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COUN 5364 -Graduate Theories Of Counseling - Final Exam
Terms in this set (103)
Founder of choice theory, the essence of reality therapy, now taught all over the world, is that we are all responsible for what we choose to do.
(1) Director of the Center for Reality Therapy
(2) Extended the theory and practice of reality therapy with his conceptualization of the WDEP system.
The difference between Choice Theory and Reality Therapy?
(1) Reality Therapy is a term used to describe the counselor and client's work together; Choice Theory is the theoretical construct which guides such work. It is a belief system based on an integration of psychology, behavior, systems, and genetics. I usually think of these as "bookends" and note I need both all of the time.
(2) Reality Therapy is the vehicle through which we are able to apply Choice Theory concepts. In a nutshell, Reality Therapy is comprised of the following questioning loop--What do I/you want? (Refers to Quality World), What am I/are you doing? (Refers to Total Behavior), Is it working? (Evaluation/Processing) and What else can I/you do? (Reorganization of our Behavioral System). Via the Reality Therapy loop, we are always investigating new ways to meet our needs.
What are the five needs addressed in Choice Theory?
(1) The need to survive
(2) The need to belong
(3) The need to gain power
(4) The need to be free
(5) The need to have fun
1. Choice therapy teaches that we do not satisfy our needs directly. What we do, beginning shortly after birth and continuing all our lives, is to keep close track of anything we do that feels very good. We store information inside our minds and build a file of wants, called our quality world, which is at the core of our life.
2. It is our personal world, the world we would like to live in if we could.
3. It is completely based on our wants and needs, but unlike the needs, which are general, it is very specific.
4. The quality world consists of specific images of people, activities, events, beliefs, possessions, and situations that fulfill our needs
5. Our quality world is like a picture album.
1. We develop an inner picture album of specific wants as well as precise ways to satisfy these wants.
2. We are attempting to behave in a way that gives us the most effective control over our lies
3. Some pictures may be blurred, and the therapist's role is to help the client clarify them.
4. Pictures exists in priority for most people, yet clients may have difficulty identifying their priorities.
(1) Teaches that all behavior is made up of four inseparable but distinct components—acting, thinking, feeling, and physiology—that necessarily accompany all of our actions, thoughts, and feelings.
What are the four components of total behavior?
(3) feeling, and
Why does Choice Theory use verbs (e.g., angering) instead of nouns (e.g., anger)?
(1) Glasser says that to speak of being depressed, having a headache, being angry, or being anxious implies passivity and lack of personal responsibility, and it is inaccurate.
(2) It is more accurate to think of these as parts of total behaviors and to use the verb forms to describe them.
(3) It is more accurate to think of people depressing or angering themselves rather than being depressed or being angry.
How is contemporary RT more relationally focused than in the past?
(1) Focuses on the authentic encounter between therapist and client
(2) Therapy relationship as a key factor in treatment success
(3) Relationship characterized by kindness, connection, and a genuine desire to help the client combined with teaching choice theory principles.
(4) Emphasis on connection
What are the key underlying characteristics of reality therapy?
(1) Emphasize choice and responsibility
(2) Reject transference
(3) Keep the therapy in the present
(4) Avoid focusing on symptoms
(5) Challenge traditional views of mental illness
What are the goals of RT?
(1) A primary goal of contemporary reality therapy is to help clients get connected or reconnected with the people they have chosen to put in their quality world (To help people become more effective in meeting all of their psychological needs)
(2) In addition to fulfilling this need for love and belonging, a basic goal of reality therapy is to help clients learn better ways of fulfilling all of their needs, including achievement, power or inner control, freedom or independence, and fun (To enable clients to get reconnected with the people they have chosen to put into their quality worlds and teach clients choice theory.)
What are characteristics and behaviors of a reality therapist?
(1) Therapy is often considered as a mentoring process in which the therapist is the teacher and the client is the student.
(2) Reality therapists teach clients how to engage in self-evaluation, which is done by raising the question, "Is what you are choosing to do getting you what you want and need"
(3) The role of the therapist is to challenge client to examine what they are doing.
(4) Reality therapists assist clients in evaluating their own behavioral direction, specific actions, wants, perceptions, level of commitment, possibilities for new directions, and action plans.
(5) The job of the therapists is to convey the idea that no matter how bad things are, there is hope.
(CONT.) What are characteristics and behaviors of a reality therapist?
The therapeutic relationship:
(1) A fundamental task is for the therapist to create a good relationship with the client.
(2) Therapists are then able to engage clients in an evaluation of all their relationships with respect to what they want and how effective they are in getting this.
(3) Therapists find out what clients want, ask what they are choosing to do, invite them to evaluate present behavior, help them make plans for change, and get them to make a commitment.
(4) The therapist is a client's advocate, as long as the client is willing to attempt to behave responsibly.
What are the clients' responsibilities in the process of RT?
(1) Clients are not expected to backtrack into the past or get sidetracked into talking about symptoms.
(2) Neither will much time be spent talking about feelings.
(3) They can expect to begin to use what they are taught in their life.
What is meant by "the cycle of counseling"?
(1) The practice of reality therapy can best be conceptualized as the cycle of counseling, which consists of two major components
(a) Creating the counseling environment
(b) Implementing specific procedures that lead to changes in behavior.
What is the WDEP System?
(1) The WDEP System assists people in satisfying their basic needs.
(2) Each of the letters refers to a cluster of strategies:
(a) W = wants, needs and perceptions
(b) D = direction and doing
(c) E = self-evaluation
(d) P = planning
What occurs in the WANTING phase of the WDEP process?
WANTING - exploring client's wants and perceptions (i.e., what they want from the world around them and how hard they are willing to work to satisfy their wants). Also, examine how they perceive themselves in the world as well as what they can control and not control.
What occurs in the DOING phase of the WDEP process?
DOING - the counselor helps clients describe their choices, their self-talk (e.g., "even though my choices are ineffective, I'll continue to do the same thing"), and their feelings such as hurt, fear, anger, depression, and many others.
What occurs in the EVALUATING phase of the WDEP process?
EVALUATING - Self-evaluation (the cornerstone in the practice of Reality Therapy)
(1) Self-evaluation questions:
(a) Is what you're doing helping or hurting?
(b) Is what you want realistically attainable?
(c) Does your self-talk help or impede need satisfying choices?
What occurs in the PLANNING phase of the WDEP process?
