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Strength Based Believer

January 31, 2012 Leave a comment

One of the first things I learned at my current workplace is to be “strength based.” Strength based is the idea of focusing on the positives to empower the clients rather than the negatives which can tear them down. It may seem simplistic or even idiotic, but it does have some merit. When I first heard of strength based, I used to think it was ludicrous. I understood that staying positive would empower clients, but what if their actions did not warrant empowerment? How can you empower a child who just drew a picture of a classmate dying a horrible and graphic death? The answer comes from a twist in thinking. Instead of looking to punish negative behaviors, you must reward positives. In theory, rewarding positives encourages those behaviors while negative behaviors fade away. So when Tommy draws a horrible picture, use it as an opportunity to talk about his thoughts, compliment his drawing style and his use of drawing as a coping skill.
It is hard to be strength based because it is often the theme within our culture to just fix things or people. When I first started in the field, my main focus was to fix the problem, but often the problem I was trying to fix was a perceived problem by the social worker and a non issue for the family. When I get a referral for services, I get contact info, providers involved and a few little blurbs on the presenting issues. The presenting issues are the referral writer’s interpretation of the problems. When I first started, I would develop a game plan for myself. Sometimes I did so consciously, sometimes subconsciously, but I was not taking into account the families view. One example was a case I had involving a family of five, the two parents and their two younger biological children as well as an older child from father’s first marriage. The older child was the identified client and my referral sheet stated that I was to do psychoeducation around Aspergers because that was his diagnosis. I went into my first meeting with a large stack of papers and articles dealing with Aspergers, but realized I had jumped the gun. Upon entering the home, the mother was in nurse’s scrubs and explained that she was a nurse on the adolescent floor at Mass General and was well educated about Aspergers through work and her own research upon learning about the oldest son’s diagnosis. For a while I tried to stick with the psychoeducation piece as it was the presenting issue on the referral, but with time I learned it was fruitless. After multiple sessions that lead nowhere, I finally asked the family what they felt they needed to work on. From there on out I was able to help the family address the issues they wanted to work on. There was finally some improvement within the family after working on the issues they felt were pressing. By acknowledging the family as having strengths and not focusing on the problem, I was able to be much more effective.
From my personal experience and in my professional opinion, being strength based is a very effective method in helping others. It shows clients a side of themselves they can take pride in. It also limits the emphasis on the negatives within the family. By focusing on the positives, clients can build self esteem, learn positive behaviors and address problems without putting an emphasis on the negatives. It can be hard to see a silver lining, but the more you do it the easier it gets. Sometimes the positives can be absurd on the surface, but it is important to find the light in the darkest times. Think about it, if you had someone telling you how great you are as opposed to pointing out your mistakes, you might have a better outlook on life yourself.

Christopher Curran, MA

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How parents and counselors can communicate effectively with young children: Developmental theory as a guide

January 30, 2012 3 comments

First Psych Nerds Post by Dr. John Calicchia.

As a counselor of young children many parents frequently ask me how to communicate effectively with their children.  Similarly, as a counselor educator students often ask me how does developmental theory inform and guide counseling practice?  These seemingly disparate questions essentially have the same answer: developmental theory is necessary to understand critical stages but, more importantly, what modalities of expression and communication the child is able to use.  In order to effectively communicate with children and to permit developmental theory to guide our practice we must understand the “languages” children speak as they mature. The purpose of this article is to share with the reader a framework for understanding and using developmental theory to speak to children in the nonverbal language they know best: action based play and fantasy.

In order to simplify the multidimensional complexity of human psychological and physical development, theorists have attempted to describe maturational processes in one domain at a time. Students routinely study developmental theorists that have examined cognitive, psychosocial, moral, psychosexual, and interpersonal development to name but a few.  The problem students have with developmental theory is they tend to view only a single domain of the child’s development at a time. As good counselors we seek to view a child from a holistic lens and understand a child’s thoughts, emotions, personality, and worldview concurrently.  If we ask ourselves what commonalities do most or all of the developmental theorists share in their view of children we begin to understand and conceptualize a mega-developmental model to guide our work with children as parents and therapists (for further information on this perspective please read Santostefano & Werner).

