This article begins the next level of learning for prescribers. While the first series introduced the stages of change and strategies for each phase, this advanced article equips prescribers with deeper tools, assessment checklists, and implementation tactics to master clinical conversations about behavior change.

Mr. W is a 50-year-old man who carried a diagnosis of opioid use disorder for two decades.

He’s now been sober for 10 years, serves as a peer counselor, exercises regularly, and mentors youth in his community.

Ms. R is a 35-year-old woman with bipolar disorder and a history of medication non-adherence.
She’s been stable for 6 months and has kept all appointments.

Mr. B is a 63-year-old man with a history of alcohol use disorder and chronic insomnia.
After months of contemplation and planning, he has now stopped drinking for two weeks.

Helping Prescribers Lay the Foundation for Sustainable Change

Mr. K is a 56-year-old man with COPD and hypertension. He smokes half a pack per day. You’ve discussed it before.

Your task is not to convince, persuade, or educate in a traditional sense; rather, it’s to evoke curiosity, elicit discrepancy, and plant a seed.

Mr. J, a 42-year-old man with a history of alcohol use disorder, hypertension, and poor sleep hygiene, comes in for medication follow-up.

“People keep asking me if I’m okay.
I don’t know what ‘okay’ looks like.
But I know I’m not disappearing anymore.”
— Cynthia, 62

“They watched me for 20 years.

Not to protect me—just to control me.

Now you say I’m free, but I don’t know where to put my back.”

— Cynthia, 62

“Every time I took their pills, I lost pieces of myself.” — Cynthia, 62

You’ve met with Cynthia several times now. She shows up. She’s quiet. She listens. She watches.

“They call it a disorder. But it’s how I survived.”

— Cynthia, 62

By now, you’ve walked with Cynthia through her first appointment, then through the story of her life—layer by layer.

“They kept asking me what happened.

But things didn’t happen all at once.

They happened over time. That’s how you break someone.”

— Cynthia, 62

“They said I’m free now. But out here… everything feels dangerous.” — Cynthia, 62

“I still have hard days. But now I notice them.

Before, I didn’t even know I was drowning. I just thought that was life.”

— Marcus, 48

“We talk about the depression. The thoughts. The behaviors.

But I don’t think I’ve ever told anyone what it actually feels like to be me.”

— Marcus, 48

“They keep switching the meds. I take them, I wait, I hope. Then it fades—or nothing happens at all. It’s like everyone’s just guessing.”

— Marcus, 48

“They said I have depression. I guess that fits. But sometimes I wonder if that’s just the word we use when we don’t really know what else to call it.” — Marcus, 48

“I don’t even remember when it started. Maybe it’s always been there. Like a dull hum in the background of everything.”
— Marcus, 48

“I’ve been depressed most of my life.
I’ve tried everything.
Therapy. Meds. Meditation. Journaling.
They help for a while, and then… nothing.
So maybe this is just who I am now.”
— Marcus, 48