie we can all have a healthy life with my doctors own okay +T: so it looks to me like something and you're motivated scream and they will help you along your certain tone actual target any feel like if they're there with you then to improve monopoly entire thing and I'll just after the succession beauty like you have a plan +C: yeah I think I'm new start going to the gym this year they really went to me the next step is maybe after I'm done here i can get the gym class for likely be first to apply there and then in frigid spot for a whole year and start working again +T: have you tried? +C: me know because i always thought i would be exhausted but now that I figure out the timing a one to go and tough oh I can definitely do it Thank I'm +T: scale of one to ten one being you're not really sure at all ending returning to do with how how come are you in different as you don't go to you mate +C: I think I can do it well right now I know I want to do it I can do it but to reach his time I feel as I have to be doing it for a whole week of regular yes some medical school some wonder open to any sort of follower or check out after to make sure there's sure maybe I can come see you in a month and I feel like to know what I've been doing and maybe I since my fateful blocks from the movie activities yeah and let me know if my glucose levels are going down or what's happening official website so like always going to be to perform position with Kentucky's if we make success all in there over I maybe go for minutes minutes per day and we'll try going around seven o'clock +T: that way I concede little not your life better \ No newline at end of file diff --git a/HighLowQualityCounseling/transcripts/high_143 b/HighLowQualityCounseling/transcripts/high_143 new file mode 100644 index 0000000000000000000000000000000000000000..e796ceb474e6fe46ef6ece24078edafe1a49ce8b --- /dev/null +++ b/HighLowQualityCounseling/transcripts/high_143 @@ -0,0 +1,71 @@ +T: you leap in so far I'm still a little bit anxious +T: yes last week when you were and you were telling me that you were experiencing great anxiety and we had developed a plan a plan for your anxiety and according to my notes you were going to look into some yoga classes you were going to attempt to drink less coffee you were going to get out more with people because you were kind of isolating yourself in the home and you were going to spend more time in nature so I'm wondering how all that went +C: well I looked at the gym and there weren't really any yoga classes so I didn't I didn't really do that I did cut back on my coffee a little bit but I just find that it wakes me up in the morning so you know I've cut back to one cup instead of two cups and I did take the dog for a walk but I haven't really gotten out other than that +T: okay so it sounds like you've made some movement forward towards your goals you did at least look into yoga even though the gym didn't have yoga classes you did cut down from two cups of coffee to one and you did get out with your dog in nature for a walk but it sounds like you had a little bit of an issue getting out more with people +C: yeah I don't I don't really like to go out with people there's usually a lot a lot of chatter a lot of talking and it's hard for me to be in there +T: so it's uncomfortable for you to be out around people with all the speaking and chatting and talking and how does that make feel +C: um it just makes me feel a little bit nervous and then when I get out there don't really I don't really engage in conversation +T: okay so actually getting out with people actually makes you even more anxious so I'm wondering what we could do about that +C: um I'm not really sure maybe I could invite people over instead +T: that would absolutely be one option you could invite people over to your house and then you could get to choose who you're around +C: yeah it's a good idea +T: and in terms of the the yoga let's get back to the yoga format tell me more about where you looked for yoga classes +C: well I just looked at my gym I didn't really look anywhere else because I'm already paying to go to a gym and I don't really want to pay extra to go somewhere else so that's why I didn't really look anywhere else +T: mm-hmm and so if I were to ask you right now how motivated are you to find a yoga class on a scale of one to ten +C: maybe about a five or six +T: okay and so what made you say five or six rather than two or three +C: um well I I see all these pictures in my newsfeed about yoga and I see all these pictures and I just want to do it so I'm interested in doing it it's just really hard +T: so when you see the pictures on your newsfeed it makes you excited about doing it but when you actually go to do it it makes it yeah more challenging +C: well it's it I haven't done it before so it's a little bit hard to get out there because I don't think I'm as flexible as the other people +T: mm-hmm and so you're thinking that you're not as flexible as the other people I'm wondering if that's what yoga is about civility +C: well I think I think that people go to become flexible but I think that maybe some people are already just flexible +T: mm-hmm so you are concerned that maybe you might not be as flexible as the rest yeah and you'd be a beginner +C: well I'm worried I wouldn't be able to do the poses in class +T: okay so what do you think would happen if you couldn't do the poses in class +C: well I I feel embarrassed I think and then if the teacher tried to get me to do it and everybody else would see that they're trying to get me into a pose and I think it would be embarrassing +T: okay so you'd be embarrassed if you couldn't do the certain poses and how would you feel if you could do all the poses in the class +C: well I think I feel really good +T: and so what do you think it is preventing you from not doing all the poses in the class +C: why I guess it's just the embarrassment of maybe not being able to do it +T: what what would cause you to not be able to do it with the closest or not +C: I'm not sure +T: okay I remember when you first came in last week you told me that when you were younger you used to be very very flexible and I'm wondering what would make that difference between then and now +C: well when I was a kid I used to just practice a stretch a lot and now that I don't I don't have that same flexibility +T: mm-hmm +C: so as I've gotten older I've lost a lot of flexibility +T: and how would it be if you couldn't do all the poses in the class and you did get embarrassed and you just let it be embarrassed +C: I mean it would be okay but I don't I don't like that feeling what would be the payoff +T: do you think if you put up with a little bit of embarrassment +C: well I probably feel we're not a good in the end +T: you know I can give you a lots of studies that I can give you and videos that I can show you of people that started yoga and started practicing yoga and their anxiety went way down as a matter of fact some studies show that anxiety doing yoga can be decreased the same as medications so I'm not sure if you were if you knew that or not +C: I didn't really know that I just thought that that yoga was more about flexibility I didn't realize there were so many other benefits +T: okay so how motivated would that make you feel on a scale of one to ten +C: well I probably if I thought that I'd be it would make me less anxious I think I'd probably be around an eight or nine +T: good good that's a definite improvement and and you could determine after that first class whether you're levels have decreased or not and that would that be validation for you or would that be you give you even more motivation if your anxiety levels were decreased instantly after the yoga class +C: I think that would be a lot of motivation +T: okay to continue so one other thing that I wanted to to mention to you um was you said that you'd walk your dog in nature and I'm curious as to how much time did you spend walking your dog in nature +C: wow it was only about minutes it was really cold and windy so we didn't want to stay out and by we I mean the dog and I +T: mmm-hmm and so because of it was cold and Wendy you decided to kind of cut the walk short +C: yeah +T: and and that's definitely understandable I'm wondering what you could do to possibly get an hour of walking the dog in a day +C: Wow it might help if I take a jacket next time +T: okay so if you took a check in case it's gold +C: yeah +T: and do you have a special place in nature that makes you feel peaceful that you could be and that would help you even more enjoy it +C: as long as I'm just away from road noise and traffic and then it's a lot better +T: okay +C: and there's lots of trails around my house like that +T: okay excellent it's great that you have trails around your house where you're not exposed to all that noise and so do you think you could commit to an hour probably and on a scale of one to ten tell me what that probably means +C: um it's probably a ten I can I can to that +T: okay all right so it sounds like last week you had a few problems carrying out play assignments towards decreasing your anxiety you really couldn't find a yoga class because you're already signed up for a gym that doesn't have the yoga classes but you you already know about the yoga videos that I've sent you so you could actually do them at home how strongly do you feel about doing them at home +C: if I could do them at home I would probably do them all the time +T: mm-hmm I think that would be a big difference and then there would be no embarrassment factor if you couldn't do the poses less coffee you've gone from two cups to one cup that's very good and get out more with people you've decided to invite people over to your house rather than going out with other people not knowing who's going to be in your space that's always an apprehensive moment when you don't know you have no control over who's going to be in your space and on a scale of one to ten you think that you could spend at least an hour a day walking with the dog job I think we have a plan so overall on all four of these items how motivated do you feel on a scale of one to ten +C: I think it's a I think I can do them on all four all four +T: fabulous and how do you think you will feel if you were to envision how you would feel incorporating all of these items in your life next week of the course of next week how much of a difference do you think it would make you feel +C: I think it but maybe even make me look forward to doing these if I were doing them on a regular basis +T: mm-hmm and how would it make you feel +C: I think it would make me feel really good +T: and so you feel relaxed and you would feel more positive and I think you would - very good +C: thank you +T: we'll check in next week we'll make an appointment for next week and catch up and see how you're doing with all this good job +C: thank you so much \ No newline at end of file diff --git a/HighLowQualityCounseling/transcripts/high_144 b/HighLowQualityCounseling/transcripts/high_144 new file mode 100644 index 0000000000000000000000000000000000000000..0f5b2e4d3a37b5e9c5db7a5c9997fbe5aff8f1c0 --- /dev/null +++ b/HighLowQualityCounseling/transcripts/high_144 @@ -0,0 +1,72 @@ +T: good afternoon Bruce I'm glad you could make it in today thanks for coming in here last week when you were an you had come in because you had had a positive urine analysis test for marijuana and so we were working on ways that you could cut down or extinguish marijuana use all together and how did you feel about our talk last week +C: I was okay I guess +T: yeah just okay yeah all right okay I want to refresh your memory at not godly notes here do you mind if I refer to my notes +C: what's good +T: oh we had developed for strategies to help you decrease the amount of marijuana if not cut it off altogether and one of the items were worlds were to run more you used to run a lot and you like to run and so we have realized that the marijuana use usage was merely a mask to self-medicate for the depression but we also know that running up serotonin and in many cases is just as good as an antidepressant so you're excited about this last week so I'm wondering how you made up with the running last week +C: well it was raining out so I didn't really get around to it it was pretty cold +T: so yeah yeah and so because of the rain and the coldness it kind of took away from your from your mood and your motivation to go running +C: yeah I wasn't in the mood +T: I'm wondering what you could have done to get in the mood +C: I'm not sure what I could have done and so because of the not exercising +T: did it make any difference in your marijuana usage this week +C: yeah with what i use a bit more +T: okay okay so how would you tie those two things together by not running +C: I think that it makes what I'm not exercising that generally I would turn to the more usage +T: yeah yeah so when you reflect back now on last week and the rain coming down and it was cold I'm wondering if there's a way that you could change your perception about that such that it wouldn't stop you from running how do you think +C: yeah I could probably change the perception about that maybe we're a rain jacket or something +T: mm-hmm that would be a great idea that would be an excellent idea some people even think that it's fun running in the rain and the cold so that might that might absolutely be an alternative the other thing was to stay away from your friends that you would consider bad influences with using the marijuana how did you make out with that +C: oh I tried to stay away but I didn't I still saw some of them +T: so it was it was difficult to cut them out of your life last week and can you tell me more but what was difficult about it +C: well I just thought that they think something badly of the only one time to think avoiding or AZ +T: so you didn't it sounds like you didn't want to hurt their feelings three by them thinking that you were going to avoid them +C: yeah +T: and so as a result of this what what happened +C: oh well I just ended up going to see them yeah +T: and so because you were worried about them thinking that you were trying to avoid them you ended up using marijuana is that correct +C: yeah we did +T: yeah and I'm wondering how you could do that differently this week +C: oh well I could I suppose I could just try or not to go in and see little guys and what would that involve trying hard or not to go see them hmm i guess it's as simple as just not going +T: yeah sometimes it is that simple is just making that commitment to yourself and just drawing the line and do you have any friends that do not use marijuana that you could kind of associate with +C: yes yeah I do I don't see that often but I could I could go see it start to see that more +T: okay how motivated on a scale one to ten would you say you are too kind of reignite friendships with people with people that don't smoke pot +C: maybe a vote of three +T: okay so you're still you're still a little iffy about you what about whether you want to associate with those friends again but I have to ask you Bruce what gee what made you say three instead of one +C: well because i know i have pro so i feel like i need to i think i should start doing something about it I think +T: that's great insight that you're able to see that moving towards the friends that don't smoke pot and making the effort to do that is actually going to enhance your life incredibly and when you associated with the friends that didn't smoke pot in the past what kind of things did you do what was your life like +C: oh I like with what this kind of thing is activity is insane yeah was it fun being with them yeah it was fun yeah we just mostly like doing some activities maybe just sort of get some fresh air kind of thing usually it's a not so like you know there's more they tend to do more healthy activity +T: that would say so you can recall living up healthier life than and having fun of doors and basically having the healthier life overall without using the pot +C: yeah I think I think that writer it could be a might take my mind off of it +T: mm-hmm sometimes it's good to remember having those good times with the friends that didn't smoke the part because it makes you realize that you don't really need it and I think it's a great I think that's a great idea the other item on your goal whether it's a goal not an item was to get a pet how did you make out go and it was a dog you were going after a dog at the SPCA and how did you make out with that why was +C: I really had a lot of second thoughts about it and I was worried about commitment and and I kind of think so I didn't feel like that was the right idea +T: mm-hmm okay so you had some second thoughts about that you are excited about it in last week's session but after a chance to reflect upon it you kind of realize that it wasn't getting a dog was not the best thing for you +C: well there's lark think there'd be a lot of commitment and a lot of time that I just don't have the motivation to to be put in I think that's why is to recognize that right up front I'm given the research on pets any kind of pet and how it helps people sustained from alcohol and drug usage +T: I'm wondering if there is another option that you might consider +C: maybe maybe what what do you have in what I'm thinking do you like pets that are don't require such a commitment +T: that's a good idea +C: I didn't think we'll that because a dog is the talk is a large commitment +T: yeah there's all kinds of animals and snakes or fish or something okay snakes are fish that would definitely be a star these animals that you like +C: yeah +T: all right yeah I think it's important that you have an animal that you like and that you can relate to alright so in the final goal was to find and join a support group for people that were trying to be asked and then from marijuana how did you make out with that +C: well I looked into it but like I went to the first the first meeting and I just I felt like like those people were bought on the barrel and I was just not I just didn't fit in with that crowd just I'm not where they are that place +T: so you made the effort to go and you went but that was +C: I couldn't I just didn't want it +T: and so we you didn't say the whole time and so you left early because you felt you didn't feel in you they were the bottom of the barrel and you're still higher functioning +C: yeah yeah +T: I can definitely understand that I'm wondering if there is any purpose for you joining some sort of support group to help you what do you think +C: yeah I can see there could be some positive I just don't I don't I just don't see it that much you at this point +T: mm-hmm and what might be some positives that you would get out of the support group +C: why would I would probably be able to relate to people the same kind of situation oh maybe it's just a positive to be able to have connection with people +T: so you're you're saying that the positives of being in a support group would be that you'd get a chance to relate to other people who are on that same journey and do have connections with other people and again I can send you information that will show you that that just these two items alone are incredibly helpful for not only decreasing or being abstinent from pod but from increasing the feel-good hormones in your body the connection and the relating to other people it might be similar when you are younger you had mentioned last week that you were a hockey player and so you had support that was sort of like a the team was sort of like a support group I'm wondering if you could relate to people and had connections so I'm wondering if you could see a support group as a team +C: yeah it would probably be the same kind of situation like essentially people in support group for all there for the same goal so it's kind of in hockey or embrace very with their win +T: mm-hmm and and do you remember when you were playing hockey how it felt to be encompassed in that team it's good it gave and that's because of those good feeling hormones that come and neurotransmitters that come throughout your body when you have those connections so how committed do you think you are if I were to send you a list of support group so you could try out some others where there weren't the bottom of the barrel as you say there how committed do you think that you would be trying out at least two of them this coming week +C: probably eight +T: yeah wow what made you see an eighth rather than a +C: well just a team analogy i think is a good analogy +T: so you thought of how you remembered you remember how you felt when you were on the team and how it gave you that sense of connection +C: yeah and also you know i don't have to be the mean if if he said if I think of it as a team maybe I would be like a star on the team because I'm not quite so long barrel maybe +T: I love that analogy good thinking good thinking Bruce that's excellent Wow well just to summarize today you came then you had made some progress that you had some stumbling blocks um you have decided that whether it's rain or shine you're going to run anyway because you're going to have you raincoat and you're going to embrace more of your positive friends rather than the friends that are not such a good influence on you and getting a pet rather than getting a dog you're going to look into getting a snake or what was the other thing ovation okay and in terms of a support group I will send you a list of support groups and you feel that on a scale of one to ten that you're about an eight and actually caring through and drying up two of these support groups because of the hockey team analogy great job so overall how would you rate today's session +C: it was good very good +T: and if we were to put it on a scale again one to ten for debate +C: about right +T: we did good that if we didn't eight glad you came in to Dave Bruce and I will see you next week and check up and we will we will see how you did with these goals and then we will move forward from there all right way to go +C: thanks all right you \ No newline at end of file diff --git a/HighLowQualityCounseling/transcripts/high_145 b/HighLowQualityCounseling/transcripts/high_145 new file mode 100644 index 0000000000000000000000000000000000000000..50612596658c0d04c54b0f245ba368de40f36575 --- /dev/null +++ b/HighLowQualityCounseling/transcripts/high_145 @@ -0,0 +1,54 @@ +T: hello Maria it's nice to see you +C: hello there was a good say it's nice to see you but it's never good to go to the doctor +T: mmm unfortunately for me I hear that a lot so we're going to be talking about ways to manage your blood clots and options for treatment but first I'd like to check in on a few things the first is your smoking you were at a half pack at during your last visit and we talked about how important it is for you to quit I'd say it's even more important now that smoking is associated with Davey T so have you quit +C: no I haven't quit +T: so do you remember our conversation from our last visit that's when I give you the information about quitting smoking and the contact number for tobacco treatment specialist +C: yes I remember but no I didn't quit and no I didn't call her +T: and why is that +C: I'm not ready and I'm too upset to talk about this I don't mean to be rude doctor but I've had a hard time lately and I'm not in the mood for you to get mad at me for not quitting I'll let you know when I'm ready and we can talk about it but here now today I'm here to talk about my blood clots +T: well we're on the same page then because that's exactly why I'm talking to you about quitting smoking because smoking is a major risk factor for DVT even if you even if we treat you now if you don't quit smoking I'm afraid the blood clots will return again +C: let's just talk about my treatment right now +T: hello Maria it's nice to see you again +C: hello I wish I could say it's nice to see you but it's never good to have to come to the doctor +T: unfortunately for me I hear that a lot so we're going to talk today about how to manage your blood clots and some options for treating but first I wanted to check in on your smoking status in our last visit I recommended that you begin to think about quitting and I would be interested in hearing your thoughts +C: well I haven't really thought about it actually I thought about canceling this appointment because I knew you were going to bring it up again talking about smoking with me as hard for you yes it's because you're going to tell me to quit like you always do and then it feels you're just like everyone else like my caseworker the building manager everybody seems to think they know what I need to do and nobody thinks I know anything +T: so when it comes to smoking you feel that other people want to tell you what to do and make your decisions for you you you don't feel heard or respected no respect that's it +C: yes +T: well I just want to say that I am very glad you decided to come in today so we can take care of this blood clot because blood clots are very serious and I know you're concerned as your provider I have to be honest and say that smoking can cause blood clots but hopefully some of the information I give you today will help you in your decision to quit smoking +C: yeah +T: having said that I know my opinion is not the deciding factor quitting smoking as a decision only you can make +C: well I'm really glad I came into I have to get this blood clot condition under control +T: I know that would it be okay with you if I share some information about smoking and blood clots and I can tell you what I know and then we'll see what you think +C: yes I don't know that