Table 1 Clinical vignettes
“How would you advise . . . | Elements of counseling |
|---|---|
. . . a 45-y.o. smoker?” | 1) Discuss risks of smoking |
2) Make a clear recommendation for quitting smoking | |
3) Discuss ways to reduce risk if smoking continues (e.g., reduce consumption) | |
4) Assure patient you will care for him or her regardless of his or her decision regarding quitting smoking | |
. . . a 38 y.o. with signs of alcoholism, including several “driving while intoxicated” arrests?” | 1) Discuss risks of alcohol |
2) Make a clear recommendation for abstinence from alcohol | |
3) Discuss ways to reduce risk if drinking continues (e.g., limit consumption, avoid driving when drinking) | |
4) Assure patient you will care for him or her regardless of his or her decision regarding cessation of alcohol use | |
. . . a 23 y.o. who is sedentary and 20 pounds overweight?” | 1) Discuss risks of sedentary lifestyle and obesity |
2) Make a clear recommendation for improved diet and exercise | |
3) Discuss ways to reduce risk if the patient does not wish to change diet or exercise (e.g., suggest small changes) | |
4) Assure patient you will care for him or her regardless of his or her weight and decision regarding diet and exercise | |
. . . a 16 y.o. contemplating becoming sexually active, including intercourse?” | 1) Discuss risks of sexual intercourse |
2) Make a clear recommendation for abstinence from sexual intercourse | |
3) Discuss ways to reduce risk if the patient begins engaging in sexual intercourse (e.g., condom use, contraception) | |
4) Assure patient you will care for him or her regardless of his or her decision regarding sexual activity. |