Datasets:

michelleyunun

/

therapydata

like 15

55

reducing drug use

client

Yeah, that's right.

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neutral

55

reducing drug use

therapist

So weighing what you like and don't like about your use, where do you want to go from here? What do you want to do differently?

question

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55

reducing drug use

client

I don't know.

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neutral

55

reducing drug use

therapist

Well, some patients who inject heroin are interested in a medication called Suboxone. It reduces cravings, withdrawal symptoms without making you high. Some patients want information on how to inject drugs more safely or where to get new syringes. Other patients want to carry Naloxone which is a drug that can prevent one from overdosing.

therapist_input

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55

reducing drug use

client

Uh, are you talking about Narcan? Is that the same thing?

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neutral

55

reducing drug use

therapist

Yes.

therapist_input

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55

reducing drug use

client

Yeah, I got some of that already. I got it from the needle exchange.

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neutral

55

reducing drug use

therapist

Where do you keep it?

question

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55

reducing drug use

client

Uh, at home mostly.

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neutral

55

reducing drug use

therapist

In case you see someone overdosing?

question

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55

reducing drug use

client

I mean, that's a concern, of course, right? Uh, I'm on the app just in case somebody nearby is OD-ing and I can get pinged. But no, mostly I just keep it in case I overdose, uh, and, uh, I'm realizing now I have it but I haven't told my roommate about it so—

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neutral

55

reducing drug use

therapist

Your housemate may be willing to give you Narcan if they see you overdosing.

reflection

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55

reducing drug use

client

Yeah, that's what I'm thinking.

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neutral

55

reducing drug use

therapist

Anything else you want to do about your use?

question

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55

reducing drug use

client

I would really like a little bit of information on, uh, injecting in my arm.

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change

55

reducing drug use

therapist

Okay. I can email you some information on how to inject in a way that reduces the chance of infection and we also have behavioral health specialists in our clinic who can go over how to reduce harm with you. I bet the syringe exchange has similar resources too.

therapist_input

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55

reducing drug use

client

Okay.

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neutral

55

reducing drug use

therapist

So it sounds like you have two goals right now. You want to tell your housemate about where you keep the Narcan in case you overdose and you want some information on how to inject safely?

reflection

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55

reducing drug use

client

Mm-hmm. Yeah.

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neutral

55

reducing drug use

therapist

How confident are you to do these two things? On a scale of 1 to 10, 1 meaning not ready at all and 10 meaning very ready, what number would you pick?

question

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55

reducing drug use

client

I'd probably say 10.

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change

55

reducing drug use

therapist

Okay. You're very ready. Why do you think you picked a 10 instead of a lower number like 8?

question

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55

reducing drug use

client

Well, uh, I don't want to have an overdose and I don't want to get an infection. Seems like easy things to do.

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change

55

reducing drug use

therapist

What kind of plan could you put in place to make sure you meet these goals?

question

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55

reducing drug use

client

Um, well, I can talk to my housemate tomorrow night. I'm pretty sure that he doesn't work tomorrow night so he'll be around.

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change

55

reducing drug use

therapist

That's great. And how do you want to get the information on injecting?

question

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55

reducing drug use

client

Uh, if you could email me that right now, that'd be great.

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change

55

reducing drug use

therapist

Okay. I'd like to hear how your plan worked out for you if you're willing to come back for another appointment. I look forward to hearing about what worked for you and what was challenging say in four weeks.

other

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55

reducing drug use

client

Uh, yeah, yeah. It's fine. Let's do that.

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neutral

55

reducing drug use

therapist

Great. I'll see you then.

other

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56

more exercise / increasing activity

therapist

Hi, Mrs. Smith. I'm Denise. I'm the social worker here at the clinic work that's working with Dr. Fields and the rest of the team. And, um, I know you were here to see Dr. Fields today, and I-I just wanted to let you know, I usually work with people who are similar to- have situations similar to you, and that have gone back home from rehab. And, uh, so I'd like to find out a little bit if you would, if that's okay, about how it's been going since you got home.

question

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56

more exercise / increasing activity

client

Pretty good.

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neutral

56

more exercise / increasing activity

therapist

Yeah?

other

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56

more exercise / increasing activity

client

Yeah. Um, I'm glad to be there.