I will quit but I will listen +T: so what do you think +C: I always thought that the blood clots came from my mother hello like passed down like genetics I didn't know that smoking could cause this I just thought that blood clots run in my family I guess I also didn't get how dangerous this clotting +T: can be you seem surprised and a little more aware now the smoking risks I guess so yes so Maria I'd like to get a better sense of what you think about smoking so on a scale of one to ten with one being you don't think it is at all important that you quit and ten being you're ready to quit today where would you put yourself +C: well if you had asked me when I first came in i would have said less than one +T: but now i would have to say for why a four and not a lower number +C: that's a good question let me think about it um I guess it's a four because of the blood clots the blood clots are really heavy on my mind right now +T: so having a better understanding of how smoking adds to the risk of blood clots increases your desire to quit or little +C: yes +T: what else if anything makes quitting important to you +C: you know the bigger thing for me is the fear of being evicted from my apartment there's a rule that we can't smoke in the house and I stick to it for the most part but the other day I smoked out the window and that was only the second time I've done it but don't you know the building manager caught me so now i am sure she's going to be watching me even more I can't lose my apartment +T: the possibility of losing your apartment because of smoking really upsets you in addition to your health +C: I would hate to think that my son t and they lost their home because their mom chose smoking over a biting by a stupid code even if I hate that rule I smoked when I was pregnant with them and thank you Holy Mother they were born healthy I don't think I could live with myself if they lost their home because of something I'm doing +T: so it sounds like your priority in life is taking care of providing for your children it's obvious that you're a good mom and if you had to leave your home because you were smoking that would be tough to bear +T: so let me ask you a slightly different question on that same scale of one to how would you rate your confidence to quit +C: Oh confidence oh I'd have to stay at two so you are not feeling very confident right now hello no not confident at all I mean I've tried to quit so many times and I just can't do it +T: so you've been persistent in trying and haven't been successful yet still you you said a two and not a one I'm curious about that +C: well the only reason I said her too is that I tried quitting smoking when I was pregnant with santhi and they or both I went for two months without a cigarette with Dale and I didn't make it past that and that was really mad at myself for that I really wanted to quit from my babies and I failed I guess I'm just hopeless I mean who keeps smoking when there's a baby inside +T: it sounds like you really feel like you let yourself and your children down and that's hard to accept given how much you love your kids +C: yes and I'm doing it again right now by not following the rules I'm addicted to cigarettes just like a drug addict in the end the cigarettes always win +T: so what what do you think sante and thao think about your smoking +C: mmm Southee yells at me and sometimes they'll cries when I go out to smoke he says mama smoking is bad +T: so you know it would be best for you and your children if you quit if you had the right support and tools to manage this addiction if you believed you could do it you would +C: I'd like to think so but I just don't think I can do it +T: you quit for two months when you were pregnant with Te'o how did you do it then +C: I don't know and I just did it I fought the urges with sucking on straws and some hard candies said I just did it +T: wow so you were able to quit on your own for two months that's impressive have you ever used any other form of help like nicotine replacement or support groups +C: mmm no I think people can quit if they really want to I'm just too weak +T: ah wow you must be pretty hard on yourself what would you say if I told you that very few people only four percent of us are able to quit successfully cold turkey no really is that true hmm yes and and most people try many times before their successful their medications and groups yet and I'd be happy to share that information with you I'd like to help you if that's something that you'd like +C: well I don't know I'm let me think about it can you give me the information again the booklets that brochure you gave me before I didn't want to tell you but I threw them away when I got home but i really want to read them this time +T: that's great maria you can look them over and i'll have our tobacco treatment specialist sonya follow up with you we have an excellent tobacco treatment program here and I am I believe that Sonya can help you quit when you're ready okay what one would be a good time to check back in she can call me next week and I'll let you know I may be ready to try again absolutely and I'll have Sonya call you I just want you to know that I understand how hard it is for you to talk about quitting smoking and I really appreciate it so would you like to talk about how to manage a blood clots +C: yes that sounds +T: good all right \ No newline at end of file diff --git a/HighLowQualityCounseling/transcripts/low_001 b/HighLowQualityCounseling/transcripts/low_001 new file mode 100644 index 0000000000000000000000000000000000000000..732e9cef9b4c043901c22d4eb2251e4ac45d1170 --- /dev/null +++ b/HighLowQualityCounseling/transcripts/low_001 @@ -0,0 +1,94 @@ +T: hi Laura so thanks for coming in I'm not sure how much you know about why you're here or what we're supposed to talk about so basically I'm going to be meeting with all the students in the school usually once or twice per semester and we're gonna talk about you know whatever's kind of going on in your life I'll ask you some questions about you know your goals and what you like to do for fun and those sorts of things and then we'll talk a little bit about you know different behaviors and and stuff like that and so it's it's pretty casual pretty informal just sort of a chance for me to get to know you +C: alright +T: okay why don't we start by just having you tell me a little bit about yourself +C: okay um my name is Laura and I'm 17 and I'm a senior in high school +T: okay and what do you like to do for fun +C: mostly just hang out with my friends and stuff on the weekends things like that +T: and when you and your friends are hanging out and what do you do go to ball games go to party +C: if it's school related maybe like a game or two or go to the mall like to shop or go to the movies or something and that night maybe like a party or something someone's throwing +T: okay and what kind of hobbies do you have +C: um I like to be and I like to go outside and like take walks and like hike and stuff I'm very outdoorsy so oh cool +T: what are your plans for after high school +C: well I plan to apply to college and maybe you know have a good career and something like that hopefully +T: that's great what do you think you'll study +C: well I'm I'm looking at the journalism maybe pre-law +T: Oh neat +C: which is a little different but +T: yeah that's great that's a really good goal +C: yeah thanks +T: it's a hard work to get into law school are you doing school what kind of grades do you get +C: I'm doing okay I'm getting mostly A's and B's so we're pretty good okay +T: okay what classes are you not getting A's and B's in +C: um I think all my grades raisin B's +T: oh +C: yeah +T: okay and do you know where you're going to apply to college +C: I'm not sure yet but I'm looking into schools if like in the area so maybe I don't know maybe I only poem or something +T: okay cool and and what made you decide maybe law school or journalism +C: um well I'm definitely not a math or science person so I started off by there that I start looking at careers that maybe I would like so +T: okay great sounds like you have like I said really good goals and you're working hard in school you said that when you're going out with your friends you like to hang out and shop and stuff like that and also go to parties so do you drink alcohol +C: um not really maybe one or two drinks at a party at the most +T: okay and how often do you think you drink +C: um maybe like once or twice a month at the most +T: mm-hmm so like once or twice a month you're having alcohol +C: yeah +T: okay and so that's maybe like 20 times a year +C: possibly yeah +T: so that's actually kind of a lot of drinking then +C: yeah I guess you can say that +T: okay what do you thinks the most you've ever had +C: um just two drinks at a party at the most I don't I don't like to drink a lot I don't getting drunk is not something that appeals to me so I just have like a drink in my hand so my friends won't bug me about not drinking I just like to look like I'm actually doing something most a lot of time I don't even drink at all so +T: but you've been drunk before +C: um no not really maybe tipsy but not like drunk +T: okay so the most you've ever ever had is two drinks in a day +C: yeah +T: okay interesting so do you know all the bad stuff about alcohol +C: um yeah yeah +T: okay so one of the things that you know it's really important to talk to teenagers about is drinking and driving so you know that's actually a really big problem and and even around here we have kids die every year from getting in a drunk driving accident so that's something that you really need to make sure you're not doing all right have you ever done that have you ever done +C: never drunk driven and I've never got in the car with a drunk driver +T: okay how much do your friends drink +C: um I mean I have some friends that drink someone others like my close group of friends don't really drink as much because I'm not really interested in that but I know that there are people that +T: okay +C: drink a lot more +T: what about at these parties you're going to there are other kids there who are drinking a lot +C: yeah there are kids that drink a lot more than I do definitely you +T: and do you hang out with them +C: not really closely like I know who they are and I'll say hi but not they're not really that close friends of mine +T: mm-hmm so you know even just hanging out around kids who are drinking a lot actually puts you at a lot more risk did you know that +C: um yeah that make sense +T: yeah so there I mean a lot of the other dangers of drinking like not just car accidents we can have other accidents you know people you know will fall or you know break things or a lot of people actually end up breaking their bones and ending up in the emergency room because they've been drunk and fallen down or you know as a girl it's really important too that you're careful because you could be sexually assaulted +C: yeah +T: you know especially if you've been drinking then you know you're at a lot more risk because a guy can take advantage of you did have you thought about that +C: yeah yeah I have that's one of the main reasons I don't like to drink that much so +T: and then you know people get in fights more often when they've been drinking too also you know there have been a lot of kids even at this school gotten in trouble because they were drinking and someone took pictures with their cell phone and put it up on Facebook and then their parents find out or school finds out and you know we have a no tolerance policy here about drugs and alcohol and really can get you into trouble and could put your whole college career in jeopardy have you thought about that +C: yeah definitely +T: but you're still drinking +C: yeah I mean I guess it's the thing to do at a party so +T: so I mean do you think it's the thing to do if you want to be an attorney +C: um definitely not that's why I don't try to drink that much just make it look like I kind of +T: okay hmm so I mean I guess what we need to do then is kind of talk about some goals for how to be safer +C: okay +T: um obviously you shouldn't be drinking at all um what do you think about that +C: I definitely agree I know that there are some other risks involved in alcohol other than the ones you mentioned like health-wise and things like that so I agree that alcohol may not be the best thing +T: so do you think you can quit +C: um yeah I mean it's not like a really big part of my life so +T: okay so I'm gonna write down then that you've decided to quit +C: okay +T: and that's going to be your goal and that's great you know that's really why we're here is to talk about that and make sure that you come to that decision um so I guess can you quit this weekend then +C: yeah yeah definitely I'll just not have a drink +T: okay and then what about your friends who are still drinking +C: um I really can't control what they do but I'll definitely try to get my closest friends to maybe stop like I will +T: okay and what if they won't +C: well then I guess I'll just try to hang around unless or something or try to find things for us to do that don't involve alcohol like a party anything +T: yeah probably if your friends won't quit drinking you should just find new friends because you know the problem is if they're drinking they're going to pressure you into drinking and then you're going to feel awkward and you know you're going to be stuck and and not know what to do and really just be better off probably without them if they're if they're the kind of people who are going to keep drinking they're probably not a good influence +C: okay yeah +T: and then then you'll be better set for college too because you know the issue is you're getting good grades now but when you get to college it's a lot harder and you know if you're needing really good grades to get into law school which you will need then you really can't be distracted by alcohol +C: okay yeah definitely +T: okay so um that's great because it pretty much covers all the stuff that I think I needed to go over with you um let's see I guess we didn't talk about what would happen if your parents found out you were drinking +C: they would be pretty upset yeah they don't really condone alcohol use oh +T: okay so yeah just another reason why you probably need to just quit then um okay yeah okay so like I said I'm gonna write down here that you've decided to quit and you know I'm gonna be meeting with you again probably next semester sometime so we can kind of check in and make sure that you know that's still going well and you're still not drinking and not hanging out with any people who are drinking is there anything else you'd like to talk about while you're here +C: no I think I'm good +T: okay um any questions or +C: no no +T: okay you're sure okay all right um well that's probably it then you can head back to class and and thanks for coming in +C: okay thanks diff --git a/HighLowQualityCounseling/transcripts/low_006 b/HighLowQualityCounseling/transcripts/low_006 new file mode 100644 index 0000000000000000000000000000000000000000..b1f920ae901b77f863d089971a2c3d1dd328a3ef --- /dev/null +++ b/HighLowQualityCounseling/transcripts/low_006 @@ -0,0 +1,25 @@ +C: okay so I'm really worried about my sister she's been hanging out +this: boy and I read some lean and her diary about her and his boy +she's: been hanging out with and I think they're like doing it +T: and how does that make you feel +C: well I already said I'm concerned about my sister +T: and why are you concerned +C: cuz I read her diary +T: wait you read her diary why would you read her diary that is her +personal: space +C: well I was worried about her and she's been not hanging out their +friends: cuz she's been hanging out with this boy +T: well first of all if she was hanging out with this boy she wouldn't be +writing: about it in her diary she'd be out there actually doing it and +if: her friends aren't like actually hang out with her it's probably +because: she's being all weird with them because she knows that her +friend: likes this guy even though she likes this guy and it's just not +your: business to go in her diary and do that +C: but I was just really concerned about her +T: oh +C: don't anymore +T: just stop because that is not what you're supposed to do going +through: her diary like that that's just so gross of you +C: but I'd be like a bad sister if I'm not helping her if I don't know +what's: wrong with her +T: I just can't even I have phone call to think alright diff --git a/HighLowQualityCounseling/transcripts/low_007 b/HighLowQualityCounseling/transcripts/low_007 new file mode 100644 index 0000000000000000000000000000000000000000..75e03836135e69d6408a3ffdb31ca54ff19766b9 --- /dev/null +++ b/HighLowQualityCounseling/transcripts/low_007 @@ -0,0 +1,24 @@ +C: you know +T: no I don't +C: we just you know started to we just had some time in the I spent that I it's not that +T: I know but that's part of it so I don't have to give you music you know what your lovemaking with Jason that was music to my ears +C: okay +T: so how many times you guys have sex that night on a scale of one to five five being the lowest how many times did you guys have sex that night how many pieces of furniture +C: one +T: it was on the bed +C: yeah +T: are you were you a virgin before you would chase them no judgment you did go to private school +C: I wasn't +T: jobs count who you was being in college +C: why is that relevant +T: just I have a hunch were you a lesbian in college +C: what hunch do you have +T: that's the hunch this this type of sex is actually very indicative of the type of relationship well if was it in conventional law was it like was ever done that or was it with her past was it slow was it you know you know what I'm talking about when I do that say stop cygwin let me win okay this is what we're gonna do I like to wrap up sessions with a game obvious this award Association have you heard of it +C: yeah +T: they're going to say the first thing that pops in your head hair +C: Blonde +T: Redhead +C: brunette +T: penis the word association for penises penis okay as I think you're repressed +C: I don't feel repressed +T: that is the first sign of oppression diff --git a/HighLowQualityCounseling/transcripts/low_008 b/HighLowQualityCounseling/transcripts/low_008 new file mode 100644 index 0000000000000000000000000000000000000000..aad3f98e5bdc54f0be907900cb955bb843fcf30a --- /dev/null +++ b/HighLowQualityCounseling/transcripts/low_008 @@ -0,0 +1,23 @@ +T: Hi Emily how are you +C: I'm doing right how are you +T: I'm good um Wow what's changed what do we have here +C: oh I got my lip pierced +T: Emily why why did you get your lip pierced +C: why I don't wanted to change and you can kind of cool +T: gorgeous your teeth are lovely you do not need a piercing +C: I mean nobody needs up here saying I wanted one or then +T: do you know what those oral piercings can do to your teeth +C: I mean it's my lip that's pierced not my teeth +T: well yes except that you know what's going to happen see how do you feel how when you're moving your lips smile for me okay so do you see how when your muscles are moving that piercing is rubbing against your gums as well as your teeth so we can see some recession that's going to start to happen +C: yeah +T: possibly affecting the tooth itself chipping the tooth etc so it's something that we definitely don't like to see +C: I mean it's been okay so far it doesn't cause me any problems +T: well it's only been a month +C: yeah +T: okay orderly days yet and it might not be a bad idea to reconsider the piercing +C: I mean I just chose it I'm not going to take it right out it's like you said I've only had it in for a month I mean +T: Emily I've been seeing you for so long and you know that I really just I think you have lovely teeth and I've watched you you know just mature etc and I hate I'd hate to see you wreck your teeth for something like this I really would +C: well I mean if it starts to cause a problem then maybe talk about but at this point I mean +T: all right all right okay okay okay we'll continue the exam but you know where I stand on this okay +C: all right +T: all right diff --git a/HighLowQualityCounseling/transcripts/low_009 b/HighLowQualityCounseling/transcripts/low_009 new file mode 100644 index 0000000000000000000000000000000000000000..1a92cb9dbaa632b2f1c146e99f480e3973df0b73 --- /dev/null +++ b/HighLowQualityCounseling/transcripts/low_009 @@ -0,0 +1,21 @@ +T: hi I'm Hannah I talked with you I knew the other day but I just wanted to touch base today you know about your softer situation I'm so I read your chart and I know tell that side are you still feeling depressed +C: yeah +T: a depressions and I know you feel like depressed now but I felt depressed before and it will pass like you'll get over it it's it's not that big a deal and so this depression why are you feeling depressed +C: um +T: oh wait wait sorry I did another note something else I wanted to ask you before no why or is that depression what brought you in here +C: well I owed heed +T: oh yeah +C: because I was depressed as dad +T: yeah um okay so that overdose love to talk about um so then why are you feeling depressed +C: well um I was abused on I mean you're like - +T: I looked in your chart and your life doesn't seem all that bad so this depression I think you can get over it um yeah let me like my notes here no song oh hey yeah can I talk to you later I'm gonna finish on there okay um sorry I lost my train of thought my my notes here you got booze overdose um so can you talk about these thoughts oh that like that area do you want to do um very still having those thoughts +C: no +T: no okay then great no that's because I know I mean if you're having them it's kind of like why I don't understand what people think of like it so it's really very weak them to do personally but any who is oh hold on a second hello no I'm at work right now yeah you know at Belmont yeah I want to talk with this patient here yeah I'll call you back okay okay all right yeah anyhoo so let me look at my notes but so you those thoughts were saying who are you saying about those did you have that I forget +C: oh no +T: no okay okay that's great I'm glad so are you feeling better than +C: yeah +T: so what do you think has worked in your therapy +C: I'm talking to the therapist +T: one-on-one okay what do you want me to see if your doctors available I can totally arrange that +C: okay +T: I'm going to go check that then right diff --git a/HighLowQualityCounseling/transcripts/low_012 b/HighLowQualityCounseling/transcripts/low_012 new file mode 100644 index 0000000000000000000000000000000000000000..17f8030b5584ce636a51689ecba2b143fb3dcbb6 --- /dev/null +++ b/HighLowQualityCounseling/transcripts/low_012 @@ -0,0 +1,25 @@ +T: hey yo girl yeah it was cool all right I gotta do with anything all right oh hey sorry it was a long night and I'm not feeling so great right now hi what's your name again sorry +C: Joe +T: so so what is this yeah that's not really my thing I mean you know I'm gonna do this voluntarily rare that you my boss is making me yeah not too happy about it um okay so you need advice +C: yeah +T: aren't you a student like don't you know I mean like our anyone counseling student them you know this stuff +C: I'm just Anton crack bellman just concerned down doing right way +C: okay what does that mean +T: what is the right way negatively impact please okay and our nose the rightful you like that +C: okay well all right okay so tell me like are you seeing anybody now or like you gotta give me sup a Tod client +T: yes +C: I can't give you advice +T: well well the 1i really talk about uh when I got it she says she's depressed that's her was named prom and she said that you know there's no reason to live and yeah funny solution-focused sees less foot Wow silence well hello fraud yeah yeah +C: you should probably switch to that you want advice excuse my legs these cycles get a couch all about it +T: well with the I mean I don't really have that just time be able to fuse +T: I mean I still need to change ok so saluted oh yes is what you are now yeah +C: I asked our pm Jesus Lucas you know when was she when we happy and she says she wasn't +T: you asked a depressed person when they were happy he's kind of rubbing it in her face that she's not happy +C: well I was trying to give her I guess another situation where she was having find out when she's happy what made the anchor Gator happy so I can show babies more stuff cooking skills around +T: when I guess I works no no I told you lose your focus I don't know anything about that +C: oh okay for what you're saying I you know I don't think I have enough time to use to do right there so we think I should do and tong sui +C: this how do we get over it yeah +T: well that'll be quick for sure +C: there you go so win-win and then we can end early right like how longs it was the last +T: hour +C: oh I give you like maybe 15 minutes if we were pushing that busy person well it's not that you're doing great I'm actually buzzing right now I got a phone call I've got to take this so I'm gonna step out I'm just you know clean up a bit before you leave a pleasure meeting you jumped it has it eliminated with head okay I'm out I'll see you later hello diff --git a/HighLowQualityCounseling/transcripts/low_015 b/HighLowQualityCounseling/transcripts/low_015 new file mode 100644 index 0000000000000000000000000000000000000000..5f2998259d8d576f1e102b7fc4da72eab566fa7e --- /dev/null +++ b/HighLowQualityCounseling/transcripts/low_015 @@ -0,0 +1,48 @@ +T: come in hello +C: hello and you know um I'm just back again +T: yes yes yeah it's not that