Transcription
By could you sort of summarize what you see is the essential elements and the essential some skills and strategies that you've used in these interviews?
I think the first is really done building a collaboration from the get-go, showing you're interested and and really listening attentively to the patient, giving a hundred percent of your focus. And then using some well-known motivational interviewing strategies. The basic ones are the open-ended questions, reflecting, affirming, then summarizing. I try to do that quite frequently. And then maybe bringing in one of the techniques like a readiness ruler, the pros and cons, some of these techniques that are so helpful to get people to take a look at their behaviors and where they are right now.
Hi, I'm Marcia Cox.
Hi, I'm Marcia Cox. Hi, my GP sent me in.
Nice to meet you. Nice to meet you. I'm Dr. Turner. I'm the health psychologist here at the practice. I'd like to get to know you before we get started, but I know you're probably wondering why your GP did send you in.
Okay, your GP sent you in because when she had you take that secondary screening tool, I don't know if you remember the one specifically for your drinking. Oh, yeah. Mm-hmm. The scores on that tool and some of the ways you were drinking concerned her, and so she thought it would be good for you to come in and talk to me for a bit. Hope that's okay.
Okay. Sure. And that's not unusual in this practice. A lot of patients will come in and see me after those after taking those screening tools.
Okay. Okay. Yeah, no, sounds good. All right, so before we get started with that, it's always good for me to just spend a minute or two and just get to know you.
Sure. Um, I just finished my second year of grad school and getting a degree in Environmental Policy.
Wow, sounds interesting.
It is. I really enjoy it.
Where can you see yourself ending up with a degree like that?
Um, well, my fiance, Ben, is interested in international politics, so we're thinking about um, going abroad after we get married. Um, so yeah, in grad school it's going well. Yeah, thinking about maybe traveling abroad. Mm-hmm. Mm-hmm. Thinking about marriage, especially sometime soon, and having a family. Mm-hmm.
What are you doing your free time? What, um, when we have it, which right now is is pretty often. Um, we get outside as much as possible. I have a big group of friends. Um, we just went whitewater rafting last week. Um, some rock climbing, not nothing crazy. Um, I like to host parties at my house. I like to cook, so sometimes we have people over.
So your social. Yeah. Get outdoors. Yeah. We have a good group.
All right, so let's get back to why your GP sent you in to see me.
All right. Um, you showed by by answering the scores as honestly as you did that your drinking level is putting you at risk. And now that you're also thinking about having a family, that also might be even more add to the concern. More. And I'm gonna sort of look at this around the alcohol. Where does the alcohol fit in there?
I guess my worry as to why this is a concern is because I feel like, um, so many of my friends drink as much or more than me. Yeah. Almost everyone my age that I know. Um, and they're all very busy, active people. Um, it's just something that we definitely do on the weekends. Definitely. My fiance probably has a drink every day. Yeah. So it sounds like, you know, and almost like a surprise. Well, I can't believe that I'm even being asked to come see me. Yeah, when my friends drink, my fiance drinks, right? If anything, they drink sometimes more than I do. It's something I'm aware of. I don't. And I've haven't always said this, but I definitely feel like, you know, I don't want to be drinking this much when I'm thirty. I've definitely had that thought. Um, and especially if I'm starting a family, I don't see that as part of, you know, my future.
Okay, so you even have noticed that maybe as you get older, it might be good to sort of bring it down a little bit.
Uh, yeah. I mean, I'm aware of it. Yeah, for the most part. Yeah.
All right, and and so let's talk about to what I read in your answers. Let your drinking about three or four the nights that you drink, does that seem accurate? And then maybe once a week you might go out and really have a good time and let loose and have more than five?
Six. Yes. And and one thing I want to say is it also said that you're not doing any drugs. And and you're shaking your head like, of course not, right? Is that right? But that's really nice. You know, we deal with a lot of patients here and some have both, but in this case, you know, that's really to your benefit that it's really strictly we're talking about alcohol. Is that right? And so it's really seven, seven drinks a week is really that the safe limit for women. And that what happens as doctors get concerned and the research shows that when you drink more than that, you could be at risk for medical complications with your drinking, right? And also psychological ones, relationship ones. And how's that sound? And you know that your drinking is putting it at risk.
Yeah, I mean, I'd prefer to be healthier, I guess. Yeah. It's definitely been. It's not something I've never thought of. As I said, my parents and my brother have had some issues with it. So yeah.
So if we were to write down some of the pros and cons of your drinking, just to understand them. Um, it's always good for me to know why people when they drink, like to drink, and even maybe for you to figure out, and then figure out what might not be so good about it. Okay. Get into that. So so what are some of the pros?
Well, definitely the social aspect. Um, it's fun. It's fun. You know, what is it about it that makes it fun for you?
I think when we're all together and we can all feel a little less inhibited. Um, my group of friends, that's definitely the primary place where I'm drinking the most with my groups of friends for sure. So it sort of loosened you up. It gets you less inhibited. And yeah, definitely. Um, it's a way to let go on the weekends when I'm not doing around those papers. It has fun, loose in general. So it's definitely a social. Yeah. Yeah. Part of your group. Mm-hmm.
