diff --git "a/AnnoMi-therapist/test.tsv" "b/AnnoMi-therapist/test.tsv" new file mode 100644--- /dev/null +++ "b/AnnoMi-therapist/test.tsv" @@ -0,0 +1,1141 @@ +video_name text label task +AnnoMi-therapist_117_24.mp4 Okay. other therapist_behaviour +AnnoMi-therapist_117_26.mp4 Sure. other therapist_behaviour +AnnoMi-therapist_117_28.mp4 That's interesting isn't it? You-- 'cause you kind of mentioned it there, like, you know, on one side of the coin, um, it helps calm the nerves to get yourself get out there and- reflection therapist_behaviour +AnnoMi-therapist_117_30.mp4 -talk to guys at the same time, on the other side it's not working you're finding. And i-i-it results in hangovers or? reflection therapist_behaviour +AnnoMi-therapist_117_32.mp4 Okay, and so I guess, you know, what would you like to do given the circumstances? question therapist_behaviour +AnnoMi-therapist_117_34.mp4 Yeah. other therapist_behaviour +AnnoMi-therapist_117_36.mp4 Okay. other therapist_behaviour +AnnoMi-therapist_117_38.mp4 Okay. other therapist_behaviour +AnnoMi-therapist_117_40.mp4 Okay, okay, so, uh, sounds like you really want to stop drinking, particularly during the weekdays? reflection therapist_behaviour +AnnoMi-therapist_117_42.mp4 Right, because you're noticing it's having a negative impact on what you're eating. reflection therapist_behaviour +AnnoMi-therapist_117_44.mp4 No, I get it. Yeah. I mean, you know, it sounds like it's, it is helpful to a degree for you when you go out because it makes you feel a little bit more calm to talk to-to guys is that right? reflection therapist_behaviour +AnnoMi-therapist_117_46.mp4 Yeah. other therapist_behaviour +AnnoMi-therapist_117_48.mp4 Yeah. other therapist_behaviour +AnnoMi-therapist_117_50.mp4 Sure. other therapist_behaviour +AnnoMi-therapist_117_52.mp4 "Yeah, yeah. So, you've got, you know, some benefits there then, you know. The social element, hanging with friends and-and going out together is something which is-is quite enjoyable. So, it's not a case of removing it completely but it’s a case of, ""Okay, I’m noticing this is impacting on me more than what I’d like to."" Yeah. Yeah, okay. " reflection therapist_behaviour +AnnoMi-therapist_117_54.mp4 Has there been times in the past where you’ve tried to cut back on drinking? question therapist_behaviour +AnnoMi-therapist_117_56.mp4 Oh, this is the first time anything like this has come up? question therapist_behaviour +AnnoMi-therapist_117_58.mp4 Yes, yes. other therapist_behaviour +AnnoMi-therapist_117_60.mp4 Okay, yeah. Well, it’s great that you’re able to identify, you know, what’s going on at the moment and you've-- not only know that, you almost picked up on a bit of a pattern too you're in- other therapist_behaviour +AnnoMi-therapist_117_62.mp4 -as to why you’re-you're drinking. In terms of looking at cutting back on-on drinking, you know, on a scale of 0 to 100 and 100, uh, meaning it’s tremendously important for you and 0 not important at all. How important is it for you to cut back on the drinking? question therapist_behaviour +AnnoMi-therapist_117_64.mp4 Okay, yeah yeah sure, you're already taking a huge step forward in many ways by coming along to-to start talking about it. other therapist_behaviour +AnnoMi-therapist_117_66.mp4 Um, I guess 80 is quite high, what makes you say an 80 over say 50? question therapist_behaviour +AnnoMi-therapist_117_68.mp4 Okay. other therapist_behaviour +AnnoMi-therapist_117_70.mp4 "Okay, yes, so you’ve got this real sense of, ""I've gotta do something."" " reflection therapist_behaviour +AnnoMi-therapist_117_72.mp4 That’s what it seems like. reflection therapist_behaviour +AnnoMi-therapist_117_74.mp4 So, at the moment, it's been a case of the last six months, this is a pattern that you’ve been noticing more and more, um, a sign that it has had negative impacts on your lifestyle which you’re not happy with and you are in you're in a position where, you know what? I wanna do something about it. reflection therapist_behaviour +AnnoMi-therapist_117_76.mp4 Okay, I mean what do you think that next step is? therapist_input therapist_behaviour +AnnoMi-therapist_117_78.mp4 Yeah. other therapist_behaviour +AnnoMi-therapist_117_80.mp4 Okay. other therapist_behaviour +AnnoMi-therapist_117_82.mp4 Okay. other therapist_behaviour +AnnoMi-therapist_117_83.mp4 -so it just doesn’t go crazy. other therapist_behaviour +AnnoMi-therapist_117_84.mp4 Okay, okay, so you’re thinking about perhaps looking at trying to keep weekdays free of alcohol? Was that what you were saying? therapist_input therapist_behaviour +AnnoMi-therapist_117_86.mp4 Okay, how does that sound like a first step goal for you? therapist_input therapist_behaviour +AnnoMi-therapist_117_88.mp4 Okay. other therapist_behaviour +AnnoMi-therapist_117_90.mp4 Okay, you sound really mad about it to-to turn it around. reflection therapist_behaviour +AnnoMi-therapist_117_92.mp4 Okay, oh, that-that's excellent, okay. other therapist_behaviour +AnnoMi-therapist_119_0.mp4 Thanks for coming in. Tell me what's been happening since we last spoke. question therapist_behaviour +AnnoMi-therapist_119_2.mp4 Wow, that's so great. other therapist_behaviour +AnnoMi-therapist_119_4.mp4 You sound disappointed. reflection therapist_behaviour +AnnoMi-therapist_119_6.mp4 It's gonna keep happening that you have to turn down opportunities. reflection therapist_behaviour +AnnoMi-therapist_119_8.mp4 Mm-hmm, okay. Well, tell me, um, on a scale from one to 10, how important is it for you to get a job? question therapist_behaviour +AnnoMi-therapist_119_10.mp4 Yeah. You're-you're-you're it. reflection therapist_behaviour +AnnoMi-therapist_119_12.mp4 You have to provide for your children. reflection therapist_behaviour +AnnoMi-therapist_119_14.mp4 Um, and tell me on a scale from one to 10, how confident are you that you could get a job? question therapist_behaviour +AnnoMi-therapist_119_16.mp4 So, it sounds like, you know, the childcare issue has been getting in the way, and so finding something that would work for you would be really helpful. reflection therapist_behaviour +AnnoMi-therapist_119_18.mp4 And then also it sounds like you're kinda feeling not so great about your resume and your experience. reflection therapist_behaviour +AnnoMi-therapist_119_20.mp4 Okay. What is it that you- what is it that you want? question therapist_behaviour +AnnoMi-therapist_119_22.mp4 Yeah. Yeah. So, if you had- if you had consistent work, it would change your life in a lot of ways. reflection therapist_behaviour +AnnoMi-therapist_119_24.mp4 Mm-hmm. It would provide the income that you need and you wouldn't worry so much. reflection therapist_behaviour +AnnoMi-therapist_119_26.mp4 Right. So every day you know where you're going. reflection therapist_behaviour +AnnoMi-therapist_119_28.mp4 Okay. And you know, what's- what's happening for the- for the day, for the week. reflection therapist_behaviour +AnnoMi-therapist_119_30.mp4 Yeah. other therapist_behaviour +AnnoMi-therapist_119_32.mp4 Right. Yeah. Because you're- you're the kind of parent that wants to make sure your kids are doing well. reflection therapist_behaviour +AnnoMi-therapist_119_34.mp4 Yeah. Um, so tell me, what would it take to get you to like a five in confidence, to feel a little bit more confident about getting work? question therapist_behaviour +AnnoMi-therapist_119_36.mp4 Okay, Yeah. other therapist_behaviour +AnnoMi-therapist_119_38.mp4 Mm-hmm. other therapist_behaviour +AnnoMi-therapist_119_40.mp4 Yeah. Because you definitely need to go to an interview in order to get the job. reflection therapist_behaviour +AnnoMi-therapist_119_42.mp4 So having taken care of that part, having some reliable childcare would definitely help. reflection therapist_behaviour +AnnoMi-therapist_119_44.mp4 What else would get you to a five? question therapist_behaviour +AnnoMi-therapist_119_46.mp4 Okay. other therapist_behaviour +AnnoMi-therapist_119_48.mp4 Mm-hmm, mm-hmm. other therapist_behaviour +AnnoMi-therapist_119_50.mp4 Okay. other therapist_behaviour +AnnoMi-therapist_119_52.mp4 Yeah, so if you had something on your resume that was around education training, maybe a certificate of some kind of a field that you're interested in, that you would feel proud of yourself. reflection therapist_behaviour +AnnoMi-therapist_119_54.mp4 Mm-hmm. Okay. What-- do you have any ideas as to what fields you might be interested in getting some more education, more training? question therapist_behaviour +AnnoMi-therapist_119_56.mp4 Like what's going to be fastest. reflection therapist_behaviour +AnnoMi-therapist_119_58.mp4 Okay, and so if- if you were, it sounds like if you were going to do something you'd wanna to do something really quickly like a short- a short certificate. reflection therapist_behaviour +AnnoMi-therapist_119_60.mp4 Yeah, sort of like a short-term or transition into something else. reflection therapist_behaviour +AnnoMi-therapist_119_62.mp4 But that would be steady and pays well? reflection therapist_behaviour +AnnoMi-therapist_119_64.mp4 Okay, and allow you to afford everything you need to afford. reflection therapist_behaviour +AnnoMi-therapist_119_66.mp4 Okay, so specifically getting some computer skills will help? reflection therapist_behaviour +AnnoMi-therapist_119_68.mp4 The technology. reflection therapist_behaviour +AnnoMi-therapist_119_70.mp4 Mm-hmm. Okay. So whatever and so far it sounds like getting a job is really important right now and you really need the money and you really need to take care of your children and it sounds like you have some ideas as to how you could get to these interviews for one, and then once you're there at the interview, feeling more confident about your skills, um, getting some child-- reliable child care certainly sounds very important. reflection therapist_behaviour +AnnoMi-therapist_119_72.mp4 Um, as well as maybe doing some sort of certificate or getting some classes and training in computers? question therapist_behaviour +AnnoMi-therapist_119_74.mp4 Okay. other therapist_behaviour +AnnoMi-therapist_119_76.mp4 So what would you like to do next, you think? question therapist_behaviour +AnnoMi-therapist_119_78.mp4 Okay, okay. other therapist_behaviour +AnnoMi-therapist_119_80.mp4 That's a priority. reflection therapist_behaviour +AnnoMi-therapist_119_82.mp4 Yeah. other therapist_behaviour +AnnoMi-therapist_119_84.mp4 Yeah. other therapist_behaviour +AnnoMi-therapist_120_0.mp4 Well, I'm glad we figured that out and I think you'll feel better over the next few days. other therapist_behaviour +AnnoMi-therapist_120_2.mp4 Well, since I have you here and we still have a few minutes left, I'd like to bring up another topic. I noticed that your blood pressure and your weight have been climbing a bit over the past few years. We haven't really had time to talk about this much before and I may be able to offer some useful strategies. Would it be okay if we discussed weight and health for a few minutes? question therapist_behaviour +AnnoMi-therapist_120_4.mp4 I know how you feel. Managing weight can be frustrating. Maybe we can just start trying to figure it out together and I'll be here to help you through the challenges. reflection therapist_behaviour +AnnoMi-therapist_120_6.mp4 Yeah, that's certainly understandable. We both know that there's a lot that plays into weight management, but there's no need to figure it all out today, especially since things are so busy for you right now. Maybe we could put our heads together and think about something small that fits reasonably into your life and then we can take further steps when you're ready. therapist_input therapist_behaviour +AnnoMi-therapist_120_8.mp4 Well, let's see. One of the things that's involved in managing weight and health is being active. Physical activity benefits the whole body. It's healthy for our joints, our stress levels, and especially for weight management. Perhaps we could talk about some ways of adding activity that fit into your life. therapist_input therapist_behaviour +AnnoMi-therapist_120_10.mp4 Well, I understand that. I don't have an hour to go to the gym every day either, but one of the great things about physical activity is that any amount in any type of activity can be very helpful. For example, let's think about some activities that you enjoy doing. therapist_input therapist_behaviour +AnnoMi-therapist_120_12.mp4 Me too. Walking is great exercise. therapist_input therapist_behaviour +AnnoMi-therapist_120_14.mp4 Actually, even just a few minutes of walking is really healthy and worthwhile, and then when you have time to do even more, that's great. Walking is also great because you can do it anywhere, it doesn't need to be at the gym. therapist_input therapist_behaviour +AnnoMi-therapist_120_16.mp4 That sounds great. other therapist_behaviour +AnnoMi-therapist_120_18.mp4 Well, dancing is a great exercise, especially because it's fun. therapist_input therapist_behaviour +AnnoMi-therapist_120_20.mp4 Oh, that's great to hear that your family is so supportive. And I bet there's a dance class somewhere around where you live or maybe even a dance fitness class at the gym. reflection therapist_behaviour +AnnoMi-therapist_120_22.mp4 Would you like to do some research on this and give it a shot? therapist_input therapist_behaviour +AnnoMi-therapist_120_24.mp4 Well, small steps can go a long way. So, even things like taking the stairs instead of the elevator every once in a while or parking just a bit further from the door when you go to a store can be ways to increase movement in your day. therapist_input therapist_behaviour +AnnoMi-therapist_120_26.mp4 How about we start there and let's plan to follow up in a few weeks so we can see how it's going and then maybe talk about some other strategies that might help. therapist_input therapist_behaviour +AnnoMi-therapist_120_28.mp4 Not necessarily. What we eat is certainly important for weight and health, but just like we did today, we can talk about some small steps that can fit into your life, and especially ones that you feel good about. therapist_input therapist_behaviour +AnnoMi-therapist_120_30.mp4 That's great. I'll see you soon other therapist_behaviour +AnnoMi-therapist_121_0.mp4 Uh, welcome. And, uh— other therapist_behaviour +AnnoMi-therapist_121_2.mp4 I'd say my name is Mark and I work here at Green Prescriptions. And- therapist_input therapist_behaviour +AnnoMi-therapist_121_4.mp4 I know a little bit about you from the referral letter from the doctor. reflection therapist_behaviour +AnnoMi-therapist_121_6.mp4 From your GP, yeah. reflection therapist_behaviour +AnnoMi-therapist_121_8.mp4 But before we get to anything, I'll probably want to just ask you a little bit about what's led you to come here today and get a bit of an idea about what's been going on for you. other therapist_behaviour +AnnoMi-therapist_121_10.mp4 Mm. other therapist_behaviour +AnnoMi-therapist_121_12.mp4 And what did he have to say? question therapist_behaviour +AnnoMi-therapist_121_14.mp4 mm. other therapist_behaviour +AnnoMi-therapist_121_16.mp4 Right. other therapist_behaviour +AnnoMi-therapist_121_18.mp4 Mm. other therapist_behaviour +AnnoMi-therapist_121_20.mp4 Right, so he kinda gave you a directive? reflection therapist_behaviour +AnnoMi-therapist_121_22.mp4 Mm. other therapist_behaviour +AnnoMi-therapist_121_24.mp4 So it kind of came a bit of a surprise, you feeling okay. reflection therapist_behaviour +AnnoMi-therapist_121_26.mp4 "You go for this checkup with the doctor. And he says, ""You've got Type II diabetes."" " reflection therapist_behaviour +AnnoMi-therapist_121_28.mp4 Mm. Came out of the blue for you? reflection therapist_behaviour +AnnoMi-therapist_121_30.mp4 Mm. other therapist_behaviour +AnnoMi-therapist_121_32.mp4 And you said you kind of don't fit that kinda Type II diabetes look. That you kinda have had this idea- reflection therapist_behaviour +AnnoMi-therapist_121_34.mp4 -you've been-been overweight with it. reflection therapist_behaviour +AnnoMi-therapist_121_36.mp4 Mm. other therapist_behaviour +AnnoMi-therapist_121_38.mp4 Mm. other therapist_behaviour +AnnoMi-therapist_121_40.mp4 Mm. other therapist_behaviour +AnnoMi-therapist_121_42.mp4 Mm. other therapist_behaviour +AnnoMi-therapist_121_44.mp4 Hmm. So it doesn't quite fit in your head, Type II diabetes and- reflection therapist_behaviour +AnnoMi-therapist_121_46.mp4 -your lifestyle? question therapist_behaviour +AnnoMi-therapist_121_48.mp4 Comes as a big surprise. And what was your reaction when he told you that at the time? question therapist_behaviour +AnnoMi-therapist_121_50.mp4 Mm. other therapist_behaviour +AnnoMi-therapist_121_52.mp4 Mm, mm. other therapist_behaviour +AnnoMi-therapist_121_54.mp4 Yeah, yeah. other therapist_behaviour +AnnoMi-therapist_121_56.mp4 He's got a lot to do. reflection therapist_behaviour +AnnoMi-therapist_121_58.mp4 Mm. other therapist_behaviour +AnnoMi-therapist_121_60.mp4 Right. other therapist_behaviour +AnnoMi-therapist_121_62.mp4 Mm. other therapist_behaviour +AnnoMi-therapist_121_64.mp4 So how are you feel in your head- question therapist_behaviour +AnnoMi-therapist_121_66.mp4 -and what the tests say kind of like don't join up. reflection therapist_behaviour +AnnoMi-therapist_121_68.mp4 Mm. other therapist_behaviour +AnnoMi-therapist_121_70.mp4 Hmm. other therapist_behaviour +AnnoMi-therapist_121_72.mp4 Hmm-hmm. other therapist_behaviour +AnnoMi-therapist_121_74.mp4 Hmm. other therapist_behaviour +AnnoMi-therapist_121_76.mp4 Yeah. What's the problem? Mm. reflection therapist_behaviour +AnnoMi-therapist_121_78.mp4 And how did this happen is probably kind of what you're also thinking. Well, how did this--? reflection therapist_behaviour +AnnoMi-therapist_121_80.mp4 Mm. other therapist_behaviour +AnnoMi-therapist_121_82.mp4 Okay. other therapist_behaviour +AnnoMi-therapist_121_84.mp4 Yeah. other therapist_behaviour +AnnoMi-therapist_121_86.mp4 Mm. other therapist_behaviour +AnnoMi-therapist_121_88.mp4 So he mentioned, it might be a family thing. And so you- reflection therapist_behaviour +AnnoMi-therapist_121_90.mp4 -maybe got from your parents or something of the sort. reflection therapist_behaviour +AnnoMi-therapist_121_92.mp4 Mm. other therapist_behaviour +AnnoMi-therapist_121_94.mp4 Mm. other therapist_behaviour +AnnoMi-therapist_121_96.mp4 Right. other therapist_behaviour +AnnoMi-therapist_121_98.mp4 Mm-hmm. other therapist_behaviour +AnnoMi-therapist_121_100.mp4 Yeah. other therapist_behaviour +AnnoMi-therapist_121_102.mp4 Mm. other therapist_behaviour +AnnoMi-therapist_121_104.mp4 Right. other therapist_behaviour +AnnoMi-therapist_121_106.mp4 So he fits the picture- reflection therapist_behaviour +AnnoMi-therapist_121_108.mp4 -when you think about what he-he-- Yeah, he's stereotypical. reflection therapist_behaviour +AnnoMi-therapist_121_110.mp4 A little bit bigger, perhaps doesn't look after himself that well, and he fits that foot reflection therapist_behaviour +AnnoMi-therapist_121_112.mp4 Yeah. other therapist_behaviour +AnnoMi-therapist_121_114.mp4 Mm. So you got this knowledge as a witness there's some family history of diabetes in the past? reflection therapist_behaviour +AnnoMi-therapist_121_116.mp4 Doctor mentioned that as being a factor. reflection therapist_behaviour +AnnoMi-therapist_121_118.mp4 That's certainly true. Yes. We know that people who've had parents or have been in the past, there is a hereditary factor or genetic factor in-involved. therapist_input therapist_behaviour +AnnoMi-therapist_121_120.mp4 Mm. other therapist_behaviour +AnnoMi-therapist_121_122.mp4 Correct. Yeah. therapist_input therapist_behaviour +AnnoMi-therapist_121_124.mp4 But it's not inevitable. therapist_input therapist_behaviour +AnnoMi-therapist_121_126.mp4 Because its genes or the-the-the-the hereditary factor is not the only factor that causes it or is involved in it happening to you. So there's other factors that come into play. therapist_input therapist_behaviour +AnnoMi-therapist_121_128.mp4 Well, you've-you've mentioned some of the things you know, and one of those is hereditary factors. You mentioned that the doctor mentioned that. And what else do you know or have you heard? You say you haven't had a lot of time to do the research. What else? Other things you've. question therapist_behaviour +AnnoMi-therapist_121_130.mp4 Yeah. other therapist_behaviour +AnnoMi-therapist_121_132.mp4 That makes a bit of sense. other therapist_behaviour +AnnoMi-therapist_121_134.mp4 Yeah. other therapist_behaviour +AnnoMi-therapist_121_136.mp4 Yeah. other therapist_behaviour +AnnoMi-therapist_121_138.mp4 They managed with it. reflection therapist_behaviour +AnnoMi-therapist_121_140.mp4 Okay. I don't know if it'd be helpful for you if you'd like to know a little bit more about some of the factors involved in time Type II diabetes. other therapist_behaviour +AnnoMi-therapist_121_142.mp4 If that would help. other therapist_behaviour +AnnoMi-therapist_121_144.mp4 