long since you were last here +C: I know but I'm really not happy with these heavy please +T: you're not happy +C: well no I've been to see you several times and you put me on tablets and you know they're just they're just not working and but you're really thinking I want +T: excuse excuse me if not you've not had the time to take the whole course of tablets so how do you know they're not working +C: I'm just far too busy I have a really busy hectic life and I'm running this major organization that's having a huge conference and you know I've been thinking a lot about +T: but you know I see children has to learn +C: Hayley +T: he kept a history yeah me that's what I want I want to be required on so I can have a hysterectomy work and just get this whole scenario finished and done with +C: I think you're overreacting I think I think that +T: you don't live my life I'm I'm really +C: can I Dracula tell you what your options are here let's just +T: all I can I let bad options listen to your options +C: first of all tell me what was the problem is taking the medicine what was the problem no that you couldn't take the medicine as prescribed +T: well it's it I mean I'm busy I'm traveling +C: or visiting +T: I always said +C: if this isn't reality frijoles with me you need to make a pro +T: I've already made my mind of it I'm not wanting to go down the tablet route it's the history okay a hysterectomy assaulting +C: the last time you were here we discussed and having a coil that can be quite effective in helping with favourably +T: not interested in that +C: well that's a non-medical alternative +T: I really as I say my lifestyle is such that I need to move on a bit taking time off work I look I work in a male environment it's all it's it's starting to be flagged up as an issue and I'm not prepared to have that compromised my career +C: yeah +T: I really want to go ahead and how to distract me +C: um see from your records here that you're 32 +T: yes +C: I'm afraid that I'm not prepared to consider even putting your name forward of that +T: it's my choice +C: no +T: idea she done you might want and regrets +C: I don't want to learn I want amid that life choice I'm quite happy +T: it might be your decision if you want children but as a doctor I'm not prepared to make that decision and to verify that decision for you +C: as a doctor you're there to to listen to me yes help me +T: and I have been listening to you for a period of six weeks +C: and I I'm feeling you're not actually listening to me +T: I am you have a heavy view +C: you have a heavy sigh you don't manage +T: you're wanting somebody to say +C: sorry +T: earlier I think fix I think +C: I'm going to have to it's to ivett it sorry Susan riese +T: if what you're asking you're not listening to me and I appreciate your time but this is not working for me so I think I'm going to have to go elsewhere +C: I think that would be for the best because I can't help you any further I'll cube-like you come to that agreement +T: thank you very much +C: thank you you diff --git a/HighLowQualityCounseling/transcripts/low_023 b/HighLowQualityCounseling/transcripts/low_023 new file mode 100644 index 0000000000000000000000000000000000000000..75113e166e2d188dc146d19d94e613e8da16e7c3 --- /dev/null +++ b/HighLowQualityCounseling/transcripts/low_023 @@ -0,0 +1,12 @@ +T: come in +C: hello how are you today +T: I'm very well thank you I just need money repeat prescription and whatsapp for the road doctor +C: you're ductile +T: and that's +C: all right know what when was the last time you got that prescription from us yes I'm surprised did you see the local GP hmm you shouldn't have been given the doctor why do you think you need that no no no you can't you you can't get that drug anymore I'm afraid no no you're not having that trap anymore and it's been proven that that drug is not good for you and so I'm very surprised that the look and gave it to you but we're not doing it anymore yes but it's not it's not fine it's not good for your heart it's causing heart problems and it's been proven that it's not the most effective way to lose weight and what what are you doing about your lifestyle what are you doing about losing weight other than depending on tablets really that's doing a bit more stairs well it's gonna take a bit more than that I think and have you thought about planning in advance if you work you know taking a packed lunch pre-planning your meals and turning to healthy options because really even diet cooks not good for you you should be replacing that with water yeah but I roll the other doctors over wait you know so clearly you could be improving your lifestyle you could take a rap and just have it you know you could make her rap a healthy rap and take it and just have it instead of reaching for a bar of chocolate because that'll also affect your blood pressure and your sugar levels so what I think he should maybe do is maybe just have a maybe do a diary of your lifestyle because well it's I know popping a pill seems like an easy option but really you're gonna have to do the hard work this is only going to come if you get in the right headspace and you start looking at your lifestyle looking at your exercise looking at your eating habits looking at the frequency and your might that you're eating because if you're running about as a doctor you shouldn't beginning we if you if you've got a busy lifestyle you should be losing weight naturally so you there must be something in your daily routine that's stopping you so you maybe need to look and see if you're a comfort eater or what what your triggers are for food and and get that sorted but you know I'm afraid drugs are no longer the answer no I know I you know we would all like a magic wand because it makes life easier but I can't do that it's not worth the risk to your heart I can't I can't do that you just need to take a long hard look at yourself and what you're doing and if you want help with that we do have pamphlets you know have you thought about and you know doing some exercise that would make you feel more energized +T: no lack of energy bear on your little day that's not a problem it's just really time to do something else it's just work asleep yeah +C: so you need to put some thought into if you if that is your lifestyle you're going to have to put some thought into when you can devote some time to looking after yourself so are you putting on weight or have you been loosing the weight +T: let's think you can be steady +C: so you've not you've not been losing weight with it +T: that's been okay +C: so you can't you know it's it's good that you're standing still but it's not good that you're not losing weight especially if you're on the drugs so clearly the drug wasn't the answer for you and really the only answer for you as is lifestyle changes and you know look at your colleagues and are they what are they eating and adopt some of their policies in was their eating on the hoof they must there must be some of your colleagues that are eating healthy options that you could you could take a flask of soup you know soups salads wraps fruit and veg you know that's that's the only way it's the hard way but it's that's why I think you need to control of it yourself by planning and making sure that you have healthy options available because otherwise you're just going to stay in a vicious cycle and you know drugs we would all like a drug to me things easy for us but I'm afraid it's not the option it's going to be a hard slog but I think I think you'll find that once you start if you get yourself into the right headspace once you start then you will have a sense of achievement and the wheat will start loose you will start losing the weak because if you're that energetic in your job you're obviously doing enough activity so it has to be down to the diet well why don't you make a diary of everything that you eat because you might not realize I had you might be grazing and not realizing it so why don't you keep a food diary and come back and see me and two weeks time can you keep a diet have you got cake keep a diary for two weeks if you if you write down everything that you eat and any extra activity other than running a boat in your jobs that you do and we'll look at that and we're you know before you go and will we when you come back and then we'll see if you can start making a conscious effort and then we'll maybe sit you down with a dietician set you up with an appointment with the dietician to get some nutritional advice but I think you need to start preparing yourself mentally and to be in the right headspace to make this work for you because if you're not in the right frame of mind if you're doing it grudgingly then you're not going to lose weight okay thank you you you diff --git a/HighLowQualityCounseling/transcripts/low_024 b/HighLowQualityCounseling/transcripts/low_024 new file mode 100644 index 0000000000000000000000000000000000000000..12b8d03b679878bfca9e1cfe4045f3937fcb6605 --- /dev/null +++ b/HighLowQualityCounseling/transcripts/low_024 @@ -0,0 +1,25 @@ +T: okay finish the exam have some good news and they have some not-so-good news looks like you don't have any cavities so that's the good news +C: that's great +T: however I'm pretty concerned about something I'm noticing in your mouth actually if you look up here a roof of your mouth I'm noticing a lot of irritation that's really consistent with tobacco use and you had said on your form that you're not a tobacco user so I'm just wondering what's going on +C: I don't smoke cigarettes +T: okay well as I said there's a lot of irritation in particular like I was mentioning up here in the roof of your mouth it's turned really deathly white colored and there's little red spots and you probably didn't notice because we don't spend a lot of time looking at the roof of our mouth but you're really damaging this tissue in your mouth which can really cause some severe problems in terms of your oral health it's called nicotinic stomatitis and this is something we don't see in any patients who don't use tobacco so maybe you're not smoking cigarettes are you smoking a pipe or cigars or is there something else they will be contributing to this because I don't know what else might be causing it +C: well the only thing I've never smoked cigarettes ever but when when I go out with my friends we like to go to you know we'd like to go out to lounges and and you know sometimes there are those those nice young men that gift you different sorts of things and we got some of those mini cigars that swisher Sweets they come on peach and and grape and and you know that's the only time that really you know I've ever really used anything that that's got to pack Oh in it +T: okay so I think that's a pretty common misconception because they're fruit flavored people think they're okay those are really bad for you did you know that +C: I'm really bad but they're just little mini little cute little girly cigars +T: right there still cigars and there's still tobacco and so they still cause lung cancer oral cancer emphysema all those same kinds of things that you would see with cigarettes +C: boy only if it were just to relax I mean it's not like it's something that I would smoke 20 or 30 cigarettes a day I mean I only do it when we go out +T: uh-huh well that's I mean at least you're not doing that so that's good but it's still causing a lot of problems and as I said I can see that the evidence in the roof of your mouth you're causing some serious damage and this needs to stop have you thought about quitting +C: well I didn't really know I'd started +T: what do you mean +C: I didn't really think that it was anything more than just like social drinking just something that I do in a social setting when me and my friends go out to the bars +T: so you're going to quit then +C: oh maybe +T: what do you mean maybe I just told you how bad it is for you it's messing up your mouth you're putting yourself at risk for all these other diseases this is really important you need to quit +C: well it's something that I'll have to think about +T: what's there to think about you said it's not that something you do all that often I'm there's all these negative side effects there's all these risks that you're putting yourself in +C: well it's just something that I do to relax and I don't with that often and so I probably could cut back +T: okay well that's a good start but cutting back isn't going to do it if you actually quit the smoking you can reverse all the damage you've done in your mouth and you can stop yourself from from being at risk for these other diseases but as long as you're continuing to use these cigars you're really putting yourself in a lot of danger +C: well I don't believe that their cigars and what I do believe is that it's a choice and it's my right and it's something that I choose to do and so I will think about cutting back but I'm not at a point where I'm ready to do that and I'm not really sure that I even believe that what you're telling me is real +T: you're choosing to really damage your mouth and actually it can cause problems with your teeth too I don't know if you notice your teeth might be getting yellower than they were before that's another side effect there are a lot of really negative things that go along with any tobacco use whether it's cigarettes cigars dip to snuff snooze hukkah any of it this is a really important decision that you're making and you said it's your choice but you're really choosing to make yourself sick and potentially die +C: well it's something that I'll think about +T: well I appreciate you thinking about I hope you'll think about it really hard you know this is something that I'm going to continue to ask you about because it's something that really needs to change diff --git a/HighLowQualityCounseling/transcripts/low_030 b/HighLowQualityCounseling/transcripts/low_030 new file mode 100644 index 0000000000000000000000000000000000000000..31c453fcfb24d7cbad9b012ca2229f57bd625c3f --- /dev/null +++ b/HighLowQualityCounseling/transcripts/low_030 @@ -0,0 +1,39 @@ +T: good morning is really nice that you've come along to see me to talk about stopping smoking what have you got in mind what you want from us +C: well I need some medication if you can offer me some +T: absolutely when the right place for that +C: and whatever else you can do just to get me to go smoke-free +T: okay what just remind me in why is you want to stop +C: it's just these days I'm finding that I'm smoking 20 30 a day of getting sick of it in certain I've seen my friends have stopped smoking too and it's kind of looking at me weird these days like I'm the only one left who's still smoking +T: good and severe depression here +C: especially the other night I was at the restaurant it's been embarrassing on the only walk walking out +T: so that can't feel like I'm comfortable being myself so that sounds like one of the reasons you have to quit is it's all getting smelly and it's getting see any other reasons um +C: it's expensive these days it's actually cause to believe this about our buyer go through pack a day so it's almost seven pounds +T: seven pounds a week or +C: seven pounds a day today +T: forty +C: fifty +T: could really quit we even my math you see okay so we're talking about spec fifty couldn't we being one of the few left smoggy in your crowd and not liking the smell that sounds like three reasons do you think that's enough to make you say goodbye to cigarettes eight okay so have you got a date in mind when you like to stop smoking +C: what you do what do you suggest +T: generally it works well if you find a time when you're not under a huge amount of other stresses and strains one of the main reasons why you actually smoke what you enjoy most about +C: it's just something when I bought it oh my god I smoke or something I go out as I said I'm the only one kind of outside thank you +T: do you think you'll be supposed about the +T: sort of stresses +C: just when I go down after a break at work I go down I just need break away from it all just a shelf so I really enjoyed that the cigarette just helps me calm down +T: does your favorite cigarette the day +C: it's definitely the one at the end of evening +T: at the end of the day I think that helps you just online put an end to the work section and move into your own time +C: yeah +T: okay so after you've had the quit date what do you think you might do when is the first day at work it's time if you're not gonna cigarette +C: I guess I'll just I'll just have some fresh air as well but this time without a cigarette in my hand to try and give myself regular breaks one of those tough things +T: how do you manage to stop sneaking in the past +C: I've managed for a couple of weeks and +T: what got you back it was +C: to be honest is stress an argument with my partner +T: remember it says I make just how many I sort of took you back into right let me just make sure I've understood what's going on here you really want to sort of thinking with this we kind of the last guy in your group still smoking it costs a lot of money and you don't be like smell the main reason that you smoke is because at the end of the day gives you the kind of relaxation and there's quite a little stress is going on which you're using cigarettes to help you cope with what you like to do is stop and you'd like to sort of choose a time to quit when it's going to be there's not as much stress around as possible when do you think would be a good time for you to choose to being your quit date okay +C: so the weekend I've got a party coming up so maybe Monday morning +T: Monday morning after party really good day that's next week okay now one of the things that we do the pharmacy is recommended medication to help you know this increases your chance of success and it makes it more likely come along a lot of people make using nicotine replacement therapy which comes in a variety of formats like patches gum you probably seen people using any of these products and other options are tablets which you can get from the GP local champion again so have you something in mind that you might like to use to help you through managing the cravings +C: I'm thinking one of these patches +T: okay so patches I think you've already seen them again I'll get some out and I'll show you what they look like this course of medication lasts for ten to twelve weeks and we strongly recommend that we will stay on the whole course of medication and that that gives you the best chance of success stopping smoking is not easy but it's and when the type of support we offer here in the pharmacy you absolutely make your chance of success for x greater than try on your own so that's why it's really good that you come to see me you said that you really want to do it and then next week sounds like a good day for you to start because the party's opened up with you've got the time at the end of the day when you finish work which might be the first time you've gone without a cigarette so what I like to recommend is that you use two products perhaps and I'm thinking of you having a patch and then suggesting that you might use something that you can top up with often a person who smokes that's exactly what it feels like when they're craving for cigarette what does it feel like to you thing that you want one +C: it's just like a irritable +T: okay and that's exactly one of the symptoms of nicotine withdrawal that I'm looking to stop happen to you so I would strongly recommend that you have the patch talk about how to use it and that we have another product that I leave you to use as when any of those feelings of irritation coming out that typically in that first week so you're happy with the date for me okay would you like to come back and see me again other and what would you like me to do if you don't come back +C: nice Frank diff --git a/HighLowQualityCounseling/transcripts/low_031 b/HighLowQualityCounseling/transcripts/low_031 new file mode 100644 index 0000000000000000000000000000000000000000..79e60e59df61a3f3d0ea7a1addad70405c6dbba9 --- /dev/null +++ b/HighLowQualityCounseling/transcripts/low_031 @@ -0,0 +1,102 @@ +T: I you know you don't have to sign up if you don't want to but you know I'm kind of here to like fix things for you and just make sure everything goes no real smoothly with the different issues that you've been having and just kind of oh you know kind of manage things and just take care of stuff so you know it's again if you want the service you can have it but it's kind of up to you but I am here if you want me to be and you know I'll couldn't kind of teach you about things you might not know about or tell you some things about your house and you know just Marlys make sure everything goes okay so you know you think that might be something you'd be interested in wanting to be a part of because I'd you know really like to help you +C: okay well sure when you put it that way sure +T: because it seems like I you know you've expressed some health issues lately and I know you've had a lot of problems with your weight so that's certainly something we can talk about and I know a lot about you know weight loss and have helped a lot of people with you know managing their weight and figuring out what they need to do so you know what are your main problems about your weight I mean why is it a problem for you +C: um I eat too much you eat too much yeah +T: so why do you eat too much I mean how is that a problem +C: because whenever I'm stressed out about anything it makes me feel relaxed and calm +T: so you like it you just like eating food so you just kind of eat more than you know you should be eating +C: yes like do you know about portion control has anyone told you about like you know a card size for a piece of meat or some salad I mean have you has anyone showed you that cuz I can pull out our +T: yeah yeah +C: samples and give you those that I could probably tell you about it +T: you could tell me about it I mean about what you should be eating for yeah meat size and like you know baseball size for fruit so it's not that you don't know about it you you you do know about poor lighting control +C: yeah +T: so if you know how much you should be eating and then how is it a means you know how much you should be eating then how do you stop +C: well I guess you told me that you know a lot and you can fix my problem so that that's interesting I'm that's one of the reasons why I decided to participate so I was wondering if you could tell me +T: well that's great I could do about this yeah because you know there's there's just so many different things when it comes to like weight loss you know and really being able to have some self-control I mean that's a really really important factor this is really being able to have some self-control and you know I found a lot of people just really need to increase their fruits and their vegetables and just not eat any processed foods and you know not eat any anything that might be kind of junk but then you know not not cheat either I mean you want to be able let yourself have some ice cream or some things that you might really like from time to time because you know you don't want to completely not let yourself have good stuff either so +C: it sounds though that you're seeing some opposite things because when one moment you're saying not have any don't have any junk but then allow yourself ice cream once in a while so that would make it really confusing for me +T: oh I see well you know obviously you want to make sure you're not eating you know junk food all day long but on the other hand you want to make sure that you give yourself some opportunities to have that bite of brownie or cake or you know I for myself personally I really love like lemon meringue pie so I always have to you know save that little piece for myself in the fridge to make sure I have my little bite of lemon meringue pie and then I can feel good about you know where I where I was eating good the rest of the day then I could still have my lemon meringue pie so something like that might kind of work better you know for you to really take a look at your portion sizes and then you know making sure you get out there and exercising me if you're not exercising that's certainly not going to help you with being able to get off the weight either so that's that's critical how are you doing on weight loss as far as exercising +C: oh I haven't been exercising lately +T: oh so see that's really key right that's a really key portion to it so it sounds like when we talk next time if you kind of kind of give me an idea maybe keep a journal for a week and tell me what you've been eating and we can really look at you know what good things that I can tell you what things you shouldn't be eating out of that plan and then I really think it'd be important if you just start maybe even just start walking three times a week if you could just start that really slowly and then you Muenster now we can kind of see if that's helped some and we can talk about the items you've had on your journal and we can go from there and all kind of direct you from there what you shouldn't be eating how does that sound +C: well what does walking three times a week like for how long really like you know +T: sure whatever whatever is comfortable for you so you know start out small so that you can feel really good about having some success and doing some exercise so you know if you feel tired at ten fifteen minutes really just kind of paste it along for yourself and feel what's right so that you can feel like you're getting out there and getting moving because it's all about taking a small step and you know at least getting active +C: okay +T: and