PLANNING - Much of the significant work of the counseling process involves helping clients identify specific ways to fulfill their wants and needs.
a) Once clients determine what they want to change, they are generally ready to explore other possible behaviors and formulate in action plan.
b. Plans should be SAMIC
iv. Immediate, and Involved
v. Controlled by the planner
What are key strengths of RT from a multicultural perspective?
(1) Focus is on clients making their own evaluation of behavior (including how they respond to their culture).
(2) Through personal assessment clients can determine the degree to which their needs and wants are being satisfied.
(3) The can find a balance between retaining their down ethic identity and integrating some of the vales and practices of the dominant society.
What are key shortcomings of RT from a multicultural perspective
(1) This approach stresses taking charge of one's own life, yet some clients are more interested in changing their external environment.
(2) Counselor needs to appreciate the role of discrimination and racism and help clients deal with social and political realities.
What are the overall key contributions of RT?
(1) This is a positive approach with an action orientation that relies on simple and clear concepts that are easily grasped in many helping professions.
(2) It can be used by teachers, nurses, ministers, educators, social workers, and counselors.
(3) Due to the direct methods, it appeals to many clients who are often seen as resistant to therapy.
(4) It is short-term approach that can be applied to a diverse population, and it has been a significant force in challenging the medical model of therapy.
What are the overall key limitations of RT?
(1) This approach stresses taking charge of one's own life, yet some clients are more interested in changing their external environment.
(2) Counselor needs to appreciate the role of discrimination and racism and help clients deal with social and political realities.
(3) 1) In working with clients from certain ethics groups, RT may not take fully into account some very real environmental forces that operate against them in their everyday lives.
(4) 2) Some RT therapist may make the mistake of too quickly or too forcefully stressing the ability of their clients to take charge of their lives.
(5) 3) Some clients are very reluctant to directly verbally express what they need. Their culture and norms may not reinforce them in assertively asking for what they want.
Who are the main influences/developers of contemporary FT?
Jean Baker Miller
Carolyn Zerbe Enns
Olivia M. Espin
iv) Laura S. Brown
Jean Baker Miller
Dr. Miller collaborated with diverse groups of scholars and colleagues on the development of relational-cultural theory. She made important contributions toward expanding this theory and exploring new applications to complex issues in psychotherapy and beyond, including issues of diversity, social action, and workplace change.
Carolyn Zerbe Enns
Her most recent efforts are directed toward articulating the importance of multicultural feminist therapy, exploring the practice of feminist therapy around the world (especially in Japan), and writing about multicultural feminist pedagogies.
Olivia M. Espin
specializes in counseling and therapy with women from different cultures and Latin American Studies. She is a pioneer in the theory and practice of feminist therapy with women from different cultural backgrounds and has done extensive research, teaching, and training on multicultural issues in psychology.
Laura S. Brown
a founding member of the feminist Therapy Institute. Dr. Brown has made particular contributions to thinking about ethics and boundaries, and the complexities of ethical practice in small communities. Her current interests include feminist forensic psychology and the application of feminist principles to treatment of trauma survivors.
What are the main differences between the second and third waves of feminism?
(1) Second wave of feminism is identified by four enduring feminist philosophies: liberal, cultural, radical, and socialist feminism.
(2) Third wave feminism embraces diversity with its inclusion of women of color, lesbians, and the postmodern and constructivist viewpoints espoused by many of the most recent generation of feminist women. New developments in feminism also include global and international perspectives.
How does feminist theory differ from traditional theories in regard to human nature and personality development?
(1) Human Nature - Many of the traditional theories grew out of a historical period in which social arrangements were assumed to be rooted in one's biologically based gender. Men were assumed to be the norm and were the only group studied or understood within the normative construct. It was also assumed that because of biological gender differences women and men would pursue different directions if life.
(a) Worell and Remer are critical of traditional theories for being
(i) androcentric (using male-oriented constructs to draw conclusions about human, including female, nature),
(ii) gendercentric (proposing two separate paths of development for women and men,
(iii) heterosexist (viewing a heterosexual orientation as normative and desirable and devaluing lesbian, gay male, and bisexual orientations),
(iv) deterministic (assuming that personality patterns and behavior are fixed at an early stage of development), and
(v) Having an intrapsychic orientation (attributing behavior to internal causes, which often results in blaming the victim and ignoring sociocultural ad political factors).
(b) Worell and Remer describe the constructs of feminist theory as being gender fair, flexible-multicultural, interactionist, and life-span-oriented.
(i) Gender-fair approaches explain differences in the behavior of women and men in terms of socialization processes rather than on the basis of our "innate" natures, thus avoiding stereotypes in social roles and interpersonal behavior.
(ii) A flexible-multicultural perspective uses concepts and strategies that apply equally to individuals and groups regardless of age, race, culture, gender, ability, class, or sexual orientation.
(iii) The interactionist view contains concepts specific to the thinking, feeling, and behaving dimensions of human experience and accounts for contextual and environmental factors.
(iv) A life-span perspective assumes that human development is a lifelong process and that personality and behavioral changes can occur at any time rather than being fixed during early childhood.
(2) Personality Development -
(a) Feminist therapist emphasize that societal gender-role expectations profoundly influence a person's identity from the moment of birth and become deeply ingrained in adult personality.
(i) Gilligan recognized that theories of moral development were based almost exclusively on research with males. Women's sense of self and morality is based on issues of responsibility and care for other people and is embedded in a cultural context. Concepts of connectedness and interdependence—virtually ignored in male-dominated development theories—are central to women's development
(ii) In feminist therapy women's relational qualities are seen as strengths and as pathways for healthy growth and development instead of being identified as weaknesses or defects.
What is relational-cultural theory?
(1) The founding scholars of relational cultural theory suggest that a woman's sense of identity ad self-concept develop in the context of relationships.
(2) According to Bern, men, as the dominant group, define and determine the roles that women play. Because women occupy a subordinate position, to survive and thrive in society they must be able to interpret the needs and behaviors of the dominant group. To that end, women have developed "women's intuition" and have included in their gender schema an internalized belief that women are less important than men.
(3) Understanding and acknowledging internalized oppression is central in feminist work.
(4) Women and men who reject traditional roles are saying that they are entitled to express the complex range of characteristics that are appropriate for different situations and that they are open to their vulnerability as human beings
What are the six core principles of FT according to your text? Differentiate between each.
