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 to edit and go to the Conversations tab (here’s how to get there). 

On the left hand side of each column header you can see an "+ Add..." button. To add a new item to that column, simply click on this button.

When you click the "+ Add" button a new item box will appear at the bottom of that column. Simply enter the content you'd like and hit ENTER to save it.

While for "Category" and "Questions" items you will receive a box to enter a single piece of information, don't forget that with newly created Topic and Response items you'll need to enter not only the topic  but also the response you wish ALEX to give you for the "Questions" you'll list.

Newly added items 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 edit existing items here, or how to delete unnecessary items here.