If we look at the world of the very young child between birth and two years of age we see a variety of maturational progressions that theorists have described using stages and issues. Where theorists share common ground is that the child experiences all of these developmental issues in the same modality of body based action.  During this early developmental level a child does not have access to language or to play, therefore, they experience and construct meaning of the world through rituals of physical action.  Regardless of the developmental issue being negotiated the child of this age has only one venue from which to engage the world.  In order to effectively communicate with a child of this age we don’t need language or even pretend play. We need to physically interact in a nonverbal manner to communicate with the child.  We tend to forget that we experienced the world from our caregivers for two years without using language or play. This nonverbal action-oriented mode of expression in understanding is available throughout one’s lifetime but is dominant during this phase of development.

Around the age of two children are beginning to understand and use language, however, the preferred mode for engaging the world is based in fantasy and pretend play. During this period children are compelled to symbolize and animate as they construct meanings of the world around them. Eventually, children of this age began to use the rich environment of pretend play and fantasy to learn and negotiate developmental challenges. During this phase children still actively make use of the action based mode previously discussed and they also have access to some use of language although this mode does not become fully dominant till the teen years. If you observe children in the two through six age range it is obvious that action and imaginary play are the preferred languages that they “speak”.  In order to effectively communicate with a child of this age we don’t need much language. We do however need to recall and use our earliest forms of communication: action and imaginary play.  As with the nonverbal action-oriented mode this “imaginary play” form of expression is available throughout one’s lifetime but is dominant during this phase of development.

Around the age of six, when children are entering first grade, they become more focused on the outer world and are dominated less by play and fantasy themes. At this age children have developed solid language skills and become enamored with industry and production as they advance in school. However, the modes of action and imaginary play are still very active.  Children of this age will rarely sit idly and talk, they still prefer to speak and to communicate while in action and play. In order to effectively communicate with a child of this age we need to be able to integrate action, play, and language.

As a parent or counselor we now see the world of the preadolescent child filled with developmental stages that all need to be negotiated through action, imaginary play, and language.  Children have little difficulty speaking these three languages because they are developmentally pre-wired to do so.  In my experience it is often adults that have been so long dominated by the language mode they forget their abilities to communicate in other ways.  Parents and novice counselors of young children often don’t realize that their dominant use of language is not effective in communicating with young children.  Children I have worked with often express their understanding of the adult world as being filled with language they do not understand.  Often children will draw pictures or play to show that adults are speaking to them in a language they do not understand.  Do you remember the teacher in the Charlie Brown cartoon? Do you remember the voice with unintelligible fast-paced droning language? Children I have worked with have drawn pictures of adults with “big mouths” that are perceived in the same way.  Is it any wonder that I frequently hear from parents “I don’t understand… it seems as if they’re not listening to me or don’t understand what I am saying”. Could it be that we are not speaking to children in a language they can understand.  I frequently tell my students that using only language, without action/play, to speak to a child would be akin to counseling an adult using a foreign language they did not understand.  Let us turn to a brief commonsense strategy that counselors and parents can use to effectively communicate with young children.

First, when you’re attempting to communicate with a child don’t focus on language, in fact, don’t say anything. Observe what the child is doing by attending to their actions and imaginary play without speaking. (As a guideline I often tell beginning counselors to observe themselves on tape and limit themselves to the same number and type of words the child is using.  The tapes usually reveal the adult counselor using far too much language and not enough action and play.) As you observe the child you should easily be able to determine what developmental modes of expression and themes a child prefers using.  Second, using body based actions and imaginary play, naturally integrate the issues you wish to convey to the child without resorting to language or rupturing the child’s interactive play.  Let me share with you an example from a personal rather than clinical perspective that illustrates these two points.

