Once you’ve got the nuts and bolts of how your patient’s conversation settings are built up (details here) and how to avoid duplicates of the same/similar items (as explained here)  you should be ready to customize away.

Open the patient state you wish you edit and go to the Conversations tab (here’s how to get there). 

While you won't be able to edit the names of default items in any of the columns, you will be able to edit the responses ALEX should give to the questions under any default item in the "Topic and Response" column.

Additionally of course, you can edit any item you've created under any column. Simply click in the box you want to modify and edit away. Hit ENTER when you're done.

Items you’ve edited will always appear with bold text. This way it'll be easy for you to determine what modifications you've made.

That’s not all you can do to customize your patient’s conversation settings. Check out how to add new items here, or how to delete unnecessary items here.