Well, I'll perhaps share with you what I know from working with other people and some of the things I've experienced in working with people. other therapist_behaviour +AnnoMi-therapist_121_146.mp4 And see what you make of it. See if it fits a little bit more with where you're at. We know that there is a strong family factor or hereditary factor, so that's one aspect. So also it tends to happen a little bit later in life, rather than something you might get when you're a teenager, this type of diabetes. So-so it's a later onset. It takes a bit of time for it to develop maybe. And the main reason I think, um, the main aspect of it is that it, have you heard about insulin. therapist_input therapist_behaviour +AnnoMi-therapist_121_148.mp4 So that's a hormone or a chemical, it allows you to utilize sugar in your body. therapist_input therapist_behaviour +AnnoMi-therapist_121_150.mp4 All right. And Type II diabetes typically people have a resistance or a resistance to insulin in their cells, in their fat cells or their muscle cells or liver cells. They can't use insulin. And so sugar builds up in your system. therapist_input therapist_behaviour +AnnoMi-therapist_121_152.mp4 You need insulin in your cells, individual cells in muscle or in fat or wherever to, um, use up excess sugar or to utilize sugar. therapist_input therapist_behaviour +AnnoMi-therapist_121_154.mp4 That's right. other therapist_behaviour +AnnoMi-therapist_121_156.mp4 Kind of, as your. other therapist_behaviour +AnnoMi-therapist_121_158.mp4 Yap. other therapist_behaviour +AnnoMi-therapist_121_160.mp4 Yeah. other therapist_behaviour +AnnoMi-therapist_121_162.mp4 That's a good way to think. other therapist_behaviour +AnnoMi-therapist_121_164.mp4 Exactly. And what's happening in Type II diabetes is your-your fat cells and liver cells and muscle cells are resistant to insulin. It's almost like they're saying we can't use that. therapist_input therapist_behaviour +AnnoMi-therapist_121_166.mp4 And if-- Well, there's a number of-- We're not entirely sure, there's a lot of research still going on as to how this happens and how that could be modified. But what we do know is that, um, one of the key things in managing it is to try and modify or modulate, control the amount of sugar that are in your system. therapist_input therapist_behaviour +AnnoMi-therapist_121_168.mp4 Yeah. So there's a couple of things that we know that people with Type II diabetes have to look after and have to think about if they want to control the amount of sugar that's in their system, which is the main issue that's causing some of the health problems that people have with Type II diabetes. Too much sugar, and if it's not able to be utilized in the blood cell, in the fat cells, or liver cells, and the muscle cells stays in your bloodstream. And that can cause problems with your circulation. So too high blood sugar and too low a blood sugar can be a problem. So sugar is the main concern in Type II- Type II diabetes.And you mentioned earlier on, a couple of things that the doctor-- You've mentioned some signs that he was kind of a little bit concerned about. Well, what things did you notice over the-over the last month or so? therapist_input therapist_behaviour +AnnoMi-therapist_121_170.mp4 Yeah. other therapist_behaviour +AnnoMi-therapist_121_172.mp4 Yeah. other therapist_behaviour +AnnoMi-therapist_121_174.mp4 Yeah. other therapist_behaviour +AnnoMi-therapist_121_176.mp4 Yeah. other therapist_behaviour +AnnoMi-therapist_121_178.mp4 A slightly more sedate lifestyle. reflection therapist_behaviour +AnnoMi-therapist_121_180.mp4 Yeah. other therapist_behaviour +AnnoMi-therapist_121_182.mp4 Yeah. other therapist_behaviour +AnnoMi-therapist_121_184.mp4 Yeah. It should feel like there's something really wrong with you. other therapist_behaviour +AnnoMi-therapist_121_186.mp4 What's-how have you been feeling over the last month? So, you say you're very busy you're doing a lot of work. question therapist_behaviour +AnnoMi-therapist_121_188.mp4 Yeah. other therapist_behaviour +AnnoMi-therapist_121_190.mp4 Mh-hmm. other therapist_behaviour +AnnoMi-therapist_121_192.mp4 Okay. other therapist_behaviour +AnnoMi-therapist_121_194.mp4 So a little bit sort of energy is not quite there sometimes? The vitality. reflection therapist_behaviour +AnnoMi-therapist_121_196.mp4 Yeah, Mh-hmm. other therapist_behaviour +AnnoMi-therapist_121_198.mp4 Yeah. other therapist_behaviour +AnnoMi-therapist_121_200.mp4 Mh-hmm. other therapist_behaviour +AnnoMi-therapist_121_202.mp4 You haven't noticed it. So it's a progressive, you know, you've just seen this, as-as you got older, things have slowed down. You know those activities you used to do, but that's kind of like what happens. reflection therapist_behaviour +AnnoMi-therapist_121_204.mp4 Mh-hmm. other therapist_behaviour +AnnoMi-therapist_121_206.mp4 Yeah. other therapist_behaviour +AnnoMi-therapist_121_208.mp4 Okay. other therapist_behaviour +AnnoMi-therapist_121_210.mp4 Hmm, a bit of a mystery there. reflection therapist_behaviour +AnnoMi-therapist_121_212.mp4 Really? So what I'm hearing is there's actually a lot of aspects in your life which are really good. reflection therapist_behaviour +AnnoMi-therapist_121_214.mp4 From your perspective, things are going well? reflection therapist_behaviour +AnnoMi-therapist_121_216.mp4 Yeah. It doesn't fit. reflection therapist_behaviour +AnnoMi-therapist_121_218.mp4 Mh-hmm. other therapist_behaviour +AnnoMi-therapist_121_220.mp4 Right. other therapist_behaviour +AnnoMi-therapist_121_222.mp4 Yeah. When you get uh, a headache. reflection therapist_behaviour +AnnoMi-therapist_121_224.mp4 Yeah. other therapist_behaviour +AnnoMi-therapist_121_226.mp4 So the idea of having to test-test your blood sugar and take medications is kinda like off-- reflection therapist_behaviour +AnnoMi-therapist_121_228.mp4 And you know that's a bit too- other therapist_behaviour +AnnoMi-therapist_121_230.mp4 Too much. reflection therapist_behaviour +AnnoMi-therapist_121_232.mp4 Yeah. Okay. other therapist_behaviour +AnnoMi-therapist_121_234.mp4 And you're here today and that's probably something in you you've thought well I'll follow this through, you know I'll-I'll come along and see what-see what they've got to say. And I'm just wondering for this session, for the time we have today, there's a number of things we could talk about. You mentioned a couple of things about your lifestyle and, um, medication is one thing you've been told by the doctor you might need to do that. And a number of things that we could talk about today. Which-which area would you think would be useful for you to focus on? question therapist_behaviour +AnnoMi-therapist_121_236.mp4 Hmm. other therapist_behaviour +AnnoMi-therapist_121_238.mp4 Okay. other therapist_behaviour +AnnoMi-therapist_121_240.mp4 Mh-hmm. other therapist_behaviour +AnnoMi-therapist_121_242.mp4 So then, since you've been on your own since you've separated, divorced and you've noticed that the things you eat and how you eat has changed. reflection therapist_behaviour +AnnoMi-therapist_121_244.mp4 Hmm. other therapist_behaviour +AnnoMi-therapist_121_246.mp4 Yeah, yeah. other therapist_behaviour +AnnoMi-therapist_121_250.mp4 Hmm. Yeah, yeah. other therapist_behaviour +AnnoMi-therapist_121_252.mp4 Yeah. And your-- part of your wife used to do a lot of that for you? reflection therapist_behaviour +AnnoMi-therapist_121_254.mp4 Yeah. other therapist_behaviour +AnnoMi-therapist_121_256.mp4 And so she would kinda look after what you ate and healthy things that you had, spread in front of you and off you go. reflection therapist_behaviour +AnnoMi-therapist_121_258.mp4 Mm-hmm. And now you have to think about what you might eat and sometimes you don't eat the best. reflection therapist_behaviour +AnnoMi-therapist_121_260.mp4 Okay. other therapist_behaviour +AnnoMi-therapist_121_262.mp4 Hmm. other therapist_behaviour +AnnoMi-therapist_121_264.mp4 Yeah. other therapist_behaviour +AnnoMi-therapist_121_266.mp4 Yeah. reflection therapist_behaviour +AnnoMi-therapist_121_268.mp4 Very appealing, isn't it? reflection therapist_behaviour +AnnoMi-therapist_121_270.mp4 Mm-hmm, Mm-hmm. other therapist_behaviour +AnnoMi-therapist_121_272.mp4 Yeah they look pretty good on the plate, don't they? reflection therapist_behaviour +AnnoMi-therapist_121_274.mp4 Yeah. other therapist_behaviour +AnnoMi-therapist_121_276.mp4 They're food choices in what you eat and what's in your diet it's not what-something you actually you've actually been aware of or had to think about in the past. reflection therapist_behaviour +AnnoMi-therapist_121_278.mp4 So one thing that you noticed is diet and the eating patterns and- reflection therapist_behaviour +AnnoMi-therapist_121_280.mp4 -when you eat. That's one aspect. What other aspects do you think you've-- you would be--? question therapist_behaviour +AnnoMi-therapist_121_282.mp4 Right. other therapist_behaviour +AnnoMi-therapist_121_284.mp4 You kinda juggle those two things and kinda-- reflection therapist_behaviour +AnnoMi-therapist_121_286.mp4 You still run and have a cigarette? reflection therapist_behaviour +AnnoMi-therapist_121_288.mp4 Hmm. Hmm. Yeah, part of the culture. reflection therapist_behaviour +AnnoMi-therapist_121_290.mp4 Yeah. other therapist_behaviour +AnnoMi-therapist_121_292.mp4 Yeah. other therapist_behaviour +AnnoMi-therapist_121_294.mp4 Hmm. other therapist_behaviour +AnnoMi-therapist_121_296.mp4 But over the years, you've actually reduced your smoking or you've stopped altogether or at times? reflection therapist_behaviour +AnnoMi-therapist_121_298.mp4 Hmm. other therapist_behaviour +AnnoMi-therapist_121_300.mp4 Okay, so you meant to reduce. reflection therapist_behaviour +AnnoMi-therapist_121_302.mp4 You were noticing that it's having an impact on your breathing and health wasn't so good. reflection therapist_behaviour +AnnoMi-therapist_121_304.mp4 When you related that to your smoking, so you managed to reduce your smoking. reflection therapist_behaviour +AnnoMi-therapist_121_306.mp4 So you've made our decision to do that? reflection therapist_behaviour +AnnoMi-therapist_121_308.mp4 Hmm. other therapist_behaviour +AnnoMi-therapist_121_310.mp4 Yeah, and it's hard to get to stop something you enjoy, isn't it? reflection therapist_behaviour +AnnoMi-therapist_121_312.mp4 Hmm. other therapist_behaviour +AnnoMi-therapist_121_314.mp4 Yeah. other therapist_behaviour +AnnoMi-therapist_121_316.mp4 Hmm. other therapist_behaviour +AnnoMi-therapist_121_318.mp4 But they go together so well. And sugar in the coffee? question therapist_behaviour +AnnoMi-therapist_121_322.mp4 Hmm. other therapist_behaviour +AnnoMi-therapist_121_324.mp4 "You're drinking more coffee. So what I've heard you say so far is, if I can just start right back from the beginning and you used to come in and sais, ""I went to the doctor."" You went for-- it sounds like you went for just a checkup. " reflection therapist_behaviour +AnnoMi-therapist_121_326.mp4 MIT. reflection therapist_behaviour +AnnoMi-therapist_121_328.mp4 Got to check out, why not? reflection therapist_behaviour +AnnoMi-therapist_121_330.mp4 Hmm. other therapist_behaviour +AnnoMi-therapist_121_332.mp4 Yeah. other therapist_behaviour +AnnoMi-therapist_121_334.mp4 So everything else looked pretty good? reflection therapist_behaviour +AnnoMi-therapist_121_336.mp4 Cholesterol good, your weight is good. reflection therapist_behaviour +AnnoMi-therapist_121_338.mp4 Um, you are smoking, but you've managed to reduce that. reflection therapist_behaviour +AnnoMi-therapist_121_340.mp4 And anything else, you know, you go ticking down the list. The tire is good, oil good. reflection therapist_behaviour +AnnoMi-therapist_121_342.mp4 So we're looking good. reflection therapist_behaviour +AnnoMi-therapist_121_344.mp4 And ah, hang on. reflection therapist_behaviour +AnnoMi-therapist_121_346.mp4 Yeah, there's something wrong with the, uh, with this bit. reflection therapist_behaviour +AnnoMi-therapist_121_348.mp4 And it doesn't quite fit with how you see your own lifestyle. reflection therapist_behaviour +AnnoMi-therapist_121_350.mp4 Because you've-- it sounds like what you've been doing, you've made some conscious effort to be aware of some of those things you might think are important. reflection therapist_behaviour +AnnoMi-therapist_121_352.mp4 Mm. other therapist_behaviour +AnnoMi-therapist_121_354.mp4 Yeah. other therapist_behaviour +AnnoMi-therapist_121_356.mp4 So like a domino effect, and they'll all be just sitting- reflection therapist_behaviour +AnnoMi-therapist_121_358.mp4 Mm-hm. other therapist_behaviour +AnnoMi-therapist_121_360.mp4 A bit broad kind of like you've gotta change everything. reflection therapist_behaviour +AnnoMi-therapist_121_362.mp4 Yeah. And your thought was, yeah, right, I hear that, but actually, I don't want to make all these big changes in my life. reflection therapist_behaviour +AnnoMi-therapist_121_364.mp4 Feel like you need to. Yeah. reflection therapist_behaviour +AnnoMi-therapist_121_366.mp4 Mm. other therapist_behaviour +AnnoMi-therapist_121_368.mp4 The test, is the test, and experience, yeah. therapist_input therapist_behaviour +AnnoMi-therapist_121_370.mp4 I don't know. I think it's up to you where we start, and that's the question I've got in my mind. You've mentioned a couple of things that you've already made some effort, or been conscious of. You've mentioned the diet, you've mentioned your smoking, those are two quite important aspects that we often talk about here in how people work. reflection therapist_behaviour +AnnoMi-therapist_121_372.mp4 It can have an impact, yes. So smoking, um, affects your blood system, so it hardens the arteries, um, and over time, it can have a significant impact on the healing of wounds. So people with Type II diabetes, often, if they get a cut, or a bruise, or something, it takes a long time to heal. Smoking reduces the amount of oxygen in your system, so that can further, you know, limit the time it takes your body to heal. therapist_input therapist_behaviour +AnnoMi-therapist_121_374.mp4 So we know that smoking and Type II diabetes together- therapist_input therapist_behaviour +AnnoMi-therapist_121_376.mp4 -isn't a good combination. therapist_input therapist_behaviour +AnnoMi-therapist_121_378.mp4 Well, the question is, I suppose, that I have for you is, where would you think, for you, would be a good place to start? If you were gonna make any changes, even small changes at the beginning, rather than just thinking, oh, I got to change everything, which it sounds like you're not prepared to, you know, do a whole lifestyle change, and I don't think that's what we're talking about here. Where would you feel most comfortable to start if you were gonna make any changes at all? question therapist_behaviour +AnnoMi-therapist_121_380.mp4 Yeah. Hmm, that might be a start. therapist_input therapist_behaviour +AnnoMi-therapist_121_382.mp4 Hm. What we also find is that people make these little changes, small changes, and that starts to kind of well, it makes them- therapist_input therapist_behaviour +AnnoMi-therapist_121_384.mp4 -rollover, the domino effect starts to happen, and they start looking at other aspects. reflection therapist_behaviour +AnnoMi-therapist_121_386.mp4 "So rather than thinking, ""oh, my God, I have to change all these things. I've gotta stop smoking, I've gotta exercise more, I've gotta, you know, start eating more fruit and vegetables,"" you might start with these small changes, and then- " reflection therapist_behaviour +AnnoMi-therapist_121_388.mp4 Um, I-I'm reluctant to give a prescription for that because I think it's really up to you. And I think it depends on how things go, as to how much you need to do. therapist_input therapist_behaviour +AnnoMi-therapist_121_390.mp4 You mentioned earlier on, the doctors talking about you monitoring your blood sugar. reflection therapist_behaviour +AnnoMi-therapist_121_392.mp4 So on how-- It depends on how-how that goes. Let's say, if you started doing that and you do some more exercise, you start to have longer blacks, rather than short blacks with lots of sugar. And you get down the sugar and you find your blood sugar starts to come down, then we're heading in the right direction. reflection therapist_behaviour +AnnoMi-therapist_121_394.mp4 So it's really, I suppose, up to how things go for you, and you get that feedback. And if that's going in the right direction, you carry on doing and do some more of that. reflection therapist_behaviour +AnnoMi-therapist_121_396.mp4 I think where we start is where you feel comfortable starting. other therapist_behaviour +AnnoMi-therapist_121_398.mp4 Apples for breakfast. therapist_input therapist_behaviour +AnnoMi-therapist_121_400.mp4 So what I'm hearing you're kind of saying is, that there's-- You're now starting to think of some very useful little starting points. reflection therapist_behaviour +AnnoMi-therapist_121_402.mp4 Not huge changes, but some little things you could do. reflection therapist_behaviour +AnnoMi-therapist_121_404.mp4 And it's kind of dawning on you there may be some possibilities here for making some changes. Let me ask you this. Um, let's say you put some of these things in place and you start to make some of these small changes. reflection therapist_behaviour +AnnoMi-therapist_121_406.mp4 Um, where do you see that taking you in the next set of three, four, five years? You know, where do you want to be in three to four years' time? What would be your ideal picture? question therapist_behaviour +AnnoMi-therapist_121_408.mp4 No. other therapist_behaviour +AnnoMi-therapist_121_410.mp4 Yeah? You like the social aspect? reflection therapist_behaviour +AnnoMi-therapist_121_412.mp4 No, no, I get that. I get that. other therapist_behaviour +AnnoMi-therapist_121_414.mp4 So part of that whole keeping fit and exercise stuff is actually the social side of it, isn't it? reflection therapist_behaviour +AnnoMi-therapist_121_416.mp4 Yeah. other therapist_behaviour +AnnoMi-therapist_121_418.mp4 Haven't quite that- other therapist_behaviour +AnnoMi-therapist_121_420.mp4 And the coffee helps a little bit because it perks you up? reflection therapist_behaviour +AnnoMi-therapist_121_422.mp4 And the sugar in it helps too. reflection therapist_behaviour +AnnoMi-therapist_121_424.mp4 So what I'm hearing is that your life, your work, your routines are-- Sometimes you're driving or you've got to keep awake, get up in the morning sometimes and you haven't quite got that buzz or the energy. You need a shot, and then throughout the day you might need just more shots to keep that energy up. reflection therapist_behaviour +AnnoMi-therapist_121_426.mp4 Yeah. other therapist_behaviour +AnnoMi-therapist_121_428.mp4 And an activity which has got a starting to finish and it's something you do for a slot. therapist_input therapist_behaviour +AnnoMi-therapist_121_430.mp4 And then there's maybe some social aspects to it as well. reflection therapist_behaviour +AnnoMi-therapist_121_432.mp4 You can see some benefits and some enjoyment that. reflection therapist_behaviour +AnnoMi-therapist_121_434.mp4 That sounds like a great plan. reflection therapist_behaviour +AnnoMi-therapist_121_436.mp4 Yeah, sounds like a good idea. other therapist_behaviour +AnnoMi-therapist_121_438.mp4 I think anything you do, it has to be something you've decided. You know, just start where you want to start. You've mentioned some really good ideas about possibly getting a little bit more exercise into your life, doing something like squash or something of that nature. You've mentioned some really good ideas about reducing the amount of sugar you-you-you're-you're intaking during the day, and coffee is a good place to start. Having an apple for breakfast, I think you mentioned that, a bit of fruit. reflection therapist_behaviour +AnnoMi-therapist_121_440.mp4 Those are some really good ideas and good starting points. So thinking about it like that, what-- Where are you now? What's your-- What-what-- Where-where is your thinking now? question therapist_behaviour +AnnoMi-therapist_121_442.mp4 What's to lose? What's to gain? question therapist_behaviour +AnnoMi-therapist_121_444.mp4 It does make sense, yeah. other therapist_behaviour +AnnoMi-therapist_121_446.mp4 So when you look at it, there's probably more to gain from making these changes than there is to lose. reflection therapist_behaviour +AnnoMi-therapist_121_448.mp4 Right. other therapist_behaviour +AnnoMi-therapist_121_450.mp4 Yeah. other therapist_behaviour +AnnoMi-therapist_121_452.mp4 So you've got to work these things on your mind. You know, the-- And workout where's the place to start. reflection therapist_behaviour +AnnoMi-therapist_121_454.mp4 Yeah. other therapist_behaviour +AnnoMi-therapist_121_456.mp4 You've been stuck? reflection therapist_behaviour +AnnoMi-therapist_121_458.mp4 Yeah? other therapist_behaviour +AnnoMi-therapist_121_460.mp4 