I recall when my firstborn daughter was two and 1/2 years old and, as parents, my wife and I were attempting to persuade her to relinquish her pacifier. We tried “speaking” to our daughter about the various reasons why a big girl should not use a pacifier.  Despite our well-intentioned and creative verbal attempts we were unsuccessful and became frustrated.  As I thought of the situation from the perspective of a professional counselor I felt foolish.  I also felt that my daughter was ”tuning me out” since I had not the courtesy to speak to her in a language she understood. The next day I sat down for five minutes and just watched my daughter play with her animal farm. She was taking the farm animals and other assorted toys, showing them the way home, and making them a proper bed on the farm.  After my daughter understood that I was not going to say anything (much to her relief I might add) she invited me to play with one of the farm animals. We had fun and I also felt connected with my daughter. However, I still needed to promote my agenda for discontinuing with the pacifier but now I had a new modality to communicate my concerns.  Rather than saying a word, I looked for a way to use the play farm characters and the theme of taking them to bed.  A small brown Beaver with large front teeth grabbed my attention.  I aptly named him “Bucktooth Beaver” and grabbed a play pacifier from a doll’s crib.  We made a bed for him on the farm and I put him to bed while imploring “Bucktooth” to give up his binki (pacifier) like a big Beaver should.  Soon Bucktooth began spitting out his binki before he went to bed since it was bad for such beautiful teeth.  Needless to say, my daughter thought this was hilarious and entertaining.  She recruited me daily up to her farm to play “Bucktoothed Beaver”.  Not surprisingly, after a week my daughter relinquished her pacifier noting that it was bad for her teeth.  In retrospect, had I noted her developmental need for play early on I would have had much better success and less stress trying to rid her of the pacifier habit.

In summary, developmental theory not only informs us of stages, issues, and needs, but of the child’s ability and preference to communicate in a modality other than language.  Children negotiate developmental issues through action, imaginary play, and language.  Each child’s unique makeup determines the balance and preference for these modalities since development is inescapable and all children will need to act, play, and speak as they construct meaning of their world.

 

Dr. John A. Calicchia began at Bridgewater in 1993 in the Department of Counselor Education where he served as a faculty member, Graduate Program Coordinator and Department Chair before joining the Psychology Department in the Fall of 2007. He has taught a variety of courses including applied pre-adolescent counseling, research methods, and legal and ethical issues. Over the past 20 years, his research and clinical practice have focused mainly on children and adolescence and Dr. Calicchia has an eclectic array of peer-reviewed articles, presentations, and a co-authored book. Dr. Calicchia is a Licensed Psychologist/Health Service Provider in the state of Massachusetts and has special training in child and adolescent psychology. He completed his pre-doctoral internship and post-doctoral fellowship in clinical child psychology at McLean Hospital and served as a Child & Adolescent Psychologist at McLean Hospital & Harvard Medical School.

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5 Steps to Get Your Ideal Family

January 26, 2012 Leave a comment

We all want the perfect family. We all want to be able to come home to a relaxing environment and be able to expect to have some predictability as to the behaviors and structures of the homestead. We wish to have our spouse available and ready for insightful and engaging conversation (and the occasional empty sink without asking). We wish for our children to have their homework done, teeth brushed, and in relatively good mood. When we break from these ideals, and when our expectations when entering the home are of isolation, distant communication from our spouse, opposition and arguments from the children, and rather than teeth brushed and relative cleanliness, we are amazed that the children survived the physical onslaught brought on by older or younger siblings, it may become a possibility that things may need to change. Being overwhelmed is a realistic feeling and not knowing where to even begin is also a key issue for families.

Here are some steps to take to help get you to where you want to be:

1.)    Identify what a family means to you. Whether you write it down on paper or begin the internal monologue, you need to organize and identify some of the weaker areas of the family dynamic. This involves slowing down and taking a step back from the chaos. You must be able to step back for a moment and not become enmeshed in the current issues. It’s hard to gain perspective when your head is spinning in every direction. There’s more information on this if you  Click Here – A Family is What YOU Make it

2.)    Identify what your family strengths are and what are the weaknesses.

Although your family might have some trouble communicating, is there respect between family members? Is there love? Is the family motivated? Although communication may be an issue, is there communication at all? Maybe it’s the delivery of the communication style that needs work, not the respect between family members.

3.)    Make a choice to alter the behavior.

