| Sumario: | After Natalie starts the session by attempting to light a marijuana joint, the provider promptly asks her to stop. The provider explains the importance of making their telehealth sessions as conducive to an in-person session as possible, including refraining from using any substances. Natalie processes her reaction with the provider and discusses how the marijuana is legal and that it helps with her anxiety. The provider validates Natalie’s statements and reassures her that the request to refrain from use during sessions is not coming from a place of legality or judgment, but rather a boundary that must be maintained. The provider also highlights the role that substance use plays as a means of avoidance and explains the importance of using their time together to explore other ways of managing her anxiety. The provider then uses motivational interviewing to guide Natalie in identifying the ways that her substance use has impacted her life negatively and to re-visit her treatment goals in relation to reduction of substance use.
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