Table 2 SP case #1
From: Using standardized patients to train telephone counselors for a clinical trial
Case element | Example |
|---|---|
SP demographics | 60 year-old African American male. Married for 28 years. Divorced for 7 years. Two children (ages 26 and 30). Unemployed for 8 years. Receives all health care from the VA. |
SP demeanor | Friendly and open to cessation counseling but reserved when speaking about his military history. |
SP clinical diagnosis, history, and symptoms as necessary | Smoking: Began smoking at age 19. Smokes 10–15 cigarettes per day. Used to smoke up to 2 packs per day. Decreased his smoking about 10 years ago when cigarettes began to cost more. Likes to smoke for relaxation. Has tried to quit a few times in the past. Most quits were “cold turkey.” Has tried the nicotine gum. Has never tried counseling to quit smoking. If asked on a scale of 0–10 his motivation to quit smoking, patient will report a 7. Motivated to quit smoking because it is too expensive and because he knows it is bad for his health. If asked on a scale of 0–10 his confidence in being able to quit, patient reports a 5. He is not very confident because of his struggles with stress and his previous relapses. He is unsure if he will be able to cope with his PTSD and stress without cigarettes. |
Mental health: PTSD linked to military service during Vietnam war. Suffers from insomnia, flashbacks of his best friend being killed in front of him, and heightened startle reflex to loud noises. History of alcohol abuse but sober for 3 years. Recovered from alcohol abuse using AA (which he still attends) and religion (Catholic). Very proud of his sobriety. | |
Other SP psychosocial history | Wife left him 7 years ago due to his drinking. Does not have great relationship with his adult children and would like to be closer to them. They live in NYC but he rarely sees them. Lost his last job (NYC bus driver) due to his drinking. He has many friends through AA and VA programs. Most of his friends smoke and may not support his quitting. |
Instructions on how to respond to intervention competencies demonstrated by trainee during the SP encounter | Begins call in “contemplation” stage of change: thinking of quitting but not yet ready to set a quit date or commit to quitting. If the counselor uses appropriate counseling techniques (see protocol overview), the patient can commit to quitting. If the counselor does not use appropriate counseling techniques, the patient will remain unsure of his motivation to quitting. |