then I think the flute journal would be really important because then we'll really have a better idea what you what you truly are eating and how many calories and then we can go from there and deciding you know how many calories you really should be eating in your diet and that way you can do a better job of monitoring it +C: okay +T: so how about we meet back and say three to four weeks and we can kind of see how that journal is going so +C: that seems like a long time I mean I think in three to four weeks a lot of things can happen and I think these things +T: yeah if you have any problems along the way before then feel free to give me a call I'm always available so if there is something that you find that's just not working just give me a call we can kind of discuss it but then we can meet in person because we really should probably have about a month of your journal you know kind of down but if there's something that comes up I mean by all means just give me a call there's my extension so you'll call me if you you know +C: my weights been coming up so I think things will come up in a month +T: yeah well I I would hope that with some you know with some exercise and with starting to be more aware by writing down what you eat you may find it as you have to write it down that you may find that you will avoid eating certain things because you don't want to you know as you write it down it may make you feel like well now I'm not so sure I should eat this like if you're gonna eat a whole container of ice cream you know you might not want to have to write that down so you may just limit yourself to a scoop or two of ice cream so there is some kind of pieces that help with having to write things down and I think we're just gonna take it step by step but again there's my phone and my extension so I'm here if you need me +C: okay +T: so let's just continue on our conversation that's so Tonya I'm really glad you were able to kind of come in and just talk with me for a couple minutes as I explained kind of briefly on the phone as part of your insurance benefit I'm available for you as your own personal coach you know I am a nurse but I have a lot of background in wellness so I've been really here to help guide people and kind of as a case manager I'm able to help you there help empower you don't kind of work towards your goals of what you're trying to work on with your health and I know you would express on the phone a little bit but I would love it if you tell me some more about you know what is one of maybe the main things you've been thinking about in relation to your health right now +C: okay well basically I feel like if I don't if I don't stay on certain habits and routines then everything just kind of goes kaput +T: so the structure is really important to you in your life in order to manage your house +C: yeah I realize there's certain things I have to do in order to stay on on track yeah or else everything just kind of then I start noticing that I get into this whole this whole myriad of unhealthy unhealthy things I feel yucky basically +T: so it almost sounds like a house of cards if one kind of shifts away from from that +C: hmm +T: they just kind of all fall down very quickly and then you start to not feel good about yourself or you don't start to feel good in general physically +C: yeah I don't start field of it in general physically and then I you know I I yeah I can feel a change in my body and I just feel yucky because I'm then I end up not doing anything really +T: oh okay so because you start feeling poorly or you started feeling badly then you just kind of say well whatever or +C: yeah yeah it's kind of I move on and good habit reinforces on the so they build upon each other and it's sort of like if I don't have that collection of good habits then yeah I start to feel it because I'm not exercising and then I start to feel you know the fat come on and yeah +T: for you it feels like this whole kind of circle of things almost the quickl you're not doing what you need to be doing then you start to feel a weight difference in your weight +C: yeah +T: so it just kind of builds on itself +C: yeah +T: so what do you see is the key goal that you're trying to focus on right now or maybe a group of goals what are what are your key things that you are wanting to have happen +C: well I think just doing those things that do make me feel good you know tell me a little bit about those drinking water eating a certain amount of fruits and vegetables per day giving a certain amount of activity in per day and I was just thinking lately what's important to me is having one kind of thing that I do around physical activity that's social so I'm around other people and I realized that that makes a big difference to +T: Oh social physical activity +C: yeah +T: that you get to be out and be with people like +C: yeah j +T: ust doing on your own right like even going to a gym and just being around other people working out we're going to some kind of exercise class just to be around other people who they're their general goal is to you know do physical tivity and feel better through it +C: hmm so that you kind of feel like you're in a partnership together +T: yeah +C: that's rather than just you're wrong +T: yeah +C: yeah I'm working toward this together as a group +T: yeah +C: so you've talked about several different kind of pieces that are important to you if we just took a look at that one activity because that sounds like a newer thing that you're really trying to push with where would you put yourself on how important this is to you want to say on a scale of one to ten just just on importance +T: yeah right now I realized that it would be this is just something I came to realization today so it would be about I think it's an eight +C: Wow eight +T: yeah it's really really up there +C: yeah +T: it's not a four or five right why would you say an eight not a four or five +C: because I that it's a it is important for me to have social interaction and be around people who are doing like I guess you'd say like-minded like-minded things and then it becomes less just about me and more about you know just sharing +T: oh okay it's about sharing there's that yeah really that piece of connectedness that's really important for you +C: yeah +T: so if we were to ask your second question and that's kind of where the rubber meets the road how confident are you that you could start finding a group activity let's say in the next two weeks +C: oh +T: you could start one obviously you've got steps to find it +C: right +T: involved but within two weeks you could find yourself in some type of a group activity +C: two weeks seems reasonable I think I can do it within two weeks so I would give that a eight +T: so you would get that in ages yeah so it's something that's pretty important to you +C: yeah +T: definitely more than a six or seven and also you're really confident that you can go out there and do that +C: yeah +T: what do you see as some of the barriers that might get in your way +C: um I guess just structuring my time better +T: structuring your day better +C: yes yes so really not slacking off and really not saying okay well I'm tired you know now tonight I'll just wait till tomorrow basically that +T: so finding the time in your day +C: yeah +T: able to do or not do this or not +C: yeah +T: and how do you see that best in your day how do you see that working in like an evening kind of thing or +C: the evening yeah yeah right now the way the way just my today is structured with what I need to do in terms of um work and other commitments +T: okay +C: evening yeah +T: so one of the things I hear people frequently will be saying is that the evenings my time to unwind and then I don't have the energy or I don't feel like going out to do something that might be more rigorous how is that for you +C: I think that would be that would be okay I could always have a cup of coffee beforehand +T: you can always have a cup of coffee +C: yes yes +T: well it would be okay with you I would to touch base maybe after that class starts and just kind of see what you found how it's working and then we can go from there looking at any kind of barriers the one thing I think I would just encourage you with to normalize is to realize about doing things in small doable steps and not feeling like if you haven't done everything for the day that you're +C: right +T: the day but but that anymore water you drink or vegetables you've added it's certainly a positive and looking at trend +C: right +T: then to be hard on yourself right towards your you know movement toward wellness +C: right +T: okay so if we could touch base maybe in three weeks +C: sure +T: that would be super I'd really look forward to it I'm really glad you came in +C: okay thank you diff --git a/HighLowQualityCounseling/transcripts/low_036 b/HighLowQualityCounseling/transcripts/low_036 new file mode 100644 index 0000000000000000000000000000000000000000..a4a54e67f24b16afc3eb7f071c10425615d5a3c0 --- /dev/null +++ b/HighLowQualityCounseling/transcripts/low_036 @@ -0,0 +1,25 @@ + +T: hi I'm Jacob +C: hey I'm Dan Michi +T: I see been referred to me what brings you in today? +C: yeah well just recently I've actually gained lots of weight and I'm trying to lose that weight I see I'm going into bariatric surgery soon so about pounds again that I'm just trying to find the best option that could work for me I've tried some commercial programs that didn't really work out for me I even had my own trainer and doing the exercise that I didn't really enjoy doing +T: do you understand all that? +C: nothing helping me lose the weight and I think it's just got to be a way right +T: well you clearly have a lot of weight to lose cuz that feeling your main goal to lose weight +C: yeah I need to lose the weight in order to get the surgery +T: have you tried any weight loss programs in the past? +C ah yeah well like I was saying I was doing for me some of the commercial programs they just weren't working out +T: what kind of programs? +C: um you know just some lifting the +T: Did you like those programs? +C: well uh no I didn't either like it I had some pain especially my ankles so it wasn't really working out for me +T: what kind of activities do you like doing? +C: I like to walk around outside I guess it with my dog +T: What kind of dog do you have? +C: oh it's a golden retriever +T: yeah say like walking your dog +C: yeah yeah it's only for a little bit before my ankles start hurting +T: how long do you walk? +C: like three blocks I don't have too much dump for the day +T: all right well we'll have you do fire blocks done a couple of last couple blocks might hurt like something you have to push through and we'll have you do that six seven days a week don't you'll really get on and we'll see how that goes +C: all right sounds good diff --git a/HighLowQualityCounseling/transcripts/low_037 b/HighLowQualityCounseling/transcripts/low_037 new file mode 100644 index 0000000000000000000000000000000000000000..e75595871ccd9a5c0a0bc416311883a8110d6336 --- /dev/null +++ b/HighLowQualityCounseling/transcripts/low_037 @@ -0,0 +1,15 @@ +T: I understand that your asthma symptoms have been just really out of control so we need to look at some of the ways that you can get healthy and not be back here again +C: yeah I definitely don't want to come back here but the doc said Oscar my dog is connected to my asthma symptoms but the ridiculous part is I've had them for years before and now it's a problem +T: well you sound a bit surprise by that but I'm sure that you've see some of the material that that the clinic gave you about as with symptoms and managing your asthma and pets are a really big source of problems when that respect +C: yeah let me just clarify I've seen the materials I have them I haven't read them all I've been doing is taking the medicine so I don't know that much about this +T: well wait a second Sal what do you mean you you have...? if you as an you know to be informed about I'm just really taken aback by that because I understand from your chart that you have a young baby a new baby +C: giancarlo yeah +T: and you are very concerned about your health you want to be there for your baby and that you've already taken some steps you've almost quit smoking which is fantastic so the next step is to really deal with the dog deal with the pet I know it's it's gonna be hard to do that but there are always people who will adopt animals I'm sure that you have friends or family members +C: ah this is a little too much weight now first of all giancarlo is taken care of that's fine he doesn't have no asthma from the dog it's just me I don't I knew that I'm worried about +T: Sal it's you that I'm worried about okay the symptoms are worse you've had two or three major asthma attacks and do you appreciate how this is a risk to your life that there are some some adults with severe asthma who actually can die as a result of their symptoms it truly is something to take very very seriously I can't emphasize that enough +C: so Oscars gonna make me die? he hasn't made me die in years and the doctor saying oh I don't know if it's the stress the finance is the drinking so what are we doing saying Oscar could make me die I've had him for years +T: Sal what do you understand that what happened six years ago or ten years ago your asthma is progressively getting worse you know very well that the puffers the strength of the medication is getting higher and higher and there's only so much that can be done with medication alone you know this +C: well they can keep giving me more medicine and give me the strongest one I'll keep Oscar +T: so you're almost on the strongest one and if Oscar is that important to you then do you put Oscar higher than your baby than your wife like that makes no sense to me do you understand how important this is? +C: I understand that I don't think you get my situation I've had this dog for years so I'm not just gonna up and get him out of my house when I don't even know if that's the main thing +C: okay \ No newline at end of file diff --git a/HighLowQualityCounseling/transcripts/low_038 b/HighLowQualityCounseling/transcripts/low_038 new file mode 100644 index 0000000000000000000000000000000000000000..7d4554aa95d7ab309424461a458109307de9e8c4 --- /dev/null +++ b/HighLowQualityCounseling/transcripts/low_038 @@ -0,0 +1,19 @@ +T: hello Peter right Peter +C: I did it it hey Doc I've been doing all right work was a little rough but uh I've been doing fine overall +T: okay I mean it's too bad to hear but you know what brings you in today? +C: well I want to have bariatric surgery but my doctor says that I need to lose at least pounds in order to be eligible +T: okay sounds like you're concerned by your weight and you want to start to make positive changes so that's good to hear +C: yeah you know I just really don't know where to start +T: hmm well I mean how confident would you say that you are right? +C: I wouldn't say that I'm very confident I'm going to lose weight +T: okay well what have you tried doing to lose the weight? +C: I've tried a few different diet programs and I've had decent success but I always seem to taper off and just lose like a game back away at last +T: okay what activities specifically we have you tried to learn? +C: I enjoy weightlifting I used to do that a lot of my friends but I kind of stopped doing that at I didn't see any results as far as weight loss and doing any kind of running always just seems to aggravate my ankle +T: Oh didn't know you had an ankle pain but we can look at it later anyway um you know you're still going to need to do aerobic activities in order to lose the weight. it's proven to be the best way to +C: okay what kind of aerobic activities do you want me to do? +T: well i'd say if your ankle pain doing brief walks every day maybe three or four and like take about minutes at a time that should help you +C: all right back but what about my diet? program problems I just haven't even get anything to work +T: well you know you should eat more fruits and vegetables you know green anything green and stick with short walks and the resistance training like you said it's going to help you with the weight loss okay well do any other questions for me today? +C: no I guess I'm good +T: all right well I'll see you to follow up in two weeks thanks \ No newline at end of file diff --git a/HighLowQualityCounseling/transcripts/low_039 b/HighLowQualityCounseling/transcripts/low_039 new file mode 100644 index 0000000000000000000000000000000000000000..92320ee68579a1a55460f0a3b4138411b38fd8e2 --- /dev/null +++ b/HighLowQualityCounseling/transcripts/low_039 @@ -0,0 +1,32 @@ +T: hi I'm here to pick up description +T: okay and is it for Molly? +C: yeah okay +T: hi +C: hi +T: how are you doing? +C: good +T: well would you mind taking a seat I have a couple things I want to go over with you about this medication +C: okay sure should have some time +T: okay well this should only take a few minutes. so before we get started I just want to make sure I still got all the correct information so you're still on Emma Street with the same phone number and everything right? +C: yep +T: okay so nothing's changed wonderful. um now I was taking a look at your medication profile earlier and it looks like you're on two different strengths of lipitor so that obviously it can't be right +C: yeah I don't think no I don't think that's what I do +T: okay so do you remember which one you're taking? +C: I don't know you don't know +T: okay I think you're taking the milligram tablets it's not right +C: that sounds right and I remember the doctor was telling me that now that's that's what I'm doing now I'm pretty sure okay okay +T: so the doctor gave you this new prescription but there's new medication, is that right? +C: I think so +T: okay okay so this medication is for your cholesterol +C: okay +T: and you're going to take it once a day it's really important that you take it every day all right and you can take it with or without food it doesn't really matters +C yes once a day okay okay +T: okay and now the doctor did tell you this was your cholesterol right? +C: yeah he said that's why I checked my blood last time that's why I was in for a visit +T: right right exactly so that's why he wrote you this prescription so it's greater cholesterol you're just gonna take it once a day it's really easy. Okay, there are some side effects that go along with this medication but I wouldn't really worry about it because I mean you're young you're healthy it's not an issue so don't concern yourself with it. Okay all right so just to make sure that I didn't miss anything I'm just gonna repeat everything again to make sure you got it first time okay all right so this medication is for your cholesterol you're gonna take it once a day you can take it with a lot of water and you want to make sure you don't miss any doses okay okay +C: okay +T: what questions do you have any questions at all? +C: no should be good okay +T: well if that's it I guess you can go ahead now so here's your prescription +C: thank you +T: all right have a nice day diff --git a/HighLowQualityCounseling/transcripts/low_040 b/HighLowQualityCounseling/transcripts/low_040 new file mode 100644 index 0000000000000000000000000000000000000000..2208e309f5d49c0eb4a4c94e48aec2357c334365 --- /dev/null +++ b/HighLowQualityCounseling/transcripts/low_040 @@ -0,0 +1,77 @@ +T: Laura so thanks for coming in I'm not sure how much you know about why you're here or what we're supposed to talk about so basically I'm going to be meeting with all the students in the school usually once or twice per semester and we're gonna talk about you know whatever's kind of going on in your life I'll ask you some questions about you know your goals and what you like to do for fun and those sorts of things and then we'll talk a little bit about you know different behaviors and and stuff like that and so it's it's pretty casual pretty informal just sort of a chance for me to get to know you. alright okay why don't we start by just having you tell me a little bit about yourself? +C: okay um my name is Laura and I'm and I'm a senior in high school +T: okay, and what do you like to do for fun? +C: mostly just hang out with my friends and stuff on the weekends things like that +T: and when you and your friends are hanging out and what do you do go to? +C: ball games go to party if it's school related maybe like a game or two or go to the mall like to shop or go to the movies or something and that night maybe like a party or something someone's throwing +T: okay and what kind of hobbies do you have? +C: um I like to be and I like to go outside and like take walks and like hike and stuff I'm very outdoorsy +T: so oh cool what are your plans for after high school? +C: well I plan to apply to college and maybe you know have a good career and something like that hopefully +T: that's great what do you think you'll study? +C: well I'm I'm looking at the journalism maybe pre-law +T: Oh neat +C: which is a little different but yeah +T: that's great that's a really good goal yeah +C: thanks +T: it's a hard work to get into law school. How are you doing in school? what kind of grades do you get? +C: I'm doing okay I'm getting mostly A's and B's +T: so we're pretty good okay okay. What classes are you not getting A's and B's in? +C: um I think all my grades raisin B's +T: oh yeah okay and do you know where you're going to apply to college? +C: I'm not sure yet but I'm looking into schools if like in the area so maybe I don't know maybe I only poem or something +T: okay cool, and and what made you decide maybe law school or journalism? +C: um well I'm definitely not a math or science person so I started off by there that I start looking at careers that maybe I would like so +T: okay great sounds like you have like I said really good goals and you're working hard in school you said that when you're going out with your friends you like to hang out and shop and stuff like that and also go to parties, so do you drink alcohol? +C: um not really maybe one or two drinks at a party at the most +T: okay and how often do you think you drink? +C: um maybe like once or twice a month at the most +T: mm-hmm so like once or wice a month you're having alcohol? +C: yeah +T: okay and so that's maybe like times a year possibly yeah so that's actually kind of a lot of drinking then +C: yeah I guess you can say that +T: okay what do you think the most you've ever had? +C: um just two drinks at a party at the most I don't I don't like to drink a lot I don't getting drunk is not something that appeals to me so I just have like a drink in my hand so my friends won't bug me about not drinking I just like to look like I'm actually doing something most a lot of time I don't even drink at all +T: so but you've been drunk before? +C: no not really maybe tipsy but not like drunk +T: okay so the most you've ever ever had is two drinks in a day. okay interesting. so do you know all the bad stuff about alcohol? +C: um yeah +T: yeah okay so one of the things that you know it's really important to talk to teenagers about is drinking and driving so you know that's actually a really big problem and and even around here we have kids die every year from getting in a drunk driving accident so that's something that you really need to make sure you're not doing. all right, have you ever done that have you ever done ever drunk driven? +C: and I've never got in the car with a drunk driver +T: okay, how much do your friends drink? +C: um I mean I have some friends that drink someone others like my close group of friends don't really drink as much because I'm not really interested in that but I know that there are people that okay drink a lot more +T: what about at these parties you're going to? there are other kids there who are drinking a lot? +C: yeah there are kids that drink a lot more than I do definitely you +T: and do you hang out with them? +C: not really closely like I know who they are and I'll say hi but not they're not really that close friends of mine +T: mm-hmm so you know even just hanging out around kids who are drinking a lot actually puts you at a lot more risk. Did you know that? +C: um yeah +T: that make sense. yeah so there I mean a lot of the other dangers of drinking like not just car accidents we can have other accents you know people you know will fall or you know break things or a lot of people actually end up breaking their bones and ending up in the emergency room because they've been drunk and fallen down or you know as a girl it's really important too that you're careful because you could be sexually assaulted you know especially if you've been drinking then you know you're at a lot more risk because a guy can take advantage of you did have you thought about? +C: that yeah, I have that's one of the main reasons I don't like to drink that much +T: so and then you know people get in fights more often when they've been drinking too also you know there have been a lot of kids even at this school gotten in trouble because they were drinking and someone took pictures with their cell phone and put it up on Facebook and then their parents find out or school finds out and you know we have a no tolerance policy here about drugs and alcohol and really can get you into trouble and could put your whole college career in jeopardy have you thought about that? +C: yeah definitely +T: but you're still drinking +C: yeah I mean I guess it's the thing to do at a party so +T: so I mean do you think it's the thing to do if you want to be an attorney? +C: um definitely not that's why I don't try to drink that much just make it look like I kind of +T: okay