(1) The personal is political
(2) Commitment to a social change
(3) Women's and girl's voices and ways of knowing are valued and their experiences are honored
(4) The counseling relationship is egalitarian
(5) A focus on strengths and a reformulated definition of psychological distress
(6) All types of oppression are recognized
The personal is political
This principle is based upon the assumption that the personal or individual problems that individuals bring to counseling originate in a political and social context.
Commitment to a social change
Feminist therapy aims not only for individual change but for social change. The goal is to advocate a different vision of societal organization that frees both women and men from the constraints imposed by gender-role expectations.
Women's and girl's voices and ways of knowing are valued and their experiences are honored
Women's perspectives are considered central I understanding their distress. Traditional therapies that operate on androcentric norms compare women to the male norm and find them deviant.
The counseling relationship is egalitarian
Attention to power is central in feministic therapy. Feminist therapists recognize that there is a power imbalance in the therapeutic relationship, so they strive for an egalitarian relationship, keeping in mind that clients are the experts on their own lives. The intent is to shift power and privilege to the voices and experiences of those who come to counseling and away from those who deliver it.
A focus on strengths and a reformulated definition of psychological distress
Feminist therapy has a "conflicted and ambivalent relationship" with diagnostic labeling and the "disease models" of mental illness. Psychological distress is reframed, not as disease but as a communication about unjust systems. When contextual variables are considered, symptoms can be reframed as survival strategies. Feminist therapists talk about problems in the context of living and coping skills rather than pathology.
All types of oppression are recognized
Clients can best be understood in the context of their sociocultural environments. Feminist therapists acknowledge that social and political inequalities have a negative effect on all people. Feminist therapists work to help individuals make changes in their lives, but they also are committed to working toward social change that will liberate all members of society from stereotyping, marginalization, and oppression.
What are the goals of FT?
(a) At the individual level, feminist therapist work to help females and males recognize claim, and embrace their personal power.
(b) Feminist therapists also work toward reinterpreting women's mental health. Their aim is to de-pathologize women's experiencing and to influence society so that female voices are honored and relational qualities are valued.
(a) To bring about transformation both in the individual client and in society
(b) To assist clients in recognizing, claiming, and using their personal power to free themselves from the limitations of gender-role socialization.
(c) To confront all forms of institutional policies that discriminate or oppress on any basis.
What are key characteristics and behaviors of a counselor using FT?
(1) The therapeutic relationship is based on empowerment and egalitarianism
(2) Therapists actively break down the hierarchy of power and reduce artificial barriers by engaging in appropriate self-disclosure and teaching clients about the therapy process
(3) Therapist actively focus on the power their clients have in the therapeutic relationship and make this part of their informed consent processes.
(4) Therapist encourage clients to identify and express their feelings, to become aware of the ways they relinquish power in relationships with others as a result of socialization or as a means for survival, and to make decisions with this knowledge as the basis.
(5) Therapists strive to create a collaborative relationship in which clients can become their own expert.
(6) Therapist work to demystify the counseling relationship by sharing with the client their own perceptions about what is going on in the relationship, by making the client an active partner in determining any diagnosis, and by making use of appropriate self-disclosure.
(7) A defining theme of the client-counselor relationship is the inclusion of clients in both the assessment and the treatment process, keeping the therapeutic relationship as egalitarian as possible.
What is the role of the client in FT?
(1) Clients are active participants in the therapeutic process.
(2) Appropriate self-disclosure is affirmed within feminist therapy.
(3) Feminist therapists do not restrict their practice to female clients; the relationship is always a partnership.
(4) The client will be the expert in determining what he or she needs and wants from therapy.
(5) Clients need to be prepared for major shifts in their way of viewing the world around them, changes in the way they perceive themselves, and transformed interpersonal relationships.
How does FT view diagnosis?
(1) Feminist therapist have been sharply critical of the DSM classification system, and research indicates that gender, culture, and race may influence assessment of clients' symptoms.
(2) From the perspective of feminist therapy, diagnostic criteria were established through a system that views male gender-role traits as "normative."
(3) The feminist approach emphasizes the importance of considering the gender-normative context of men and women's lives and points out that many symptoms can be understood as coping or survival strategies rather than as evidence of pathology.
(4) Using the DSM-IV-TR, depression is diagnosed twice as often in women as in men. Feminist therapist believe women have many more reasons to experience depression than do men, and they often frame depression as a normative experience for women.
(5) Perhaps the potentially most damaging diagnosis is borderline personality disorder, a diagnosis usually assigned to and critical of women.
(6) Feminist therapists do not refuse to use the DSM-IV-TR in this age of managed care and the prevalence of the medical model of mental health, but therapists who participate in the process of diagnosis have a responsibility to challenge the current diagnostic system.
(7) Diagnosis, when used, results from a shared dialogue between client and therapist.
(1) Enns and Byars-Winston point out that many of the strategies of multi-cultural feminist therapy are part of the general umbrella of empowerment, which enables people to see themselves as active agents on behalf of themselves and others.
(2) At the heart of feminist strategies is the goal of empowering the client. The process of feminist therapy begins with the informed consent process, referred to as "empowerment consent." Informed consent offers a place to begin a relationship that is egalitarian and collaborative.
A hallmark of feminist therapy, gender-role analysis explores the impact of gender-role expectations on the client's psychological well-being and draws upon this information to make decisions about future gender-role behaviors.
(1) Using this technique, the therapist responds to the client's concern b placing it in the context of society's role expectations for women.
(2) The aim is to provide the client with insight into the ways social issues are affecting her.
(3) By placing the client's concern in the context of societal expectations, the therapist gives the client insight into how these expectations have affected her psychological condition ad have contributed to her feeling anxious about judgment from others.
(1) Groups share a common denominator emphasizing support for the experience of women.
(2) Groups can provide women with a social network, decrease feelings of isolation, create an environment that encourages sharing of experiences, and help women realize that they are not alone in their experiences.
(3) Groups provide a supportive context where women can share and begin to critically explore the messages they have internalized about their self-worth and their place in society.
(1) Power analysis refers to the range of methods aimed at helping clients understand how unequal access to power and resources can influence personal realities.
(2) Together therapists and clients explore how inequities or institutional barriers often limit self-definition and well-being.
(3) Interventions are aimed at helping the client learn to appreciate herself as she is, regain her self-confidence based on the personality attributes she possesses, and set goals that will be fulfilling to her within the context of her cultural values.