Indeed, yeah. other therapist_behaviour +AnnoMi-therapist_121_462.mp4 So rather than-- other therapist_behaviour +AnnoMi-therapist_121_464.mp4 Carrying on. reflection therapist_behaviour +AnnoMi-therapist_121_466.mp4 So it's been a bit of a-a bit of a shock, but now you kinda reflect on it. reflection therapist_behaviour +AnnoMi-therapist_121_468.mp4 Maybe this is the- other therapist_behaviour +AnnoMi-therapist_121_470.mp4 "-bit of a shake that I needed, you know, just sort of remind me. I might feel okay. I might-- From my perspective, your perspective, you're thinking, ""Well, what's the problem? Everything's fine."" " reflection therapist_behaviour +AnnoMi-therapist_121_472.mp4 "But now you seem to be thinking looking and thinking, ""Maybe things weren't, or aren't, as good as I thought they were."" " reflection therapist_behaviour +AnnoMi-therapist_121_474.mp4 Things could be better? reflection therapist_behaviour +AnnoMi-therapist_121_476.mp4 Yeah, I sense that. I sense that in you that you're-- reflection therapist_behaviour +AnnoMi-therapist_121_478.mp4 Quite invigorated with the idea of-- reflection therapist_behaviour +AnnoMi-therapist_121_480.mp4 Making some of these changes. Yeah. reflection therapist_behaviour +AnnoMi-therapist_121_482.mp4 You're up for the challenge? reflection therapist_behaviour +AnnoMi-therapist_121_484.mp4 So think about when you were-- This-this is an interesting question to see what you think. You were- you were a coach. You-- Maybe you'll be a coach again. reflection therapist_behaviour +AnnoMi-therapist_121_486.mp4 "What would you say if you were talking to yourself, if you like, you know, if you were the coach saying, ""Right--"" " question therapist_behaviour +AnnoMi-therapist_121_488.mp4 Yeah, what-what would you be saying? question therapist_behaviour +AnnoMi-therapist_121_490.mp4 Yeah. other therapist_behaviour +AnnoMi-therapist_121_492.mp4 Yeah. other therapist_behaviour +AnnoMi-therapist_121_494.mp4 And, I suppose, our own personalized a little bit like that, there's lots of different aspects that need to be tweaked. therapist_input therapist_behaviour +AnnoMi-therapist_121_496.mp4 Modified and looked at, to get the best out of ourselves, to get the best out of the opportunities we have. therapist_input therapist_behaviour +AnnoMi-therapist_121_498.mp4 Yeah, yeah. other therapist_behaviour +AnnoMi-therapist_121_500.mp4 "Some good things I'm- some things I'm good at and there are some other aspects we think, ""Well--"" " reflection therapist_behaviour +AnnoMi-therapist_121_502.mp4 It's not about giving up your personality or- reflection therapist_behaviour +AnnoMi-therapist_121_504.mp4 -changing who you are fundamentally. reflection therapist_behaviour +AnnoMi-therapist_121_506.mp4 It's just tweaking things. Just fine-tuning a few areas and being a bit more aw-aware of one aspect of your life a bit more, like the food choices or whatever. Well, Mike, I-I've really enjoyed listening to your perspective, and your story a little bit, and it's helped me a lot to get an idea about where you're coming from, and a little bit about who you are, and what's happened in your past. And-and we've also talked a bit about what's going to happen next. And you've come up with some great ideas. What I hear you saying is that, you know, before all this, before you met the GP, things are going fine.Well, as you would of-- As, you know, as you'd seen it, you were just doing your thing, and getting on working, and being busy, and being successful, and then suddenly this diagnosis, this doctor tells you that you've got a problem. reflection therapist_behaviour +AnnoMi-therapist_121_508.mp4 It comes along to me and talk today a bit about how you felt about that. Initially, it can be quite a bit of a-bit of a shock. It didn't quite fit with how you saw things. reflection therapist_behaviour +AnnoMi-therapist_121_510.mp4 And as we've been talking, I'm hearing you're saying that maybe if you look back to where you were before you went to the doctor, things weren't quite that right, maybe. Things weren't as good as you thought they were. reflection therapist_behaviour +AnnoMi-therapist_121_512.mp4 Yeah. other therapist_behaviour +AnnoMi-therapist_121_514.mp4 And what I also hear you saying, it's possibly the-- It's now possibly more possible, in your mind, that you could make some of these changes, rather than bring broad-brush, you know, huge changes to your lifestyles. It's not about changing who you are, it's not changing huge facets of your life, but maybe small steps that need to be taken. reflection therapist_behaviour +AnnoMi-therapist_121_516.mp4 What you're kind of thinking about what those might. reflection therapist_behaviour +AnnoMi-therapist_121_518.mp4 Mm. other therapist_behaviour +AnnoMi-therapist_121_520.mp4 Yeah. other therapist_behaviour +AnnoMi-therapist_121_522.mp4 Nobody there too. reflection therapist_behaviour +AnnoMi-therapist_121_524.mp4 Yeah. other therapist_behaviour +AnnoMi-therapist_121_526.mp4 Mhm. other therapist_behaviour +AnnoMi-therapist_121_528.mp4 So now it's time- reflection therapist_behaviour +AnnoMi-therapist_121_530.mp4 -to think about looking after yourself a bit more. reflection therapist_behaviour +AnnoMi-therapist_121_532.mp4 Why not? reflection therapist_behaviour +AnnoMi-therapist_121_534.mp4 Yeah. So, we've run out of time but I also want to ask you a final question, where to from here, what's next? question therapist_behaviour +AnnoMi-therapist_121_536.mp4 You'll start with that? reflection therapist_behaviour +AnnoMi-therapist_121_538.mp4 Yeah. other therapist_behaviour +AnnoMi-therapist_121_540.mp4 The gym. reflection therapist_behaviour +AnnoMi-therapist_121_542.mp4 Yeah. other therapist_behaviour +AnnoMi-therapist_121_544.mp4 Yeah. other therapist_behaviour +AnnoMi-therapist_121_546.mp4 Yeah. other therapist_behaviour +AnnoMi-therapist_121_548.mp4 Yeah. other therapist_behaviour +AnnoMi-therapist_121_550.mp4 Yeah. other therapist_behaviour +AnnoMi-therapist_121_552.mp4 And you also mentioned you'll perhaps go and- back and see the doctor and just give him a bit of an update as to- reflection therapist_behaviour +AnnoMi-therapist_121_554.mp4 Yeah. other therapist_behaviour +AnnoMi-therapist_121_556.mp4 Mhm. other therapist_behaviour +AnnoMi-therapist_121_558.mp4 Yep. other therapist_behaviour +AnnoMi-therapist_121_560.mp4 It's fine. other therapist_behaviour +AnnoMi-therapist_121_562.mp4 Sure. other therapist_behaviour +AnnoMi-therapist_121_564.mp4 Mhm. other therapist_behaviour +AnnoMi-therapist_121_566.mp4 You are gonna make a start? reflection therapist_behaviour +AnnoMi-therapist_121_568.mp4 It is. Well, just to help you, because there's probably a lot of other questions you might have, other questions that might come up after this session. other therapist_behaviour +AnnoMi-therapist_121_570.mp4 -before we go, I'd like to just-just give you a lot of- some information that might help-help you. therapist_input therapist_behaviour +AnnoMi-therapist_121_572.mp4 Not too much, just some stuff that might just give you a little bit of background information on- therapist_input therapist_behaviour +AnnoMi-therapist_121_574.mp4 -some of the things that have- other therapist_behaviour +AnnoMi-therapist_121_576.mp4 -around type- around Type II diabetes and some,- other therapist_behaviour +AnnoMi-therapist_121_578.mp4 [unintelligible 00:36:53] some of that. other therapist_behaviour +AnnoMi-therapist_121_580.mp4 Um, and I'd like to us- for us to meet again, so to catch up with you and make an appointment before you leave. Just to see how things are going and- therapist_input therapist_behaviour +AnnoMi-therapist_121_582.mp4 -see what sort of little changes you've managed to make. I'd be really [unintelligible 00:37:07]- reflection therapist_behaviour +AnnoMi-therapist_121_584.mp4 It's really up to you. Probably a little bit sooner would be good. therapist_input therapist_behaviour +AnnoMi-therapist_121_586.mp4 That'd be great. other therapist_behaviour +AnnoMi-therapist_121_588.mp4 How does that sound? question therapist_behaviour +AnnoMi-therapist_121_590.mp4 Because you don't know the timeline? question therapist_behaviour +AnnoMi-therapist_121_592.mp4 Mhm. other therapist_behaviour +AnnoMi-therapist_121_594.mp4 Yeah. other therapist_behaviour +AnnoMi-therapist_121_596.mp4 Excellent, excellent. Thanks, Mike. [croostalk] other therapist_behaviour +AnnoMi-therapist_122_1.mp4 Mm-hmm. other therapist_behaviour +AnnoMi-therapist_122_3.mp4 Got it. other therapist_behaviour +AnnoMi-therapist_122_5.mp4 Uh-huh. other therapist_behaviour +AnnoMi-therapist_122_7.mp4 Mm-hmm. other therapist_behaviour +AnnoMi-therapist_122_9.mp4 Mm-hmm. other therapist_behaviour +AnnoMi-therapist_122_11.mp4 Yeah. So-so you've got this new group of friends and-and, um, you-you actually kind of like where you're at with things right now. And your mom was going through your stuff and found your stash, and it's just turned into a, you know, all of this. reflection therapist_behaviour +AnnoMi-therapist_122_13.mp4 Yeah. reflection therapist_behaviour +AnnoMi-therapist_122_15.mp4 Yeah. reflection therapist_behaviour +AnnoMi-therapist_122_17.mp4 And, uh, sounds like you're-you're pretty upset with your mom for-for doing that? reflection therapist_behaviour +AnnoMi-therapist_122_19.mp4 Yeah. reflection therapist_behaviour +AnnoMi-therapist_122_21.mp4 Right. It's like your private place and, you know, it's-- that's-- it's your stuff. reflection therapist_behaviour +AnnoMi-therapist_122_23.mp4 Yeah. So why should she go through yours? reflection therapist_behaviour +AnnoMi-therapist_122_25.mp4 Yeah. Yeah other therapist_behaviour +AnnoMi-therapist_124_0.mp4 Okay. So what ideas do you have, Natalie for, um, getting started in adding more physical activity? question therapist_behaviour +AnnoMi-therapist_124_3.mp4 Great. It sounds like there are a lot of activities that you do like- reflection therapist_behaviour +AnnoMi-therapist_124_5.mp4 -and I'm hearing a theme of climate control, [chuckles] being important to you and you've already been researching gyms. reflection therapist_behaviour +AnnoMi-therapist_124_7.mp4 Tell me more about that. question therapist_behaviour +AnnoMi-therapist_124_9.mp4 Right. Okay. So you're looking for some-something that's reasonably priced- reflection therapist_behaviour +AnnoMi-therapist_124_11.mp4 -and that you don't have to sign a contract and you're right. It's hard to tell what the cost is just from looking on the website. reflection therapist_behaviour +AnnoMi-therapist_124_13.mp4 And I completely agree [laughs]about wanting to avoid the sales pitch- reflection therapist_behaviour +AnnoMi-therapist_124_15.mp4 -um, element of it. What seems like a logical next step based on-- You've kind of already gotten the ball rolling. What feels like a logical next step? question therapist_behaviour +AnnoMi-therapist_124_17.mp4 Okay. So maybe visiting a gym and then also choosing a non-gym activity to sort of get started when the weather's permitting. reflection therapist_behaviour +AnnoMi-therapist_124_19.mp4 I have one, um, idea that is jumping into my mind as you're talking. Is it okay if I share that? question therapist_behaviour +AnnoMi-therapist_124_21.mp4 I'm wondering about the price of the YMCA compared to other gyms. Uh, is that one that you have an interest in or have looked at already? therapist_input therapist_behaviour +AnnoMi-therapist_124_23.mp4 Yes. And honestly, I don't either. [chuckles] I just suspect that it might be slightly cheaper than some of the more private gyms. other therapist_behaviour +AnnoMi-therapist_124_25.mp4 So something to look into if you're interested. reflection therapist_behaviour +AnnoMi-therapist_124_27.mp4 And they-- I would suspect they'd be less sales pitch-oriented than a private gym. So it might be a safe place to explore first- therapist_input therapist_behaviour +AnnoMi-therapist_124_29.mp4 -and to build some confidence in that conversation. reflection therapist_behaviour +AnnoMi-therapist_124_31.mp4 Okay. Great. So, um, in addition to exploring the gym possibility, what sounds like a logical next step for a non-gym activity to get started, some small goal that feels doable, um, and you have control over because it doesn't require the perfect weather- question therapist_behaviour +AnnoMi-therapist_124_33.mp4 -or the perfect gym? reflection therapist_behaviour +AnnoMi-therapist_124_35.mp4 Okay. So exploring some yoga classes. Is-is doing yoga in your living room appealing to you at all? question therapist_behaviour +AnnoMi-therapist_124_37.mp4 That's great. It's important to know this about yourself, what works, and what doesn't work, and what you feel motivated to do. So, it sounds like we sort of have two small goals right now. One is to maybe visit the YMCA and-and find out how much that costs- reflection therapist_behaviour +AnnoMi-therapist_124_39.mp4 -and the other goal being maybe just a walk, um, one time between now and the next time I see you. Um, and I say one time, you can, of course, go more than that, but just with snow in the forecast, it might be reasonable to start with a small goal like that and go for one nice day between now and a few weeks from now when I get to see you again. How do those two goals sound? reflection therapist_behaviour +AnnoMi-therapist_124_41.mp4 Okay. So you'd like to kind of get motivated with- with the use of an app and that might help you get started. reflection therapist_behaviour +AnnoMi-therapist_124_43.mp4 Okay, fantastic. So, on a scale from 0 to 10, 10 being really confident, I can research a gym and go for one walk, and zero being not at all confident, how are you feeling about these two small goals? question therapist_behaviour +AnnoMi-therapist_124_45.mp4 Okay. other therapist_behaviour +AnnoMi-therapist_124_47.mp4 Wonderful. Are there any other barriers that would be helpful to sort of talk through? question therapist_behaviour +AnnoMi-therapist_124_49.mp4 Okay. So being creative with your indoor space is a-is a solution you've come up with yourself for - f there just aren't any good days, nice days outside. reflection therapist_behaviour +AnnoMi-therapist_124_51.mp4 Great. Well, you came in today feeling pretty discouraged about your energy levels and your mood and, um, feeling lousy about your body in general. And, uh, today we've talked about a small-small step to get started and you're hoping to experience some mood boost and some energy as you get rolling here. Um, how are you feeling about today's session? reflection therapist_behaviour +AnnoMi-therapist_124_53.mp4 Great. Well, I look forward to checking in with you, and thanks so much for coming in. other therapist_behaviour +AnnoMi-therapist_125_1.mp4 So, what you're saying is you've had a rough night? reflection therapist_behaviour +AnnoMi-therapist_125_3.mp4 So, she needed to eat every three hours last night and that was really frustrating for you? reflection therapist_behaviour +AnnoMi-therapist_125_5.mp4 Hmm. So, based on what your mom told you, you were expecting Lilly at this point to be sleeping through the night? reflection therapist_behaviour +AnnoMi-therapist_127_0.mp4 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. reflection therapist_behaviour +AnnoMi-therapist_127_2.mp4 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? question therapist_behaviour +AnnoMi-therapist_127_4.mp4 Mm-hmm. other therapist_behaviour +AnnoMi-therapist_127_6.mp4 Hmm. other therapist_behaviour +AnnoMi-therapist_127_8.mp4 Right. other therapist_behaviour +AnnoMi-therapist_127_10.mp4 Okay. And that your pet has never been mentioned as a concern? question therapist_behaviour +AnnoMi-therapist_127_12.mp4 Hmm. Yeah. And I-I can see that you've already worked hard to make some changes. You've almost quit smoking. reflection therapist_behaviour +AnnoMi-therapist_127_14.mp4 You're just down to your last couple of cigarettes- reflection therapist_behaviour +AnnoMi-therapist_127_16.mp4 -and you're not even smoking those in the house. reflection therapist_behaviour +AnnoMi-therapist_127_18.mp4 So, your house is totally smoke-free. reflection therapist_behaviour +AnnoMi-therapist_127_20.mp4 Yeah, okay. And you have also thought about cutting back on alcohol. reflection therapist_behaviour +AnnoMi-therapist_127_22.mp4 -and-and I think you mentioned done-done a little bit towards that. reflection therapist_behaviour +AnnoMi-therapist_127_24.mp4 Okay, okay. other therapist_behaviour +AnnoMi-therapist_127_26.mp4 So now almost like that's not good enough, like now you have to, now it's the dog and now- reflection therapist_behaviour +AnnoMi-therapist_127_28.mp4 -what's next. Right. Okay. 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. therapist_input therapist_behaviour +AnnoMi-therapist_127_30.mp4 -but I wonder what are your experiences with Oscar, you know, when he's in the house or-or maybe sleeping near you or you're around him, what happens with your asthma symptoms? question therapist_behaviour +AnnoMi-therapist_127_32.mp4 Okay. other therapist_behaviour +AnnoMi-therapist_127_34.mp4 Hmm. So, it doesn't make total sense to you that-that it's all Oscar's fault and that- reflection therapist_behaviour +AnnoMi-therapist_127_36.mp4 That's that the only solution. other therapist_behaviour +AnnoMi-therapist_127_38.mp4 I guess I also wonder whether, regardless of-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- reflection therapist_behaviour +AnnoMi-therapist_127_40.mp4 -such a big part of your life for so long. reflection therapist_behaviour +AnnoMi-therapist_127_42.mp4 Hmm. 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 solid. It really is your choice. other therapist_behaviour +AnnoMi-therapist_127_44.mp4 Mm-hmm. other therapist_behaviour +AnnoMi-therapist_127_46.mp4 There's a lot of decisions and a lot of change with your wife, with the new baby. reflection therapist_behaviour +AnnoMi-therapist_127_48.mp4 And now thinking about, looking after your health and wanting to be healthy for your wife and your baby. reflection therapist_behaviour +AnnoMi-therapist_127_50.mp4 Mm-hmm, so what-what would need to happen or how would you know, when you- when or if you ever did have to make a decision about whether to keep Oscar with you or not? question therapist_behaviour +AnnoMi-therapist_127_52.mp4 Mm-hmm. other therapist_behaviour +AnnoMi-therapist_127_54.mp4 Yeah and I get the feeling that it's something that you wanna think about that this is a really big decision- reflection therapist_behaviour +AnnoMi-therapist_127_56.mp4 -and it's not one that you're gonna make in a hurry. reflection therapist_behaviour +AnnoMi-therapist_127_58.mp4 Mm-hmm. other therapist_behaviour +AnnoMi-therapist_128_1.mp4 Yeah. He wasn't too happy with the exam, was he Hailey? question therapist_behaviour +AnnoMi-therapist_128_3.mp4 Um, well the good news is that the exam's over and I don't think Jake has pneumonia. What I actually think he has is a cold. So there are some things you could do to manage his symptoms. Would you be interested in knowing? question therapist_behaviour +AnnoMi-therapist_128_5.mp4 What I would recommend is that you avoid over-the-counter cold remedies, keep him away from any friends or family who may have the flu, keep him well hydrated, um, avoid excessive dust, and avoid smoking. And at least that last one's easy because you are an ex-smoker now. therapist_input therapist_behaviour +AnnoMi-therapist_128_7.mp4 Oh, fun. other therapist_behaviour +AnnoMi-therapist_128_9.mp4 All right, Well, first I'd just like to commend you for your honesty and that's really helpful information that you shared with me. Thank you for letting me know that you're smoking again and-and, um, I also appreciate the fact you're taking so many measures to protect your son from secondhand smoke. Can I give you some advice on how you could protect him, even the- even further? question therapist_behaviour +AnnoMi-therapist_128_11.mp4 So, my sense is that you're smoking and you're minimizing hi-his exposure by not smoking in the same room and smoking near windows. Is that- therapist_input therapist_behaviour +AnnoMi-therapist_128_13.mp4 -correct? question therapist_behaviour +AnnoMi-therapist_128_15.mp4 So what I would recommend then, is to move your smoking outside completely. As a smoker, the ideal situation for a smoker in the house is if their home can be made smoke-free and the smoking is moved entirely outside, especially while he's experiencing this cold. therapist_input therapist_behaviour +AnnoMi-therapist_128_17.mp4 Okay, so, what I'm hearing you say is that, it sounds like a feasible short-term plan, not ideal and not comfortable because what you really enjoy is that cigarette with a glass of wine, kicking back up on the sofa and chilling out perhaps while you're watching TV. And to maintain that long-term outside smoking outside in Canadian winters where it's cold