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neutral

56

more exercise / increasing activity

therapist

Yeah. What are you really glad about?

question

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56

more exercise / increasing activity

client

Uh, well, I'm glad to see my dog, he's very cute, and it just feels good to be home.

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neutral

56

more exercise / increasing activity

therapist

Yeah.

other

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56

more exercise / increasing activity

client

Yeah. And my garden is coming along, and my neighbors have stuff-- It's-it's good. It's good to be home.

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neutral

56

more exercise / increasing activity

therapist

I know, I-I understand that it was really-- That was your goal. That was a really important thing for you to be able to get home and it sounds like you've been able to really en- enjoy parts of it, and I know you've been going to the- both the physical therapy and the Tai Chi and how's-how's that going?

reflection

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56

more exercise / increasing activity

client

Well, um. I-I didn't get- go to physical therapy this week, and the- or Tai Chi, actually.

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neutral

56

more exercise / increasing activity

therapist

So, I'm wondering if something happened that that led you not to go. You look a little, um, down.

question

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56

more exercise / increasing activity

client

Yeah. Well, um. Actually, I-I had a little semi fall, I didn't fall down, I didn't fall down completely but I-I did-- I guess I still had the wobblies and I was hoping that the physical therapy and the Tai Chi would be- get me further along than it has, and I-I still don't have the balance. So, I'm thinking that maybe I was pushing too hard, that maybe I should cut back, you know, and kind of not try so hard to-to keep moving like that.

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sustain

56

more exercise / increasing activity

therapist

Mm. So you've been working really hard-

reflection

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56

more exercise / increasing activity

client

Yeah.

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neutral

56

more exercise / increasing activity

therapist

-through this whole thing, you worked really hard to get home.

reflection

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56

more exercise / increasing activity

client

Yes.

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neutral

56

more exercise / increasing activity

therapist

And you- you've continued to work really hard with both the physical therapy and the Tai Chi and taking care of your house and doing all those things.

reflection

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56

more exercise / increasing activity

client

Yeah.

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neutral

56

more exercise / increasing activity

therapist

And you had this fall or semi-fall, and you're feeling like maybe- maybe you were pushing too hard?

reflection

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56

more exercise / increasing activity

client

Yeah, yeah.

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neutral

56

more exercise / increasing activity

therapist

Yeah.

other

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56

more exercise / increasing activity

client

So I'm-I'm-I cut back, and I-I don't know if I should really even continue the Tai Chi because it's-it's very demanding.

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sustain

56

more exercise / increasing activity

therapist

Yeah, yeah. It's a lot of work.

reflection

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56

more exercise / increasing activity

client

Uh, it's beautiful and-and- but, um, yeah.

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neutral

56

more exercise / increasing activity

therapist

What are you concerned about?

question

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56

more exercise / increasing activity

client

That I'll- that I'll fall again.

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sustain

56

more exercise / increasing activity

therapist

Mm-hmm.

other

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56

more exercise / increasing activity

client

I'll really fall and hurt myself, and this way, if I don't move around so much, there's less chance that I will.

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sustain

56

more exercise / increasing activity

therapist

Yeah, yeah, yeah. And- so you don't want to hurt yourself.

reflection

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56

more exercise / increasing activity

client

No.

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neutral

56

more exercise / increasing activity

therapist

And what are- what are your concerns about-- It doesn't sound like you-you feel like you hurt yourself in this fall.

question

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56

more exercise / increasing activity

client

No, I didn't- it was just more scary, and it was like a-a signal that maybe I'm doing too much.

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sustain

56

more exercise / increasing activity

therapist

Mm-hmm.

other

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56

more exercise / increasing activity

client

Yeah.

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neutral

56

more exercise / increasing activity

therapist

Yeah. And, what are you concerned will happen if-if you get hurt or if something-

question

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56

more exercise / increasing activity

client

Well, yeah, if I- if I lose my balance and fall down, I could- anything, you know, really get hurt, and then-then I wouldn't be able to be home anymore, and that's not what I want. I want to stay home. So I want to do what I have to do to-to-to stay home.

n/a

sustain

56

more exercise / increasing activity

therapist

And it feels like the only way that you can really stay safe and not fall is to not do anything to kind of just hunker down.

reflection

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56

more exercise / increasing activity

client

Yeah. [laughs] Yes, you've put it very well, hunker down-

n/a

neutral

56

more exercise / increasing activity

therapist

Yeah, yeah.

other

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56

more exercise / increasing activity

client

Watch the TV and pet my dog. I-I, you know, not to that extreme, but yeah, I think- I think maybe, um, yeah, I was-was going- pushing too hard.