(1) Social action, or social activism, is an essential quality of feminist therapy.
(2) As clients become more grounded in their understanding of feminism, therapist may suggest that clients become involved in activities such as volunteering at a rape crisis center, etc. Participating in such activities can empower clients and help them see the link between their personal experiences and the sociopolitical context in which they live.
How might FT be useful for working with male clients?
(1) Feminist therapy can be practiced with male clients.
(2) The principles and practices of feminist psychotherapy are useful in working with male clients.
(3) Social mandates about masculinity such as restrictive emotionality, overvaluing power and control, the sexualization of emotion, and obsession with achievement can be limiting to males.
(4) Any presenting issue can be dealt with from a feminist perspective.
What are key strengths of FT from a multicultural perspective?
(1) Focus is on both individual change and social transformation.
(2) A key contribution is that both the women's movement and the multicultural movement have called attention to the negative impact of discrimination and oppression for both women, and men.
(3) Emphasizes the influence of expected cultural roles and explores client's satisfaction with and knowledge of these roles.
What are key shortcomings of FT from a multicultural perspective?
(1) This model has been criticized for its bias toward the values of White, middle-class, heterosexual women, which are not applicable to many other groups of women nor to men.
(2) Therapists need to assess with their clients the price of making significant personal change which may result in isolation from extended family as clients assume new roles and make life changes.
What are key contributions of FT?
(1) The feminist perspective is responsible for encouraging increasing members of women to question gender stereotypes and to reject limited views of what a woman is expected to be.
(2) It is paving the way for gender-sensitive practice and bringing attention to the gendered uses of power in relationships.
(3) The unified feminist voice brought attention to the extent and implications of child abuse, incest, rape, sexual harassment, and domestic violence.
(4) Feminist principles and interventions can be incorporated in other therapy approaches.
What are key limitations of FT?
(1) A possible limitation is the potential for therapists to impose a new set of values on clients—such as striving for equality, power in relationships, defining oneself, freedom to pursue a career outside the home, and the right to an education.
(2) Therapists need to keep in mind that clients are their own best experts, which means it is up to them to decide which values to live by.
Who are some of the founders of contemporary postmodern therapies?
(1) Insoo Kim Berg
(2) Steve de Shazer
(3) Michael White
(4) David Epston
Insoo Kim Berg
co-developer of the solution-focused approach.
Steve de Shazer
one of the pioneers of solution-focused brief therapy
cofounder with David Epston, of the narrative therapy movement
one of the co-developers of narrative therapy
What are the main tenets of postmodern/social constructivism?
(1) Postmodernist, believe that realities do not exist independent of observational processes. Social constructionism is a psychological expression of this postmodern worldview; it values the client's reality without disputing whether it is accurate or rational.
(2) The collaborative partnership in the therapeutic process is considered more important than assessment or techniques.
(3) In social constructionism the therapist disavows the role of expert, preferring a more collaborative or consultative stance.
(4) Social constructionist theory is grounded on four key assumptions which form the basis for the difference between postmodernism and traditional psycho-logical perspectives
(a) Social constructionist theory invites a critical stance toward taken-for-granted knowledge.
(b) Social constructionists believe the language and concepts we use to generally understand the world are historically and culturally specific
(c) Social constructionists assert that knowledge is constructed through social processes. What we consider to be truth" is a product of daily interactions between people in daily life.
(d) Negotiated understandings are considered to be practices that affect social life rather than being abstractions from it.
What is meant by a counselor taking a not-knowing position when working with clients?
(1) In the "not-knowing position", therapists still retain all of the knowledge and personal, experiential capacities they have gained over years of living, but they allow themselves to enter the conversation with curiosity and with an intense interest in discovery.
(2) The aim is to enter a client's world as fully as possible.
(3) Clients become the experts who are informing and sharing with the therapist the significant narratives of their lives.
(4) The not-knowing position is empathic and is most often characterized by questions that "come from an honest, continuous therapeutic posture of not understanding too quickly."
What is Solution-focused brief therapy (SFBT)?
(1) Solution-focused brief therapy is a future-focused, goal-oriented therapeutic approach to brief therapy developed initially by Steve de Shazar and Insoso Kim. SFBT emphasizes strengths and resiliencies of people by focusing on exception their problems and their conceptualized solutions.
(2) SBFT differs from traditional therapies by eschewing the past in favor of both the present and the future.
(3) Therapists focus on what is possible, and they have little or no interest in gaining an understanding of how the problem emerged.
(4) Behavior change is viewed as the most effective approach to assisting people in enhancing their lives.
(5) In SFBT, clients choose the goals they wish to accomplish; little attention is given to diagnosis, history taking, or exploring the emergence of the problem.
(a) Positive orientation - SFBT is grounded on the optimistic assumption that people are healthy ad competent and have the ability to construct solutions that can enhance their lives.
(b) Looking for what is working - SFBT has parallels with positive psychology, which concentrates on what is right and what is working for people rather than dwelling on deficits, weaknesses, and problems.
(c) The emphasis of SFBT is to focus on what is working in clients' lives, which stands in stark contrast to the traditional models of therapy that tend to be problem-focused.
(d) Basic Assumptions guiding practice - Walter and Peller think of solution-focused brief therapy as a model that explains how people change and how they can reach their goals.
What are the goals of SFBT?
(1) The SFBT therapist believes people have the ability to define meaningful personal goals and that they have the resources required to solve their problems.
(2) Goals are unique to each client and are constructed by the client to create a richer future.
(3) SF Therapist concentrate on small, realistic, achievable changes that can lead to additional positive outcomes.
(4) SF offers several forms of goals: changing the viewing of a situation or a frame of reference, changing the doing of the problematic situation, and tapping client strengths and resources.
What are characteristics and behaviors of a counselor using SFBT?
(1) Much of what the therapeutic process is about involves clients' thinking about their future and what they want to be different in their lives.
(2) FBT therapists adopt a not-knowing position to put clients in the position of being the experts about their own lives.
(3) Therapists do not assume that by virtue of their expert frame of reference they know the significance of the client's actions and experiences.
(4) The therapist's task is to point clients in the direction of change without dictating what to change.
(5) Therapists strive to create a climate of mutual respect, dialogue, ad affirmation in which clients experience the freedom to create, explore, and coauthor their evolving stories.