and snowy, not realistic. reflection therapist_behaviour +AnnoMi-therapist_128_19.mp4 So, on the one hand I'm hearing smoking and drinking at night as a way to chill out but at the same time the next day, you're not feeling so great. reflection therapist_behaviour +AnnoMi-therapist_128_21.mp4 Would it be helpful to give you some information on low risk drinking guidelines? question therapist_behaviour +AnnoMi-therapist_128_23.mp4 Okay. Well, Hailey, what they suggest is that women don't have more than one to two standard drinks a day or a total of nine standard drinks in a week. How does that fit for you? therapist_input therapist_behaviour +AnnoMi-therapist_128_25.mp4 So, it sounds like you'd be open to reducing as a way to still enjoy the wine but perhaps alleviate the way you feel in the morning, some of the hangover effects that sounds like you're experiencing. reflection therapist_behaviour +AnnoMi-therapist_128_27.mp4 Okay. So, you're gonna try to reduce the drinking, not sure about the smoking, what the plan is but I think we did agree upon earlier that you would move it outside, at least while he's sick? question therapist_behaviour +AnnoMi-therapist_128_29.mp4 That's okay. All right and, um, I guess we'll see you next week for Jake's six-month checkup. Is there anything else we could talk about that might be helpful? question therapist_behaviour +AnnoMi-therapist_128_31.mp4 Sure, of course, Hailey a-and again I really appreciate your openness and honesty about letting me know what's going on with, you know, the stress levels and coping and drinking. I just had a thought that there's also a good mom's group, we run out of our center. So if you'd like a referral to that or some information, I'd be happy to give you and while you think about it, if you want to, um, talk about this further with one of my colleagues, I'd be happy to make you an appointment. therapist_input therapist_behaviour +AnnoMi-therapist_128_33.mp4 Thanks, Hailey. We'll see you next week. other therapist_behaviour +AnnoMi-therapist_129_1.mp4 Huh, you feel like you dodged the bullet. reflection therapist_behaviour +AnnoMi-therapist_129_3.mp4 It feels like it was like two days was a year? question therapist_behaviour +AnnoMi-therapist_129_5.mp4 Ah. other therapist_behaviour +AnnoMi-therapist_129_7.mp4 Okay. other therapist_behaviour +AnnoMi-therapist_129_9.mp4 Okay. other therapist_behaviour +AnnoMi-therapist_129_11.mp4 So what would have happened if you found out that you were pregnant? question therapist_behaviour +AnnoMi-therapist_129_13.mp4 Okay. That's a big step and that's not the direction you want to go in right now. reflection therapist_behaviour +AnnoMi-therapist_129_15.mp4 Would you be open to kind of exploring the idea of birth control and family planning? question therapist_behaviour +AnnoMi-therapist_129_17.mp4 Now, it's a discussion you don't really wanna have. reflection therapist_behaviour +AnnoMi-therapist_129_19.mp4 At the same time, you have some concerns about the possibility of getting pregnant. reflection therapist_behaviour +AnnoMi-therapist_129_21.mp4 "So you found some ways to prevent pregnancy up until-- well, maybe, um, you've been pretty fortunate, and then there is also some times where you feel like, ""Oh, no. What if I didn't dodge the bullet?"" " reflection therapist_behaviour +AnnoMi-therapist_129_23.mp4 Mm-hmm. other therapist_behaviour +AnnoMi-therapist_129_25.mp4 Okay. So, you've been able to kind of avoid any kind of consequences, and right now, you're not feeling that talking about birth control is something on your-your list. reflection therapist_behaviour +AnnoMi-therapist_129_27.mp4 Sure. I totally appreciate that, and it's your decision, Olivia. You know yourself best and what fits for you. If you ever feel like you like to open up the idea of conversation about family planning or birth control, I'd love to talk to you about that another time. therapist_input therapist_behaviour +AnnoMi-therapist_129_29.mp4 Okay. other therapist_behaviour +AnnoMi-therapist_129_31.mp4 Okay. I respect that. Thanks though for coming in to see me today. other therapist_behaviour +AnnoMi-therapist_129_33.mp4 And I'm glad that this appointment was a positive one for you. other therapist_behaviour +AnnoMi-therapist_129_35.mp4 You're welcome. other therapist_behaviour +AnnoMi-therapist_132_0.mp4 Hello, again, Mr. Green. It's really nice to see you again. If you remember last week, we looked at your results here and you've got impaired glucose tolerance and you were a bit worried about type two diabetes, your blood pressure and your cholesterol are up a bit too. So today, we're meeting up to talk through some of the things that you could do for yourself that might improve the situation. And as you know, there's all sorts of things can affect your health. So can we just have a bit of a general chat, but how are you getting on? reflection therapist_behaviour +AnnoMi-therapist_132_2.mp4 Actually, I'm not going to do that because you're the boss. It's up to you what you want to do with you about your own health. therapist_input therapist_behaviour +AnnoMi-therapist_132_4.mp4 You don't seem too happy about that. reflection therapist_behaviour +AnnoMi-therapist_132_6.mp4 Well, there's a lot of things you can do yourself that will improve the situation as well. So what we can do today is wee up some of those things, smoking, diet, exercise, weight, loss, all those kinds of things. So we're just gonna start and see how you feel as we go. therapist_input therapist_behaviour +AnnoMi-therapist_132_8.mp4 Well, it's very much up to you, you're the boss of your own life. Where would you like to start? question therapist_behaviour +AnnoMi-therapist_132_10.mp4 Well, I could give you my opinion. Um, and I can give you lots of information, but I think you know the score pretty well. And I think you'd know what I would say. therapist_input therapist_behaviour +AnnoMi-therapist_132_12.mp4 Absolutely. Spot on. So stopping smoking would have a huge impact, that would have a big impact very early on. Losing weight would also have a big impact because that would help with your blood pressure, your cholesterol, and also lower your diabetes risk. So what-what'd you think about those things? Uh, question therapist_behaviour +AnnoMi-therapist_132_14.mp4 It’s really tough. It's hard to know where to start, isn't it? reflection therapist_behaviour +AnnoMi-therapist_132_16.mp4 How important is it for you then to lose weight? question therapist_behaviour +AnnoMi-therapist_132_18.mp4 So can it be in there for your-your family's important to you? question therapist_behaviour +AnnoMi-therapist_132_20.mp4 Yeah. So w-where do you think you can start with that? question therapist_behaviour +AnnoMi-therapist_132_22.mp4 What's kind of the first thing you might think about doing? question therapist_behaviour +AnnoMi-therapist_132_24.mp4 Yeah. That would be a really good place to start, mm-hmm. reflection therapist_behaviour +AnnoMi-therapist_132_26.mp4 So I think it should be really supportive of that then. reflection therapist_behaviour +AnnoMi-therapist_132_28.mp4 So what would you do to make sure you didn't get hungry at work? question therapist_behaviour +AnnoMi-therapist_132_30.mp4 Yeah. Well, a big bowl of vegetable soup. You could probably count that as one or maybe even two of your five a day. So it'd be a really good place to start. Anything else you could think about doing? reflection therapist_behaviour +AnnoMi-therapist_132_32.mp4 Well, that's good. That's probably benefited you already. And the other thing you might not be aware of is that salt intake is linked to loss of calcium from our bones, which makes the bones more fragile. So reducing your salt intake will really help with that too. therapist_input therapist_behaviour +AnnoMi-therapist_132_34.mp4 So well, maybe you can help her as well and that would be good. Well, I think you've got off to a really great start, Mr. Green. You're very well aware of what you-you need to do, and you've obviously thought about it and got some good plans in place. So you're going to reduce your-your alcohol intake, you've already started by reducing your salt intake. Um, perhaps when we meet up next time we could talk a little bit about smoking and exercise as well, when you're ready for that. So how do you feel now? reflection therapist_behaviour +AnnoMi-therapist_132_36.mp4 That's great. So should we meet up at the same time next week then? question therapist_behaviour +AnnoMi-therapist_132_38.mp4 That’s great. All the very best then. other therapist_behaviour +AnnoMi-therapist_133_0.mp4 Thanks for coming in today. I guess you've, uh, sat in that seat with lots of people like me in the past. question therapist_behaviour +AnnoMi-therapist_133_2.mp4 Yeah. And you have some ideas about that and some experiences about that. So today I wanna- be good for us to talk about that and, um, I'm really interested to know what you've been thinking about in terms of what you may wanna change in your life 'cause we're gonna be working together for a while here. question therapist_behaviour +AnnoMi-therapist_133_4.mp4 What you've been thinking about, um, over the last little while about getting your life back on track. 'Cause I noticed you've— question therapist_behaviour +AnnoMi-therapist_133_6.mp4 Yeah. other therapist_behaviour +AnnoMi-therapist_133_8.mp4 Sure. So what I'm picking up is-is that-that-that's a life that you know a lot about. reflection therapist_behaviour +AnnoMi-therapist_133_10.mp4 And you can make lots of money and set yourself up well. What's the other side, because I guess when I talk to guys like yourself who have done time, often they're thinking about actually, mm, maybe life can be with different. So I'm wondering where-where you're at with the kind of thinking about— question therapist_behaviour +AnnoMi-therapist_133_12.mp4 Okay. other therapist_behaviour +AnnoMi-therapist_133_14.mp4 Sure. So life on the outside is pretty different than the kind of- reflection therapist_behaviour +AnnoMi-therapist_133_16.mp4 -the expectation of life on the inside something? question therapist_behaviour +AnnoMi-therapist_133_18.mp4 Yeah? question therapist_behaviour +AnnoMi-therapist_133_20.mp4 So tell me how you've been managing. 'Cause I don't know if you'd been back dealing? How have you been managing to-to-to— question therapist_behaviour +AnnoMi-therapist_133_22.mp4 Okay. other therapist_behaviour +AnnoMi-therapist_133_24.mp4 Yeah? other therapist_behaviour +AnnoMi-therapist_133_26.mp4 Uh, tell me- question therapist_behaviour +AnnoMi-therapist_133_28.mp4 It's there and-and-and you've a lot of contacts? question therapist_behaviour +AnnoMi-therapist_133_30.mp4 You've been in the system, so lots of context. So this isn't a new challenge for you. reflection therapist_behaviour +AnnoMi-therapist_133_32.mp4 So what stopped you over the last-- How long have you been out now? question therapist_behaviour +AnnoMi-therapist_133_34.mp4 Yeah. other therapist_behaviour +AnnoMi-therapist_133_36.mp4 Three weeks, isn't it? question therapist_behaviour +AnnoMi-therapist_133_38.mp4 So what's been there? What's it about that you haven't done in three weeks one day? question therapist_behaviour +AnnoMi-therapist_133_40.mp4 22 days you've actually made a decision not to-to pick up your old life and continue on. reflection therapist_behaviour +AnnoMi-therapist_133_42.mp4 Okay. other therapist_behaviour +AnnoMi-therapist_133_44.mp4 Right. So the one hand you've-you-you could sit yourself up and-and take the risk, but on the other hand, you know, that actually it might not last? reflection therapist_behaviour +AnnoMi-therapist_133_46.mp4 Never lasts. Mm. You seem like a bit of a crossroads to me. reflection therapist_behaviour +AnnoMi-therapist_133_48.mp4 Mm. But there've been times when those crossroads would be more sort of focused than other times. reflection therapist_behaviour +AnnoMi-therapist_133_50.mp4 Yeah. And it sounds like maybe like- reflection therapist_behaviour +AnnoMi-therapist_133_52.mp4 Yeah. other therapist_behaviour +AnnoMi-therapist_133_54.mp4 Yeah. other therapist_behaviour +AnnoMi-therapist_133_56.mp4 Okay. Okay. So— other therapist_behaviour +AnnoMi-therapist_133_58.mp4 No. Well, I've-I've got lots of ideas, but I'm really interested to hearing your ideas kind of first though because you know, and there might be some things that we can work on. other therapist_behaviour +AnnoMi-therapist_133_60.mp4 But I guess what I'm really interested in is-is you've made a commitment 22 days, drug-free. Haven't gone back into that lifestyle. What-what's keeping you, 'cause you're at the crossroads, you kind of just pause there at the moment. I'm not sure about this other bit over here. What keeping you in that place? question therapist_behaviour +AnnoMi-therapist_133_62.mp4 Yeah? question therapist_behaviour +AnnoMi-therapist_133_64.mp4 Tell me about Fiona? question therapist_behaviour +AnnoMi-therapist_133_66.mp4 Okay. other therapist_behaviour +AnnoMi-therapist_133_68.mp4 Okay. So you've been with Fiona for how long? question therapist_behaviour +AnnoMi-therapist_133_70.mp4 12 years. Okay. So she's stood by you then for the time, [crosstalk] but this time she said, it happens again I'm out of here? reflection therapist_behaviour +AnnoMi-therapist_133_72.mp4 Okay. And it sounds like you're listening to that black and white line. reflection therapist_behaviour +AnnoMi-therapist_133_74.mp4 Yeah, yeah. other therapist_behaviour +AnnoMi-therapist_133_76.mp4 Yeah. other therapist_behaviour +AnnoMi-therapist_133_78.mp4 Okay. So something's changed in your relationship between you, yeah? question therapist_behaviour +AnnoMi-therapist_133_80.mp4 Okay. So what's Fiona want you from you? question therapist_behaviour +AnnoMi-therapist_133_82.mp4 She wants him. So which him does she want, Daryl? question therapist_behaviour +AnnoMi-therapist_133_84.mp4 Does she want the- did she want the-the him that she fell in love with and saw great things in? question therapist_behaviour +AnnoMi-therapist_133_86.mp4 Or does she want the-the-the-the him that's- that keeps on getting into trouble? question therapist_behaviour +AnnoMi-therapist_133_88.mp4 Okay. other therapist_behaviour +AnnoMi-therapist_133_90.mp4 So what's it gonna take to reclaim this Daryl that she fell in love with? question therapist_behaviour +AnnoMi-therapist_133_92.mp4 Sure, yeah. other therapist_behaviour +AnnoMi-therapist_133_94.mp4 "All right. Well, let's-let's just play with this idea a little bit, Daryl. So what did Fiona fall in love with? What were the qualities of Daryl that she said, ""This is him""? " question therapist_behaviour +AnnoMi-therapist_133_96.mp4 I know. other therapist_behaviour +AnnoMi-therapist_133_98.mp4 Sure. Everyone will age, but that will happen on time. reflection therapist_behaviour +AnnoMi-therapist_133_100.mp4 Um, but that's okay. So-so it's she fell in love with this, the sense of fun, the sense of Daryl, and things have changed, but she's still with you? reflection therapist_behaviour +AnnoMi-therapist_133_102.mp4 Yeah? other therapist_behaviour +AnnoMi-therapist_133_104.mp4 Yeah. And you're still with her? question therapist_behaviour +AnnoMi-therapist_133_106.mp4 Yeah. So catch me up with the conversations you've had with Fiona about this crossroads you're at. You know, these 22 days, you haven't gone back, you've coming out and you're not back? You could pick up this dealing quite easily and probably some workout here tomorrow and get back into it. question therapist_behaviour +AnnoMi-therapist_133_108.mp4 Okay. All right. So-so back together, things are starting to get tense at home, and your relationship a little bit? reflection therapist_behaviour +AnnoMi-therapist_133_110.mp4 Yeah. Don't put words in your mouth. I'm sure if that is— reflection therapist_behaviour +AnnoMi-therapist_133_112.mp4 Oh, yeah? Yeah? other therapist_behaviour +AnnoMi-therapist_133_114.mp4 Second, I'd like to talk, Daryl, about this all- whole idea, that's this crossroads idea, yep? So on the one hand here, you've got this 12 year history of being in the other system and done some time and being away from Fiona, but you're now back, sitting back together, and you've got some choice about where to go. So, in that 'where to go', what ideas have you been thinking about in terms of where this-this Daryl, non-dealing [crosstalk] guy— question therapist_behaviour +AnnoMi-therapist_133_116.mp4 Okay. Yep. So a part of you knows you need to go something different, but the direction doesn't seem to be that clear at the moment? other therapist_behaviour +AnnoMi-therapist_133_118.mp4 It [unintelligible 00:09:33] picking up? question therapist_behaviour +AnnoMi-therapist_133_120.mp4 No idea. Okay. So I'm wondering, you've been in the system a while. You're now 34, is it right from the pick-up? question therapist_behaviour +AnnoMi-therapist_133_122.mp4 "Yeah. So, you know, often at 34, guys start to think about being with a girl in their life and what's important. And-and you would have also been part- not as a guy, so they've actually made some shifts and changes and thought, ""Time to move on"". " reflection therapist_behaviour +AnnoMi-therapist_133_124.mp4 And now you've got— other therapist_behaviour +AnnoMi-therapist_133_126.mp4 Not many? question therapist_behaviour +AnnoMi-therapist_133_128.mp4 But some. question therapist_behaviour +AnnoMi-therapist_133_130.mp4 One? question therapist_behaviour +AnnoMi-therapist_133_132.mp4 Yeah. other therapist_behaviour +AnnoMi-therapist_133_134.mp4 Yeah? question therapist_behaviour +AnnoMi-therapist_133_136.mp4 Tell me something about that. question therapist_behaviour +AnnoMi-therapist_133_138.mp4 Okay. other therapist_behaviour +AnnoMi-therapist_133_140.mp4 He did it? reflection therapist_behaviour +AnnoMi-therapist_133_142.mp4 Yeah. other therapist_behaviour +AnnoMi-therapist_133_144.mp4 Cool. So how interested would you be to find out more information about how he did it? 'Cause I'm thinking about this is someone who you know, you've done time with, got a relationship. question therapist_behaviour +AnnoMi-therapist_133_146.mp4 No, I'm not suggesting you-- No, not about being a drug counselor, but about he made that transition from-from being involved in crime- therapist_input therapist_behaviour +AnnoMi-therapist_133_148.mp4 -to a transition about being in a different place. other therapist_behaviour +AnnoMi-therapist_133_150.mp4 Okay, no 12-step higher power idea? question therapist_behaviour +AnnoMi-therapist_133_152.mp4 So that might work for him, but what might work for you? question therapist_behaviour +AnnoMi-therapist_133_154.mp4 Sure. other therapist_behaviour +AnnoMi-therapist_133_156.mp4 Okay, so part of being here with me, and the work we might do, will be to find- try and find- search for that- therapist_input therapist_behaviour +AnnoMi-therapist_133_158.mp4 -thing. Whatever it is. other therapist_behaviour +AnnoMi-therapist_133_160.mp4 Well, it's a search, isn't it? reflection therapist_behaviour +AnnoMi-therapist_133_162.mp4 No. other therapist_behaviour +AnnoMi-therapist_133_164.mp4 Yep, it is a big ask. So what qualities would you need to have to-to go there? question therapist_behaviour +AnnoMi-therapist_133_166.mp4 Guts? Yeah? other therapist_behaviour +AnnoMi-therapist_133_168.mp4 I think it is. other therapist_behaviour +AnnoMi-therapist_133_170.mp4 Yeah? So you're the sort of guy, Daryl, with guts? reflection therapist_behaviour +AnnoMi-therapist_133_172.mp4 Yeah. other therapist_behaviour +AnnoMi-therapist_133_174.mp4 Not yet? question therapist_behaviour +AnnoMi-therapist_133_176.mp4 Yeah? other therapist_behaviour +AnnoMi-therapist_133_178.mp4 Yet you're sitting here with me today- reflection therapist_behaviour +AnnoMi-therapist_133_180.mp4 -and-and-and you're talking about stuff. reflection therapist_behaviour +AnnoMi-therapist_133_182.mp4 Well, you're sitting here, and you're talking with me- reflection therapist_behaviour +AnnoMi-therapist_133_184.mp4 -about stuff that's-that's quite deep- reflection therapist_behaviour +AnnoMi-therapist_133_186.mp4 -in a way. Um, that takes guts. That takes courage. reflection therapist_behaviour +AnnoMi-therapist_133_188.mp4 In my view, it does. other therapist_behaviour +AnnoMi-therapist_133_190.mp4 'Cause you could've come in here and said- other therapist_behaviour +AnnoMi-therapist_133_192.mp4 "-""Look, Ken, you know, I'll come in, report in, I'm outta here."" " other therapist_behaviour +AnnoMi-therapist_133_194.mp4 You could've done that, but you're not. So I'm wondering what's different? 