hmm so I mean I guess what we need to do then is kind of talk about some goals for how to be safer +C: okay +T: um obviously you shouldn't be drinking at all um what do you think about that? +C: I definitely agree I know that there are some other risks involved in alcohol other than the ones you mentioned like health-wise and things like that so I agree that alcohol may not be the best thing +T: so do you think you can quit? +C: um yeah I mean it's not like a really big part of my life +T: so okay so I'm gonna write down then that you've decided to quit and that's going to be your goal and that's great you know that's really why we're here is to talk about that and make sure that you come to that decisio um so I guess can you quit this weekend? +C: yeah yeah definitely I'll just not have a drink +T: okay and then what about your friends who are still drinking? +C: um I really can't control what they do but I'll definitely try to get my closest friends to maybe stop like I will +T: okay and what if they won't? +C: well then I guess I'll just try to hang around unless or something or try to find things for us to do that don't involve alcohol like a party anything +T: yeah probably if your friends won't quit drinking you should ust find new friends because you know the problem is if they're drinking they're going to pressure you into drinking and then you're going to feel awkward and you know you're going to be stuck and and not know what to do and really just be better off probably without them if they're if they're the kind of people who are going to keep drinking they're probably not a good influence and then then you'll be better set for college too because you know the issue is you're getting good grades now but when you get to college it's a lot harder and you know if you're needing really good grades to get into law school which you will need then you really can't be distracted by alcohol +C: okay yeah definitely +T: okay so um that's great because it pretty much covers all the stuff that I think I needed to go over with you um let's see I guess we didn't talk about what would happen if your parents found out you were drinking they would be pretty upset +C: yeah they don't really condone alcohol use +T: oh okay so yeah just another reason why you probably need to just quit then +C: um okay +T: yeah okay so like I said I'm gonna write down here that you've decided to quit and you know I'm gonna be meeting with you again probably next semester sometime so we can kind of check in and make sure that you know that's still going well and you're still not drinking and not hanging out with any people who are drinking is there anything else you'd like to talk about while you're here no I think I'm good okay um any questions or no? +C: no +T: okay you're sure okay all right um well that's probably it then you can head back to class and and thanks for coming in \ No newline at end of file diff --git a/HighLowQualityCounseling/transcripts/low_041 b/HighLowQualityCounseling/transcripts/low_041 new file mode 100644 index 0000000000000000000000000000000000000000..d5a8928efd662fd11126388bc68af2df61bd721f --- /dev/null +++ b/HighLowQualityCounseling/transcripts/low_041 @@ -0,0 +1,9 @@ +T: alright Chris so I need to talk to you because as you know we have a zero tolerance policy for drugs and alcohol at this school and as as athletic director it's my job to check in with our student athletes and make sure everyone's adhering to that rule and I've been hearing some chatter from some other kids about party this weekend and from what I hear where you were there and you know I can't confirm or deny anything so I'm not at the point where i can give you consequences but i do want to talk to you about whether or not you're drinking and how you know you really can't be doing this as a member of one of our teams right? +C: actually I do want to speak to you about something to happen during this past weekend usually as you know I'm an honor student I usually am studying over the weekend my parents to let me go out to parties but I kind of used that to my advantage to convince my parents to go to this party that my friends were pressuring me to go to and when I when I got there like I'm not used to this like party environment where everything you see in the movies is kind of what happens where you have people just drinking out of the bottle or playing random games with alcohol just to get drunk for no reason because I was there in the moment I felt pressured to do and conform to what everyone else is doing so I wouldn't be I wouldn't be ostracized +T: yeah I get it like it we've all been there okay you know I was in high school once too you know I drank too I get it there's not a ton to do in this town and kids drink but you know promise we have these rules and you're on a team you have to stick by the rules +C: um I know that it's bad for me it's bad for my body it's bad for being on the team for being an athlete it hinders my performance just I don't know I feel that my friends pressure me I don't know if I should like go with different fine groups maybe I don't know +T: yeah Chris come on you're getting peer pressure I don't know like being in a sports team you feel very you have to like be unified with the group yeah well you're one of the leaders right and as being one of the leaders but my fellow teammates expect me to be except expect them to Li not only in the sports but also in social environments and if that's socialist social custom in our society so well maybe cancer leading as a non-drinker then I could but that could also backfire on me I feel that I could be ridiculed for being having a stick up my butt you know you're a star player who's gonna pick on you +C: I mean it's just one I'm just one person +T: it's the all right well what's of the mob yeah so the issue again is I can't be hearing reports about you drinking I can't be hearing that you're at parties and you can't be seeing pictures on facebook you know they're there are rules at this school and in my job I have to enforce them so you know like I said I get it you know I understand I know what it's like I get that you want to have fun your teenage years I get that but you know you are a star player we want to keep you on the team you know we got to figure out a way to get through this well I'll dedicate the time not to party and like no not-not-not party but you get involved with alcohol to that extent and like have it publicized on the Internet +C: what do you mean like on facebook all the pictures that you saw on the internet like I avoid those situations where I have to go to a party where I feel pressured to actually drink alcohol and allow what I do in my own private time put on the internet so I'll just can see you're done +T: all right yeah I mean we got to have a deal here if you're gonna be on the team okay right oh stop all right you promise all right shake all right. I'll see you later \ No newline at end of file diff --git a/HighLowQualityCounseling/transcripts/low_046 b/HighLowQualityCounseling/transcripts/low_046 new file mode 100644 index 0000000000000000000000000000000000000000..3729b7abadc920fd199dc94624d6f4a821d088d7 --- /dev/null +++ b/HighLowQualityCounseling/transcripts/low_046 @@ -0,0 +1,7 @@ +T: oh you know doc I'm still not sure that I'm ready to quit yet and I'm just not sure I can do this now +T: well mr. I'd you know we've talked about it length at this visit we've talked about other visits as well you know I I just think you just need to make up your mind and just do it +C: yeah but you know I'm trying to pass I just can't do it no matter what I do you know +T: I'm not really sure you tried that hard and last time remember last time you quit two days after your quit date you got laid off for several months I made it really difficult this time will be different and we have some new medication we can try and +C: I've tried all those medications and I've tried all the patches and all that stuff and now that new medication I heard some crazy stuff about that +T: it's not as scary as what will happen to you to keep smoking besides I'll be monitoring your closely +C: yeah it's just not a good time for me right now \ No newline at end of file diff --git a/HighLowQualityCounseling/transcripts/low_047 b/HighLowQualityCounseling/transcripts/low_047 new file mode 100644 index 0000000000000000000000000000000000000000..673236d75c8ae83977ad6ef9b0637e36d58e5137 --- /dev/null +++ b/HighLowQualityCounseling/transcripts/low_047 @@ -0,0 +1,22 @@ +T: okay so why don't you have a rinse David. how are you feeling +C: okay +T: good here take a look see what you think that feeling and the colors okay? you know there is quite a lot of stainings so I'm just wondering about um some concerns about smoking possibly gonna get that a coffee tea yeah have you heard this before yeah mm-hmm so you know the smoking is going to be related not just to some of the other negative consequences you know physically it infects dental caries dental cavities +C: yeah +T: um healing yeah in your mouth okay +C: sure so I heard it all I but I just want to get my teeth fixed +T: yes and I really want to be helpful I really want to you know my commitment is to your oral health so there are lots of medications out there David that actually take away a lot of the cravings there they make winning song to my old things +C: I did try it so like I did try it i just did the pills and they didn't work yeah it was a waste and a cause more side effects +T: know it but David it's not a waste research hows that people take on average about seven tries before they quit smoking so think of it as you're one step closer to quitting +C: or seven lectures along the road +T: well I don't think I'm giving you a lecture it's really not what I meant I know +C: I just feel that way I get really I get very defensive about when the brick because I get it from my family doc my cardiologist everybody is like I'm not a complete fool I am for smoking +T: well there's there's a reason that other people are talking to quit no but as I said these medications so you've tried the medication you've been willing once then can I write you a prescription for the medication can we talk about how you could use it? because this is something that that's very important not just for your overall physical ha guess +C: I got to really want to it things I've tried usually caused me more problems and they helped +T: oh no the smoking is going to cause you more problems than the than anything else I can promise you that David the side effects from the medications are nothing compared to what can happen from the smoking like that's the I think thing to really consider +C: okay low can I go now? +T: I'm okay but you +C: know i know it i know'd I know doc what you're trying to do with it I I just don't want to get into that right now +T: okay well thanks for listening and honestly I I am really worried about the smoking so okay +C: Iappreciate your care +T: I'm here to help +C: okay okay \ No newline at end of file diff --git a/HighLowQualityCounseling/transcripts/low_048 b/HighLowQualityCounseling/transcripts/low_048 new file mode 100644 index 0000000000000000000000000000000000000000..2e828ac4ea3c1393c4862ad698e41a6f87d80dc7 --- /dev/null +++ b/HighLowQualityCounseling/transcripts/low_048 @@ -0,0 +1,15 @@ +T: hi Emily how are you? +C: I'm doing right how are you? +T: I'm good um Wow what's changed? what do we have here? +C: oh I got my lip pierced +T: Emily why why did you get your lip pierced why? I don't wanted to change and you can kind of cool gorgeous your teeth are lovely you do not need a piercing +C: I mean nobody needs up here saying I wanted one or +T: then do you know what those oral piercings can do to your teeth? +C: I mean it's my lip that's pierced not my teeth +T: well yes except that you know what's going to happen see how do you feel how when you're moving your lips smile for me okay so do you see how when your muscles are moving that piercing is rubbing against your gums as well as your teeth? so we can see some recession that's going to start to happen yeah possibly affecting the tooth itself chipping the tooth etc so it's something that we definitely don't like to see +C: I mean it's been okay so far it doesn't cause me any problems +T: well it's only been a month yeah okay orderly days yet and it might not be a bad idea to reconsider the piercing +C: I mean I just chose it I'm not going to take it right out it's like you said I've only had it in for a month +T: I mean Emily I've been seeing you for so long and you know that I really just I think you have lovely teeth and I've watched you you know just mature etc and I hate I'd hate to see you wreck your teeth for something like this I really would +C: well I mean if it starts to cause a problem then maybe talk about but at this point I mean all right +T: all right okay okay okay we'll continue the exam but you know where I stand on this okay all right all right \ No newline at end of file diff --git a/HighLowQualityCounseling/transcripts/low_049 b/HighLowQualityCounseling/transcripts/low_049 new file mode 100644 index 0000000000000000000000000000000000000000..f1d8356a2e0894225ae85376217278502e03f123 --- /dev/null +++ b/HighLowQualityCounseling/transcripts/low_049 @@ -0,0 +1,9 @@ +T: um apparently you got something on friday +C: yeah i got sentencing on friday and i had a chance to read my pretty sentence and i'm getting months so I'm kind of freaking out +T: freaking out about what? +C: well I mean all kinds of stuff of me knew it what's going to happen I can truly get an months and I complied with all the conditions you ask what you're doing here I doesn't impact my sentence I've got it worried about my family what do i tell my job I'm just tempted to sit heck with it live it up what the heck +T: I'm sure you knew from the beginning you the options word you could go to jail we could be found not guilty but you elected to plead guilty so you knew the auction was it was very likely that you were going to go to jail +C: well I mean I invited by all these conditions and it didn't do mean you get it exactly didn't do me a bit +T: you'll get an opportunity to walk in the court +C: that's something versus coming in from the prison well the time did didn't count for towards my sentence +T: didn't know we explained that early on \ No newline at end of file diff --git a/HighLowQualityCounseling/transcripts/low_052 b/HighLowQualityCounseling/transcripts/low_052 new file mode 100644 index 0000000000000000000000000000000000000000..ea38c6ca5115342df052ab6c07611fcc819e588d --- /dev/null +++ b/HighLowQualityCounseling/transcripts/low_052 @@ -0,0 +1,21 @@ + +T: leann I've noticed that it's been quite some time since your daughter's last dental checkup +C: I know I feel like I just can't find the time +T: I know that you know that dental health is really important especially for robbery and you've just got to try to make it a priority +C: I understand it's a priority but I do also have to work to you know +T: I know and work can make a dental appointment difficult yeah +C: it makes it very hard especially when I have to work days which +T: I see which makes a dental visit almost impossible it sure does could you talk to your boss about it? +C: I don't think that's gonna work my boss is not very flexible +T: So what do you think will help +C: I wish there was a dentist with evening hours +T: you know we do have some appointments that are later in the afternoon and we have appointments early in the morning or I could give you a referral +C: okay but listen how often do you really have to come in there just baby teeth right that's right +T: but the baby teeth are really important for for eating and for speech development and to help ensure that the permanent teeth come in properly +C: but the teeth aren't in bad shape +T: so tell me what you're thinking about the baby teeth +C: well as long as she can eat fine and they look ok what does it matter they're just baby teeth the new teeth will come in eventually is there some other reason +T: you're right nutrition is important but the baby teeth are also important in speech and in space maintenance and just in helping the kids feel better about the way they look +C: ok so it's to prevent problems later than +T: right it's all about prevention so what would you like to do now? +C: well I think then maybe we could come in for an appointment before work what appointment times do you have you? diff --git a/HighLowQualityCounseling/transcripts/low_053 b/HighLowQualityCounseling/transcripts/low_053 new file mode 100644 index 0000000000000000000000000000000000000000..18dd58d90d21c75ecdae711fa1171fa7e2c9b6b8 --- /dev/null +++ b/HighLowQualityCounseling/transcripts/low_053 @@ -0,0 +1,12 @@ +T: how have you been? +C: I've been great thank you how about you? +T: good thanks for asking today we're going to start by just asking a few questions I was just wondering how your home care has been since the last time I saw you know? so what type of products are you using to clean your teeth and to help prevent the build-up of plaque and bacteria and stuff? +C: well I've been using the manual toothbrush that you gave me in my last visit six months ago and then I've lost when I think about it probably only once a month and whatever i buy toothpaste I normally just get what's on sale to store +T: okay well that wasn't what I was expecting here and I'm pretty disappointed in your home care habits that's not the proper way to care for your teeth Oh as a professional and your hygienist I need you to buy an electric toothbrush because they remove way more than your manual one I also need you to brush twice a day and floss once a day and use some type of toothpaste of fluoride in it and lastly I really need you to use a mouthwash to prevent the build-up of bacteria and help print out everything out of your mouth after brushing and flossing +C: wow that's kind of a lot for me to do all in one try I have a really hard time with mouthwash especially because it really burns my mouth and I end up having to spit it out really quickly because it just hurts me too bad and I have to drink a lot of water after to get the burning sensation in my mouth +T: well I know what I'm talking about i went to school for two years to get my degree and what I'm telling you is really important if you want to try to keep all of your teeth and not get gingivitis or periodontal disease do you not care about your health? +C: I do but like I said it just burns my mouth so badly use mouthwash +T: you only have to swish for seconds and then go minutes without food or water if you can't handle that it's pretty embarrassing as an adult here's my favorite it's Listerine cool mint let me see you swish for seconds that way I know that you know what to do with the product when you get home and you can just keep that to spit out whenever I tell you that the time is up is it burning? mm-hmm keep going almost there okay you can go ahead and spit it out into the cup thank you so is it bad? +C: yeah it really burned so can I have some water my mouth is really burning? +T: well you have to go minutes without it so it'll go by fast okay and then i'm going to give you this little mini bottle that you can take home with you until you go to the store to buy your own just make sure it's this one cuz that one's really going to clean your mouth the best even though it burns a little bit okay just remember it's the best for your help and if you don't want to lose your teeth then you're going to need to do that +C: thanks \ No newline at end of file diff --git a/HighLowQualityCounseling/transcripts/low_054 b/HighLowQualityCounseling/transcripts/low_054 new file mode 100644 index 0000000000000000000000000000000000000000..6c6a962c770ed1cb2ceb23189fb0069940c3bd30 --- /dev/null +++ b/HighLowQualityCounseling/transcripts/low_054 @@ -0,0 +1,48 @@ +T: you know you don't have to sign up if you don't want to but you know kind of here to like fix things for you and just make sure everything goes no real smoothly with the different issues that you've been having and just kind of oh you know kind of manage things and just take care of stuff so you know it again if you want the service you can have it but it's kind of up to you but I am here if you want me to be and you know I'll couldn't kind of teach you about things you might not know about or tell you some things about your house and you know just more or less make sure everything goes okay so you know you think that might be something you'd be interested in wanting to be a part of because I you know really like to help you +C: okay well sure when you put it that way sure +T: because it seems like I you know you've expressed some health issues lately and I know you've had a lot of problems with your weight so that's certainly something we can talk about and I know a lot about you know weight loss and have helped a lot of people with you know managing their weight and figuring out what they need to do so you know what are your main problems about your weight I mean why is it a problem for you? +C: um I eat too much you eat too much yeah +T: so why do you eat too much? I mean how is that a problem? +C: because whenever I'm stressed out about anything it makes me feel relaxed and calm +T: so you like it you just like eating food so you just kind of eat eat more than you know you should be eating yes like do you know about portion control has anyone told you about like you know a card size for a piece of meat or some salad I mean have you has anyone showed you that? because I can pull out our yeah yeah samples and give you those that +C: i could probably tell you about it +T: you could tell me about it? I mean about what you should be eating for ya meet size and like you know baseball size for food so it's not that you don't know about you you you do know about poor iron control yeah so if you know how much you should be eating and then how is it a let me know if you know how much you should be eating then how do you stop? +C: well I guess you told me that you know a lot and you can fix my problem so that that's interesting i'm that's one of the reasons why i decided to participate so i was wondering if you could tell me +T: well that's great i could do about this yeah because you know there's there's just so many different things when it comes to like weight loss you know and really being able to have some self control i mean that's a really really important factor this is really being able to have some self control and you know i found a lot of people just really need to increase their fruits and their vegetables and just not eat any processed foods and you know not need any anything that might be kind of junk but then you know not not cheat either i mean you want to be able let yourself have some ice cream or some things that you might really like from time to time because you know you don't want to completely not let yourself have good stuff either so +C: it sounds though that you're seeing some opposite things because when one moment you're saying not have any don't have any junk but then allow yourself ice cream once in a while so that would make it really confusing for me +T: oh I see well you know obviously you want to make sure you're not eating you know junk food all day long but on the other hand you want to make sure that you give yourself some opportunities to have that bite of brownie or cake or you know I for myself personally I really love like lemon meringue pie so I always have to you know save that little piece for myself in the fridge to make sure i have my little bite of lemon meringue pie and then i can feel good about you know where I where I was eating good the rest of the day then I could still have my lemon meringue pie so something like that might kind of work better you know for you to really take a look at your portion sizes and then you know making sure you get out there and exercising me if you're not exercising it certainly not going to help you with being able to get off the weight either so that's that's critical how are you doing on weight loss as far as exercising? +C: oh I haven't been exercising lately +T: oh so see that's really key right that's a really key portion to it so it sounds like when we talk next time if you kind of kind of give me an idea maybe keep a journal for a week and tell me what you've been eating and we can really look at you know what good things that I can tell you what things you shouldn't be eating out of that plan and then I really think it'd be important if you just start maybe even just start walking three times a week if you could just start that really slowly and then months from now we can kind of see if that's helped some and we can talk about the items you've had on your journal and we can go from there all kind of direct you from there what you shouldn't be eating how does that sound? +C: well what does walking three times a week like for how long really like you know +T: sure what it was or whatever is comfortable for you so you know start out small so that you can feel really good about having some success in doing some exercise so you know if you feel tired at - minutes really just kind of paste it along for yourself and feel what's right so that you can feel like you're getting out there and getting moving because it's all about taking a small step and you know at least getting active okay and then I think the food journal would be really important because then we'll really have a better idea what you what you truly are eating and how many calories and then we can go from there I'm deciding you know how many calories you really should be eating in your diet and that way you can do a