What are some of the negatives that have come up for you in drinking?
Well, um, well, no one likes a hangover, so that's no fun.
Hangovers. And how often does that happen to you?
I mean, I probably have, I would say I wake up with a headache on the weekends, one day of the weekend. And and again, just so I'm real clear, how much I say you drink in most of the week. So when when you know during the week, what would you say a drink? And then on the weekend?
Um, probably two or three times. Two or three days of the week. Days of the week. And how many during those days would you say?
Me, three or four. Three or four drinks. And then during the weekend? Yeah, sometimes it's more. Orders. Yeah. Um, maybe five. Five a night.
Five a night. Yeah. How about what other effects have you noticed or others? I'm sorry.
Sure. Uh, this doesn't happen very often, but definitely I would prefer to never get to this place where I've had a few blackouts. Probably hardly.
Damn. In college. In college. Degree idea. Yeah. What's head? And undergrad. Especially an undergrad. And um, what was concerning about those for you?
Well, I'm not remembering what exactly happened. Never feels great. Um, I got into a one bad situation in college that my mother was involved in, which was not pleasant. Um, really risky to you to your health and to your safety. Bad, like embarrassing. Um, I would say not usually risky to my health. I feel safe around the people that I drink with for the most part. Okay. Um, but there have been a few embarrassing moments there for sure. It's an embarrassing photos. All right. So yeah.
So, you know, one thing you said and I just want to bring that back up as you talked about wanting to have a family. Mm-hmm. And, um, so I'm wondering if you know, you're pretty aware, probably that it's really unhealthy for the fetus to drink during stage of pain. So if you thought about that at all, as you've been thinking?
Yeah, absolutely. Yeah. And, yeah, um, you know, my my mom stopped smoking and drinking right away when she um, had my brother. So I definitely plan on doing that. And I think I have more friends from home who are already starting to have kids. So I think there's some definitely support there.
It seems like you do it socially. It's really helped you feel less inhibited. Mm-hmm. Sounds like. And then there's you do it frequently on the weekends, really, you let loose that way and have a good time. You have some blackouts that are of concern, right? Um, you haven't seen a lot of effect up till now, although your mom and now your doctor, mm-hmm, this time you is concerned. And you said you're also interested in starting a family. Yeah. And so that's something that might have you change your mind? I'm wondering what would have to happen to you, you know, when you think about it, like what would be an indication for you that this is more like your brother and your dad, that this is something that really is a concern?
I think that I just have been ignoring it, maybe. Um, not putting it all, putting all these pros and cons out makes it sort of more an apparent issue. It's dink the most difficult part is that everyone I'm around is sort of doing the same thing. Yeah.
And I get that. And that's funny. That's very common for people your age. And I hear you saying that. I guess what I'm wondering is, you know, just personally, would there be something that would tell you, okay, I really do need to cut back? Is there something that would have to happen in your life right now that would say, hey, it's time? In your doctor's concern and your, you know, the tools that we use, I examine this say you're at risk. But what has to happen?
I mean, given where I want to be, I think in the future and with having a family, I think I'd like to start cutting back right away.
So I'm wondering on a scale of one to ten, how ready you are right now to take a look at this seriously, like you've done today, and then have that have you bring it down? One being, you know, not at all, ten being very motivated.
Honestly, making eight point five.
Wow, you are very decisive. I can see why you. So it's eight point five. And you know, what I'm wondering is, I wonder like that there's so many reasons socially for you to, but it's really only cute. I feel like it's really only social. And I feel like if I can't overcome that, that's kind of.
So you feel like those reasons that you're drinking aren't enough to you personally to have you continue with these harmful rubbers or risky, let's call them?
Yeah, I mean, I'm not gonna lose friends. Okay. I don't think so.
Given that, what do you think you could do in this next week? And I'd like to see you next week, but what what can you do in this next week that's that's good with you to actually change your drinking?
Well, I definitely would want to talk to my fiance. Oh, you're not it. Um, not even necessarily get him to cut back, but just tell him where I'm at and what you guys have said. Um, and then, um, with my mom as well. I think my mom would be a great person to hold me accountable, although I would hate to admit that she might be right about my habits.
But sighs, those sound like some great steps. Is there anything that I can do to remind you to do those and to follow through on that?
Um, I think, uh, you know, seeing you next week will be good motivation for it. And if I think if seven is a weekly limit to work for, then I think probably drinking only on the weekends is something manageable. So knowing the safe limit and then yeah, limited to a set period during a week. Yeah. Why is that something you can try this week?
Yeah. All right, great. So what I'd like to is great to talk to you. You have any questions for me?
Not right now. Okay. All right. So like you to go out and make an appointment to see me next week. Okay. All right. Nice to meet you. Nice to meet you. Take it. Yep. Bye.
So in this in in this first couple of videos, what's the setting? What's what's the scene that that's going to get played out to demonstrate the? Well, in in all of the demonstration videos, our intent here is to try and replicate as much as possible just like normal people, so that the cases in the studies that were selected are the kinds of clients or the kinds of patients that you might see in a primary care practice. And we look through a number of different case profiles and made these selections, and that we try to really have just the kind of normal, expert brief and.