'Cause you may have done that in the past, I don't know, Daryl, with other people like me, but-but sounds like something's different this time. reflection therapist_behaviour +AnnoMi-therapist_133_196.mp4 Yeah? other therapist_behaviour +AnnoMi-therapist_133_198.mp4 Yeah. other therapist_behaviour +AnnoMi-therapist_133_200.mp4 Sure. other therapist_behaviour +AnnoMi-therapist_133_202.mp4 I kind of see a sense of sadness there when you have to kind of think about this. reflection therapist_behaviour +AnnoMi-therapist_133_204.mp4 Yeah. other therapist_behaviour +AnnoMi-therapist_133_206.mp4 Okay. So I'm interested in this idea, let's, uh-- Opportunities come and go all the time. reflection therapist_behaviour +AnnoMi-therapist_133_208.mp4 They do. other therapist_behaviour +AnnoMi-therapist_133_210.mp4 Well you said before you had an opportunity to pick up and start dealing again. reflection therapist_behaviour +AnnoMi-therapist_133_212.mp4 And-and so-so-so there's opportunities- there's opportunities in one world, and I'm wondering about what might make it hard to see opportunities in a different world? question therapist_behaviour +AnnoMi-therapist_133_214.mp4 Sure, sure. You're in the system- reflection therapist_behaviour +AnnoMi-therapist_133_216.mp4 -you're not in the system. Pick up that, where is it gonna take you? question therapist_behaviour +AnnoMi-therapist_133_218.mp4 Yeah, what-what's gonna happen if you start dealing again? question therapist_behaviour +AnnoMi-therapist_133_220.mp4 Yeah. other therapist_behaviour +AnnoMi-therapist_133_222.mp4 Okay, okay. other therapist_behaviour +AnnoMi-therapist_133_224.mp4 So-So again, I'm-I'm wondering about this other world, and you're saying it doesn't look to attractive at the moment. reflection therapist_behaviour +AnnoMi-therapist_133_226.mp4 You can't se it? question therapist_behaviour +AnnoMi-therapist_133_228.mp4 Yeah? other therapist_behaviour +AnnoMi-therapist_133_230.mp4 Yeah? You just described to me how it looked like a minute ago. reflection therapist_behaviour +AnnoMi-therapist_133_232.mp4 Minimum wage- reflection therapist_behaviour +AnnoMi-therapist_133_234.mp4 -night shift, petrol station. reflection therapist_behaviour +AnnoMi-therapist_133_236.mp4 Yeah? other therapist_behaviour +AnnoMi-therapist_133_238.mp4 Yeah? It is really hard. therapist_input therapist_behaviour +AnnoMi-therapist_133_240.mp4 Sure. other therapist_behaviour +AnnoMi-therapist_133_242.mp4 Sure. We talked about courage before and you've got the guts to be talking with me about this stuff today, and I'm wondering if you actually do have some courage to think about these ideas. I'm not saying that pumping gas at minimum wage is where you wanna go, but-but the guts to actually start steeping into this other world. I wonder if you do have, I'm-I'm-I'm just not sure. reflection therapist_behaviour +AnnoMi-therapist_133_244.mp4 Maybe. You're not convinced at the moment, I understand that and, um— other therapist_behaviour +AnnoMi-therapist_133_246.mp4 Sure. Well, it's hard to me to convince you- therapist_input therapist_behaviour +AnnoMi-therapist_133_248.mp4 -'cause this is your life and this is your story, and you-you've got to walk your life and I can't walk your life for you. I only walk my. And so, but I can walk with you on this life to try and think about-- 'Cause I-I-- You know, I-I've no interest in actually you falling over and going back into-into a lifestyle a crime 'cause I know where it'll take you. And I'm hearing that with your relationship, where it's going to take your relationship too, [unintelligible 00:16:39] got the bottom line drawn pretty clearly. reflection therapist_behaviour +AnnoMi-therapist_133_250.mp4 So it seems like what's gonna push in this direction, just tip that balance a little bit to give this other world of go? Because it is new, it's different. It means doing stuff, a lot of stuff actually that-that's kind of mundane. question therapist_behaviour +AnnoMi-therapist_133_252.mp4 It's kind of cool? question therapist_behaviour +AnnoMi-therapist_133_254.mp4 Not part of on the wire? reflection therapist_behaviour +AnnoMi-therapist_133_256.mp4 No? question therapist_behaviour +AnnoMi-therapist_133_258.mp4 You don't. And who's sitting on the porch with you? question therapist_behaviour +AnnoMi-therapist_133_260.mp4 Mm-hmm. other therapist_behaviour +AnnoMi-therapist_133_262.mp4 Cool. So I'm picking up this world actually has the freedom to you to be your own man? reflection therapist_behaviour +AnnoMi-therapist_133_264.mp4 Maybe? question therapist_behaviour +AnnoMi-therapist_133_266.mp4 Yeah? other therapist_behaviour +AnnoMi-therapist_133_268.mp4 Yeah. other therapist_behaviour +AnnoMi-therapist_133_270.mp4 Yeah it is. It is. other therapist_behaviour +AnnoMi-therapist_133_272.mp4 Absolutely massive. And, uh-- So, is there a challenge you're up to, to start creating some-some-some of that sort of world for Fiona? 'Cause I'm hearing that— question therapist_behaviour +AnnoMi-therapist_133_274.mp4 Sure. So what I'm hearing is, you're not convinced at the moment. reflection therapist_behaviour +AnnoMi-therapist_133_276.mp4 "No. So what would convince you to-to make that shift? 'Cause I hear a lot of kind of-- And in this hard, like, y-you've done time and then once you've got a record, the employers- you know, we know, I know that. That's-that's not easy. You can't just wonder into a job, a high-paying job and go, ""Pick me, pick me, pick me."" I know that. " question therapist_behaviour +AnnoMi-therapist_133_278.mp4 You know that. other therapist_behaviour +AnnoMi-therapist_133_280.mp4 So, um-- And-and maybe it's about small steps and first steps. therapist_input therapist_behaviour +AnnoMi-therapist_133_282.mp4 Well, you trying to get a job, maybe and get into some routine. other therapist_behaviour +AnnoMi-therapist_133_284.mp4 Okay. other therapist_behaviour +AnnoMi-therapist_133_286.mp4 "Yeah. I'm confused though at the moment because you're saying, ""Yeah, I could make in a night what you make in a week,"" but you've haven't. 22-22 days- " reflection therapist_behaviour +AnnoMi-therapist_133_288.mp4 -and you haven't done that. So-so tell me what that's about. question therapist_behaviour +AnnoMi-therapist_133_290.mp4 So you told yourself you wouldn't, so you're once you- you're the sort of guy that once you make a decision you're gonna go, you're staunch with that decision? question therapist_behaviour +AnnoMi-therapist_133_292.mp4 Oh, it's a decision whether it's right or wrong-- It's not gonna be- reflection therapist_behaviour +AnnoMi-therapist_133_294.mp4 Yeah, you're that kinda guy okay, so once you make a decision. So you made a decision that you're not gonna- you're not gonna go back to dealing? reflection therapist_behaviour +AnnoMi-therapist_133_296.mp4 Yet. question therapist_behaviour +AnnoMi-therapist_133_298.mp4 You're keeping the door open- reflection therapist_behaviour +AnnoMi-therapist_133_300.mp4 -at the moment, is what I'm picking up. reflection therapist_behaviour +AnnoMi-therapist_133_302.mp4 Yeah, okay, so that will be a call you-you've got to make. other therapist_behaviour +AnnoMi-therapist_133_304.mp4 I'm-I'm not gonna- I'm not gonna make that call. You'll make that call, but there's a consequence of making that call, and there's big consequences more time probably and Fiona not being around. On the other hand, what I'm picking up is a call to-to do some- do some stuff that may not be racy and exciting and in the big dollars, but me being with Fiona and engaging in this transition into a-a different life. reflection therapist_behaviour +AnnoMi-therapist_133_306.mp4 Yeah. other therapist_behaviour +AnnoMi-therapist_133_308.mp4 No. other therapist_behaviour +AnnoMi-therapist_133_310.mp4 But we're talking about it. other therapist_behaviour +AnnoMi-therapist_133_312.mp4 So how much time have you been talking about this- question therapist_behaviour +AnnoMi-therapist_133_314.mp4 -position? question therapist_behaviour +AnnoMi-therapist_133_316.mp4 Okay-okay, so the fact we're even having a conversation about it, it's kind of interesting? reflection therapist_behaviour +AnnoMi-therapist_133_318.mp4 Yeah, so I wanna summarize, Daryl, what-what I picked up so far and then just so I make sure I'm really listening to you well 'cause it's important, isn't it? 'Cause, you know, it's important you're listened to- question therapist_behaviour +AnnoMi-therapist_133_320.mp4 -by people me. So what I'm picking up is-is-is that if you've-you've got this long 12-year history, you can make some big money or you can dealing, doing crime, that stuff, I'm-I'm picking up that Fiona's set the bottom line, is if you go back in that lifestyle, she's out of here, yet she stayed here for 13, 12, 13 years? reflection therapist_behaviour +AnnoMi-therapist_133_322.mp4 Nearly 13 years, so and-and so-so she stuck with you, and I'm pick up that's important to you, um, and-and-and yet you talk about it, it just seems easy, this bit over here, this whole lifestyle. reflection therapist_behaviour +AnnoMi-therapist_133_324.mp4 This other lifestyle over here though when we talk about, actually thinking about, you know, doing stuff, doing the stuff that-that everybody else generally does, [unintelligible 00:22:30] will gets on doing, it doesn't have that same kinda seem to excitement, and it doesn't seem to be a-a starting point for you over here. reflection therapist_behaviour +AnnoMi-therapist_133_326.mp4 Oh, it does? reflection therapist_behaviour +AnnoMi-therapist_133_328.mp4 Right, okay. other therapist_behaviour +AnnoMi-therapist_133_330.mp4 Okay, you're over that one, okay. So, let's start to think about what might be the first step. therapist_input therapist_behaviour +AnnoMi-therapist_133_332.mp4 Yeah, with while going in, I think you got a high steep. reflection therapist_behaviour +AnnoMi-therapist_133_334.mp4 Yeah, a steep, you see before you had a mate who turned his back on offending. reflection therapist_behaviour +AnnoMi-therapist_133_336.mp4 And for him this 12-- You wondered that the 12-step stuff working for him. reflection therapist_behaviour +AnnoMi-therapist_133_338.mp4 Yeah, maybe that, I'm wondering the conve- the conversation with him that might be around actually how did he do it, and how did he stay without slipping back across the line, 'cause like-like get this crossroads you've got the path and go the other path and go here, so I'm wondering about conversation with him, what would it take to have that conversation? question therapist_behaviour +AnnoMi-therapist_133_340.mp4 Ringing him? question therapist_behaviour +AnnoMi-therapist_133_342.mp4 Yeah. You seem a little surprised, I'm-I'm [crosstalk] wondering about, surprising face. reflection therapist_behaviour +AnnoMi-therapist_133_344.mp4 So possibility to call? other therapist_behaviour +AnnoMi-therapist_133_346.mp4 Yeah there's possible. other therapist_behaviour +AnnoMi-therapist_133_348.mp4 Yeah, okay, and Fiona's been pretty staunch. reflection therapist_behaviour +AnnoMi-therapist_133_350.mp4 Is someone who actually who has some pretty clear ideas about where she wants you as a couple to go- reflection therapist_behaviour +AnnoMi-therapist_133_352.mp4 -I get a sense. other therapist_behaviour +AnnoMi-therapist_133_354.mp4 Yeah. other therapist_behaviour +AnnoMi-therapist_133_356.mp4 Yeah, but I'm picking up though behind that doing what you're told, she's got some hopes. reflection therapist_behaviour +AnnoMi-therapist_133_358.mp4 So what will it take for you to start thinking about some of her hopes and sharing some of her hopes? question therapist_behaviour +AnnoMi-therapist_133_360.mp4 Yeah? other therapist_behaviour +AnnoMi-therapist_133_362.mp4 You said before you're sort of guy that once you make a decision you're pretty staunch with that decision. reflection therapist_behaviour +AnnoMi-therapist_133_364.mp4 So if you made a decision to go there, it might be a scary as shit but again it seems that, uh, it could work if see it look, this is important, this relationship's important, let me go for— reflection therapist_behaviour +AnnoMi-therapist_133_366.mp4 Sure. other therapist_behaviour +AnnoMi-therapist_133_368.mp4 Yeah. That's-that's what I'm thinking- I'm thinking actually. Here's someone that actually has made a different decision then, uh, it sounds like that's the pathway that starts over here and I'm wondering. I wonder whether you might have wisdom about what it's like to t-to tread that path. reflection therapist_behaviour +AnnoMi-therapist_133_370.mp4 So you know there's a part of you going, I was thinking in this place that's hard work. reflection therapist_behaviour +AnnoMi-therapist_133_372.mp4 And this is a pretty lonely road to-to walk by yourself. I'm wondering who else might be around you that might actually walk with you? question therapist_behaviour +AnnoMi-therapist_133_374.mp4 Yeah. other therapist_behaviour +AnnoMi-therapist_133_376.mp4 You know maybe they'll walk that road with you too. other therapist_behaviour +AnnoMi-therapist_133_378.mp4 There's a couple of people. other therapist_behaviour +AnnoMi-therapist_133_380.mp4 If you want to do that. It gotta be your call. therapist_input therapist_behaviour +AnnoMi-therapist_9_0.mp4 So now that we've discussed a little bit of your medical history and- and taking your vitals, I'd like to ask you a few more questions. The- therapist_input therapist_behaviour +AnnoMi-therapist_9_2.mp4 -the rise in your blood pressure is concerning to me, so I'd like to gather a bit more information about your lifestyle. therapist_input therapist_behaviour +AnnoMi-therapist_9_4.mp4 Okay. Have you had any major stressful events recently or any change in your work situation? question therapist_behaviour +AnnoMi-therapist_9_6.mp4 Yeah, that's certainly true. I'd also like to ask about some health habits that can contribute to high blood pressure. other therapist_behaviour +AnnoMi-therapist_9_8.mp4 Okay, do you smoke at all? question therapist_behaviour +AnnoMi-therapist_9_10.mp4 Okay, great. Um, do you drink alcohol, including beer or wine? question therapist_behaviour +AnnoMi-therapist_9_12.mp4 Okay. Well, I'm concerned about the amount that you're drinking currently. It sounds like you're having about 15 to 20 drinks per week, and that's definitely more than what we would recommend and could certainly be contributing to your high blood pressure. therapist_input therapist_behaviour +AnnoMi-therapist_9_14.mp4 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? therapist_input therapist_behaviour +AnnoMi-therapist_9_16.mp4 Alcohol can have some dangerous effects on your body. So along with contributing to high blood pressure, it can have a big impact on your liver, which you need to keep in mind. So your liver has several different roles in your body. First, it helps process excess fatty acids before they get distributed to the rest of your body. It 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, and over time, your liver won't be able to work as well. therapist_input therapist_behaviour +AnnoMi-therapist_9_18.mp4 Okay. And how about the use of other drugs like cocaine, heroin, marijuana? question therapist_behaviour +AnnoMi-therapist_9_20.mp4 Okay. Have you ever used any prescription medications that weren't prescribed for you or in a way that wasn't prescribed? question therapist_behaviour +AnnoMi-therapist_9_22.mp4 Okay, excellent. Well, it sounds to me like 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. therapist_input therapist_behaviour +AnnoMi-therapist_9_24.mp4 Okay. And then we'll set up an appointment for about a month from now. We'll recheck your blood pressure and see how you're doing with all this, sound okay? therapist_input therapist_behaviour +AnnoMi-therapist_9_26.mp4 Okay. other therapist_behaviour +AnnoMi-therapist_10_0.mp4 Hi. You are [unintelligible 00:00:02]? question therapist_behaviour +AnnoMi-therapist_10_2.mp4 Okay. Um, what brings you in? question therapist_behaviour +AnnoMi-therapist_10_4.mp4 Mm-hmm. I see- I see that your A1C or your blood glucose is very high. therapist_input therapist_behaviour +AnnoMi-therapist_10_6.mp4 Mm-hmm. Well, you do need to take your medicine. We, uh, will need to start dieting, uh, you know, lose some weight, change-change your eating habits, exercise, uh, to get your diabetes under control, because your doctor is right, it is very serious. therapist_input therapist_behaviour +AnnoMi-therapist_10_8.mp4 So, it sure can. therapist_input therapist_behaviour +AnnoMi-therapist_10_10.mp4 So, uh, you know, we-we need to start looking at doing all those different things to get your diabetes under control 'cause your-your number is very high. therapist_input therapist_behaviour +AnnoMi-therapist_15_0.mp4 Can I help you? question therapist_behaviour +AnnoMi-therapist_15_2.mp4 So you want nicotine replacement, but you don't wanna quit smoking? reflection therapist_behaviour +AnnoMi-therapist_15_4.mp4 We don't really recommend that. The idea is 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. therapist_input therapist_behaviour +AnnoMi-therapist_15_6.mp4 Okay. Well, smoking really is really bad for you, you know. It causes things like lung cancer, emphysema, heart disease- therapist_input therapist_behaviour +AnnoMi-therapist_15_8.mp4 -oral diseases. therapist_input therapist_behaviour +AnnoMi-therapist_15_10.mp4 Well, to be honest with you, you mentioned the patch. I can't recommend a patch to you if you're gonna 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. therapist_input therapist_behaviour +AnnoMi-therapist_15_12.mp4 Okay. Well, we actually consider 20 cigarettes a day to be a significant amount, and in fact, I would then recommend to you that you would start on the highest dose of nicotine replacement. therapist_input therapist_behaviour +AnnoMi-therapist_15_14.mp4 Well, there are some products that you could use to take away some of your cravings, and probably the gum would be the best option for you. It's not something you would continue to use continuously throughout the day, however, but gum is something you use just when you have a craving. therapist_input therapist_behaviour +AnnoMi-therapist_15_16.mp4 Well, we have that here, but again, the-the idea would be for you to actually quit smoking. therapist_input therapist_behaviour +AnnoMi-therapist_15_18.mp4 Well, aside from the gum, you could try the nicotine lozenge, that would be another option for you. Again, that's not something you'd 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. therapist_input therapist_behaviour +AnnoMi-therapist_15_20.mp4 Okay. other therapist_behaviour +AnnoMi-therapist_17_0.mp4 Okay, so I'm just gonna ask you a couple of more background questions. therapist_input therapist_behaviour +AnnoMi-therapist_17_2.mp4 Do you use any tobacco products, or smoke cigarettes? question therapist_behaviour +AnnoMi-therapist_17_4.mp4 Okay. How about in the last year? question therapist_behaviour +AnnoMi-therapist_17_6.mp4 Okay. And how often do you have a drink containing alcohol? question therapist_behaviour +AnnoMi-therapist_17_8.mp4 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 20 drinks a week? question therapist_behaviour +AnnoMi-therapist_17_10.mp4 Okay. Do you use any street drugs like any marijuana, cocaine, heroin? question therapist_behaviour +AnnoMi-therapist_17_12.mp4 Do you, um, do you ever use any prescription medicines that were not prescribed for you, or ever use your own prescriptions in a way on which they were not prescribed? question therapist_behaviour +AnnoMi-therapist_17_14.mp4 Okay. So, you know, as we said before, you're drinking-- it sounds like you're drinking about 20 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. therapist_input therapist_behaviour +AnnoMi-therapist_17_16.mp4 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, okay? Things like greater risk of injury, damage to different parts of your body, um, just a bunch of different problems. And, uh-- so I'm going to recommend that you cut down- cut down that amount to the recommended limit. Again, that's no more than seven drinks a week and no more than three on a given day. Do you think you could do that? Would that be a good goal for you? therapist_input therapist_behaviour +AnnoMi-therapist_17_18.mp4 Yeah, I know that making changes isn't always easy. But when you drink more than what's recommended, it creates problems. You know, you said you hurt your ankle when you came out of the bar this time. reflection therapist_behaviour +AnnoMi-therapist_17_20.mp4 Yeah. 