better job of monitoring it +C: okay +T: so how about we meet back and say three to four weeks and we can kind of see how that journals going? C well that seems like a long time I mean I think in three to four weeks a lot of things can happen and I think these things come on it yeah +T: if you have any problems along the way before then feel free to give me a call i'm always available so if there is something that you find it's just not working just give me a call we can kind of discuss it but then we can meet in person because we really should probably have about a month of your journal you know kind of down but if there's something that comes up I mean by Allah me just give me a call there's my extension so you'll call me if you you know my weights been coming up so +C: I think things will come up in a month yeah +T: well I I would hope that with some little you know with some exercise and with starting to be more aware by writing down what you eat you may find it as you have to write it down that you may find that you will avoid eating certain things because you don't want to you know as you write it down it may make you feel like well now I'm not so sure I should eat this like if you're going to eat them a whole container of ice cream you know you might not want to have to write that down so you may just limit yourself to scoop or two of ice cream so there is some kind of pieces that helps with having to write things down and I think we're just going to take it step by step but again there's my I'm phoning my extension so I'm here if you need me okay so let's just continue on our conversation that's so Tanya I'm really glad you're able to kind of come in and just talk with me for a couple minutes as i explained kind of briefly on the phone as part of your insurance benefit i'm available for you as your own personal coach you know i am a nurse but i have a lot of background in wellness so I've been really here to help guide people and kind of as a case manager I'm able to help you to help empower you don't kind of work towards your goals of what you're trying to work on with your health and I know you would expressed on the phone a little bit but I would love it if you tell me some more about you know what is one of maybe the main things you've been thinking about in relation to your health right now C okay well basically I feel like if I don't if I don't stay on certain habits and routines then everything just kind of goes kaput +T: so the structure is really important to you in your life in order to manage your health? +C: yeah I realize there's certain things i have to do in order to stay on on track yeah or else everything just kind of then i start noticing that i get into this whole this whole myriad of unhealthy unhealthy things and I feel yucky basically +T: so it almost sounds like a house of cards if one kind of shifts away from from that hmm they just kind of all fall down very quickly and then you start to not feel good about yourself or you don't start to feel good in general physically? +C: yeah I don't start feel good in general physically and then I you know I I yeah I can feel a change in my body and I just feel yucky because I'm then I end up not doing anything really +T: oh okay so because you start feeling poorly or you start feeling badly then you just kind of say well whatever or +C: yeah yeah it's kind of a move one and good habit reinforces on the other so they build upon each other and it's sort of like if I don't have that collection of good habits then yeah I start to feel it because I'm not exercising and then I start to feel you know the fat come on and yeah +T: for you it feels like this whole kind of circle of things almost cyclical and the fact if you're not doing what you need to be doing then you start to feel a weight difference in your weight yeah so it just kind of builds on itself +C: yeah +T: so what do you see is the key goal that you're trying to focus on right now or maybe a group of gold what are what are your key things that you are wanting to have happen? +C: well I think just doing those things that do make me feel good you know +T: tell me a little bit about those +C: drinking water eating a certain amount of fruits and vegetables per day getting a certain amount of activity in per day and I was just thinking lately what's important to me is having one kind of thing that I do around physical activity that's social so I'm around other people and I realized that that makes a big difference to +T: a social physical activity yeah that you get to be out and be with people like yeah just doing on your own +C: right like even going to a gym and just being around other people working out we're going to some kind of exercise class just to be around other people who their their general goal is to you know do physical tivity and feel better through it +T: so that you kind of feel like you're in a partnership together yeah that's rather than just your own yeah we aren't working toward this together as a group yeah so you've talked about several different kind of pieces that are important to you if we just took a look at that one activity because that sounds like a newer thing that you really need to push with where would you put yourself on how important this is to you want to say on a scale of one to ten? just just on importance +C: yeah right now I realized that it would be this is just something I came to realization today so it would be about I think it's an eight T Wow on eight yeah no it's really really up there yeah it's not a four-fight right and why would you say it aint not a four or five? +C: because I real i SAT tom it's a it is important for me to have a social interaction and be around people who are doing like I guess you could say like-minded like-minded things and then it becomes less just about me and more about you know just sharing +T: okay it's about sharing is that yeah really that piece of connectedness that's really important for you yeah so if we were to ask your second question and that's kind of where the rubber meets the road how confident are you that you could start finding a group activity let's say in the next two weeks? oh that you could start one obviously that steps to find it I involved but within two weeks you could find yourself in some type of a group activity +C: two weeks seems reasonable I think I can do it within two weeks so I would give that a +T: so you would get that in aid as yeah so it's something that's pretty important to you yeah I'm definitely more than a and also you're really confident that you can go out there and do that yeah what do you see is some of the barriers that might get in your way? +C um I guess just um structuring my time better Chuck sure you're doing better yes yes so really not slacking off and really not saying okay well I'm tired you know now tonight I'll just wait till tomorrow basically that +T: so finding the time in your day be able to do or not do this or not yeah and how do you see that best in your day how do you see that working in like an evening kind of thing around the evening? +C: Yeah Yeah right now the way the way--just might today is structured with what I need to do in terms of them work and other commitments okay evening yeah +T: so one of the things I hear people frequently will be saying is that the evenings my time to unwind and then I don't have the energy or I don't feel like going out to do something that might be more rigorous how is that for you? +C: I think that would be that would be okay I could always have a cup of coffee beforehand you can always have a cup of coffee at we're hand yes +T: well if it be okay with you I would love to touch base maybe after that class starts and just kind of see what you found how it's working and then we can go from there looking at any kind of barriers the one thing I think I would just encourage you with to normalize is to realize about doing things in small doable steps and not feeling like if you haven't done everything for the day that you are hailed the day but but that any more water you drink or vegetables you've added it's certainly a positive and look at my friend right then to be hard on yourself right towards your you know movement toward wellness right okay so if we could touch base maybe in three weeks sure that would be super I'd really look forward to it I'm really glad you came in okay thank you diff --git a/HighLowQualityCounseling/transcripts/low_055 b/HighLowQualityCounseling/transcripts/low_055 new file mode 100644 index 0000000000000000000000000000000000000000..0a4858cb20e0023ba9e8d7ede72a42ab7fe8673e --- /dev/null +++ b/HighLowQualityCounseling/transcripts/low_055 @@ -0,0 +1,16 @@ +T: hi my name is Cambridge I was a pharmacist I see you're taking a lot of medications what do you have the time to walk through them with? +C: yeah I got a few moments +T: okay so I see that you're taking simvastatin amlodipine and sertraline I know this is kind of a lot of medications what patients have a lot issues taken all those medications dude do you ever miss a dose or how do you take them? +C: I usually just take them right out of the bottle but yeah like you said it's kind of complicated so I missed doses here and there +T: what you missed doses? +C: yeah yeah I mean it's complicated sorry +T: okay well a lot of a lot of people missed dose is what are you doing to kind of combat the missed doses? +C: I usually don't worry about it little say any side effects from this feel any different if I suppose +T: well there's a lot of things we can do to kind of help you make sure you keep taking your doses it's a pretty important are you aware of like some of the benefits that always be on your dosage and taking them regularly has? +C: I haven't have seen anything I feeling different +T: yeah and make many faces sort of feel like that way but you really want to take care of your health and make sure that you're improving to the best of your ability in the long run so I can help you with some meds sync apps and that kind of stuff to help you walk through your medication to make sure you get the reminders that you need +C: all right +T: yeah I need to respond to this real fast okay it's my girlfriend ok back to what I was saying is there anything else that I can help you with today? oh you you feel frustrated because it's so many medications it's hard that +C yeah if you could go to feel like explain how it could make it easier i'm taking medication +T: ok well we have a what's called a med box and a lot of patients like to use that so if you are Phil the communications that have been box I can help you with that and then all you have to do is no would you wants to take or what which time is there? already good that seemed like something you would want? +C: oh yes yeah I think that'd make a nice today okay thank you very much yeah i would get that key to diff --git a/HighLowQualityCounseling/transcripts/low_062 b/HighLowQualityCounseling/transcripts/low_062 new file mode 100644 index 0000000000000000000000000000000000000000..5c869ded750759479ffddce12e03fd13dfaf3833 --- /dev/null +++ b/HighLowQualityCounseling/transcripts/low_062 @@ -0,0 +1,51 @@ +T: finded life a bit anxious making just am I'm I'm working full time my husband's abroad okay my child's just left to go to university and I'm doing an online course and I really feel as if everything's getting on top of me and I felt like this once before about three or four years ago you'll you'll have it in your records and and you give me some tablets and not just helped me just get over the hump and I'm really thinking that I need some medication +T: okay let's see your records that be sorry about two years ago roughly? +C: yes that would be about right yes and +T: do remember the name of you tablets you got them? +C: valium +T: let's see it yeah you got tablets at that point +C: yes yes and that was enough I didn't need any more than I just helped me get over the hump I'm just I just I'm feeling tearful and I don't feel able to get moving motivated and things are slipping and I'm just just a bad day yeah Jess I just feel anxious +T: but you're working now is that right? +C: i guess i'm working now mmhmm yeah +T: is ok? +C: yeah ever since fine at work uh-huh yeah i know what's key i enjoy but obviously it's because i'm feeling a bit i feel as if things are getting on top of me at work a little bit but it's not really i know this noise just that we are feeling okay +T: you're sleeping well? +C: i'll wake up harrell in the morning and I don't seem to be able to get back to sleep or go to sleep okay at night but wake up hell in the morning edge or soon to be able to get back to sleep very quickly okay +T: you eating fine concentrations good core memory is good? +C: Constitution could be a bit better my memory getting older you know my memory to schools a little bit but other than that normal really just feeling just I'm worried about things I'm worried about my daughter she left home and you know worried about all of that and my husband's abroad and you know this online courses drive me and scene but I know that I know that when I'm on for him and when I'm not just feeling so overburdened I'm fine +T: is that why you're not looking after yourself as well at the moment? +C: I am looking after myself I'm eaten quite healthily I just struggled to get sleep I guess sleep okay and I wake up in the morning I mine's going nuts +T: and alcohol? +C: I have a couple of glasses at Wayne at night just helps me get off to sleep +T: with glasses how much do you mean? +C: and maybe about mils in a glass that reasonably smallish classes yeah +T: two of those? yeah okay and you wanting tablets? +C: yes that helped me the last time and that's what I want +T: we've no Rini to follow guidelines and recommendations on how they've had just had recently updated guidelines we use things like nice guidelines and stuff and you're describing anxiety symptoms that seem to be related to specific issues and we don't think tablets are the best thing anymore we're there's much more recommendation to big you know talking with professionals having what we call CBT cognitive behavioral therapy working through these issues is probably a better long-term option and is what is firstly recommended and second recommendation we try and avoid especially those types of drugs you're talking about valium because we know they just make addicted to them +C: ah so what about this did you see cognitive cbt cbt what does that mean +T: it's a psychologist to talk to you about you how things you do +C: how long does it take well +T: it's usually our obsessions in a seminar if you're lucky once a week that week wicked +C: I don't have time to do I wear long sessions once a week I'm working full time and I'm doing an online course and I've still got a house to manage I just would prepare the tablets work for me before I would prefer that I got +T: you don't have anyone any of them left yet still we finished all those you had? C two years ago yes yep she took all than one then when I needed them yet and that was fine that was all I needed though you gave me I think tablets that was all I needed just to get me over the hump nope just about - weeks +T: still think be worth having a more in-depth discussion about this to see what would be your best options because I other tablets as well that can be used again there again more preventative it's more to keep these things getting so it doesn't happen again and again and again right and also your ways of coping assume does it +C: how long is it if you get referred for cbt how long does it take to be seen +T: it depends a bit on different areas where is it you live just locally here don't you yeah i would have to send a letter and we would get a reply to tell us how long you'd have to wait and i would hope it would be too long because this is one of our prioritized areas and it how long is too long what i should be within the month i would take a month yeah +C: i could get tablets and be fixed in a month yeah so you're saying i can't get tablets +T: well i definitely when you give you that many and i really think you'll be worth looking at the other options how about i gave you just a few like a couple to see if that does you a little better than it +C: and then i have to come back when I'm finished in and go through this whole conversation again +T: no I think no I think we should refer your straightaway +C: right so no tablets you've gone from +T: I'll give you a few tablets I'll give you a few tablet and we'll refer you because I need you don't have to come back here unless there is a problem +C: but you're seeing that a Pharaoh's going to take a month and you're going to give me a few tablets I can i'll be back here next week seen can have some more tablets then +T: do you think it's going to last that long? +C: as if it's good like tell that's the last time and it took the tablets to help me get myself sorted out so yes i do i just think this is ridiculous changes are more for changes but it worked what if it works like like oh it's just we know the damage +T: i can do you affect your driving light over they dictate just as a short bar so it was won by suppose if that's your day I'm saying well I think you know that beam in between we can give you a couple of times now to try for the next few days I'll send a referral today and obviously if you feel so better you can come back but I would hope you wouldn't need to ask okay let just to do check here as well computers reminding me that you ever do you smear as well that we will as well yep you know we have targets we need to read targets yeah so worth getting them done +C: but I you sure your records are right i'm pretty sure i had last me or less than a year ago +T: was that somewhere else then? because that might not be recorded here no is good something here +C: this is my plant assistant single you can ask me about my blood pressure names don't you +T: that was done we need to do that every three or five years I've got that has been done that's okay and for the smear it's not being recorded here did you get a letter with the result? if you do member we could be good records that way no it's not going to do any harm getting an extra one so make the point with the nurse right the time the +C I will get that done as well so everything is up to date +T: okay i'll just write the description +C: okay thank you sir okay +T: thank you see you diff --git a/HighLowQualityCounseling/transcripts/low_063 b/HighLowQualityCounseling/transcripts/low_063 new file mode 100644 index 0000000000000000000000000000000000000000..72000309e22ccefa2f6028c8da89417a7338fb66 --- /dev/null +++ b/HighLowQualityCounseling/transcripts/low_063 @@ -0,0 +1,28 @@ +T: come in hey doctor hello how are you today? +C: I'm very well thank you have you seen many repeat prescription and what's up for the real doctor Reducto and that's for my my class cuz I've done with it all of them +T: right no no no no what when was the last time you got that prescription from us? +C: although you few miles back +T: yes I'm surprised did you see the local GP? +C: yeah could be hmm +T: you shouldn't have been given a doctor why do you think you need that? +C: I'm using it for a while this kind of referee well because i've been using rate and it well a little bit wait but it helps i'm not so happy anymore and I kind of think it's a bit more and still lose weight +T: no no no you can't you you can't get that drug anymore I'm afraid no no you're not having that drug anymore and it's been proven that that drug is not good for you and so I'm very surprised that the look and gave it to you but we're not doing it anymore yes but it's not it's not fine it's not good for your heart it's causing heart problems and it's been proven that it's not the most effective way to lose sweet and what what are you doing about your lifestyle? what are you doing about losing weight? other than depending on tablets? +C: oh okay and change my cooter died kick both ways however Larry's I kind of working chichester really that's doing a bit more stairs and but doesn't much time for you +T: well it's going to take a bit more than that I think and have you thought about planning in advance? if you work you know taking a packed lunch pre planning your meals and turning to healthy options? because really even diet cooks not good for you you should be replacing that with water +C: oh yeah we don't get meals we can't have to do it in between and Julie doctor at the hospital we have a good time and we need to kind of just bringing her face yeah lovely often you can to be kind you can't even get food is just like you chocolate or something +T: yeah but I roll the other doctors overweight no no so clearly you could be improving your lifestyle you could take a wrap and just have it you know you could make a wrap a healthy wrap and take it and just have it instead of reaching for a bar of chocolate because i'll also affect your blood pressure and your sugar levels so and what I think you should maybe do as maybe just have a maybe do a diet e of your lifestyle because well it's a no popping a pill seems like an easy option but really you're going to have to do the hard work this is only going to come if you get in the right headspace and you start looking at your lifestyle looking at your exercise looking at your eating habits looking at the frequency and your magnet you're eating because if you're running about as a doctor you shouldn't beginning we if you if you've got a busy lifestyle you should be losing weight naturally so you're there must be something in your daily routine that's stopping you so you maybe need to look and see if you're a comfort eater or what what your triggers are for food and and get that sorted but you know I'm afraid drugs are no longer the answer C I'll just get one half down to the last few months of my job and then +T: no I know I you know we would all like a magic wand because it makes life easier but I can't do that it's not worth the risk to your heart I can't I can't do that you just need to take a long hard look at yourself and what you're doing and if you want help with that we do have pamphlets you know have you thought about and you know doing some exercise that you feel more energized +C: oh I've not lack of energy around all day that's not a problem it's just really time I'm getting time to do something else moment it's just work asleep I'm afraid mm-hmm not much to be there it's just wreck yeah +T: so you need to put some thought into if you is that is your lifestyle you're going to have to put some thought into when you can devote some time to looking after yourself +C: I think I'll be able to do as I finish this job but I just need something now mm-hmm because otherwise I can't really afford to buy new clothes and it was it was keeping me kid +T: so are you putting on weight or have you been losing the weight? +C: let's think you can be steady and speak +T: so you've not you've not been losing weight with it? C that's being okay yeah I probably should put on weight of an that's been using it yeah +T: so you can't you know it's good that you're standing still but it's not good that you're not losing weight especially if you're on the drugs so clearly the drug wasn't the answer for you and really the only answer for you as its lifestyle changes and you know look at your colleagues and are they what are they eating and adopt some of their policy Asian was there eating on the hoof they must there must be some of your colleagues that are eating healthy options that you could you could take a flask of soup you know I'm soup salads wraps fruit and veg you know that's that's the only way is the hard way but it's the only way yeah +C: I can't see me doing that that's a problem it's sleeping where no time to give the shelves no time to do preparation that this just like so happy equals there and if we get time to go to the cantinas you just okay just something don't seem to be very many healthy options and if they're either you be gone by the time we get there +T: that's why I think you need to control of it yourself by planning and making sure that you have healthy options available because otherwise you're just going to stay in a vicious cycle and and you know drugs we would all like a drug to me things easy for us but I'm afraid easy it's not the option it's going to be a hard slog but I think I think you'll find that once you start if you get yourself into the right headspace once you start then you will have a sense of achievement and the wheat will start loose it you will start losing the week because if you're that energetic in your job you're obviously doing enough activity so it has to be down to the diet +C: is there nothing you can do to help +T: but why don't you make a diary of everything that you eat? because you might not realize I had you might be grazing and not realizing it so why don't you keep a food diary and come back and see me and two weeks time can you keep a diet have you got k cubed I you for two weeks? +C: yeah I think I should give it yeah if you +T: if you write down everything that you eat and any extra activity other than running a boat in your jobs that you do and we'll look at that and where you now before you go and will we when you come back and then we'll see if you can start making a conscious effort and then we'll maybe set you down with a dietician set you up with an appointment with the dietitian to get some nutritional advice but I think you need to start preparing yourself mentally and to be in the right headspace to make this work for you because if you're not in the right frame of mind if you're doing it grudgingly then you're not going to lose weight +C: okay