This piece becomes complicated because it involves a lot of “stuff.” From here, the individual making the commitment to progress the family towards a healthier dynamic must make the decision and commitment to first alter their behavior and admit that, to some degree, part of how they interacted with the family contributed to the ongoing issues in the home. From the individual’s perspective, you may feel that you have done everything right, but in every conflict all engaging members share some of the blame-so start there. Second, begin to model the behaviors in the home and in the community. Don’t be quick to yell or blame others. Use coping skills when in a bad mood. Involve others in your struggles and allow others to help. It may not seem like a lot, but when people feel involved and irreplaceable, they tend to be more attentive and appreciative. Side note: For some families, contracting as a starting point for growth works. Some families simply do not know where or how to begin the process so developing a definitive starting point can sometimes help. Write up a contract stating that we are going to work towards a goal and have all the family members sign it. Sounds silly, but you can keep it as a reference and reminder of the commitment.

4.)    Map out what progress looks like.

How will the family know they are making progress? Write down the ideal family as the end goal and make subgoals that are achievable in the short run as well.  People like to make achievements. They want to know they are accomplishing something and the positive reinforcement gained from these accomplishments both motivates and encourages further achievement.

5.)    Maintain the progress.

Just because you’ve made your goals and achieved the milestones does not mean you’re in the clear. Continue with the maintenance portion. Families can easily slip back into maladaptive patterns because it is sometimes the path of least resistance. This piece requires that all family members be mindful of their thoughts and actions. Behavior is difficult to change because it can become engrained in our personalities. Therefore, if there is a pattern that you wish to see altered, you must make the commitment to be mindful when the behaviors begin to revert back.

If moving the family towards a specific goal is what a family is looking for these steps can help. However, the entire family must be onboard. The idea is not to make a family EXACTLY how you want it, but rather move the family towards a state of contentment that all family members can enjoy. The point is not to change anyone or fix the family. That is neither fair nor a realistic expectation. Rather, we want to work on behaviors and thought processes that the individual and family feel are maladaptive. Work together and listen to one another, you might be surprised with what you hear.

I’d like to hear some of the tips and tricks you use to motivate and maintain your family. Leave some suggestions in the comments box!

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The Helper and the Help-ee?

January 24, 2012 Leave a comment

One of the biggest issues people have with psychotherapy is that it’s an inexact science. A lot of people question the motives, expertise and compassion of therapists due to the media portraying them as being insensitive and distracted. An even bigger aspect is the amount of work clients have to do for therapy to be effective. Although therapists can be very helpful, their role is contingent upon the clients they see. If a client is open with the therapist, and is able to look at themselves with a critical eye, therapy can be very effective. If a client holds back from the therapist, or even sabotages their sessions, then a therapist is essentially useless. A therapist is a vehicle for the client to use, and its success is dependent on the honesty and openness of the client. For example, you don’t go to a mechanic and complain about the odd noise you have been hearing without mentioning your wrong turn into that swamp last week; that doesn’t give the mechanic the tools they need to fix your car. Similarly, if you go and see a therapist and neglect to bring up a traumatic event in the past, or a current stressor, then you are not allowing them the tools they need to be effective. Now I don’t want to give off the impression that nobody out there tells their therapist crucial information simply because a lack of trust, there are other factors which lead to the breakdown. Some people struggle with the intimacy of therapy. It can be very hard to walk in and talk to a complete stranger about the biggest issues in your life without knowing anything about them. Most therapists prefer relative anonymity in the therapeutic relationship as it keeps things professional and preserves the helper – helpee relationship. For example, it would be incredibly hard, if not completely impossible, to talk about your own problems when you know your therapist is going through a divorce, a death in the family, or another crisis in their life. It is hard to see a person in need in their own life as an effective helper in yours.

So there is a definite need to have a break between therapist and friend, but what happens when that break creates a seemingly unbridgeable gap between therapist and client? How can you connect with your therapist without violating the therapist’s privacy and preserving the professional relationship? I have often had this conversation with teenage clients who struggle to make connections with their individual therapists. The best way to combat this is to take control of the situation and ask your own questions. Ask questions that will let you know more about the therapist without compromising the professional relationship. Below is a list of questions former clients have used on me and other therapists, to build rapport:
1) What type of music do you listen to?
2) Favorite sport?
3) Favorite book?
4) Favorite Movie(s)?
5) Who would you pick to save the world, Batman, Harry Potter or Jack Bauer?
6) What would be your weapon of choice for the zombie apocalypse?
As you can see, I mostly work with kids and teens, but it doesn’t mean the questions are invalid for adults. Simple alterations can make these questions viable for adults, it just takes creativity. It is important to remember that personal, identifying questions will compromise the professional relationship, so be aware of boundaries. At the end of the day these questions can be more useful than a biopsychosocial assessment, because who wouldn’t want to talk about the effectiveness of Harry Potter’s wand in a Zombie apocalypse?

