JANET: This exhibit: I’m excited for it but it’s getting to me. You know how it goes. The second you have everything handled, something else pops up. The gallery asked me to reschedule after I already sent the invitations. It’s really just not the right time to kick bad habits.
JANET’S THOUGHT: Ugh, so much to think about.
JANET: I don’t know how I let it all get to me like this. I mean, I’ve been through some stuff.
CLARK: Sometimes it’s easy to overbook and force ourselves into corners that are hard to get out of. Maybe you could take some time away from the art exhibit to focus on making quitting a priority?
JANET: This art exhibit is a priority. Are you saying I can’t handle it? I’ve put a lot of time and effort into my art and I want to see it through. You don’t understand. I don’t have a lot of things left that are just for me. Ever since my husband died and I had to raise my kids solo, I feel like I haven’t been able to express myself like I want to. I live through my kids.
CLARK: I didn’t mean that you couldn’t handle it. Just, that if you’re stressed about being able to juggle two big goals like this art exhibit and quitting smoking, maybe setting the art exhibit down could make quitting more manageable.
JANET: And that’s why I’m taking a break. From quitting. It’s almost like you’re not even listening to me.
COACH: Making a suggestion, especially one that discounted what is important to Janet, provoked discord and distrust. Instead, consider exploring her experience with managing stress by using open ended questions or reflections.
CLARK: You stayed strong when your husband died and you raised your kids alone. That takes a lot of bravery and I think you should be proud of that.
JANET: Thanks. Heard that a lot at our family get together a few years back. They didn’t know what I went through though, how could they? Sure I held it together for the kids but I gained all this weight, I’m still smoking. What have I really done for me? (scoffs) I’m rambling. Sorry.
CLARK: It’s okay. You need to get that stuff off your chest.
JANET: Sure. It’s just a bit of a stressful time right now.
COACH: Great! You offered an affirmation that recognized Janet’s strengths in response to life challenges, which she appreciated.
CLARK: I don’t want to hold you up while you’re so busy.
JANET: Oh, okay. Uh, that’s everything I guess.
CLARK: Great.
CLARK: When would be a good time for you to return to talk some more about options for quitting smoking?
JANET: Well, the exhibit is in six weeks. The earliest I could come back here would be two months from now.
CLARK: That would be great! Why don’t you make an appointment on the way out?
JANET: Yeah, I’ll think about it. Anyway, thanks for chatting today. Not sure if I’m sold on the whole thing, but I’ll have a think after the exhibit.
CLARK: Of course. Hopefully see you soon. Good luck with the show in the meantime.
COACH: Let’s pause here to look at how effective your choices were in eliciting motivations from Janet. Then you will have a chance to conclude the conversation by discussing her barriers to change and collaborating on a plan.
Effective Path:
CLARK: Our last chat was six months ago. It’s good to see you again!
JANET: Good to see you too.
CLARK: Ok, so you’ve just seen the doctor, your blood pressure is good, and your recent blood work looks good. How are you doing?
JANET: I’m doing just fine. That said, I’m (coughs)(clears throat), I’m pretty busy at the moment.
CLARK: No problem, we’ll keep this as short as possible.
CLARK: How have you been lately?
JANET: I have another exhibit coming up. It’s taking up most of my time lately.
CLARK: Art, right? Painting?
JANET: That’s it.
CLARK: I can imagine that putting something together like that takes a lot of energy and focus.
JANET: Yes. But I fit in a little exercise when I can like we talked about last time. Something’s better than nothing, right?
CLARK: So how’s the art exhibit going?
JANET: Ok, I guess. Just this week I’ve been getting my website together, figuring out spacing things with the gallery, and I wasn’t happy with how the postcards turned out so I’ve been back and forthing with the designer. I’m sorry, I’m rambling. Boring details. We can talk about something else.
CLARK: Not boring at all, but if you like, we can switch topics.
COACH: Nice! When you asked about the exhibit, Janet felt like you had a genuine interest in her and her well being.
JANET: I’m just happy I’ve managed to exercise as much as I have.
CLARK: Nice to hear you’re keeping up the exercise. How’s it been going?
JANET: Not half bad! I walk along the beach and chat on the phone with my friend Margaret.