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 gonna 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 on a given day? therapist_input therapist_behaviour +AnnoMi-therapist_17_22.mp4 So, it sounds like, you know, the amount you drink is pretty normal- reflection therapist_behaviour +AnnoMi-therapist_17_24.mp4 -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? therapist_input therapist_behaviour +AnnoMi-therapist_17_26.mp4 Well, I think you can still have fun within these amounts. So that's what I'm gonna recommend. Um, I think this is a really good goal, and hopefully, we won't see any more injuries. Okay? So why don't you try that? therapist_input therapist_behaviour +AnnoMi-therapist_17_28.mp4 All right. Thank you so much. other therapist_behaviour +AnnoMi-therapist_27_0.mp4 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. therapist_input therapist_behaviour +AnnoMi-therapist_27_2.mp4 Yeah. other therapist_behaviour +AnnoMi-therapist_27_4.mp4 Well, you sound a bit surprised by that. But I'm sure that you've seen some of the material that-that the clinic gave you about asthma symptoms and managing your asthma, and pets are a really big source of problems in that respect. therapist_input therapist_behaviour +AnnoMi-therapist_27_6.mp4 Mm-hmm. other therapist_behaviour +AnnoMi-therapist_27_8.mp4 Well, uh, wait a second, Sal, what do you mean you-you- ha- If you-- As in-- 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- other therapist_behaviour +AnnoMi-therapist_27_10.mp4 -a new baby. other therapist_behaviour +AnnoMi-therapist_27_12.mp4 -and you are very concerned about your health, you wanna be there for your baby and that you've already taken some steps, you've-you've almost quit smoking- reflection therapist_behaviour +AnnoMi-therapist_27_14.mp4 -which is fantastic. So, the next step is to really deal with the dog, deal with the pet. I know it's- so- 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. therapist_input therapist_behaviour +AnnoMi-therapist_27_16.mp4 It's you that I'm worried about, Sal. It's you that I'm worried about, okay? The-the symptoms are worse. You've had two or three major asthma attacks. And-and do you appreciate how-- This is, uh, 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-it truly is something to take very, very seriously. I can't emphasize that enough. therapist_input therapist_behaviour +AnnoMi-therapist_27_18.mp4 Sal, what, uh, do you understand that what happened 6 years ago or 10 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. therapist_input therapist_behaviour +AnnoMi-therapist_27_20.mp4 Sal, 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, uh, that makes no sense to me. Do you understand how important this is? therapist_input therapist_behaviour +AnnoMi-therapist_27_22.mp4 Uh, okay, well other therapist_behaviour +AnnoMi-therapist_32_0.mp4 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 were transported to detox. Plus, you're only 21 years old. Is the report accurate? therapist_input therapist_behaviour +AnnoMi-therapist_32_2.mp4 Okay. Behavior like this could get you suspended, doesn't that concern you? therapist_input therapist_behaviour +AnnoMi-therapist_32_4.mp4 What were you thinking when you got into your car after having six beers, you could have caused an accident and killed somebody. question therapist_behaviour +AnnoMi-therapist_32_6.mp4 You need to take responsibility for your actions. If you keep partying like this, your problems will only get worse. You're likely to face costly legal citations, poor grades, health problems. Getting kicked out of school and disappointing your parents. You don't want that to happen, do you? therapist_input therapist_behaviour +AnnoMi-therapist_32_8.mp4 Your behavior is not what Minnesota State University expects of its students. If you wanna 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? therapist_input therapist_behaviour +AnnoMi-therapist_32_10.mp4 Okay. Well, your sanction is you'll be placed on university disciplinary probation and you'll have to attend an alcohol education seminar that'll cost you $150. Also, disciplinary action is progressive and cumulative, meaning that any further violations will result in suspension for one semester or longer. therapist_input therapist_behaviour +AnnoMi-therapist_44_0.mp4 Hey, hi, Andrea. Thanks for coming in today. So I don't know how much you've been told about why you're here, but basically, it's my job just to meet with all the students. I usually meet with you once or twice a semester. And I'm going to be talking to you kind of about your life and your goals and some behaviors that you might engage in and just the sorts of things like that. reflection therapist_behaviour +AnnoMi-therapist_44_2.mp4 So why don't you start by telling me a little bit about yourself? question therapist_behaviour +AnnoMi-therapist_44_4.mp4 Oh. other therapist_behaviour +AnnoMi-therapist_44_6.mp4 Okay. other therapist_behaviour +AnnoMi-therapist_44_8.mp4 Okay. How long ago did you start playing saxophone? question therapist_behaviour +AnnoMi-therapist_44_10.mp4 Wow. That's a long time. What other instruments? question therapist_behaviour +AnnoMi-therapist_44_12.mp4 No kidding. other therapist_behaviour +AnnoMi-therapist_44_14.mp4 That's awesome. And you play tenor sax? question therapist_behaviour +AnnoMi-therapist_44_16.mp4 Wow. And how long have you been in marching band? question therapist_behaviour +AnnoMi-therapist_44_18.mp4 Okay. Couple of years. Great. And how do you like Marching Band? question therapist_behaviour +AnnoMi-therapist_44_20.mp4 What are your favorite parts about it? question therapist_behaviour +AnnoMi-therapist_44_22.mp4 Oh, okay. other therapist_behaviour +AnnoMi-therapist_44_24.mp4 Uh-huh. other therapist_behaviour +AnnoMi-therapist_44_26.mp4 Okay. other therapist_behaviour +AnnoMi-therapist_44_28.mp4 Cool. And do you have a lot of friends who are in band with you or- question therapist_behaviour +AnnoMi-therapist_44_30.mp4 -friends outside of band or? question therapist_behaviour +AnnoMi-therapist_44_32.mp4 Okay. other therapist_behaviour +AnnoMi-therapist_44_34.mp4 Great. And then, um, tell me a little bit about your family? question therapist_behaviour +AnnoMi-therapist_44_36.mp4 Oh, wow. other therapist_behaviour +AnnoMi-therapist_44_38.mp4 Okay. What kind of dog do you have? question therapist_behaviour +AnnoMi-therapist_44_40.mp4 Oh, nice. other therapist_behaviour +AnnoMi-therapist_44_42.mp4 Charlie. other therapist_behaviour +AnnoMi-therapist_44_44.mp4 Oh, cute. Have you had him a long time? question therapist_behaviour +AnnoMi-therapist_44_46.mp4 Oh gosh. Yeah. Okay. Very cool. And what are your plans for after high school? question therapist_behaviour +AnnoMi-therapist_44_48.mp4 Wow. other therapist_behaviour +AnnoMi-therapist_44_50.mp4 You've got big dreams. other therapist_behaviour +AnnoMi-therapist_44_52.mp4 Cool. All right. Have you started thinking about schools or majors? I guess you're thinking about psychology as a major. question therapist_behaviour +AnnoMi-therapist_44_54.mp4 Right. other therapist_behaviour +AnnoMi-therapist_44_56.mp4 All right. And how about your grades? question therapist_behaviour +AnnoMi-therapist_44_58.mp4 Okay. Good. Very good. All right. Well, what are the kinds of things do you do for fun on weekends? question therapist_behaviour +AnnoMi-therapist_44_60.mp4 Mm-hmm. other therapist_behaviour +AnnoMi-therapist_44_62.mp4 Mm-hmm. When you're hanging out, is there ever alcohol? question therapist_behaviour +AnnoMi-therapist_44_64.mp4 Uh-huh So how often do you think you drink alcohol? question therapist_behaviour +AnnoMi-therapist_44_66.mp4 Oh, so you're drinking a lot? question therapist_behaviour +AnnoMi-therapist_44_68.mp4 Okay. And how much are you drinking on the days that you're-- on the days that you drink? question therapist_behaviour +AnnoMi-therapist_44_70.mp4 Mm-hmm. other therapist_behaviour +AnnoMi-therapist_44_72.mp4 Mm-hmm. other therapist_behaviour +AnnoMi-therapist_44_74.mp4 Got it. So you've-you've had some pretty heavy drinking. What-what do you think is the most you've ever had? question therapist_behaviour +AnnoMi-therapist_44_76.mp4 Yeah. other therapist_behaviour +AnnoMi-therapist_44_78.mp4 Okay, so you don't even know. question therapist_behaviour +AnnoMi-therapist_44_80.mp4 Okay. So, and then your friends drink too? question therapist_behaviour +AnnoMi-therapist_44_82.mp4 Okay. And how much do they typically drink? question therapist_behaviour +AnnoMi-therapist_44_84.mp4 Okay, so it's one cup, but it's not-not one drink. other therapist_behaviour +AnnoMi-therapist_44_86.mp4 It has a lot of alcohol in it. other therapist_behaviour +AnnoMi-therapist_44_88.mp4 Okay. Um, so gosh, you're-you're actually really drinking quite a lot. Um, you know, your level of drinking puts you in what we call a high-risk group. therapist_input therapist_behaviour +AnnoMi-therapist_44_90.mp4 So, is that surprising to you? question therapist_behaviour +AnnoMi-therapist_44_92.mp4 Yeah. Um, so we call it high-risk because it means that there's actually quite a bit of chances that you're gonna have some bad consequences from drinking like that. So, you know, things like, um, having car accidents, or other accidents, or getting in fights, or, you know, sexual assault, or health problems, or developing alcoholism. Have you thought about those things? question therapist_behaviour +AnnoMi-therapist_44_94.mp4 Uh-huh. other therapist_behaviour +AnnoMi-therapist_44_96.mp4 Uh-huh. other therapist_behaviour +AnnoMi-therapist_44_98.mp4 Okay. So it's, um, so it's good, because you're not drinking and driving, but you're still really drinking a lot. Um, and yeah. Okay. So, let's-let's talk a little bit about that, how you might be able to make some changes. Because I think you really need to- need to stop drinking like this. other therapist_behaviour +AnnoMi-therapist_44_100.mp4 So, um, do you think you could quit drinking or? question therapist_behaviour +AnnoMi-therapist_44_102.mp4 Uh-huh. other therapist_behaviour +AnnoMi-therapist_44_104.mp4 Uh-huh. other therapist_behaviour +AnnoMi-therapist_44_106.mp4 Okay. So, does that mean you're gonna stop drinking? reflection therapist_behaviour +AnnoMi-therapist_44_108.mp4 Uh-huh. other therapist_behaviour +AnnoMi-therapist_44_110.mp4 Okay. Um, you don't sound very much like you think that's gonna work. reflection therapist_behaviour +AnnoMi-therapist_44_112.mp4 Mm-hmm. other therapist_behaviour +AnnoMi-therapist_44_114.mp4 Okay. So, how are you gonna quit drinking without your friends thinking you look stupid? question therapist_behaviour +AnnoMi-therapist_44_116.mp4 Okay. Um, so I mean, do you think they're really good friends of yours if they're gonna give you such a hard time? question therapist_behaviour +AnnoMi-therapist_44_118.mp4 Uh-huh. other therapist_behaviour +AnnoMi-therapist_44_120.mp4 It sounds like you might be better off without them though. They’re- reflection therapist_behaviour +AnnoMi-therapist_44_122.mp4 - maybe not very good friends. reflection therapist_behaviour +AnnoMi-therapist_44_124.mp4 Mm-hmm. So, um, so I think we should set a goal that you're gonna stop drinking. therapist_input therapist_behaviour +AnnoMi-therapist_44_126.mp4 And, um, I think you should probably stop as soon as possible, like this weekend. therapist_input therapist_behaviour +AnnoMi-therapist_44_128.mp4 Um, so the way this normally works is, you know, we set you a goal, and then I'll have you come back and we'll talk about it again in a couple of weeks and make sure that you actually stopped. Um, and so what do you think about that? therapist_input therapist_behaviour +AnnoMi-therapist_44_130.mp4 Okay. So- other therapist_behaviour +AnnoMi-therapist_44_132.mp4 Okay, great. So, the plan is gonna be that you're gonna quit and, um, the friends that you have that you don't think are supportive, you're just gonna, I guess, not hang out with anymore. other therapist_behaviour +AnnoMi-therapist_44_134.mp4 Okay. And then, um, you know, like, are your friends in band drinking? question therapist_behaviour +AnnoMi-therapist_44_136.mp4 Uh-huh. other therapist_behaviour +AnnoMi-therapist_44_138.mp4 Okay. So, that might be good, is really just to focus more on band. Um, because you know, the other big concern I have for you is if you wanna go to medical school, you're not ever gonna get into medical school if you're drinking like this. other therapist_behaviour +AnnoMi-therapist_44_140.mp4 You know, like college is gonna be really hard. And especially with all those pre-med classes, you're not gonna be able to handle it drinking this much. You know, have you thought about that? question therapist_behaviour +AnnoMi-therapist_44_142.mp4 Yeah. Okay. So, setting this goal then of quitting drinking is gonna be really helpful for you. And um, it sounds like i-it shouldn't be that tough really, um, especially because you can just stop hanging out with- therapist_input therapist_behaviour +AnnoMi-therapist_44_144.mp4 -the people who drink a lot, um, since you have some other friends. Um, yeah. So, do you have any questions for me or? question therapist_behaviour +AnnoMi-therapist_44_146.mp4 Mm-hmm. other therapist_behaviour +AnnoMi-therapist_44_148.mp4 "Well, you know, one good option would be to just review with them review with them all the bad things about alcohol. You can say, you know, ""I thought about it, and I realized it's gonna mess up my schoolwork. And you know, it's really a lot of risk for my health."" ""I don't want to become an alcoholic."" Um, you know, ""I don't want to get liver disease."", ""I don't want to end up driving drunk or getting into accidents- " therapist_input therapist_behaviour +AnnoMi-therapist_44_150.mp4 "-or getting in fights."" You know, one thing you could bring up is, ""I've heard a lot of stories about kids who you know, are at parties and they're drunk and acting stupid, and then people post stuff on Instagram."" " therapist_input therapist_behaviour +AnnoMi-therapist_44_152.mp4 And you know, that's it for their social life. It's like over. other therapist_behaviour +AnnoMi-therapist_44_154.mp4 So— other therapist_behaviour +AnnoMi-therapist_44_156.mp4 Mm-hmm. other therapist_behaviour +AnnoMi-therapist_44_158.mp4 Yeah. So I think just tell your friends you know, you realized there's always bad things about it and you don't want to do it anymore, so you're just not going to. therapist_input therapist_behaviour +AnnoMi-therapist_44_160.mp4 And then- other therapist_behaviour +AnnoMi-therapist_44_162.mp4 -you can tell them to stop too. You know, then that'd be really good. You'd being a good friend. other therapist_behaviour +AnnoMi-therapist_44_164.mp4 Yeah. Yeah. Exactly. All right. Any other questions or anything else I can help with? question therapist_behaviour +AnnoMi-therapist_44_166.mp4 Okay. So, like I said, I'll plan to meet with you again in a couple weeks. other therapist_behaviour +AnnoMi-therapist_44_168.mp4 And make sure that you actually quit drinking. other therapist_behaviour +AnnoMi-therapist_44_170.mp4 All right. other therapist_behaviour +AnnoMi-therapist_44_172.mp4 Great. other therapist_behaviour +AnnoMi-therapist_53_0.mp4 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 going to 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 if that's all right. question therapist_behaviour +AnnoMi-therapist_53_2.mp4 Okay. Why don't we start by just having you tell me a little bit about yourself? question therapist_behaviour +AnnoMi-therapist_53_4.mp4 Okay. And what do you like to do for fun? question therapist_behaviour +AnnoMi-therapist_53_6.mp4 Mm-hmm, and when you and your friends are hanging out, and what- what do you do? Do you go to football games, go to parties? question therapist_behaviour +AnnoMi-therapist_53_8.mp4 Okay. And what kind of hobbies do you have? question therapist_behaviour +AnnoMi-therapist_53_10.mp4 Oh, cool. What are your plans for after high school? question therapist_behaviour +AnnoMi-therapist_53_12.mp4 That's great. What do you think you'll study? question therapist_behaviour +AnnoMi-therapist_53_14.mp4 Oh, neat. other therapist_behaviour +AnnoMi-therapist_53_16.mp4 Yeah, that's great. That's a really good goal. other therapist_behaviour +AnnoMi-therapist_53_18.mp4 It's, uh, hard work to get into law school. Are you doing well in school? What kind of grades do you get? question therapist_behaviour +AnnoMi-therapist_53_20.mp4 Okay. What classes are you not getting A's and B's in? question therapist_behaviour +AnnoMi-therapist_53_22.mp4 Okay. And do you know where you're going to apply to college? question therapist_behaviour +AnnoMi-therapist_53_24.mp4 Okay. Cool. And, you know, what made you decide maybe law school or-or journalism? question therapist_behaviour +AnnoMi-therapist_53_26.mp4 Okay. Great. Sounds like you have, like I said, really good goals and you're working hard in school. Um, 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? question therapist_behaviour +AnnoMi-therapist_53_28.mp4 Okay. And how often do you think you drink? question therapist_behaviour +AnnoMi-therapist_53_30.mp4 Mm-hmm, so like once or twice a month you're having alcohol? reflection therapist_behaviour +AnnoMi-therapist_53_32.mp4 Okay, and so that's maybe like 20 times a year. question therapist_behaviour +AnnoMi-therapist_53_34.mp4 So that's actually kind of a lot of drinking then? reflection therapist_behaviour +AnnoMi-therapist_53_36.mp4 Okay. What do you think is the most you've ever had? question therapist_behaviour +AnnoMi-therapist_53_38.mp4 But you've been drunk before? question therapist_behaviour +AnnoMi-therapist_53_40.mp4 Okay. Um, so the most you've ever, ever had is two drinks in a day. reflection therapist_behaviour +AnnoMi-therapist_53_42.mp4 Okay. Interesting. So, do you know all the bad stuff about alcohol? question therapist_behaviour +AnnoMi-therapist_53_44.mp4 Okay. Um, so one of the things that, you know, is really important to talk to teenagers about is drinking and driving. So, um, you know, that's actually a really big problem. 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 gotten in the car- question therapist_behaviour +AnnoMi-therapist_53_46.mp4 Okay. Uh, how much do your friends drink? question therapist_behaviour +AnnoMi-therapist_53_48.mp4 Okay. What about at these parties you're going to, are there other kids there who are drinking a lot? question therapist_behaviour +AnnoMi-therapist_53_50.mp4 And do you hang out with them? question therapist_behaviour +AnnoMi-therapist_53_52.mp4 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? question therapist_behaviour +AnnoMi-therapist_53_54.mp4 Yeah, so, there, I mean, a lot of the other dangers of drinking, like, um, not just car accidents, but you can have other accidents, you know, people, um, you know, will fall or, um, 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 falling down or, you know, as a girl, it's really important too that you're careful because you could be sexually assaulted. therapist_input therapist_behaviour +AnnoMi-therapist_53_56.mp4 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? question therapist_behaviour +AnnoMi-therapist_53_58.mp4 Mm-hmm. other therapist_behaviour +AnnoMi-therapist_53_60.mp4 And then, um, you know, people get in fights more often when they've been drinking too. Um, also, you know, there have been a lot of kids, even at this school, who've gotten in trouble because they were drinking and someone took pictures with their cell phone and put it up on Facebook- therapist_input therapist_behaviour +AnnoMi-therapist_53_62.mp4 And then their parents find out or the 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 it could put your whole college career in jeopardy. Have you thought about that? therapist_input therapist_behaviour +AnnoMi-therapist_53_64.mp4 But you're still drinking. other therapist_behaviour +AnnoMi-therapist_53_66.mp4 Uh-huh. So, I mean, do you think it's the thing to do if you wanna be an attorney? question therapist_behaviour +AnnoMi-therapist_53_68.mp4 Mm-hmm. other therapist_behaviour +AnnoMi-therapist_53_70.mp4 Mm-hmm. Okay. Hmm. So, I mean, I guess what we need to do then is kinda talk about some goals for how to be- other therapist_behaviour +AnnoMi-therapist_53_72.mp4 -safer. other therapist_behaviour +AnnoMi-therapist_53_74.mp4 Um, obviously, you shouldn't be drinking at all. Um, what do you think about that? question therapist_behaviour +AnnoMi-therapist_53_76.mp4 Mm-hmm. So, do you think you can quit? therapist_input therapist_behaviour +AnnoMi-therapist_53_78.mp4 Okay. So, I'm going to write down then that you've decided to quit. therapist_input therapist_behaviour +AnnoMi-therapist_53_80.mp4 And, um, that's gonna be your goal, and that's great, you know, that's really why we're here, is to talk about that and-and make sure that you come to that decision. Um, so, I guess, can you quit this weekend then? therapist_input therapist_behaviour +AnnoMi-therapist_53_82.mp4 Okay, and then what about your friends who are still drinking? question therapist_behaviour +AnnoMi-therapist_53_84.mp4 Okay, and-and what if they won't? question therapist_behaviour +AnnoMi-therapist_53_86.mp4 Yeah. Probably if your friends won't quit drinking, you should just find new friends. other therapist_behaviour +AnnoMi-therapist_53_88.mp4 'Cause, you know, the problem is if they're drinking, they're gonna pressure you into drinking and then you're gonna feel awkward and, you know, you're gonna be stuck and-and not know what to do and really