thank you \ No newline at end of file diff --git a/HighLowQualityCounseling/transcripts/low_064 b/HighLowQualityCounseling/transcripts/low_064 new file mode 100644 index 0000000000000000000000000000000000000000..dbcebc21812bc7a09407581f365d84426dac3812 --- /dev/null +++ b/HighLowQualityCounseling/transcripts/low_064 @@ -0,0 +1,27 @@ +T: come on +C: hello Doctor okay +T: how can I help you t well +C: I would like a repeat prescription please for my diet drugs just confirm for me your name again +C: Laura Smith up like yes yes I brought you +T: Reducto I think that's what it was colleges and reduct I'll actually is no longer recommended and for usin in we lost weight control have you been getting on with it? +C: and I know they're not losing weight but I'm not putting it on and just give me another one then I'm not fussy which makers I am +T: you can buy em over the counter Laura doors lower doors tablets eat so you don't need a prescription for them anymore +C: well I've know that my prescription cause my prescriptions fee and I think I've got a Rachel prescription and no +T: I'm sorry we can't prescribe orlistat +C: why and +T: because it's over-the-counter medicines right +C: so just give me the equivalent and counter is great +T: we can't we can't prescribe anything reductil was the one that was on I was prescription on the medicine and we can no longer prescribe that guidance recommends that we no longer prescribe that for people because it's actually shown to increase the cardiovascular risk and actually I noticed from your last visit that your blood pressure was a little bit high I don't think you should be taking any medicines because the bottom line is actually from what you're telling me is it's not helping you to lose weight it's helping you to maintain your read and maintaining your weight should be something that you do through diet and exercise anyway this is artificially maintaining your weight +C: find that really hard just keep piling on the pounds until I started a dragon you know I really would like it are you sure that it's yet dangerous because yes not that long ago that happen well +T: it has actually been recent gaiden so in the last month or so after six weeks tips sometimes tease a bit to filter through but we've been told unequivocally that we're not allowed to prescribe this anymore your prescription to farm since they won't fill it and you really do need to be joining Weight Watchers there's been an article there's been an article in the in the BMG just a couple of weeks ago that shows are actually joining a group a Weight Watchers group or the equivalent is much more effective long-term well I'm sorry there's no choice yeah it's a much lower it's much more it because it's less there's less and drug in it it's less effective but then consequently it's also less dangerous so you can buy them orlistat and or you can join Weight Watchers you actually +C: I don't think you're thinking about how stressed I am about my week I'm sorry it's not you I know I know and +T: I can appreciate that what it's your diet and exercise that's the important thing you need to get yourself sorted out I don't eat them all well I think you might find that you possibly are eating more than you think and if you join Weight Watchers or equivalent slimming world etc then you possibly would be encouraged to do a food diet e and you might find that you're eating more than you there's nothing more I can do for you we cannot prescribe reductil anymore the recommendation is join a Weight Watchers group or Slimming World Group and just modify your diet and increase your exercise that is the only way that you are going to lose weight +C: well I'm not really happy with that approach I'm really sorry that I was unable to help you because +C: there must be somebody else in here that has got more and understanding approach to weight loss and telling me to join Weight Watchers +T: well that is the recommendation that's the guidelines if you're very welcome to go and make an appointment with another doctor but you will get the same message from them as you're getting from me and I'm uh sorry if I peered unsympathetic however the bottom line is diet and exercise is what you need to do in order to lose weight and to maintain your weight +C: but I am eating what I've always it's just know that I'm getting little age and piling on pounds so +T: if you're on if you're on a stool that you've always done then you're always going to get what you get so if you already eat and you've already used to be fat but the only reason that you're maintaining your weight is because of the deductr +C: if you would let me finish I've only started to get fat since I had the menopause so are you telling me that because I've had the menopause I'm not allowed to eat a normal amount of food +T: no I'm saying that you need to be looking at your whole lifestyle which is dying exercise I'm really sorry that i'm unable to help you today please feel free to make an appointment with another GPA +C: well i'll be taking this further because i'm not happy i'm not satisfied with this ok thank you +T: thank you \ No newline at end of file diff --git a/HighLowQualityCounseling/transcripts/low_065 b/HighLowQualityCounseling/transcripts/low_065 new file mode 100644 index 0000000000000000000000000000000000000000..03e4ea3949e89cd75035849582af654043977a84 --- /dev/null +++ b/HighLowQualityCounseling/transcripts/low_065 @@ -0,0 +1,22 @@ + +T: okay so I wrote a prescription for an antibiotic for Aidan that should help with the ear infection but in looking through this chart I mean it seems like he's had six or seven of these just in the past year or so that's really a big problem +C: yeah it's pretty stressful for both of us it gets really upset +T: well one of the primary risk factors for multiple ear infections and kids is actually smoke exposure are you smoking? +C: yeah I yeah I do smoke but I don't smoke around him I try really hard not to smoke around him +T: well the fact that he's having these ear infections is indicating to me that he is being exposed to smoke and so what can you tell me about that? +C: I I don't know I mean I try really hard not to smoke around him I don't smoke in the car when he's home I go outside to smoke I just I mean I know it's bad and I know it's bad for him so I don't want him to be around it so I try really hard +T: I really need you to quit smoking both for your health and for Aidan did you know smoking around your child is associated not only with ear infections it could get to the point where you have to put tubes in his ears pretty shortly here also things like vitamin C do efficiency cavities like dental cavities behavior problems asthma other upper respiratory infections it's really putting him at a lot of risk in addition to that kids of smokers end up smoking themselves you want him to grow up to be a smoker? +C: no but I don't smoke I'm I I I've thought about quitting but it's just it's really hard so I just don't know how to do it +T: well now is the time to quit it's really gotten to the point where you can't keep smoking not only for him like I said but also for you you're putting yourself at risk for lung cancer for emphysema for oral cancers for heart disease for all kinds +C: I know I know I've heard people have told me before I've heard all that I just don't know how to do it how am I supposed to quit it's so hard +T: well there's all kinds of things you can use now it's not as hard as it used to be you can use nicotine replacement there's patches there's lozenges there's gum there's the inhaler there's nasal spray we can talk about medications you can try chantix you can try zyban there's quit smoking groups you can go to there's hotlines you can talk +C: don't have times +T: no reason why you shouldn't be able to quit this is really important +C: I understand that I know it is I mean everybody has problems right it's just really it's really really hard +T: well what can be more important to you than the health of your child? +C: I don't know +T: I really need you to tell me that you're gonna quit smoking this is really important +C: oh I'll go look at all those things and I'll find I guess I'll try to find something and I'll talk to my doctor about it +T: okay well I think you really need to think about this seriously it like I said it's really putting yourself and your child in danger +C: okay whatever +T: okay okay \ No newline at end of file diff --git a/HighLowQualityCounseling/transcripts/low_070 b/HighLowQualityCounseling/transcripts/low_070 new file mode 100644 index 0000000000000000000000000000000000000000..591f4615093d1fc4a8ba6ee0c97c716d8aa21472 --- /dev/null +++ b/HighLowQualityCounseling/transcripts/low_070 @@ -0,0 +1,11 @@ +T: hi I'm the pharmacist how can I help you +C: hi I need to get this new prescription filled +T: you've been here before? +C: no I haven't +T: okay um so so this is a new prescription? +C: yeah it's a new another blood pressure medication Marty and one I just went to see my doctor earlier and I was hoping he told me I could stop it because I I cut my salt intake I started going to the gym regularly but no instead now he says I need a second one I'm not even sure if the first one worked +T: no problem I'm just going to ask you a few other questions before I fill this prescription okay do you have any allergies no any medical conditions? +C: just acid reflux and high blood pressure and +T: any other medications you're taking? +C: yeah well I i said i'm already on a blood pressure medication i take hydrochlorothiazide i'm already on milligrams in the morning and that's when I was hoping that I could stop but I have to keep taking that one and i'm also on pan to lock one taladon +T: okay well let me just counsel you on this medication \ No newline at end of file diff --git a/HighLowQualityCounseling/transcripts/low_076 b/HighLowQualityCounseling/transcripts/low_076 new file mode 100644 index 0000000000000000000000000000000000000000..755f9c4f604656d2d0d3280df58be62e2206c324 --- /dev/null +++ b/HighLowQualityCounseling/transcripts/low_076 @@ -0,0 +1,20 @@ +T: Discuss a little bit of your medical history in your taking your vitals. I'd like to ask you a few more questions. The rise in your blood pressure is concerning me, so I would like to gather a bit more information about your life style. +C: k. +T: Have you had any major stressful events recently or any change in your work situation? +C: Not really, I haven’t been stressed, and I have a steady job. You know these day I’m really glad I have a job, I’m really happy that I’m working. +T: I would also like to ask about some health habits that can contribute to high blood pressure. Do you smoke at all? +C: No I don’t smoke. I smoke as a young adult, quit year ago, I went cold turkey, proud of that, haven’t really thought about smoking. +T: Do you drink alcohol and including beer or wine +C: I do drink beer, I drink or times on weekdays, sometimes on weekends, maybe or Cancel me like the increase in your drinking could certainly be contributing to your high blood pressure. +T: I'm concerned about the amount that you're drinking currently it sounds like you're having about to drinks per week. It’s definitely more than what we would recommend and could certainly be contributing to your high blood pressure. +C: Well my pressure has been high for years, +T: Well according to your chart your blood pressure has gone up since July and you said that you've been drinking more recently so do you see the connection there. +C: Maybe a little bit +T: alcohol can have some dangerous effects on your body so long with contributing to high blood pressure can have a big impact on your liver would you need to keep in mind so your liver has several different roles in your body for acid helps process excess fatty acids before they get distributed to the rest of your body and also helps process Alcohol and Other Drugs so when you have an excess of alcohol your liver can't work as efficiently and the fatty acids build up an overtime your liver won't be able to work as well. +T: How about the use of other drugs like cocaine, hyrewen, marijuana? +C: I don’t use marijuana cocaine, and I’ve never thought about using the hard drugs. Back in school, years ago or so, I smoked weed, once I got out of school, I haven’t used that at all +T: Have you ever used any prescription medications they weren't prescribed for you or in a way that wasn't prescribed? +C: No I don’t really like the idea of taking pills, as a matter of fact, a couple years ago, I had this jaw surgery, they give me the prescription of … I took one, maybe felt wired, they still sit in the medicine cabin. +T: Ok, it sounds to me that the increase in your drinking could certainly be contributing to your high blood pressure. I think decreasing the number of drinks that you have when you go out and maybe decreasing the number of times that you go to the bar each week could be the best thing that you can do for your health. +C: I guess I’ll try. +T: And then we'll set up an appointment for about a month from now will recheck your blood pressure and see how you're doing with all this. \ No newline at end of file diff --git a/HighLowQualityCounseling/transcripts/low_077 b/HighLowQualityCounseling/transcripts/low_077 new file mode 100644 index 0000000000000000000000000000000000000000..03a30ac771bf9d2910bfc7e82347e57feaf5e28e --- /dev/null +++ b/HighLowQualityCounseling/transcripts/low_077 @@ -0,0 +1,25 @@ +T: okay so I'm just going to ask you a couple more background questions do you use any tobacco products or smoke cigarettes +C: no I would bum cigarettes in college but I was never a smoker +T: okay how about in the last year +C: no not really anything +T: okay and how often do you have a drink containing alcohol +C: a few times a week Wednesday's I'll go to a happy hour and have about two or three and then um Thursday's seven seven or eight Friday's probably just a couple glasses of wine with dinner but Saturday's are a bigger night and I would probably have a few drinks before I went to the bar and then have or at when when I was out so +T: okay so it sounds like you're drinking about four times a week anywhere between three and eight drinks on a given day so maybe around drinks a week +C: I guess it sounds like a lot when you say look at but yeah +T: okay do you use any street drugs like any marijuana cocaine heroin +C: no I I spoke weed in college but just a little bit I wasn't a regular smoker +T: do you ever use any prescription medicines that were not prescribed for you or ever use your own prescriptions in a way in which they were not prescribed +T: okay so you know as we said before you're drinking it sounds like you're drinking about drinks a week over the course of a few days and I did want to point out to you that the recommended limit for women is actually no more than seven drinks a week and no more than three on a given day so you're doing more than that right now and when you drink more than this amount it puts you at risk for a number of things +C: okay +T: things like greater risk of injury damage to different parts of your body just a bunch of different problems and so I'm going to recommend that you cut down to cut down that amount to the recommended limit again that's no more than seven drinks a week and no more than in a given day do you think you could do that would that be a good goal for you +C: that's a lot to change I don't know +T: yeah I know that making changes isn't always easy but when you more than what's recommended it creates problems you know you said you hurt your ankle and came out of the bar this time +C: I mean the stairs were really steep so yeah +T: well it's possible you strained your ankle as a result of the alcohol you know it can actually affect your balance and stability so really you know for where you are right now you're drinking a good amount more than what's recommended and you know I want you to be healthy and I don't want to see you coming back in here for something else so I'm really going to recommend that you try to cut down to that amount so do you think you could do that cut down to no more than three drinks in a given day +C: where are these limits from an older population because I drink just as much as my friends do I mean everybody drinks like I drank I'm not even the biggest drinker in my group so I'm pretty middle of the road +T: so it sounds like you know the amount you drink is pretty normal amongst the people you typically drink with but these limits are they're actually recommended for all adults and studies have shown that when you drink more than this it creates a bunch of problems like we talked about so you know why do you think you drink the amount you drink +C: I don't know that's what we do is this is how we have fun I guess it is fun +T: well I think it can still have fun with in these amounts so that's what I'm going to recommend I think this is a really good goal and hopefully we won't see any more injuries +T: okay so why don't you try that +C: okay +T: all right thank you so much \ No newline at end of file diff --git a/HighLowQualityCounseling/transcripts/low_078 b/HighLowQualityCounseling/transcripts/low_078 new file mode 100644 index 0000000000000000000000000000000000000000..745ac3acf3b3a320feb1a081295319ec78b51f60 --- /dev/null +++ b/HighLowQualityCounseling/transcripts/low_078 @@ -0,0 +1,10 @@ +T: hi you Julie Thompson +T: hi I'm horse Berger I work in the clinic I know you're here to pick up a prescription today I noticed that we noticed some your records that you've been coming in and getting Sarah's rescue rescue inhaler for her asthma quite frequently and you haven't got her chronic inhaler for quite some time now I also know she's been in the emergency room several times this year is can you tell me what's going on there +C: well I did a research on the chronic inhaler and I saw that there were steroids in it and I do not want my daughter taking steroids I read about all the side effects of steroids and all the potential health problems I don't want her taking them and I just want to tell you right up front I do not want to hear anything about the fact that I do smoke I smoke outside I smoke away from her I do not ever do it around her so I do not want to hear about that +T: well III need to tell you that the the medicine that she's taking the chronic inhaler which is really essential to controlling her asthma does is not a steroid like you're thinking it's it's much safer it's very safe she and she needs to take it to get her asthma under control and I also want to tell you that your smoking does affect her asthma even if even if it's outside it gets on her clothes and to be honest I'd like to see you quit smoking for you anyway but if you want to keep her out of the emergency room she needs to use that chronic inhaler every day and you need to watch your smoking +C: okay I am NOT going to allow her to take any kind of steroid I am NOT going to allow that to happen she's my daughter she's my responsibility and I'm not going to allow that to happen and I absolutely make sure that the smoking does not affect her +T: okay I you know I don't want to argue with you about this I I know that if you you died if you want to keep Sarah out of the emergency room I just wish you'd heed what I'm saying she needs to use that chronic inhaler every day to get her to get her asthma under control and the smoke and your clothes and smoking flares her asthma so she really needs to use that chronic inhaler and you really need to think about quitting smoking fine +C: I'm in a really big hurry and I need to get those prescriptions filled as soon as possible please +T: okay well I hope you really listen to what I'm telling you about it using that chronic hailer and i hope you consider quitting smoking +C: fine I just need to get my prescriptions +T: good \ No newline at end of file diff --git a/HighLowQualityCounseling/transcripts/low_079 b/HighLowQualityCounseling/transcripts/low_079 new file mode 100644 index 0000000000000000000000000000000000000000..d07c8867af3c2e904930c766725b2fd749d43689 --- /dev/null +++ b/HighLowQualityCounseling/transcripts/low_079 @@ -0,0 +1,8 @@ +T: Hi Liz will thanks for meeting with me today so what's something that you'd like to change or work towards C; well, I’ve really been thinking about working out lately, I really want to start working out again, It’s been on my mind, and I know I need to do it. It’s just getting the motivation to do it. +T: and you’ve been talking about that a lot lately, So I really feel like this is something you need to do soon, because a lot of time there’s just a lot of talk, but there’s no action. And if you really want to see results, I guess it’s something that needs to be done and stop being lazy about it and just do it. +C: Well I don't know if I'm really being lazy about it I think it's just that I have a busy schedule yeah I just need to find the time to do it and yes I might be laughing a little bit of motivation but I think it's more time again trying to fit it in. +T: and it sounds like a lot of excuses to me, and you have shared with me before that you do have a gym membership so that’s just something you need to fit in your schedule. So for you to see results you want, my guess is that you need to go about to times a week and really fit in that hour workout on a daily basis. +C: But it is part of the problem is that I don't have to times a week to do it or an hour or even I mean hours the long time cuz if I'm working out for an hour that means I'm leaving home to get there time there time back I mean it's not just an hour it's the two hours realistically and. +T: and it seems like if you really want to see the results you have to put the time in and if it’s gonna take you two hours it’s gonna take you two hours. And again, if you want the results you need to start and you need to start now. +C: well, Okay.. +T: I;m looking forward you see you tomorrow, and I'm hoping that you are going to be able to tell me that you went to the gym. \ No newline at end of file diff --git a/HighLowQualityCounseling/transcripts/low_083 b/HighLowQualityCounseling/transcripts/low_083 new file mode 100644 index 0000000000000000000000000000000000000000..df22c698f9670c19e86f10ca065f37492680ce6d --- /dev/null +++ b/HighLowQualityCounseling/transcripts/low_083 @@ -0,0 +1,25 @@ +T: finish the exam have some good news and they have some not-so-good news looks like you don't have any cavities so that's the good news +C: that's great +T: however I'm pretty concerned about something I'm noticing in your mouth actually if you look up here a roof of your mouth I'm noticing a lot of irritation that's really consistent with tobacco use and you had said on your form that you're not a tobacco user so I'm just wondering what's going on +C: I don't smoke cigarettes +T: okay well as I said there's a lot of irritation in particular like I was mentioning up here in the roof of your mouth it's turned really deathly white colored and there's little red spots and you probably didn't notice because we don't spend a lot of time looking at the roof of our mouth but you're really damaging this tissue in your mouth which can really cause some severe problems in terms of your oral health it's called nicotinic stomatitis and this is something we don't see in any patients who don't use tobacco so maybe you're not smoking cigarettes are you smoking a pipe or cigars or is there something else they will be contributing to this because I don't know what else might be causing it +C: well the only thing I've never smoked cigarettes ever but when when I go out with my friends we like to go to you know we'd like to go out to lounges and and you know sometimes there are those those nice young men that gift you different sorts of things and we got some of those mini cigars that swisher Sweets they come on peach and and grape and and you know that's the only time that really you know I've ever really used anything that that's got to pack Oh in it okay +T: so I think that's a pretty common misconception because they're fruit flavored people think they're okay those are really bad for you did you know that I'm +C: really bad but they're just little mini little cute little girly cigars +T: right there still cigars and there's still tobacco and so they still cause lung cancer oral cancer emphysema all those same kinds of things that you would see with cigarettes +C: boy only if it were just to relax I mean it's not like it's something that I would smoke or cigarettes a day I mean I only do it when we go out uh-huh +T: well that's I mean at least you're not doing that so that's good but it's still causing a lot of problems and as I said I can see that the evidence in the roof of your mouth you're causing some serious damage and this needs to stop have you thought about quitting +C: well I didn't really know I'd started +T: what do you mean +C: I didn't really think that it was anything more than just like social drinking just something that I do in a social setting when me and my friends go out to the bars +T: so you're going to quit then oh +C: maybe +T: what do you mean maybe I just told you how bad it is for you it's messing up your mouth you're putting yourself at risk for all these other diseases this is really important you need to quit +C: well it's something that I'll have to think about +T: what's there to think about you said it's not that something you do all that often I'm there's all these negative side effects there's all these risks that you're putting yourself in +C: well it's just something that I do to relax and I don't with that often and so I probably could cut back +T: okay well that's a good start but cutting