(6) A key therapeutic task consists of helping clients imagine how they would like life to be different and what it would take to make this transformation happen.
(7) One of the functions of the therapist is to ask questions and, based on the answer, generate further questions.
What is the role of the counselor-client relationship SFBT?
(1) The quality of the relationship between therapist and client is a determining factor in the outcomes of SFBT, so relationship building or engagement is a basic step in SFBT.
(2) The therapeutic process works best when clients become actively involved, when they experience a positive relationship with the therapist, and when counseling addresses what clients see as being important.
(3) Three types of relationships may develop between therapists and their clients:
(a) Customer - client and therapist jointly identify a problem and a solution to work toward.
(b) Complainant - client describes a problem but is not able or willing to assume a role in constructing a solution, believing that a solution is dependent on someone else's actions.
(c) Visitor - the client comes to therapy because someone else thinks the client has a problem.
(1) Simply scheduling an appointment often sets positive change in motion.
(2) These changes cannot be attributed to the therapy process itself, so asking about them tends to encourage clients to rely less on their therapist and more on their own resources to accomplish their treatment goals.
The miracle question
(1) Therapy goals are developed by using what de Shazer calls the miracle question, which is a main SFBT technique.
(2) The therapist asks, "If a miracle happened and the problem you have was solved overnight, how would you know it was solved, and what would be different?"
(3) This question has a future focus in that clients can begin to consider a different kind of life that is not dominated by a particular problem.
(4) This intervention shifts the emphasis from both past and current problems toward a more satisfying life in the future.
(1) Solution-focused therapists also use scaling questions when change in human experiences are not easily observed, such as feelings, moods, or communication, and to assist clients in noticing that they are not completely defeated by their problem.
(2) Scaling questions enable clients to pay closer attention to what they are doing and how they can take steps that will lead to the changes they desire.
Formula First Session Task
(1) The formula first session task (FFST) is a form of homework a therapist might give clients to complete between their first and second sessions.
(2) The therapist might say, "Between now and the next time we meet, I would like you to observe, so that you can describe to me next time, what happens in your marriage that you want to continue to have happen."
(3) This kind of assignment offers clients hope that change is inevitable. It is not a matter of if change will occur, but when it will happen.
(4) This intervention tends to increase clients' optimism and hope about their present and future situation.
(5) The FFST technique emphasizes future solutions rather than past problems.
(6) FFST intervention can be used after clients have had a chance to express their present concerns, views, and stories.
(7) It is important that clients feel understood before they are directed to make changes.
Therapist Feedback to clients
(1) Solution-focused practitioners generally take a break of 5-10 minutes toward the end of each session to compose a summary message for clients.
(2) During this break therapists formulate feedback that will be given to clients after the break.
(3) There are three basic parts to the structure of the summary feedback
(a) Compliments - genuine affirmations of what clients are already doing that is leading toward effective solutions.
(b) A bridge - links the initial compliments to the suggested tasks that will be given. This bridge provides the rationale for the suggestions.
(c) Suggesting a task. - can be considered homework.
(i) Observational tasks ask clients to simply pay attention to some aspect of their lives.
(ii) This self-monitoring process help clients note the differences when things are better, especially what was different about the way they thought, felt, or behaved.
(iii) Behavioral tasks require that clients actually do something the therapist believes would be useful to them in constructing solutions.
(iv) A therapist's feedback to clients addresses what they need to do more of and do differently in order to increase the chances of obtaining their goals.
1. From the very first solution-focused interview, the therapist is mindful of working toward termination.
2. Once clients are able to construct a satisfactory solution, the therapeutic relationship can be terminated.
3. The initial goal-formation question that a therapist often ask is, "What needs to be different in your life as a result of coming here for you to say that meeting with me was worthwhile?"
4. Prior to ending therapy, therapists assist clients in identifying things they can do to continue the changes they have already made into the future.
5. The ultimate goal of solution-focused counseling is to end treatment.
6. Because this model of therapy is brief, present-centered, and addresses specific complains, it is very possible that clients will experience other developmental concerns at a later time.
Application to Group Counseling
1. The solution-focused group practitioner believes that people are competent, and that given a climate where they can experience their competency, they are able to solve their own problems, enabling them to live a richer life.
2. From the beginning, the facilitator sets a tone of focusing on solutions in which group members are given an opportunity to describe their problems briefly.
3. The group leader works with members in developing well-formed goals as soon as possible.
4. The facilitator asks members about times when their problems were not present or when the problems were less severe.
5. The art of questioning is a main intervention used in solution-focused groups.
6. Solution-focused group counseling offers a great deal of promise for practitioners who want a practical and time-effective approach to interventions in school settings.
What is narrative therapy (NT)?
(1) Individuals construct the meaning of life in interpretive stories, which are ten treated as "truth."
(2) Therapy is, in part, a reestablishment of personal agency from the oppression of external problems and the dominant stories of larger systems.
(3) Focus of Narrative Therapy -
(a) The narrative therapy approach involves adopting a shift in focus from most traditional theories.
(b) Therapists are encouraged to establish a collaborative approach with a special interest in listening respectfully to clients stores; to search for times in clients' lives when they were resourceful; to use questions as a way to engage clients and facilitate their exploration; to avoid diagnosing and labeling clients or accepting a totalizing description based on a problem; to assist clients in mapping the influence a problem has had on their lives; and to assist clients in separating themselves from the dominant stories they have internalized so that space can be opened for the creation of alternative life stories.
(4) The role of stories -
(a) We live our lives by stories we tell about ourselves and that others tell about us.
(b) These stories actually shape reality in that they construct and constitute what we see, feel, and do.
(c) The stories we live by grow out of conversations in a social and cultural context.
(d) Therapy clients do not assume the role of pathologized victims who are leading hopeless and pathetic lives; rather, they emerge as courageous victors who have vivid stories to recount.
(e) The stories not only change the person telling the story, but also change the therapist.
(5) Listening with an open-mind -
(a) All social constructionist theories emphasize listening to clients without judgment or blame, affirming and valuing them. Narrative practice goes further in deconstructing the system of normalizing judgment that are found in medical, psychological, and educational discourse.
(b) Normalizing judgment is any kind of judgment that locates a person on a normal curve and is used to assess intelligence, mental health, or normal behavior.
(c) Narrative practitioners might be said to invite people to pass judgment on the judgments that have been working them over.