you'd just be better off probably without them. If they're- if they're the kind of people who are gonna keep drinking- reflection therapist_behaviour +AnnoMi-therapist_53_90.mp4 -they're probably not a good influence. reflection therapist_behaviour +AnnoMi-therapist_53_92.mp4 Um, 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. other therapist_behaviour +AnnoMi-therapist_53_94.mp4 Okay, so, um, that's great 'cause 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. other therapist_behaviour +AnnoMi-therapist_53_96.mp4 Mm-hmm. other therapist_behaviour +AnnoMi-therapist_53_98.mp4 Okay, so, yeah, just another reason why you probably need to just quit then. Um, okay, yeah. I-- Okay, so, like I said, I'm gonna right down here that you've decided to quit and, um, uh, you know, I'm gonna be meeting with you again probably in the next semester sometime, so we can kinda check-in and-and make sure that, you know, that's still going well- therapist_input therapist_behaviour +AnnoMi-therapist_53_100.mp4 -and you're still not drinking and not hanging out with any people who are drinking. Um, is there anything else you'd like to talk about while you're here? therapist_input therapist_behaviour +AnnoMi-therapist_53_102.mp4 Okay. Um, any questions or anything- question therapist_behaviour +AnnoMi-therapist_53_104.mp4 -like that? question therapist_behaviour +AnnoMi-therapist_53_106.mp4 Okay. You're sure? Okay. All right. Um, well, that's probably it then. You can, uh, head back to class and-and thanks for coming in. other therapist_behaviour +AnnoMi-therapist_57_0.mp4 Mr. Johnson? question therapist_behaviour +AnnoMi-therapist_57_2.mp4 Uh, I'm here to talk to you about, uh, your cholesterol and the, um, medicine your doctor prescribed. other therapist_behaviour +AnnoMi-therapist_57_4.mp4 But well, it's my job too, uh, to-to help you understand how to use your medicine and, uh, give you information about getting the most benefits from it. other therapist_behaviour +AnnoMi-therapist_57_6.mp4 So your-your-your doctor told you that if your cholesterol remains elevated, you're at risk of stroke or heart attack? therapist_input therapist_behaviour +AnnoMi-therapist_57_8.mp4 Okay. Well, the-the side effect is something that's very, very rare, it's not really something you need to worry about, and the risk of stroke or heart attack is much worse. therapist_input therapist_behaviour +AnnoMi-therapist_57_10.mp4 Well, I-I-I understand that. Um, but like I said, it's very rare. If you feel some muscle weakness, you'll let your doctor know. It's not permanent, okay? Yeah, it won't get to the blood- it won't get to the point where it affects your job— therapist_input therapist_behaviour +AnnoMi-therapist_57_12.mp4 You- you really need to take it, and-and like I said, the-the muscle weakness is rare. If you feel muscle weakness, just let your doctor know. He can take you off or switch. It's not permanent. therapist_input therapist_behaviour +AnnoMi-therapist_57_14.mp4 It's-it's not permanent. other therapist_behaviour +AnnoMi-therapist_57_16.mp4 Okay? So a stroke or heart attack is much worse, so make sure you go ahead and pick up your medicine as you're on your way out and, uh, one-one every day to get your cholesterol down. therapist_input therapist_behaviour +AnnoMi-therapist_57_18.mp4 Okay. other therapist_behaviour +AnnoMi-therapist_59_0.mp4 So, what you told me earlier was that you've got into a car with someone you knew had smoked marijuana earlier. What were you thinking? therapist_input therapist_behaviour +AnnoMi-therapist_59_2.mp4 Science fair project or not, don't you know what happens when someone drives under the influence of marijuana or alcohol? It's bad. They can wreck the car, you can lose your life. I thought you were smart, you're taking AP classes, you wanna get into a Ivy League school. This is not the way you do that. therapist_input therapist_behaviour +AnnoMi-therapist_59_4.mp4 It's a big deal. You can't drink either. You're 16. The drinking age is 21. I think you know that. You could get into an auto crash. Uh, I just wanted you to hear this. I don't' tolerate it as a doctor drinking or driving with somebody who's under the influence, and if you do it again, I'm gonna tell your parents. therapist_input therapist_behaviour +AnnoMi-therapist_69_0.mp4 Hi, Dr. Martin. I heard you had a question for me. What did you want to talk about? question therapist_behaviour +AnnoMi-therapist_69_2.mp4 Yeah, I'm the pharmacist on duty. Citalopram, okay. It's an antidepressant and it comes in 10, 20, and 40-milligram strengths. It's excreted in the urine and it has a half-life of about 35 hours. For side effects, there are sexual side effects, heart side effects, and stomach side effects. therapist_input therapist_behaviour +AnnoMi-therapist_69_4.mp4 Oh, um, yeah, I think that should be fine. therapist_input therapist_behaviour +AnnoMi-therapist_69_6.mp4 All right, thanks. Call me anytime. other therapist_behaviour +AnnoMi-therapist_72_0.mp4 All right, 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 of the other kids about a 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 did 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. therapist_input therapist_behaviour +AnnoMi-therapist_72_2.mp4 Mm-hmm. other therapist_behaviour +AnnoMi-therapist_72_4.mp4 Yeah, you know, I get it. Like, we've all been there. Okay. You know, I was in high school ones too, you know, I drank too. I get it. There's not a ton to do in this town a-and kids drink, but, you know, promise we have these rules- therapist_input therapist_behaviour +AnnoMi-therapist_72_6.mp4 -and you're on a team, you have to stick by the rules. therapist_input therapist_behaviour +AnnoMi-therapist_72_8.mp4 Yeah. Chris, come on. You're getting peer pressure? therapist_input therapist_behaviour +AnnoMi-therapist_72_10.mp4 Yeah, but you're one of the leaders. therapist_input therapist_behaviour +AnnoMi-therapist_72_12.mp4 Yeah. Well, maybe you can start leading as a non-drinker then. therapist_input therapist_behaviour +AnnoMi-therapist_72_14.mp4 You're a star player, who's going to pick on you? question therapist_behaviour +AnnoMi-therapist_72_16.mp4 All right. Well, 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, there-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- therapist_input therapist_behaviour +AnnoMi-therapist_72_18.mp4 -I'm not saying I know what it's like. I-I get that you want to have fun in 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. therapist_input therapist_behaviour +AnnoMi-therapist_72_20.mp4 What do you mean? question therapist_behaviour +AnnoMi-therapist_72_22.mp4 All right. Yeah. I mean, we got to have a deal here if you're going to be on the team. Okay? therapist_input therapist_behaviour +AnnoMi-therapist_72_24.mp4 All right. You promise? other therapist_behaviour +AnnoMi-therapist_72_26.mp4 All right. Shake. question therapist_behaviour +AnnoMi-therapist_72_28.mp4 All right. I'll see you later. other therapist_behaviour +AnnoMi-therapist_72_30.mp4 All right. other therapist_behaviour +AnnoMi-therapist_74_0.mp4 Hi, Emily. How are you? question therapist_behaviour +AnnoMi-therapist_74_2.mp4 I'm good. Um, wow, what's changed? What do we have here? question therapist_behaviour +AnnoMi-therapist_74_4.mp4 Emily, why? Why did you get your lip pierced? question therapist_behaviour +AnnoMi-therapist_74_6.mp4 You're- other therapist_behaviour +AnnoMi-therapist_74_8.mp4 -gorgeous. Your teeth are lovely. You do not need a piercing. therapist_input therapist_behaviour +AnnoMi-therapist_74_10.mp4 Do you know what- question therapist_behaviour +AnnoMi-therapist_74_12.mp4 -those oral piercings can do to your teeth? question therapist_behaviour +AnnoMi-therapist_74_14.mp4 Well, yes, except that, you know what's gonna 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- therapist_input therapist_behaviour +AnnoMi-therapist_74_16.mp4 -as well as your teeth. So, we can see some recession that's gonna start to happen- therapist_input therapist_behaviour +AnnoMi-therapist_90_0.mp4 So, Tommy, I wanted to talk to because I was on Facebook the other day and saw some pictures that are kind of concerning to me of you and some of your friends at a party, and, you know, you're such a good kid. Like, I don't know what you're doing drinking. It's going to ruin your life. therapist_input therapist_behaviour +AnnoMi-therapist_90_2.mp4 But, Tommy, there's so many consequences with drinking. You know, you're not even 21 yet, you could get arrested, you could, you know, have a drunk driving accident. You could, you know, mess up your schoolwork. You have such a bright future ahead of you. It just really, really concerns me. therapist_input therapist_behaviour +AnnoMi-therapist_90_4.mp4 There's really no such thing as not drinking too much. I mean, anything that's drinking when you're underage is drinking too much, you know. Like, think about it, think about all the things that can happen to you. therapist_input therapist_behaviour +AnnoMi-therapist_90_6.mp4 How much are you drinking? question therapist_behaviour +AnnoMi-therapist_90_8.mp4 Is it like every weekend? question therapist_behaviour +AnnoMi-therapist_90_10.mp4 Tommy, I'm just so concerned, you know, can't you think of anything better to do? question therapist_behaviour +AnnoMi-therapist_90_12.mp4 Yeah. Is-- are your friends the problem, like maybe you should just start hanging out with more kids in the youth group and not hang out with those kids that you were partying with? therapist_input therapist_behaviour +AnnoMi-therapist_90_14.mp4 Well, there's a lot of things that seem fun in the moment that we know aren't a good choice, right? That's some of the things we talk about all the time is making good choices for our life and-and really doing what's best for you. And I just, you know, I really think you should think about making a big change here. therapist_input therapist_behaviour +AnnoMi-therapist_90_16.mp4 I think you really need to quit. therapist_input therapist_behaviour +AnnoMi-therapist_90_18.mp4 I think you're wrong. You know, it really worries me. Anyway, um, I wish you would quit. If all you're going to do is cut down, that's better than nothing. You know, I appreciate you talking to me about this, but I'm gonna keep talking to you about it. It's really important. therapist_input therapist_behaviour +AnnoMi-therapist_90_20.mp4 Do you wanna wait for that happen? Do you wanna wait for a dramatic experience? question therapist_behaviour +AnnoMi-therapist_92_0.mp4 Hi, are you Julie Thompson? other therapist_behaviour +AnnoMi-therapist_92_2.mp4 Hi, I'm Bruce Berger, I work in the clinic. I know you're here to pick up a prescription today. reflection therapist_behaviour +AnnoMi-therapist_92_4.mp4 Um, I noticed, uh, we noticed some of your records that, uh, you've been coming in and getting Sarah's resc-rescue inhaler for her asthma quite frequently, and you haven't got a chronic inhaler for quite some time now. I also know she has been in the emergency room several times this year. Is-- can you tell me what's going on there? therapist_input therapist_behaviour +AnnoMi-therapist_92_6.mp4 Well, I-I 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, uh, 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, uh, 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. therapist_input therapist_behaviour +AnnoMi-therapist_92_8.mp4 Okay, I, you know, I-I don't want to argue with you about this. I-I know that if you-you know, and if you want to keep Sarah out of the emergency room, uh, I-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 on your clothes and the smoking flares her asthma up. So she really needs to use that chronic inhaler, and you really need to think about quitting smoking. therapist_input therapist_behaviour +AnnoMi-therapist_92_10.mp4 Okay, well, I-I hope you really listen to what I'm telling you about her using that chronic inhaler, and I hope you consider quitting smoking. therapist_input therapist_behaviour +AnnoMi-therapist_92_12.mp4 Okay. other therapist_behaviour +AnnoMi-therapist_102_0.mp4 Hi, Liz. Well, thanks for meeting with me today. other therapist_behaviour +AnnoMi-therapist_102_2.mp4 So what's something that you'd like to change or, um, work towards? question therapist_behaviour +AnnoMi-therapist_102_4.mp4 And you've been talking about that a lot lately. So I really- reflection therapist_behaviour +AnnoMi-therapist_102_6.mp4 -feel like this is something that you need to do soon because, um, a lot of times, you're just a lot of talk. And then, there's no action. And if you really wanna see results, I think it's something that needs to be done. And, you know, stop being lazy about it and just do it. therapist_input therapist_behaviour +AnnoMi-therapist_102_8.mp4 Yeah. other therapist_behaviour +AnnoMi-therapist_102_10.mp4 And that sounds like a lot of excuses to me. So I feel like you had shared with me before that you do have a gym membership. So I think that's something that you just need to fit in your schedule. So for you to really see results that you want, my guess is you need to go about three to four times a week and really fit in that hour workout, um, on a daily basis. therapist_input therapist_behaviour +AnnoMi-therapist_102_12.mp4 Mm-hmm. other therapist_behaviour +AnnoMi-therapist_102_14.mp4 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, then it's gonna take you two hours. And, again, if you want the results that you want, you need to start, and you need to start now. therapist_input therapist_behaviour +AnnoMi-therapist_102_16.mp4 All right. Well, um, I look forward to talking to you tomorrow. And I'm hoping that you're gonna be able to tell me that you went to the gym. therapist_input therapist_behaviour +AnnoMi-therapist_102_18.mp4 Thanks. other therapist_behaviour +AnnoMi-therapist_106_0.mp4 Okay, so I wrote a prescription for an antibiotic for Aiden and that should help with the ear infection, but in looking through the chart, I mean, it seems like he's had six or seven of these just in the past year or so. other therapist_behaviour +AnnoMi-therapist_106_2.mp4 That's really a big problem. other therapist_behaviour +AnnoMi-therapist_106_4.mp4 Well, one of the primary risk factors for multiple ear infections in kids is actually smoke exposure. Are you smoking? question therapist_behaviour +AnnoMi-therapist_106_6.mp4 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? other therapist_behaviour +AnnoMi-therapist_106_8.mp4 I really need you to quit smoking. Both for your health and for Aiden. Did you know s-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 deficiency, cavities, like dental cavities, behavior problems, um, 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. Do you want him to grow up to be a smoker? therapist_input therapist_behaviour +AnnoMi-therapist_106_10.mp4 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- other therapist_behaviour +AnnoMi-therapist_106_12.mp4 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 call. therapist_input therapist_behaviour +AnnoMi-therapist_106_14.mp4 There's no reason why you shouldn't be able to quit, this is really important. other therapist_behaviour +AnnoMi-therapist_106_16.mp4 Well, what can be more important to you than the health of your child? other therapist_behaviour +AnnoMi-therapist_106_18.mp4 I really need you to tell me that you're gonna quit smoking. This is really important. other therapist_behaviour +AnnoMi-therapist_106_20.mp4 Okay. Well, I think you really need to think about this seriously. Like I said, it's really putting yourself and your child in danger. other therapist_behaviour +AnnoMi-therapist_106_22.mp4 Okay. other therapist_behaviour +AnnoMi-therapist_115_0.mp4 Okay, so why don't you have a rinse, David. How are you feeling? question therapist_behaviour +AnnoMi-therapist_115_2.mp4 Good. Here, take a look, see what you think. And that feeling- other therapist_behaviour +AnnoMi-therapist_115_4.mp4 -and the color's okay? You know, there is quite a lot of staining so, um, I'm just wondering about, um, some concerns about smoking. question therapist_behaviour +AnnoMi-therapist_115_6.mp4 Possibly- other therapist_behaviour +AnnoMi-therapist_115_8.mp4 -coffee, tea. Yeah, you've heard this before, I'm sure. other therapist_behaviour +AnnoMi-therapist_115_10.mp4 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 affects dental caries, dental cavities- therapist_input therapist_behaviour +AnnoMi-therapist_115_12.mp4 -um, healing- other therapist_behaviour +AnnoMi-therapist_115_14.mp4 -in your mouth. other therapist_behaviour +AnnoMi-therapist_115_16.mp4 So-- other therapist_behaviour +AnnoMi-therapist_115_18.mp4 Yes, and I really want to be helpful. I really want to-- you know, my commitment is to your oral health, so um, there are lots of medications out there, David, that actually take away a lot of the cravings. They're-- they make quitting so much easier. therapist_input therapist_behaviour +AnnoMi-therapist_115_20.mp4 Mm-hmm. Yeah. other therapist_behaviour +AnnoMi-therapist_115_22.mp4 .No, it-- but David, it's not a waste. Research shows that people take on average about seven tries before they quit smoking, so think of it as you're one step closer to quitting, so-- therapist_input therapist_behaviour +AnnoMi-therapist_115_24.mp4 Well, I don't think I'm giving you a lecture, that's certainly not what I meant. I-- other therapist_behaviour +AnnoMi-therapist_115_26.mp4 Well, there's-there's a reason that [crosstalk] people are concerned. other therapist_behaviour +AnnoMi-therapist_115_28.mp4 No. But as I said, these medications-- so you've tried the medication, you've been willing once. therapist_input therapist_behaviour +AnnoMi-therapist_115_30.mp4 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 health, for your oral health-- therapist_input therapist_behaviour +AnnoMi-therapist_115_32.mp4 Oh no, the smoking's going to cause you more problems than the-- than anything else. I can promise you that, David. therapist_input therapist_behaviour +AnnoMi-therapist_115_34.mp4 The side effects from the medications are nothing compared to what can happen from the smoking. therapist_input therapist_behaviour +AnnoMi-therapist_115_36.mp4 Like, that's the, I think, thing to really consider. other therapist_behaviour +AnnoMi-therapist_115_38.mp4 I'm-- okay, but you know-- other therapist_behaviour +AnnoMi-therapist_115_40.mp4 Okay. Well thanks for listening, and honestly, I- I am really worried about the smoking, so-- therapist_input therapist_behaviour +AnnoMi-therapist_115_42.mp4 I um-- other therapist_behaviour +AnnoMi-therapist_115_44.mp4 I'm here to help, okay? other therapist_behaviour +AnnoMi-therapist_115_46.mp4 So-- other therapist_behaviour +AnnoMi-therapist_118_0.mp4 Hi, come in. [door closes] Sit- sit yourself down. Uh, what can I do for you today? question therapist_behaviour +AnnoMi-therapist_118_2.mp4 Okay. other therapist_behaviour +AnnoMi-therapist_118_4.mp4 All right. Um, okay. Um, well let's, uh, let's just have a look shall we? See what's going on. You just wanna open your mouth for me. Say ah. therapist_input therapist_behaviour +AnnoMi-therapist_118_6.mp4 Okay. Right. Uh, to be honest, you know, looking there, it just looks like one of those viruses that are going around at the moment that are causing these sore throats. So, uh, I think that we should just perhaps go for a bit of paracetamol and, uh, some fluids and let nature sort it out. therapist_input therapist_behaviour +AnnoMi-therapist_118_8.mp4 Well, I mean, I'm sorry we're a bit late, but you know that's the general practice, isn't it? You know, sometimes these things happen. Um, but it doesn't alter the fact that you do just have a virus, uh, and they are very common. And the nice thing is that it will get better with paracetamol and fluids, and the paracetamol will help the pain. Um, with giving it to the kids, I'm afraid there's nothing we can do about that. It's unlikely they'll get it, but I can't guarantee it. therapist_input therapist_behaviour +AnnoMi-therapist_118_10.mp4 Uh, well- well, not really. Uh, you need to self-certify in your first seven days off sick so if you're going to take some time off, just take some paracetamol, lots of fluids, get a self-certified note, uh, in to your employer, and put sore throat there. therapist_input therapist_behaviour +AnnoMi-therapist_118_12.mp4 Uh, well, obviously that's a non-NHS thing so we have to charge you for that and our going rate for that is, uh, £12. therapist_input therapist_behaviour +AnnoMi-therapist_118_14.mp4 Oh, I'm sorry. But, you know, if you have just got a sore throat, then there's not much I can do about that. It's just, you know, something that we all get from time to time. Perhaps, what you really need to do is, uh, you know, just take some paracetamol and get some fluids. therapist_input therapist_behaviour +AnnoMi-therapist_118_16.mp4 