Here is a difficult conversation about asthma "triggers." A patient has been told that his pet is contributing to his asthma attacks, but he is understandably resistant to the idea of giving up the pet.

http://www.youtube.com/watch?v=-RXy8Li3ZaE

My comments:

1. This is a genuinely difficult situation, and I think the provider does a good job of conveying empathy. The patient is legitimately feeling caught between a rock and a hard place.

2. The provider doesn't presuppose a solution or a willingness to change. She does a good job of leading the client through a thought process to decide how he wants to handle the problem.

3. The session ends with the client expressing some change talk ("this is something I've got to think about") without committing to a specific change in behavior. That seems appropriate for a client who does have a decision to make, and who was initially resistant to even thinking about the alternatives.

Your comments:

- In this situation it does seem that the patient began thinking about the possibility of needing to perhaps make a change. The discussion started with the patient stating that he was confused and did not really understand how the dog might be contributing to his asthma symptoms. By the end of the conversation, the patient seemed to understand that his dog might be contributing to his symptoms.