(d) Narrative therapists make efforts to enable clients to modify painful beliefs, values, and interpretations without imposing their value systems and interpretations.
(e) They want to create meaning and new possibilities from the stories clients share rather than out of a preconceived and ultimately imposed theory of importance and value.
(f) During the narrative conversation, attention is given to avoiding totalizing language, which reduces the complexity of the individual by assigning an all-embracing single description to the essence of the person.
(g) The narrative perspective focuses on the capacity of humans for creative and imaginative thought, which is often found in their resistance to dominate discourse.
What are the goals of NT?
(1) A general goal of narrative therapy is to invite people to describe their experience in new and fresh language. In doing this, they open up new visas of what is possible.
(2) This new language enables clients to develop new meanings for problematic thoughts, feelings, and behaviors
(3) Narrative therapy almost always includes an awareness of the impact of various aspects of dominant culture on human life.
(4) Narrative practitioners seek to enlarge the perspective and focus and facilitate the discovery or creation of new options that are unique to the people they see.
What are characteristics and behaviors of a counselor using NT? Pg. 412
(1) Narrative therapists are active facilitators
(2) The concepts of care, interest, respectful curiosity, openness, empathy, contact, and even fascination are seen as a relational necessity.
(3) The not-knowing position, which allows therapists to follow, affirm, and be guided by the stories of their clients, creates participant-observer and process-facilitator roles for the therapist and integrates therapy with a postmodern view of human inquiry.
(4) A main task of the therapist is to help clients construct a preferred story line.
(5) Like the Solution-focused therapist, the narrative therapist assumes the client is the expert when it comes to what he or she wants in life.
(6) The narrative therapist tends to avoid using language that embodies diagnosis, assessment, treatment, and intervention.
(7) When it comes to the effective practice of narrative therapy, there are no set formulas or recipes to follow
What is the role of the counselor-client relationship NT?
(1) Narrative therapists place great importance on the values and ethical commitments a therapist brings to the therapy venture.
(2) Some of these attitudes include optimism and respect, curiosity and persistence, valuing the client's knowledge, and creating a special kind of relationship characterized by a real power-sharing dialogue.
(3) Collaboration, compassion, reflection, and discovery characterize the therapeutic relationship.
(4) Treating clients as experts in their own lives
(5) The therapist is interested in facilitating the articulation of the values and ethical commitment of the client.
(6) When a client has a limited perception of his or her capacities due to being saturated I problem thinking, it is the job of the therapist to elicit other strength-related stories to modify the client's perception.
Questions... and more questions -
(1) Narrative therapists use questions as a way to generate experience rather than to gather information.
(2) The aim of questioning is to progressively discover or construct the client's experience so that the client has a sense of a preferred direction.
(3) Therapists ask questions from a not-knowing position, meaning that they do not pose questions that they think they already know the answer to.
(4) Through the process of asking questions, therapists provide clients with an opportunity to explore various dimensions of their life situations.
(5) The questioning process helps bring out the unstated cultural assumptions that contribute to the original construction of the problem.
(6) The therapist is interested in finding out how the problems fist became evident, and how they have affected clients' views of themselves.
(7) Narrative therapist attempt to engage people in deconstructing problem-saturated stories, identifying preferred directions, and creating alternative stories that support these preferred directions.
Externalization and Deconstruction
(1) Narrative therapists believe it is not the person that is the problem, but the problem that is the problem.
(2) These problems are often products of the cultural world or of the power relations in which this world is located.
(3) Externalization is one process for deconstructing the power of a narrative.
(a) This process separates the person from identification with the problem.
(b) When clients experience the problem as being located outside of themselves, they create a relationship with the problem.
(c) Separating the problem from the individual facilitates hope and enables clients to take a stand against specific story lines, such as self-blame.
(4) The method used to separate the person from the problem is referred to as externalizing conversation, which opens up space for new stories to emerge.
(a) Externalizing conversations counteract oppressive, problem-saturated stories and empower clients to feel competent to handle the problems they face.
(i) Two stages of structuring externalizing conversations are (1) to map the influence of the problem in the person's life, and (2 to map the influence of the person's life back on the problem.
(b) It is important to identify instances when the problem did not completely dominate a client's life.
(i) This kind of mapping can help the client who is disillusioned by the problem see some hope for a different kind of life.
Search for Unique Outcomes
(1) In the narrative approach, externalizing questions are followed by questions searching for unique outcomes.
(2) The therapist talks to the client about moments of choice or success regarding the problem.
(3) This is done by selecting for attention any experience that stands apart from the problem story, regardless of how insignificant it might seem to the client.
(4) The therapist talks to the client about moments of choice or success regarding the problem.
(5) It is within the account of unique outcomes that a gateway is provided for alternative versions of a person's life.
(a) Questions that lead to the elaboration of preferred identity stories:
(i) What do you think this tells me about what you have wanted for your life and about what you have been trying for in your life?
(ii) How do you think knowing this has affected my view of you as a person?
(iii) Of all those people who have known you, who would be least surprised that you have been able to take this step in addressing your problem's influence in your life?
(iv) What actions might you commit yourself to if you were to more fully embrace this knowledge of who you are?
(b) Circular Questions (the development of unique outcome stories into solution stories)
(i) Now that you have reached this point in life, who else should know about it?
(ii) I guess there are a number of people who have an outdated view of who you are as a person. What ideas do you have about updating these views?
(iii) If other people seek therapy for the same reasons you did, can I share with them any of the important discoveries you have made?
Alternative stories and reauthoring
(1) The point in the narrative interview when clients make the choice of whether to continue to live by a problem-saturated story or create an alternative story.
(2) The therapist works with clients collaboratively by helping them construct more coherent and comprehensive stories.
Documenting the evidence
(1) Narrative practitioners believe that new stories take hold only when there is an audience to appreciate and support them.
(2) One technique for consolidating the gains a client makes is by writing letters.
(3) The letter that the therapist writes provide a record of the session and may include an externalizing description of the problem and its influence on the client, as well as an account of the client's strengths and abilities that are identified in a session.
(4) Letters can be read again at different times, and the story that they are part of can be re-inspired.
(5) The letter highlights the struggle the client has had with the problem ad draws distinctions between the problem-saturated story and the developing new and preferred story.
(6) Epston has developed a special facility for carrying on therapeutic dialogues between sessions through the use of letters.
