Version May 2024
| Doctor: So Susan, it sounds like you're really ready to stop smoking weed every day. You've noticed that your concentration and memory are not as good as they were, and you're tired of feeling too zoned out to shop for groceries, help with your kids' homework, and keep up with your job schedule. You've always liked the feeling of being high, but now you're wanting to set a good example for your kids, and "being high through life", as you put it, doesn't really fit with that. (Summary of previous conversation) |
| Patient: Exactly. That's exactly how I feel. I'm ready to do it, but I know I have to think it through - it would be hard to just go cold turkey. |
| Doctor: We talked before about how you used to use other drugs, but you quit. (Reflection) You were successful in stopping your cocaine use, and it's been over 5 years since you used, and you're glad about that. (Affirmation) Tell me more about how you were able to do that, and what parts of that change might be relevant now, as you consider quitting smoking weed? (Open question) |
| Patient: Crack is different than weed; it takes over your life, and makes you act different. I could tell that if I didn't stop, it would not take me anywhere I wanted to go. |
| Doctor: So with crack, you looked ahead, and didn't like what you saw if you kept using. Maybe looking ahead with weed would be helpful. If you do the same thing, look ahead, imagine that you keep smoking weed daily like you are now, what do you see? |
| Patient: Probably nothing much. I'd continue to make mistakes, small stuff, but every day, like missing my shifts at work. I might even get fired, because they're starting a drug testing program. I might not be the best mom, because I'm too zoned out to really pay attention like my children need me to. Most of all, I'd feel like I'd wasted years, literally. I don't like that future much. |
| Doctor: So looking ahead with smoking weed, you see a future that looks a lot like having more of the same kinds of problems as you have now, and worse, you'd feel bad about yourself, like you'd been less than you could have been. (Complex reflection) |
| Patient: Yeah, but I don't seem to be able to smoke just a little. I think what I'm getting to realize is that I probably need to quit smoking altogether, to have the kind of life I want. |
| Doctor: So while part of you would like to find a way to smoke weed sometimes, another part thinks you need to give it up entirely. (Complex reflection) |
| Patient: Yes. I want to quit completely. I want to clean it out of my system. It's next month that work starts drug testing, and I've heard it takes a month to clean it out of you. |
| Doctor: That's about right, depending on your weight, body composition, and a few other things. (Affirmation, providing information) So you'd like to start right away, and clean the marijuana out of your system. (Reflection) |
| Patient: Yes, and that should work because I'm down to about one joint's worth left. I need to tell my friend that I'm not ordering any more. |
| Doctor: So a first step is to not replace it when you run out, which will be soon. (Reflection) |
| Patient: Yeah, like tomorrow. |
| Doctor: Tell me more about how you'll quit and stay quit. (Open question) |
| Patient: Well, I already told my husband I'm going to do this. Also, I talked about it with some of my close friends who usually smoke it with me. They all understand, and they're planning not to offer it to me. But even if they do, I will say, no thanks. But at first, I probably need to hang out with them in other ways, like going out to movies or out to eat, rather than just hang at each other's houses. |
| Doctor: You've given this a lot of thought, and you've already taken important steps - letting people know what you're doing it, asking for their help, and planning what you'll do if it's offered. (Affirmation) |
| Patient: Yes I have. I think I'm ready. |
| Doctor: How confident are you, on a scale of 0 to 10, that you can quit smoking weed now? (Open question using scaling ruler strategy) |
| Patient: I'm a 9. I think I'm ready, and I have a plan. |
| Doctor: What makes it a 9 and not a 0? |
| Patient: Like we talked about, I was able to quit using crack cocaine. I saw how it was going to ruin my life, and I said no way. It's the same with weed. I can see a bad path there, and I am ready to start a new phase of my life. I think I have enough support, and now it's time to start. |
| Doctor: You're committed. You're ready. I'm here to help in any way you need. I'm looking forward to hearing how it goes, next time you come in. Good luck! |
| Patient: Thanks - I'll call you if I need anything. |
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