CLARK: Walking is a wonderful way to keep in shape without taxing the body too much. And you’ve incorporated a fun way to enjoy yourself in the process.
JANET: Right. I get my walk in and I get to catch up with my friends. And I’m happy to keep doing it, especially since walking doesn’t take up too much time.
COACH: Great job! Janet appreciated that you reaffirmed her efforts to stay healthy, especially since her schedule is so busy
JANET: I got other priorities, too.
JANET: Like I’m thinking about taking my family on a trip, but I’m wondering if given my health it might be a little too much for me. Not to mention travelling just isn’t as cheap as it was in my day.
CLARK: You’re wondering if travelling abroad is a good idea considering your health issues, and you’re concerned about the expense.
JANET: Yeah. I mean, walking on the beach near my house is easy on the old lungs. And doesn’t cost me anything to get there.
JANET: But I see the beach every day. Heck, maybe a bit of fresh air might even be good for my health. And it’d sure be nice to take my family somewhere new. I did the math and if I booked a trip I wouldn’t have the budget for my smokes for like six months.
COACH: Good job! You used a reflection to show your interest in Janet’s perspective and she continued to share how her desire to travel relates to her health and smoking.
JANET: But look, weren’t we here to (coughs) to talk about my health?
CLARK: What can you tell me about your health these days?
JANET: Well, I still get chest pains, like we chatted about last time.
COACH: Nice! Your open ended question let Janet go into detail about one of her main concerns: her chest pain.
JANET: Doesn’t feel like I’m about to have a heart attack or anything. Doesn’t make ’em any less annoying though.
CLARK: When have you been noticing the chest pains? Any times different from our previous session?
JANET: Eh, they’ve stayed pretty consistent since last time. Still only notice ’em when I’m stressed. Or sometimes if my grandkids try to get me to run around. Or I guess I notice it sometimes when it’s cold out, or I’m walking up the hill near my house. Just the price of doing what you enjoy, I suppose
CLARK: So, what’s your understanding of the connection between smoking and chest pain?
JANET: I know that smoking affects your heart and can lead to heart attacks. It just that sometimes, even after I have chest pain, I still want a smoke.
CLARK: So for you, the connection works both ways.
COACH: Good! You asked Janet to share her understanding and she answered in an honest and open way.
CLARK: And how do you feel about smoking?
JANET: I mean, I’ve been smoking my whole life. I’m at a pack a day and I enjoy it. I know stopping would be better for my health, but I don’t have time to quit right now.
CLARK: You’ve been a smoker for a long time and you’re not sure you have time to quit right now, though you know that quitting could improve your chest pains, reduce your risk of a heart attack or stroke and make a real difference in your health.
JANET: I mean, yes I know if I cut down I’d probably reduce the coughing and chest pains. But I just don’t know how realistic me quitting at this age would be. Even with any other benefits.
COACH: Great job! You used a double sided reflection that first acknowledged Janet’s ambivalence and then reflected and affirmed Janet’s knowledge of the connection between smoking and chest pain.
JANET’S THOUGHT: Some more important than others.
CLARK: Like saving money to use for something else.
JANET: Yeah, exactly.
JANET: Having a little more money in the pocket couldn’t hurt. There’s a lot of the world to see and I’d love to have enough money to help my family see it. Only thing: trips are expensive. And cigarettes aren’t cheap.
JANET: Don’t get me wrong, I have tried quitting a bunch of times in the past. But nothing worked. The patch gave me a rash. Cold turkey just made ME feel like a turkey when I started smoking again two days later. I tried the gum, too. Felt nice to be chewing something, I guess. Lasted a couple of days, but it didn’t do it for me.
JANET’S THOUGHT: If it didn’t work in the past, it’s not going to work now. But might as well get this over with.
CLARK: Even though it wasn’t permanent, you had some success with quitting smoking in the past.
JANET: Success? The most I ever made it without having a cigarette was like two days.
COACH: Good! You affirmed Janet’s past efforts and she shared more about her experience, even though she wasn’t particularly receptive to considering her past attempts as successful.
CLARK: Sounds frustrating. The good thing is, your past attempts to quit can actually serve as opportunities for learning.
JANET: Learning what? How not to quit?
CLARK: (laughs) Sort of! You learned what doesn’t work at all, compared to where you had a little success.