(7) Letters documenting changes clients have achieved tend to strengthen the significance of the changes, both for the client and for others in the client's life.
Application to Group Counseling
Many of the techniques described in this chapter can be applied to group counseling.
What are key strengths of NT from a multicultural perspective
(1) Social constructionism is congruent with the philosophy of multiculturalism.
(2) With the emphasis on multiple realities and the assumption that what is perceived to be a truth is the produce of social construction, the postmodern approaches are a food fit with diverse worldviews.
(3) The second constructionist approach to therapy provides clients with a framework to think about their thinking and to determine the impact stories have on what they do.
(4) Narrative therapy is grounded in a sociocultural context, which makes this approach especially relevant for counseling culturally diverse clients.
(a) Narrative therapists operate on the premise that problems are identified within social, cultural, political, and relational contexts rather than existing within individuals.
(b) They are very much concerned with considering the specifications of gender, ethnicity, race, disability, sexual orientation, social class, and spirituality and religion as therapeutic issues.
(c) Therapy becomes a place to re-author the social constructions and identify narratives that clients are finding problematic.
(5) Narrative therapy is a relational and anti-individualistic practice.
(6) Therapist do not approach clients with a preconceived notion about their experience.
What are key shortcomings of NT from a multicultural perspective
(1) A potential shortcoming of the postmodern approaches pertains to the not-knowing stance the therapist assumes, along with the assumption of the client-as-expert.
(2) Individuals from many different cultural groups tend to elevate the professional as the expert who will offer direction and solutions for the person seeking help
(3) If the therapist is telling the client, "I am not really an expert, you are the expert, I trust in your resources for you to find solutions to our problems, then this may engender lack of confidence in the therapist.
What are key contributions of NT?
(1) The optimistic orientation of the postmodern approaches that rest on the assumptions that people are competent and can be trusted to use their resources in creating better solutions and more life-affirming stories.
(2) The narrative approach to counseling also tends to be based on brief methods.
(3) The non-pathologizing stance characteristic of practitioners with a social constructionist, solution-focused, or narrative orientation is a major contribution to the counseling profession.
(4) Brief therapy has been shown to be effective for a wide range of clinical problems.
(5) Studies that have compared brief therapies with long-term therapies have generally found no difference in outcomes.
(6) Outcome studies generally show that most clients receiving SFBT report accomplishing their treatment goals.
What are key limitations of NT?
(1) McKenzie and Monk express their concerns over those counselors who attempt to employ narrative ideas in a mechanistic fashion.
(a) They caution that a risk in describing a map of a narrative orientation lies in the fat that some beginners will pay more attention to following the map than they will to following the lead of the client. Subsequently, mechanically using techniques will not be effective.
(2) Although narrative therapy is based on some simple ideas, it is not a simple process.
What is meant by a family systems perspective?
(1) Family systems perspective = is that the client is connected to living systems.
(2) One central principle agreed upon by family therapy practitioners, regardless of their particular approach, is that the client is connected to living systems.
(3) Attempts at change are best facilitated by working with and considering the family or set of relationships as a whole.
(4) It is not possible to accurately assess an individual's concern without observing the interaction of the other family members, as well as the broader contexts in which the person and the family live.
(5) Family therapy perspectives call for a conceptual shift because the family is viewed as a functioning unit that is more than the sum of the roles of its various members.
(6) Actions by any individual family member will influence all the others in the family and the reactions will have a reciprocal effect on the individual.
How is this perspective different than one that focuses on the individual?
(1) Systemic therapists do not deny the importance of the individual in the family system, but they believe an individual's systemic affiliations and interactions have more power in the person's life than a single therapist could ever hope to have.
(2) By working with the whole family system, the therapist has a chance to observe how individuals act within the system and participate in maintaining the status quo; how the system influences (and is influenced by) the individual; and what interventions might lead to changes that help the couple, family, or large system as well as the individual expressing pain
(3) Rather than losing sight of the individual, family therapists understand the person as specifically embedded in larger systems.
What are the common themes that resonate across most family therapy approaches?
(1) The family as a whole is greater than the sum of its parts taken separately.
(a) The family maintains a collective identity that is different from the individual identities of each of its members.
(2) Why behavior occurs within the family is not the focus of a counselor working within a systems framework; the focus is on what, how, and when the behavior occurs.
(a) All behavior is communication, and communication is continuously occurring.
(b) It is important to attend to the two functions of interpersonal messages: content (factual information) and relationship (how the message is understood).
(c) The what of a message is conveyed by how it is delivered.
(d) Counselors practicing within a system context view the transactional patterns occurring within the family as the primary focus of counseling.
(3) The family is viewed as a system in which any change within one member affects the system as a whole and, reciprocally, affects each individual member.
(a) This idea, referred to as circular causality, indicates that events with a relationship context occur in a circular manner rather than in a linear one.
(4) A family commonly contains a number of coexisting subsystems.
(a) Subsystems are those parts of the overall system assigned to carry out particular functions or processes within the system as a whole
(b) The marital or partner dyad constitutes a subsystem, as does the mother-child, father-child, and child-child dyads.
(5) The ability of the family to modify its functioning to meet the changing demands of internal and external factors is known as morphogenesis.
(a) Morphogenesis usually requires a second-order change (the ability to make an entirely new response) rather than a first-order change (continuing to do more of the same things that have—or have not—worked previously)
(6) The family attempts to maintain stability and resist change through the process of homeostasis.
(a) When the balance of the system is disturbed, family members will seek to return to the previous level of balance or homeostasis by using internal and ongoing interactional mechanisms that maintain a balance of relationships.
(b) According to Goldenberg and Goldenberg, homeostasis is the family self-regulation efforts that result in a steady state, but the process of homeostasis is hardly a static one.
(c) Families may have to create a new balance by renegotiating relationships and altering existing family structures in order to accommodate family members' growth and change over time.
Know the key developers of the six family approaches in your text and be able to differentiate between the six approaches.
Jay Haley and Cloe Madanes
first psychologist of the modern era to do family therapy using a systematic approach.
(1) Brought this concept to the US in the form of family education centers.
(2) Conducted family counseling sessions in an open public forum, educating parents and professionals in greater numbers.
(3) Believed the problems of any one family were common to all others in the community.
one of the original developers of mainstream family therapy.
(1) He believed families could best be understood when analyzed from a three-generational perspective because patterns of interpersonal relationships connect family members across generations.