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sustain

56

more exercise / increasing activity

therapist

Mm-hmm. Mm-hmm.

other

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56

more exercise / increasing activity

client

And I'm not sure about the Tai Chi anymore. I-I think the physical therapy, I can understand that, but I'm not so sure about the Tai Chi.

n/a

sustain

56

more exercise / increasing activity

therapist

Yeah. So the physical therapy is can- you can kind of still see that it's helping you to build your strength, which-

reflection

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56

more exercise / increasing activity

client

Yeah.

n/a

neutral

56

more exercise / increasing activity

therapist

-might have probably helped you break your fall this time.

reflection

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56

more exercise / increasing activity

client

Right, right.

n/a

neutral

56

more exercise / increasing activity

therapist

Um, I'm wondering what you remember about what-what Dr. Fields said about the Tai Chi in relationship to falls. Did she talk with you about that?

question

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56

more exercise / increasing activity

client

She did. Sh-- Yeah, that's right, that's right. She said that they did studies and that they found that it was really preventative. I think she's- I forget the-the percentage, but yeah, she was really enthusiastic and she does it herself.

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neutral

56

more exercise / increasing activity

therapist

Yeah.

other

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56

more exercise / increasing activity

client

Yeah.

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neutral

56

more exercise / increasing activity

therapist

Yeah. So you're feeling a little betrayed like it didn't-- "Look, and I did this, I was doing my Tai Chi, and all of a sudden, I- here, look at this, I fall."

reflection

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56

more exercise / increasing activity

client

That's a strong word, isn't it, "betrayed". Um, wow. A little, but-but I-I know, I know that it's true. I mean, my friend who does Tai Chi, she just- she loves it. Maybe it's just not for me, you know.

n/a

sustain

56

more exercise / increasing activity

therapist

Right.

other

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56

more exercise / increasing activity

client

But, um-

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neutral

56

more exercise / increasing activity

therapist

So you're just starting to question a little bit about whether or not it might be what is useful and, you know, it-it does really come down to what works for you and what-wh-what you decide will help you stay safe. And I'd like to work with you as I know Dr. Fields would, to-to help build a plan that will help you feel as safe as you can in your home-

reflection

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56

more exercise / increasing activity

client

Right.

n/a

neutral

56

more exercise / increasing activity

therapist

-and to keep you there and to keep you feeling safe.

reflection

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56

more exercise / increasing activity

client

Yeah.

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neutral

56

more exercise / increasing activity

therapist

Wh-what do you think about that?

question

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56

more exercise / increasing activity

client

Absolutely, that- because I don't- now I'm-I'm feeling-

n/a

neutral

56

more exercise / increasing activity

therapist

Yeah.

other

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56

more exercise / increasing activity

client

-really a little frightened that what if- what if I fall down and-and-and nobody comes around and I'm lying there for two days, you know. I may have heard about that.

n/a

sustain

56

more exercise / increasing activity

therapist

Yeah, right.

other

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56

more exercise / increasing activity

client

So, um, 'cause I am alone.

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neutral

56

more exercise / increasing activity

therapist

Yeah, yeah.

other

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56

more exercise / increasing activity

client

So—

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neutral

56

more exercise / increasing activity

therapist

So it really kinda strikes you that you're- that you're there alone and this could happen and--

reflection

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56

more exercise / increasing activity

client

Yeah.

n/a

neutral

56

more exercise / increasing activity

therapist

What thoughts do you have about that? What have you heard that others have done, or what are- what are- what thoughts do you have?

question

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56

more exercise / increasing activity

client

Well, the-- I think that there's some things that could be done to-- I know people who live in-in residence, they have a cord they can pull, but how do they get to the cord? Um, is there any- anything else that I could do just to communicate if-if-

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neutral