back isn't going to do it if you actually quit the smoking you can reverse all the damage you've done in your mouth and you can stop yourself from from being at risk for these other diseases but as long as you're continuing to use these cigars you're really putting yourself in a lot of danger +C: well I don't believe that their cigars and what I do believe is that it's a choice and it's my right and it's something that I choose to do and so I will think about cutting back but I'm not at a point where I'm ready to do that and I'm not really sure that I even believe that what you're telling me is real +T: you're choosing to really damage your mouth and actually it can cause problems with your teeth too I don't know if you notice your teeth might be getting yellower than they were before that's another side effect there are a lot of really negative things that go along with any tobacco use whether it's cigarettes cigars dip to snuff snooze who got any of it this is a really important decision that you're making and you said it's your choice but you're really choosing to make yourself sick and potentially die +C: well it's something that I'll think about +T: well I appreciate you thinking about I hope you'll think about it really hard you know this is something that I'm going to continue to ask you about because it's something that really needs to change \ No newline at end of file diff --git a/HighLowQualityCounseling/transcripts/low_084 b/HighLowQualityCounseling/transcripts/low_084 new file mode 100644 index 0000000000000000000000000000000000000000..2c0bca0fc6d4f2dfb0a0ae9cac08e0c57c6168a1 --- /dev/null +++ b/HighLowQualityCounseling/transcripts/low_084 @@ -0,0 +1,65 @@ +T: so there anything else we can help you with today Jeff before we go +C: no that's all of it +T: great what I'd like to do just before you go is your recall in your reception the receptionist gave you a questionnaire to fill in +C: yeah +T: I just like to talk to you about their she enters it in the computer and I see from the way you filled it in we at the moment from a perspective of your health will classify your physical activity is inactive +C: what +T: inactive so at the moment I'm like we're going to +C: have a very busy life +T: perhaps what I could tell you is looked at the moment the current recommendation for health is that everybody should do minutes of moderate exercise at least five days that the week that's to benefit their head I fleets you mean now everybody +C: why why would I want to do that much +T: what's really important is particularly as somebody your age is you're really entering that age where we really need to think about heart disease diabetes +C: it's nothing wrong with my health and +T: that's that's how we'd like to keep it of course and if you were to exercise at that level what we know is you half your risk of getting heart disease having high blood pressure getting diabetes gaining weight etc and of course my concern is that you're healthy at the moment we keep you there +C: so what are you telling me but +T: what we really need to discuss is how we can get you to be a bit more physically active start moving this along a little bit +C: I have a very busy life +T: so you do a lot of things but from where you feel this in you really don't do enough physical activity to benefit your help or +C: give me for disagreeing with you but when you run a business but I do I mean I've got i got people in my company what you're saying it do you think it's easy running a company is it buddy chica thing you got telling me I'll growth when am I supposed to take time to get that don't want to go the gym edge imagine how running your cum I'm not aware the factory all day long you think that's not exercise I'm not sitting at a desk like you I'm sure you're all I Gobert all right I just like night +T: I understand that you're on the go all the time but what's really important is no more that you protect your health now imagine running your business if you're held in the dark deteriorate +C: there's nothing wrong with my health +T: and that's the way we'd like to keep it of course and what I'm really concerned about is all men of your age of my age is our health now is at a point where it starts to you know we have to think about heart disease and things like diabetes and one really good way of protecting ourselves this is to be physically active well we'll go around in circles it because i would say i am particularly active well +C: what are you telling me i should do that i don't do +T: well if you think about that recommendation that any equivalent if you like of walk in two to three miles an hour a day at a fairly fast pace there are things equivalent to that not just being on the go that's you know marching rather than strolling mm-hmm +C: and when would you like me to do this i mean i'm at work six thirty in the morning often don't go home till eight o'clock at night +T: well ideally this is something to do every day this is kind of a minimum amount of physical activity +C: there can't be done +T: well one of the things i should tell you about is that not doing this so not doing much physical activity does really increase this one of the most important risk factors for heart disease for some cancers colon cancer that affects many men and for elevated blood pressure all the things that we see are getting common in men as they get older start to become more risky if we avoid physical activity +C: yeah are you just trying to scare me now aren't you I'm not equate I don't need I don't need all this +T: so it's a genuine concern and obviously part of my job is to let you know about my concern and make sure you've got the right information to make decisions about your health and this is one of the important things you can't +C: okay well I've got time to go walking every day so what's the next best thing I can do +T: well the good news is you don't have to do it all in one gut you can do minutes in the morn in minutes at lunch time and ten minutes of an evening that would still lead to important health benefits I see anything in the bigger scheme of things is minutes investment in your health worth it +C: well people don't like that well of course is I don't to get sick but I die I just don't think it's necessary but I'm perfectly healthy so what why do you think it's so important +T: oh because the evidence tells us it really is an important risk factor similar in the way that smoking is we know now obviously everyone takes it as a bit of given that smoking's not really a good thing to do for their health and we're realizing that physical activity is the same avoiding physical activity is as much of a risk to your health as smoking is C; well well what else could I do +T: well I'd like you to really give some thought to doing a good brisk walk in the mornings every day and again in the evenings and you turn me walking around the factory is not enough +T: well I suspect I don't know of course but I suspect it's not really the equivalent of a good March for ten continuum minutes +C: can I ask you a personal question well you say you know we're men of a simulator much exercise do you get +T: well I try like you I've got a busy job and we're always on call etc but i do really try and fit in a good strong walk every day does that mean you do it every day most days most days I do +C: well if you could do I suppose I could do it +T: I think I do really think it's very important for you +C: you think it would make a big difference +T: I think you'd be surprised how much difference it made and indeed when you're at work I suspect you know it'll help with the energy you have for that busy job and in the long term it yeah one way to think about it it's a real investment in the future +C: I'm not convinced +T: Jeff family Jeff +C: yes I have family +T: so you can imagine at some point in the future you know you don't want to be in a situation where you you know want to play with the grandchildren for example and you can't because you simply unfit +C: yeah well my grandchildren live overseas and actually so I don't get to see the left mmm +T: but you see my point +C: goodbye I'm not stupid +T: you don't want your lack of fitness no I mean how you behind on you know of course that I supply golf but I doubt the time these days mm-hmm take +T: you have been fitter +C: what I was younger yeah yeah +T: so you think that's something you could do again +C: no yeah because you know it says it is a popular pastime and it of course unless rubbish at it and I've got walking is a different matter I want what more bye dad is he really true walking did make a difference +T: yes if you do it briskly mm-hmm this is +C: I do everything bristly +T: yeah well walk walking briskly does lead to very substantial health benefits yeah and +C: well I'll try it I'm going to +T: when do you think you will do something +C: when I because these things you can imagine you're easy to agree to and then we meet again in a few weeks time and +C: i'll tell you what i'll do then ok you've been straight with me I'll be straight with you instead of driving to work i'll walk to work that will take me minutes that'd be fantastic that's right well I'll get my chauffeur to take me home +T: ok so deal then mm-hmm when we should start doing that geez +C: I could do it tomorrow ok so deal with +T: then you're going to do minutes of brisk walking today give it a try +C: yeah if it does it up and I'm feeling different after a month I won't bother anymore because it be frank it's an inconvenience but i'll do it for you +T: why don't you and I meet again in a month mmm take stop and you can tell me what you found out yeah and then we'll have another chat about it then ok all right we'll do that ok alright fair enough thanks Jeff see you again in a month \ No newline at end of file diff --git a/HighLowQualityCounseling/transcripts/low_090 b/HighLowQualityCounseling/transcripts/low_090 new file mode 100644 index 0000000000000000000000000000000000000000..9bf87fde76dafb8ccf4107e9b1a807f18e12c217 --- /dev/null +++ b/HighLowQualityCounseling/transcripts/low_090 @@ -0,0 +1,4 @@ +T: Jim Cup hi I why are you stuff in my office all right Jim so what brings you in today +C: oh man you know just I change my lifestyle just finding what works Todd burning stuff and I got this I don't know like family problems in the past and dad died from having a hard Zak and everything and I guess I'm next so you know got to figure everything out how much it seems like a lot of work +T: all right listen up you got to make some big lifestyle changes you need be decreasing your so do you need to be an angry teasing potassium increasing magnesium cutting all that saturated fat your diet looks horrible right now I mean you're you're hardly doing anything right Jim you're going to end up just like your dad if you don't change right now you have to change Jim +C: well jesus take the wheel in because I'm stressed that's what I'm coming here for geez opium just I'm trying \ No newline at end of file diff --git a/HighLowQualityCounseling/transcripts/low_091 b/HighLowQualityCounseling/transcripts/low_091 new file mode 100644 index 0000000000000000000000000000000000000000..9fa0efb0f92a16f1e8108e6e1065cfc03a0ac57f --- /dev/null +++ b/HighLowQualityCounseling/transcripts/low_091 @@ -0,0 +1,6 @@ +T: hi pharmacists I have some questions that I really need to speak to someone about +T: yeah pharmacist go ahead +C: so I'm going to let your advice because my son doctor is really on my case about getting vaccinated against the measles because of all the cases that are happening but I really don't believe in vaccines +T: well the measles is a really bad infection so it's really important you need to give your son the vaccinations +C: what about all the risks my son's never been sick because I make sure he washes those hands I keep them away from public places and I give them walk the vitamins +T: it doesn't matter if your son's always healthy vitamins don't treat the measles diff --git a/HighLowQualityCounseling/transcripts/low_096 b/HighLowQualityCounseling/transcripts/low_096 new file mode 100644 index 0000000000000000000000000000000000000000..534e13abe1ce60e81c81c93b6e4c6db0983b5916 --- /dev/null +++ b/HighLowQualityCounseling/transcripts/low_096 @@ -0,0 +1,12 @@ +C: It calms my nerves. It makes me feel good. +T: It calms your nerves and makes you feel good. +C: I can't go without it. +T: OK Ms. Fisher listen to this, by continuing to smoke you are putting your body in a great amount of harm COPD, chronic bronchitis, pneumonia, asthma, all these other type of bad things. You know so why haven't you quit yet? +C: Because it's hard and I like it. +T: I don't understand. What's so tough about it? Can't you understand that you are putting your body at great harm by continuing to smoke? +C: I mean I guess so. +T: You guess so. OK so good. So that means you want to quit now right? +C: Yeah +T: OK, good, good I'm glad to hear you say that. So this is what were gonna do. First, were gonna set a quit date. Next, I want you to go home and remove all the cigarettes in your surroundings. Like, as soon as you leave here. And then finally, I'm gonna give you this prescription for Chantix which you can take every day, and also these nicotine patches. Ok. +C: Yeah +T: Ok, alright good. We'll set an appointment for you to come see me in another month. When we see you in another month you need to have quit smoking cigarettes because you know how bad it is for you. Alright? Alright, you can pick up the prescription from my nurse on your way out and then call me at the clinic if you have any questions. OK. Thank you so much it was good seeing you again. OK, Alright. Take care. Bye \ No newline at end of file diff --git a/HighLowQualityCounseling/transcripts/low_097 b/HighLowQualityCounseling/transcripts/low_097 new file mode 100644 index 0000000000000000000000000000000000000000..14e279027196109f0859b734aa506a3daf0cbaf0 --- /dev/null +++ b/HighLowQualityCounseling/transcripts/low_097 @@ -0,0 +1,36 @@ +C: That's great. +T: However, I'm pretty concerned about something I'm noticing in your mouth. Actually, if you look up here... the roof of your mouth, I'm noticing a lot of irritation that's really consistent with tobacco use. And you had said on your form that you're not a tobacco user, so... +C: I don't... +T: I'm just wondering what's going on. +C: I don't smoke cigarettes. +T: OK. Well, as I said, there's a lot of irritation. In particular, like I was mentioning, up here in the roof of your mouth, it's turned really deathly white colored, and there's little red spots, and you probably didn't notice cause we don't spend a lot of time looking at the roof of our mouth. But you're really damaging this tissue in your mouth, which can really cause some severe problems in terms of your oral health. It's called, Nicotinex Domotitus, and this is something we don't see in any patients who don't use tobacco. So, maybe you're not smoking cigarettes. Are you smoking a pipe? Or cigars? Or, is there something else that.. +C: Well... +T: Could be contributing to this, because I don't know what else might be causing it. +C: Well, no. Only thing... I've never smoked cigarettes, ever. +T: Mmm hmm. +C: Um, but, um, when um, when I got with my friends, um, we like to go to, you know, we like to go out to lounges... +T: Mmm hmm. +C: And, um, you know, sometimes there are those... those, uh, nice young men that gift you different sorts of things, and we got some of those many, uh, cigars, that Swisher Sweets... +T: Uh huh. +C: They come in peach, and grape, and... and, you know, that's the only time that really, you know, I've ever really used anything that, that's got tobacco in it. +T: OK. So, I think that's a pretty common misconception, because they're fruit flavored, people think they're OK. Those are really bad for you. Did you know that? +C: Really bad, but they're just little, mini little, cute little, girly cigars. +T: Right. They're still cigars. And they're still tobacco. And so, they still cause lung cancer, oral cancer, emphysema. All those same kinds of things that you would see with cigarettes. +C: Well, I only use 'em... +T: This is really important. +C: Just to relax. I mean, it's not like it's something that I would smoke twenty or thirty cigarettes a day. I mean, I only do it when we go out. +T: Uh huh. Well, that's, I mean, at least you're not doing that. So, that's good. But it's still causing a lot of problems, and as I said, I can see the... the evidence in the roof of your mouth. You're causing some serious damage. And this needs to stop. Have you thought about quitting? +C: Well, I didn't really know I'd started. +T: What do you mean? +C: I didn't really think that it was anything more than just like social drinking. Just something that I do in a social setting when me and my friends go out to the bars. +T: So, you're gonna quit then? +C: Uhh, maybe. +T: What do you mean, maybe? I just told you how bad it is for you. It's messing up your mouth. You're putting yourself at risk for all these other diseases. This is really important. You need to quit. +C: Well, it's something that I'll have to think about. +T: What's there to think about? You said it's not, that... something you do all that often. Um, there's all these negative side effects. There's all these risks that you're putting yourself in. +C: Well,it's just something that I do to relax, and I don't do it that often. And so, I probably could cut back. +T: OK, well that's a good start, but cutting back isn't gonna do it. If you actually quit the smoking, you can reverse all the damage you've done in your mouth, and you can stop yourself from... from being at risk for these other diseases. But, but as long as you're continuing to use these cigars, you're really putting yourself in a lot of danger. +C: Well, I don't believe that they're cigars, and... what I do believe is that, it's a choice. And it's my right. And it's something that I choose to do. And so, I will think about cutting back. But I'm not at a point where I'm ready to do that, and I'm not really sure that I even believe that what you're telling me is real. +T: You're choosing to really damage your mouth, and actually it can cause problems with your teeth, too. I don't know if you've noticed your teeth might be getting yellower than they were before. That's another side effect. There are a lot of really negative things that go along with any tobacco use. Whether it's cigarettes, cigars, dip, chews, snuffs, snus, hookah, any of it. This is a really important decision that you're making, and you said it's your choice, but you're really choosing to make yourself sick, and potentially die. +C: Well, it's something that I'll think about. +T: Well, I appreciate you thinking about it. I hope you'll think about it really hard. You know, this is something that I'm gonna continue to ask you about, because it's something that really needs to change. \ No newline at end of file diff --git a/HighLowQualityCounseling/transcripts/low_098 b/HighLowQualityCounseling/transcripts/low_098 new file mode 100644 index 0000000000000000000000000000000000000000..0a461b557bcb594b9b184e8e2917531f9a6984e9 --- /dev/null +++ b/HighLowQualityCounseling/transcripts/low_098 @@ -0,0 +1,22 @@ +T: Can I help you? +C: Uh yea, I just got off work and apparently they're going smoke free so I thought I'd stop by the pharmacy here and see what my options are. Some of my friends have tried nicotine patches and they say they work very well. I don't really wanna quit smoking, I just need something to get me through the day. +T: So you want nicotine replacement but you don't want to quit smoking? +C: Maybe like, during the day nicotine replacement. Is that, I mean do you have anything like that? +T: Yea, we don't really recommend that. The idea is that you would use the nicotine replacement to actually quit so then you wouldn't be smoking at work but you also wouldn't be smoking the rest of the time either. +C: Well I don't really want to quit, I mean I like smoking, I like going after work to have a beer with my friends, not smoke cigarettes. I mean, I know it's not really a big deal, cigarettes aren't that bad. I mean I know it's popular to say smoking is bad for you but ya know, I like it so I'm going to keep doing it. +T: Okay well smoking really is really bad for you, you know it causes things like lung cancer, emphysema, heart disease. +C: Yeah. Okay. +T: Oral disease. +C: Oh well what are my options now? Assuming that I am right, what are my options? +T: Well to be honest with you, you mentioned the patch, I can't recommend a patch to you if you're going to continue smoking that can actually be pretty dangerous for you. In order to advise you about this at all I need you to tell me a little bit more about your smoking history and how much you're smoking now. +C: I smoke barely a pack a day. I mean I probably smoked about or years now. It's not really a lot of cigarettes but it's sorta hard to get through the day at work. +T: Okay well we actually consider cigarettes a day to be a significant amount and in fact I would then recommend to you that you start on the highest dose of nicotine replacement. +C: Sounds good to me. The more nicotine the better. Is there like gum or something? Could I chew it like while I'm in the office? That sounds pretty great. Do you have? +T: Well there are some products that you could use to take away some of your cravings, then probably the gum would be the best option for you. It's not something that you would continue to use continuously throughout the day however but gum is something you use just when you have a craving. +C: Oh. Okay. Well where is that? +T: Well, we have that here but again but the idea would be for you to actually quit smoking. +C: Well, I'm probably not going to buy anything today. I mean I just came by to see what my options are. Thanks for the input. Do you have anything else? Do you have any other? +T: Well. +C: Advice for me? +T: Aside from the gum you could try the nicotine lozenge that would be another option for you, again that's not something you wanna use continuously throughout the day. The nicotine patch is the best for continuous nicotine replacement but again that's not something you can use while you're continuing to smoke. +C: Oh well. Okay, well, thanks, I mean I guess that helps a little bit. Maybe I'll be back later. Thanks. \ No newline at end of file diff --git a/HighLowQualityCounseling/transcripts/low_099 b/HighLowQualityCounseling/transcripts/low_099 new file mode 100644 index 0000000000000000000000000000000000000000..199ee7ff1ab08abe21fbdf99c9dce0964e80f36b --- /dev/null +++ b/HighLowQualityCounseling/transcripts/low_099 @@ -0,0 +1,22 @@ +C: Yeah. +T: That's really a problem. +C: Yeah, it's pretty stressful for both of us. He gets really upset. +T: Well, one of the primary risk factors for multiple ear infections in kids is actually smoke exposure. Are you smoking? +C: Yeah, I ... Yeah, I do smoke, but I don't smoke around him. I try really hard not to smoke around him. +T: Well, the fact that he's having these ear infections, is indicating to me that he is being exposed to smoke. And so, what can you tell me about that? +C: I ... I don't know. I mean, I try really hard not to smoke around him. I don't smoke in the car, um, when he's home, I go outside to smoke. I just ... I mean, I know it's bad, and I know it's bad for him, so I don't want him to be around it, so I try really hard. +T: I really need you to quit smoking. Both for your health and for Aiden. Do you know, smoking around your child is associated not only with ear infections, it could get to the point where he'll have to put tubes in his ears pretty shortly here. Also things like vitamins C deficiency, cavities, like dental cavities, behavior problems, um, asthma, other upper respiratory infections. It's really putting him at a lot of risk. In additions to that, kids of smokers end up smoking themselves. Do you want him to grow up to be a smoker? +C: No. But I don't smoke ... I ... I ... I've thought about quitting, but it's just, it's really hard. So, I just don't know how to do it. +T: Well, now's the time to quit. It's really gotten to the point where you can't keep smoking. Not only for him, like I said, but also for you. You're putting yourself at risk for lung cancer, for Emphysema, for oral cancers, for heart disease. For all kinds of things. +C: I know, I know. I've heard people tell me before. I've heard all that. I just ... don't know how to do it. How am I supposed to quit? It's so hard. +T: Well, there's all kinds of things you can use know. It's not as hard as it used to be. You can use nicotine replacement. There's patches, there's lozenges, there's gum. There's the inhaler. There's nasal spray. We can talk about medications. You can try Chantix, you can try Zyban. There's quit smoking groups you can go to. There's hotlines you can call ... +C: I just don't have time for any of that ... +T: There's no reason why you shouldn't be able to quit. This is really important. +C: I understand that. I know it is ... I mean, everybody has problems, right? It's just really, it's really really hard. +T: Well, what can be more important to you than the health of your child? +C: I don't know. +T: I really need you to tell me that you're gonna quit smoking. This is really important. +C: I'll, I'll, I'll go look at all those things and I'll find ... I guess I'll try to find something, and I'll talk to my doctor about it. +T: OK, well I think you really need to think about this seriously. Like I said, it's really putting yourself and your child in danger. +C: OK. Whatever. 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