Christopher Curran MA

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Take a Deep Breath and Count to Ten

January 19, 2012 Leave a comment

As any person in the field of therapy can attest to, coping skills are a fundamental tool in reaching goals. Coping skills are essentially tricks and techniques to help a person deal with emotional and behavioral issues in the moment. In simpler terms, a coping skill is something to soothe, distract or reset a person in a time of need. For example, everybody has heard that when you are angry, take a deep breath and count to ten. Although most out there will refute its effectiveness, the fundamental idea behind it is simple and useful. Counting to ten takes the person out of the situation, allows the mind to properly assess the situation and then properly plan how to deal with the situation. The issue with counting to ten comes in its follow through. A prime candidate for this lapse is my younger brother. My younger brother had a little bit of a temper growing up so of course he was instructed to use the counting method. My brother simply saw it as a preliminary step before he would wildly throw haymakers. To this day, I have never heard anyone count to ten as fast or with such focused rage as my 8yr old brother. Obviously, everyone knows a person like this; a person who gets wrapped up in the moment and has a hard time staying within themselves. With the commonality of this raging person comes an understanding of what will calm them down. “Joey is mad he didn’t get a second slice of pizza” “oh just throw him a bread stick, he’ll be fine.”  “Laurie is upset her favorite contestant on American idol got voted off.” “Just put on her soaps she will be fine.” “Tony is pissed the Patriots took 6 offensive lineman in the draft and no linebackers.” “Oh just rub his tummy, he’ll be fine.” People have certain things that will make them feel better, and it simply takes the manipulation of these things to develop coping skills.

When I begin discussing coping skills with children, there are a couple questions I make sure I ask. The first is always if they have coping skills already. If they do, I assess the effectiveness of the coping skill. Coping skills can be ineffective because they are not suited to the child or they simply are overused and thus become “old” or “boring.” After talking about current coping skills, or lack thereof, I move into new coping skills and avenues where skills can come from. I put an emphasis on having the child direct the conversation because it is their skill and they should feel ownership of it. Music, sports and art are the three main avenues where coping skills are generated from. Listening to a favorite CD or writing a song is a great way of dealing with emotions for kids who love music. Anything from playing pick up basketball to simply throwing a tennis ball is effective for kids who enjoy sports.  Simple drawing or photography could be the secret to an artistic child dealing with a tough situation. When trying to develop new coping skills there are two main rules to follow: will it help and is it interesting or fun? A lot of things are one or the other, but the best coping skills are both. It must be effective enough to keep someone from escalating and also interesting enough to be utilized when things are not going well. The point is that although coping skills sound clinical and regimented, they are meant to be soothing and supportive. Anyone can come up with coping skills, it’s just a matter of being honest with yourself and having some creativity. If you have a hard time being honest with yourself and are not creative, you could always just count to ten.

Christopher Curran, MA

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A Family is What YOU Make It

January 11, 2012 1 comment

Families are constantly evolving. They adapt to their environments and cope with change to the best of their ability to fulfill the demands of their surroundings.  Coping is typically synonymous with handling demanding situations in a positive way. However, this is not true. Coping simply refers to how an individual or group can manipulate the external world and internal drives to create and maintain structure, stability, and consistency in their lives. Sometimes, families cope with situations in a negative way that can create patterns that are more harmful overtime. As these maladaptive patterns create more difficulty amongst family members, the dynamic can drastically spiral out of control before anyone realizes it. Think of a life raft wading through the ocean. The ocean, with its current, manipulates the direction of the vessel. The raft then copes by gliding itself along the easiest path, creating a push in a particular direction. However, unchecked, the raft can drastically veer off course and place the travelers in a more dangerous predicament, further out to sea.

