Amy: Your day is packed from the minute you get up until the time you go to bed. Yet you appreciate how all of this affects your health and where these problems stop you from doing what you need to do.
Mrs. Adams: You’re right. I am concerned, especially about the future.
Amy: How important is it to you to be able to take care of yourself and Alison on a scale of 1 to 10, with 1 being not important at all and 10 being extremely important?
Mrs. Adams: I’d say an 8, definitely. I have to be independent.
Amy: Using the same scale, where would you rank your motivation to work on these issues?
Mrs. Adams: Probably a 7, but only because I would really have to figure out how I can do all of this.
Amy: And by “all of this” you mean …
Mrs. Adams: I mean that I should work on some of those things you recommended. I think it’s important to find a way to come to therapy.
Amy: How will you do it, if that is what you decide to do?
Mrs. Adams: My daughter said she’d either change her schedule around to give me more time or take Alison to day care while I’m at my appointments because she could afford an hour or two a couple of times a week. I didn’t want to ask her to do that because I felt guilty. But now that we’ve talked about it, I think that this is very important. Getting stronger and getting my hands working will help me because I won’t have to struggle getting both Alison and myself dressed, which is something I have to do every day.
Amy: Is that when you know you’ve made progress?
Mrs. Adams: Yes, I’ll be able to get us both dressed—buttons, zippers, pants, shoes. I need to do that on my own.
Amy: Let’s see what we have here. You’d like to work on your flexibility, strength, and endurance because that would mean you wouldn’t struggle to cook, clean, and run errands. You want to work on getting your hands stronger because you need to get yourself and Alison dressed. If you can do that, you can probably do other things. It seems like you’re open to other options, like using a splint if you need to and learning about adaptive equipment. You’ve decided that it’s worth taking your daughter up on her offer to make alternative plans for Alison so you can come in. You’ve really thought this through. Are you ready to start?