(2) Bowen's emphasis on a multi-generational perspective led to the development of genograms, family life cycle-development, and a comprehensive focus on a multicultural perspective in family therapy.
developed conjoint family therapy, a human validation process model that emphasizes communication and emotional experiencing.
(1) Like Bowen, she used an intergenerational model, but she worked to bring family patterns to life in the present through sculpting and family reconstructions.
(2) The core of Satir's model relied on the power of congruence to help family members communicate with emotional honesty.
(3) Her presence with people encourage them to get in touch with what was significant within, to become more fully human, to share the individual's best self with a significant other.
is the creator of symbolic-experiential family therapy, a freewheeling, intuitive approach to helping families open channels of interaction.
(1) His goal was to facilitate individual autonomy while retaining a sense of belonging in the family.
(2) From Whitaker, the field of family therapy learned to tolerate and sometimes create anxiety in families—and then how to join families in their struggles to become more real and more transparent.
began to develop structural family therapy in the 1960's through his work with delinquent boys from poor families at the Wiltwyck School in NY. He refined the theory and practice of structural family therapy.
(1) Focusing on the structure, or organization of the family, the therapist helps the family modify its stereotyped patterns and redefine relationships among family members.
(2) He believes structural changes in families must occur before individual members' symptoms can be reduced or eliminated.
(3) From Minuchin, family therapy developed an understanding of power, organization, and alignments in family life, and family therapists learned how to use themselves to set boundaries and even unbalance dysfunctional family systems.
Jay Haley and Cloe Madanes
founded the Washington School of strategic family therapy.
(1) Haley blended structural family therapy with the concepts of hierarchy, power, and strategic interventions.
(2) Madanes contributed to the development of a brief, solution-oriented therapy approach.
What is the content of a genogram?
(2) Most therapist start with a map of the family that comes to therapy.
(3) The parents are listed with their name, age, and date of birth in either a rectangle (for men) or a circle (for women).
(4) If there are multiple relationships involved in the parental subsystem, they are generally indicated in chronological order with men listed on the left and women on the right.
(5) The genogram should show at least three generations (i.e., self and siblings, parents and their siblings, and grandparents). If you have children and grandchildren, you may include them on the chart as well.
(6) Parents, siblings
(7) Children, miscarriages
(8) Marriages, divorces
(9) Use squares to represent males: and circles for females:
(10) Use double lines around the square or circle to indicate yourself, the index person.
(11) Names, dates for birth and/or death should be written above or below the symbol.
(12) Place an X inside the figures of those who are deceased:
(13) Marital relationships are shown by connecting lines that go down and across between the partners. The husband is on the left and the wife on the right. Divorce is indicated with two slashes (//) in the horizontal marriage line. The dates for marriage and divorce, if applicable, should be written above the marriage line
(14) Vertical lines are drawn below marriage lines for the children of the marriage, with the oldest child on the left and the youngest child on the right.
(15) Special Circumstances:
(16) Diverging lines connect twins to parents. Identical twins are connected by a bar between the children.
(17) Miscarriages are noted with a small filled-in circle.
(18) Dotted lines connect adopted children.
(19) Pregnancies are illustrated by a triangle.
(20) Conflicts in a relationship
(21) Problems with alcohol.
(22) Death occurred
What is the purpose of a genogram?
(1) The genogram is a pictorial graph of the structure and characteristics of a family across three or more generations.
(2) It serves as both a guide to the people and the processes that influence the client's life.
What are key strengths of FST from a multicultural perspective?
(1) One of the strengths of the systemic perspective in working from a multicultural framework is that many ethnic and cultural groups place great value on the extended family.
(2) Families cannot escape the sexism and patriarchy that are inherent in all cultures.
(a) The roles for men and women are prescribed in different societies, but in every culture women tend to come out on the short end more often than not.
(b) Because family life is where the roles of women can be most limited, a consideration of gender issues in families is an essential framework for family therapy.
(c) Perhaps the most difficult integration of all is figuring out how to honor different cultures in therapy without supporting marginalization or oppression of women.
(d) Today, family therapists explore the individual culture of the family, the larger cultures to which the family members belong, and the host culture that dominates the family's life.
(e) Interventions are no longer applied universally, regardless of the cultures involved: rather, they are adapted and even designed to join with the cultural systems.
What are key shortcomings of FST from a multicultural perspective?
(1) Perhaps the major concern for non-western cultures would be with regard to the balance of this model advocates for the individual versus the collective.
(a) The process of differentiation occurs in most cultures, but it takes on a different shape due to cultural norms.
(2) Although a multilayered approach addresses the notion of togetherness and individuality from a balanced perspective, many non-Western cultures would not embrace a theory that valued individuality above loyalty to family in any form.
(3) A possible shortcoming of the practice of family therapy involves practitioners who assume Western Models of family are universal.
What are the overall key contributions of FST?
(1) One of the key contributions of most systemic approaches is that neither the individual nor the family is blamed for a particular dysfunction.
(2) The family is empowered through the process of identifying and exploring internal, developmental, and purposeful interactional patterns.
(3) At the same time, a systems perspective recognizes that individuals and families are affected by external forces and systems, among them illness, shifting gender patterns, culture, and socioeconomic considerations.
(4) Most of the individual therapies considered in this textbook fail to give a primary focus to the systemic factors influencing the individual. Family therapy redefines the individual as a system embedded within many other systems, which brings an entirely different perspective to assessment and treatment.
(5) An advantage to this viewpoint is that an individual is not scapegoated as the "bad person: in the family.
What are the overall key limitations of FST?
(1) In the early days of family therapy, therapists all too often got lost in their consideration of the "system."
(2) In adopting the language of systems, therapists began to describe ad think of families as being made of terms such as dyads and triads, etc. It was as if the family was a well-piled machine or perhaps a computer that occasionally broke down.
(3) Just as it was easy to fix a machine without an emotional consideration of the parts involved, some therapists approached family systems work with little concern for the individuals as long as the "whole" of the family ""functioned" better.
(4) Enactments, ordeals, and paradoxical interventions were often "done" to clients—sometimes even without their knowledge.
(5) Feminists were perhaps the first, but not the only group to lament the loss of a personal perspective within a systemic framework.
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Predicate Logic - Rules (Primitive Inference Rules)
Predicate Logic - Rules (Derived Inference Rules)
MFT Law and Ethics
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