Given the challenges that life can bring, a family can become easily overwhelmed by trying to correct their course and move in a more positive direction. How do we go about doing this? It is easy for family members to point at the parents for perhaps not being as involved in the family as the rest may wish. It is easy for parents to blame their child for acting out behaviorally, or for getting low grades in school. It is easy to blame the family for not spending every night eating dinner together at the dinner table.  Then again, how many people have tried addressing these concerns, only to have an even bigger blowout? Placing blame and pointing fingers should not be where we look to start to move our families forward.

There is a simple starting point, a foundation builder, which is continuously overlooked. So obvious, however, that the answer is hidden in plain sight. In order to know where to begin, you must know where to start. So before you try and pinpoint all of the negative things that are bugging you about your family, try this:

Define what a family means to you. Start there. Define what is important to you in a family, in your family. What are your family values? Is it important that everyone sits down and eats dinner at the table; or are you content with TV dinners while watching CSI? What does the perfect family look like to you? What needs to happen to make you feel good about where your family is in relation to your ideals?

It is easy for others to tell you what to value in a family. Over the last 50 years, TV and movies have evolved from “Leave it to Beaver” to “Full House” to “Modern Family”; each decade depicting how the typical family should look and act. Why should you have to follow the mainstream definition? Look at what is important to you, because, let’s face it, TV controls enough of our lives as it is.

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A Teenage Ticking Timebomb

January 9, 2012 1 comment

When a person is asked what their most troubling time in their life was, it may take them a bit of time to decide. Was it that time they watched an ailing relative lose a battle with a sickness, or hearing they didn’t get into the college they wanted to? Maybe it was their first break up or getting into that habit of going to the gym. However, if you ask a parent of a difficult teenager, chances are the struggles they have experienced with their child are somewhere on the list. For a lot of parents, one of the hardest things to do is to establish the balance between safety and happiness for their child. The way parents walk this line has been examined by those in the field of psychology for decades and has been broken down into four major subsets.
Authoritarian parents are very strict and expect their word to be law. Authoritative parents have expectations, but where the authoritarian parents unyielding, authoritative parents explain the reasons for their expectations and are more understanding in dealing with their children. The third style of parenting is the permissive style, which puts power in the child’s hands and promotes the child to make their own decisions as a way of learning. The final style is uninvolved, which is essentially permissive without any concern for the child’s well being. Most believe that authoritative parenting works best, but it depends on the child. Although these styles are great mission statements for parents, they don’t really explain how to deal with every situation. Many parents try numerous tips and tricks in order to reach their teenager, but sometimes the easiest tactic is one that goes unnoticed.
As I stated in a previous blog, one of the major tools I use in working with teens is making a connection with them, which can also be applied to parenting. Making connections is integral in having a relationship with a teenager, and it is difficult for parents because they are often the most hated, unfair and selfish people on the planet, in the eyes of their children. Where a lot of parents go wrong is trying to force a connection with their teen; they will insert themselves into areas where teens are working their best to define themselves as individuals. If a teen shuts the door on a topic, don’t try to force your way in, look for another option. When your teen comes to you in one of those rare moments of hormone clarity and asks about something, jump on it. Although it could go back to fire and brimstone in mere minutes, that opening could provide the basis for a connection in the future. Another tip is to not bring up that connection in an argument. If “Eric” comes home in all his gothic glory complaining about how you placed a daily text limit of 300 on him and it’s unfair, don’t bring up the weekly chess match you share as a defense for you being a good parent. You are a good parent and bringing it up only poisons the connection in “Eric’s” dark, heavily mascara-ed eyes.
Connecting with teens is not an easy feat. It’s difficult to find a consistent interest to share with your teen because it’s hard for your teen to find a consistent interest themselves. One second, the Allman brothers are the greatest band ever, the next second Slayer is the human embodiment of pure awesomeness, only to be outdone by Lady Gaga a week later. This constant fluctuation is what allows teens to grow into well rounded adults. So when you see your daughter walking around town with highlighter green hair, a lip ring and gauges in her ears, don’t freak out and think that it’s the first step to her joining the circus. Instead, think of it being the first step to becoming a world renowned surgeon, because obviously she doesn’t get squeamish around needles.
Christopher Curran M.A.

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