Okay, that's pretty unlikely with sore throat. I think that's so, you know, a little bit of grand staging there. therapist_input therapist_behaviour +AnnoMi-therapist_118_18.mp4 Okay. other therapist_behaviour +AnnoMi-therapist_118_20.mp4 Bye. other therapist_behaviour +AnnoMi-therapist_123_0.mp4 Okay, I finished the exam. I have some good news and I have some not-so-good news. Looks like you don't have any cavities, so that's the good news. therapist_input therapist_behaviour +AnnoMi-therapist_123_2.mp4 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 I'm just wondering what's going on. therapist_input therapist_behaviour +AnnoMi-therapist_123_4.mp4 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 definitely 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 that could be contributing to this? Because I don't know what else might be causing it. question therapist_behaviour +AnnoMi-therapist_123_6.mp4 Mm-hmm. other therapist_behaviour +AnnoMi-therapist_123_8.mp4 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? question therapist_behaviour +AnnoMi-therapist_123_10.mp4 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 cigarette, so it's really important. therapist_input therapist_behaviour +AnnoMi-therapist_123_12.mp4 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? question therapist_behaviour +AnnoMi-therapist_123_14.mp4 What do you mean? question therapist_behaviour +AnnoMi-therapist_123_16.mp4 So you're gonna quit then? question therapist_behaviour +AnnoMi-therapist_123_18.mp4 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. therapist_input therapist_behaviour +AnnoMi-therapist_123_20.mp4 What's there to think about? [chuckles] You said it's not that something you do all that often, and there's all these negative side effects, there's all these risks that you're putting yourself in. therapist_input therapist_behaviour +AnnoMi-therapist_123_22.mp4 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. therapist_input therapist_behaviour +AnnoMi-therapist_123_24.mp4 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, chew, 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. therapist_input therapist_behaviour +AnnoMi-therapist_123_26.mp4 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. therapist_input therapist_behaviour +AnnoMi-therapist_126_0.mp4 Hello, Kaylie. It looks like you're here to pick up a prescription today. reflection therapist_behaviour +AnnoMi-therapist_126_2.mp4 Okay. It looks like cholesterol statin. Do you know how you're supposed to take the medication? question therapist_behaviour +AnnoMi-therapist_126_4.mp4 Well, you just take it once a day. Did he tell you what side effects to expect? question therapist_behaviour +AnnoMi-therapist_126_6.mp4 Well, some of the common ones are nausea, vomiting, headache. There are some severe ones like dermatomyositis, liver failure, lupus, rhabdomyolysis, hemorrhagic cerebral infarction. If you have any of those, just call your doctor. therapist_input therapist_behaviour +AnnoMi-therapist_126_8.mp4 It's for your dyslipidemia. Oh yeah, just one tablet a day. Do you have any questions for me? therapist_input therapist_behaviour +AnnoMi-therapist_126_10.mp4 All right. Great. Have a good day. other therapist_behaviour +AnnoMi-therapist_126_11.mp4 Hello, Kaylie. I see you're here to pick up a prescription today. other therapist_behaviour +AnnoMi-therapist_126_13.mp4 Oh, it looks like he called in cholesterol statin. Do you know how you're supposed to take this medication? question therapist_behaviour +AnnoMi-therapist_126_15.mp4 Okay. Well, you take this one once a day. Did he tell you what side effects to expect? question therapist_behaviour +AnnoMi-therapist_126_17.mp4 All right. Well, some of the common side effects are nausea, vomiting, headache. There are some severe side effects like dermatomyositis, liver failure, lupus, rhabdomyolysis, hemorrhagic, cerebral infarction. If you have any of those, you should call your doctor. other therapist_behaviour +AnnoMi-therapist_126_19.mp4 It's for your dyslipidemia. Oh, and you should take one every day. Do you have any questions for me? therapist_input therapist_behaviour +AnnoMi-therapist_126_21.mp4 All right. Great. Well, have a good afternoon. other therapist_behaviour +AnnoMi-therapist_126_22.mp4 Hello, Kaylie, I'm Lori, the pharmacist here at Bulldog Pharmacy. I see that you have a new prescription for cholesterol statin 20 called in by Dr. Ferris today. I wondered if you had a minute to talk to me. I just want to make sure that you know how best to take it, and if you have any questions. question therapist_behaviour +AnnoMi-therapist_126_24.mp4 Okay. What did the doctor tell you cholesterol statin is for? question therapist_behaviour +AnnoMi-therapist_126_26.mp4 He's right. This medicine is designed to help lower your cholesterol, and that means that it will help lower your risk of having a heart attack or a stroke. How did your doctor tell you to take this medicine? reflection therapist_behaviour +AnnoMi-therapist_126_28.mp4 Okay. Well, you're going to take one tablet of cholesterol statin 20 one time a day by mouth, and you can take that with or without food. When do you normally take your medications? therapist_input therapist_behaviour +AnnoMi-therapist_126_30.mp4 Okay. That's perfect because cholesterol statin works best if it's taken at night, though you can take it any time of the day. And you should take it every single day. It's important to keep that up. Where do you store your medications? therapist_input therapist_behaviour +AnnoMi-therapist_126_32.mp4 All right. Do you have any children in your home? question therapist_behaviour +AnnoMi-therapist_126_34.mp4 Okay. Well, then that sounds like a perfect location for you. Medicines keep best if they're stored away from light and heat and moisture. What did the doctor tell you to expect in terms of side effects? question therapist_behaviour +AnnoMi-therapist_126_36.mp4 All right. Well, this medication is pretty well tolerated, which means it doesn't have very many side effects. But you might experience some mild muscle aches and pains. If they seem really severe to you, then you should call Dr. Ferris and talk to him about that. Also this medicine can interact with a lot of other medications, and even over the counter things. So check with the doctor or myself before you start anything new. And lastly, grapefruit juice can interact with cholesterol statin 20. So if you use grapefruit juice every day, I probably would switch to a different juice while you're on this medication. therapist_input therapist_behaviour +AnnoMi-therapist_126_37.mp4 Just so I know we're on the same page, can you repeat back to me how you'll take this medicine? question therapist_behaviour +AnnoMi-therapist_126_39.mp4 Great, Kaylie. I know we went over a lot today. What other questions do you have for me? question therapist_behaviour +AnnoMi-therapist_126_41.mp4 Fantastic. All right. Well, here's your prescription. I even put it on auto fill for you so that it will be filled for you every- at the same time every month. And if you have any other questions later, our phone number is right here on the bottle, and you can call me at any time. Thanks so much. Have a great day. therapist_input therapist_behaviour +AnnoMi-therapist_126_42.mp4 Hello, Kaylie. I'm Lori, the pharmacist here at Bulldog Pharmacy. I see that you have a new medication to pick up today. Called in by Dr. Ferris for cholesterol statin 20. Do you have a minute to talk about it? I want to make sure that you know how best to take this medicine and to answer any questions that you might have. question therapist_behaviour +AnnoMi-therapist_126_44.mp4 All right. What did the doctor tell you cholesterol statin is for? question therapist_behaviour +AnnoMi-therapist_126_46.mp4 All right, and he's right. This medication will help lower your cholesterol, and it will help lower your risk of having a heart attack or a stroke. How did the doctor tell you to take this medicine? therapist_input therapist_behaviour +AnnoMi-therapist_126_48.mp4 All right. Well, you're going to take one tablet of cholesterol statin 20 one time a day by mouth, and you can take that with or without food. When do you usually take your medications? therapist_input therapist_behaviour +AnnoMi-therapist_126_50.mp4 That's perfect. This medication can be taken any time of the day, but it does work best if taken in the evening, and it's important to take it every day. therapist_input therapist_behaviour +AnnoMi-therapist_126_51.mp4 Where do you store your medications? question therapist_behaviour +AnnoMi-therapist_126_53.mp4 Do you have children in your house? question therapist_behaviour +AnnoMi-therapist_126_55.mp4 All right. So that sounds like a perfect place for you to store those. Medications are best when they're stored away from light, heat and moisture. reflection therapist_behaviour +AnnoMi-therapist_126_56.mp4 What did your doctor tell you to expect in terms of side effects? question therapist_behaviour +AnnoMi-therapist_126_58.mp4 All right. Well, this medication is usually well tolerated, which means that it doesn't have very many side effects, but you might experience some muscle aches or pains. If they seem really severe to you, then you should call Dr. Ferris and talk to him about that. Also, this medication can interact with over-the-counter medicines or even other medications. So before you start something new, you should check with either Dr. Ferris or myself. And lastly, this medication can interact with grapefruit juice. So while you're taking this medicine, I would avoid grapefruit juice. therapist_input therapist_behaviour +AnnoMi-therapist_126_59.mp4 Just so we know we're on the same page, can you repeat back to me how you are going to take this medicine? question therapist_behaviour +AnnoMi-therapist_126_61.mp4 That's great, Kaylie. I know we went over a lot today. What questions do you still have for me? question therapist_behaviour +AnnoMi-therapist_126_63.mp4 All right, good. Well, here's your prescription. I even put it on autofill for you so it'll be ready at the same time every month for you. And if you have any questions later, our phone number is right here on the bottle, and you can call me at any time. Thanks so much. Have a great day. therapist_input therapist_behaviour +AnnoMi-therapist_130_1.mp4 Yeah. Well, the good news is he doesn't have pneumonia. It's just an upper re-respiratory tract infection and a cold. So there's some things you can do to make- to help him get better. You can avoid excessive dust. You can keep him hydrated, avoid over-the-counter cold remedies. Keep him away from people who have flu or cold-like symptoms and avoid smoke. And the last one should be easy because you quit smoking during your pregnancy. therapist_input therapist_behaviour +AnnoMi-therapist_130_3.mp4 No, wait a minute. That has everything to do with what we're talking about. I can't believe at the end of this appointment, you're just slipping in the fact that you've resumed smoking again. That's very, very important information for me to know. And I'd like to spend some time talking about it now. therapist_input therapist_behaviour +AnnoMi-therapist_130_5.mp4 Come on, Hailey. You're here because you thought he had pneumonia. You're telling me that Jake can't breathe, you're concerned about his breathing. And then you just slip in the fact that you're smoking cigarettes and you think there's no relationship? Do I really need to review all the risks of smoking in front of your-your child or exposing him to secondhand smoke not to mention the risks that you're posing to yourself and your own health? question therapist_behaviour +AnnoMi-therapist_130_7.mp4 So it sounds like if you have alcohol, then smoking is very difficult to avoid and you know what you need to do. You need to go home and as your-your son's doctor, I need to tell you you need to go home and throw out those cigarettes. You need to quit. therapist_input therapist_behaviour +AnnoMi-therapist_130_9.mp4 And let's talk some more about wine. You keep throwing wine into the conversation. It sounds like it's become a significant part of your daily routine. How much are you drinking? question therapist_behaviour +AnnoMi-therapist_130_11.mp4 Well, no one said motherhood was going to be easy, Hailey. So let's talk about these drinks. Are we talking about the-the low-risk drinking guidelines, one to two standard drinks a night or are we talking about a mug of Margarita's? question therapist_behaviour +AnnoMi-therapist_130_13.mp4 What are you drinking? What's the quantity that you're drinking. question therapist_behaviour +AnnoMi-therapist_130_15.mp4 There's other ways to relax. There's yoga. There's deep breathing. You need to stop raising the roof and raise your kid. This is not okay. You're not just worrying about Hailey anymore. It's Hailey and Jake. You're a mom now. therapist_input therapist_behaviour +AnnoMi-therapist_130_17.mp4 I'm trying not to be hard on you, Hailey, but I've got to tell you as a position, it's a very big deal. Your drinking and your tobacco use are red flags for me and they need to stop immediately. So we've already talked about your plan for smoking. You're going home. You're throwing out your cigarettes. You're putting on the patches. What's the plan for the alcohol? therapist_input therapist_behaviour +AnnoMi-therapist_130_19.mp4 Sounds good. And if you need to relax, go for a walk, join a moms group, read a book. How about you come back in a week when we have Jake's six months checkup and you can let me know how that quit plan is going. therapist_input therapist_behaviour +AnnoMi-therapist_130_21.mp4 Thanks. other therapist_behaviour +AnnoMi-therapist_131_0.mp4 Good morning. It's really nice that you've come along to see me to talk about stopping smoking. other therapist_behaviour +AnnoMi-therapist_131_2.mp4 What have you got in mind, what do you want from us? question therapist_behaviour +AnnoMi-therapist_131_4.mp4 Absolutely, we're in the right place for that. other therapist_behaviour +AnnoMi-therapist_131_6.mp4 Okay. Well, just remind me again why it is you want to stop. question therapist_behaviour +AnnoMi-therapist_131_8.mp4 Oh, good, and so feeling under pressure here. reflection therapist_behaviour +AnnoMi-therapist_131_10.mp4 And so that-that can't feel a little uncomfortable being by yourself. So that sounds like one of the reasons you have to quit is it's a little getting smelly and it's getting embarrassing. reflection therapist_behaviour +AnnoMi-therapist_131_12.mp4 Any other reasons? question therapist_behaviour +AnnoMi-therapist_131_14.mp4 How much does it actually cost you a week? question therapist_behaviour +AnnoMi-therapist_131_16.mp4 £7 a week or a day? question therapist_behaviour +AnnoMi-therapist_131_18.mp4 So your pack a day— other therapist_behaviour +AnnoMi-therapist_131_20.mp4 £50 a week. reflection therapist_behaviour +AnnoMi-therapist_131_22.mp4 Even more mess, you see. other therapist_behaviour +AnnoMi-therapist_131_24.mp4 Okay. So we're talking about spending £50 a week- reflection therapist_behaviour +AnnoMi-therapist_131_26.mp4 -being one of the few left smoking in your crowd, and not liking the smell. That sounds like three reasons. reflection therapist_behaviour +AnnoMi-therapist_131_28.mp4 Do you think that's enough to make you say goodbye to cigarettes? question therapist_behaviour +AnnoMi-therapist_131_30.mp4 Great, okay. So have you got a date in mind when you'd like to stop smoking? question therapist_behaviour +AnnoMi-therapist_131_32.mp4 Generally, it works well if you find a time when you're not under a huge amount of other stresses and strains. therapist_input therapist_behaviour +AnnoMi-therapist_131_34.mp4 What are the main reasons why you actually smoke? What do you enjoy most about it? question therapist_behaviour +AnnoMi-therapist_131_36.mp4 Mm-hmm. other therapist_behaviour +AnnoMi-therapist_131_38.mp4 Okay. What do you think you'll miss most about it? question therapist_behaviour +AnnoMi-therapist_131_40.mp4 Mm-hmm, what sort of stresses? question therapist_behaviour +AnnoMi-therapist_131_42.mp4 Mm-hmm. question therapist_behaviour +AnnoMi-therapist_131_44.mp4 Yeah. And what is your favorite cigarette of the day? question therapist_behaviour +AnnoMi-therapist_131_46.mp4 Okay, so the end of the day- reflection therapist_behaviour +AnnoMi-therapist_131_48.mp4 -the thing that helps you just unwind, put an end to the work section and move into your own time. reflection therapist_behaviour +AnnoMi-therapist_131_50.mp4 Okay. So after you've had the quit date, what do you think you might do when it it's the first day at work and it's time to go home if you're not gonna have a cigarette? question therapist_behaviour +AnnoMi-therapist_131_52.mp4 Okay. other therapist_behaviour +AnnoMi-therapist_131_54.mp4 Have you managed to stop smoking in the past? question therapist_behaviour +AnnoMi-therapist_131_56.mp4 Okay. And what got you back? question therapist_behaviour +AnnoMi-therapist_131_58.mp4 So something just happened- reflection therapist_behaviour +AnnoMi-therapist_131_60.mp4 -so it took you back into it. All right. Let me just make sure I've understood what's going on here. You really want to stop smoking because you're kind of the last guy in your group still smoking, it costs a lot of money, and you don't really like the smell. reflection therapist_behaviour +AnnoMi-therapist_131_62.mp4 The main reason that you smoke is because, at the end of the day, it gives you a kind of relaxation, and if there's quite a little stress that's going on which you're using cigarettes to help you cope with. reflection therapist_behaviour +AnnoMi-therapist_131_64.mp4 What you'd like to do is stop and you'd like to sort of like 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 be your quit date? reflection therapist_behaviour +AnnoMi-therapist_131_66.mp4 Okay. other therapist_behaviour +AnnoMi-therapist_131_68.mp4 So Monday morning after the party will be a good day, and that's next week. Okay. Now, one of the things that we do in the pharmacy is recommend that you use medication to help you. You know this increases your chance of success and it makes it more likely that can manage any cravings that come along. A lot of people like using nicotine replacement therapy which comes in a variety of formats like patches, gum, you've probably seen people using any of these products. And other options are tablets which you can get from the GP. therapist_input therapist_behaviour +AnnoMi-therapist_131_70.mp4 So, yeah, again-- Um, so have you something in mind that you might like to use to help you through managing the cravings? question therapist_behaviour +AnnoMi-therapist_131_72.mp4 Okay. So a patch is something you've already seen, and- reflection therapist_behaviour +AnnoMi-therapist_131_74.mp4 -and, again, I'll get some out and I'll show you what they look like. This course of medication lasts for 10 to 12 weeks. And we strongly recommend that people 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 possible and with the type of support that we offer here in the pharmacy, you absolutely make your chance of success four times greater than trying on your own, so, that's why it's really good that you've come to see me. Now, what you said is you really want to do it and that next week sounds like a good day for you to start because the party is over and done with. therapist_input therapist_behaviour +AnnoMi-therapist_131_76.mp4 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'd like to recommend is that you use two products perhaps and I'm thinking of you're having a patch and then suggesting that you might use something that you can top up with. Often, a person who smokes knows exactly what it feels like when they're craving for a cigarette. What does it feel like to you, when you can't have a cigarette and you want one? therapist_input therapist_behaviour +AnnoMi-therapist_131_78.mp4 Okay. other therapist_behaviour +AnnoMi-therapist_131_80.mp4 And that's exactly one of the symptoms of nicotine withdrawal that I'm looking to stop happening to you. therapist_input therapist_behaviour +AnnoMi-therapist_131_82.mp4 So, I would strongly recommend that you have the patch. I'll talk to you about how to use that and that we have another product that I leave you to use as when any of those feelings of irritation are coming up, particularly in that first week. therapist_input therapist_behaviour +AnnoMi-therapist_131_84.mp4 So, you're happy with the date for [unintelligible 00:06:16]? question therapist_behaviour +AnnoMi-therapist_131_86.mp4 Okay and would you like to come back and see me again? question therapist_behaviour +AnnoMi-therapist_131_88.mp4 And what would you like me to do if you don't come back? question therapist_behaviour +AnnoMi-therapist_131_90.mp4 I'd be very happy to do that. therapist_input therapist_behaviour