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Paper Summary of TES Form

Download TES Form (doc)

 

CSEP-II EXPERIENTIAL THERAPY SESSION FORM
(8/02, ©R. Elliott)

CASE__________ SESSION_______ DATE____________ THERAPIST_______

 

I. Process Notes

1. Brief summary of main episodes and events of session:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

2. Unusual Within-therapy Events (e.g., late, interruptions, challenges, out-of-mode)

 

 

3. Important Extra-therapy Events (e.g., relationships, work, injury/illness, changes in medication, self-help efforts)

 

 

4. Ideas for next time (from self & supervision):

 

 

II. Overall Session Ratings:

1. Please rate how helpful or hindering to your client you think this session was overall. (Check one answer only)

THIS SESSION WAS:

1. Extremely hindering

____ 2. Greatly hindering

____ 3. Moderately hindering

____ 4. Slightly hindering

____ 5. Neither helpful nor hindering; neutral

____ 6. Slightly helpful

____ 7. Moderately helpful

____ 8. Greatly helpful

____ 9. Extremely helpful

2. How do you feel about the session you have just completed with your client? ____ 1. Perfect

____ 2. Excellent

____ 3. Very good

____ 4. Pretty good

____ 5. Fair

____ 6. Pretty poor

____ 7. Very poor

3. How much progress do you feel your client made in dealing with his/her problems in this session? ____ 1. A great deal of progress

____ 2. Considerable progress

____ 3. Moderate progress

____ 4. Some progress

____ 5. A little progress

____ 6. Didn’t get anywhere in this session

____ 7. In some ways my problems have gotten worse this session

4. In this session something shifted for my client. S/he saw something differently or experienced something freshly: ____ 1. Not at all

____ 2. Very slightly

____ 3. Slightly

____ 4. Somewhat

____ 5. Moderately

____ 6. Considerably

____ 7. Very much

 

 

III. Client Modes of Engagement:

Please rate the extent to which your client was engaging in each of the following modes of engagement during the session:

Absent

Occasional

(1 - 5% of responses)

Common

(10 – 20% of responses)

Frequent

(25 - 45% of responses)

Extensive

(³ 50% of responses)

1

2

3

4

5

1 2 3 4 5

1. External: Attending to other people, external events; may be specific or general.

1 2 3 4 5

2. Purely conceptual: Formulating things in linguistic or abstract terms without reference to concrete experiencing.

1 2 3 4 5

3. Somatic: Attending to chronic pain or illness signs.

1 2 3 4 5

4. Containing/distancing: Avoiding or holding painful or frightening feelings or experiences at bay.

1 2 3 4 5

5. Internal attending: Turning attention inward to clear feelings, thoughts, images or bodily sensations.

1 2 3 4 5

6. Experiential search: Examining unclear internal experiences with curiosity; staying with vague or ambiguous experiencing.

1 2 3 4 5

7. Active expression: Displaying or enacting strong, vivid, specific reactions.

1 2 3 4 5

8. Interpersonal contact: Trusting, opening up to therapist.

1 2 3 4 5

9. Self-reflection: Standing back from experience in order to develop meaning perspective.

1 2 3 4 5

10. Emergent action: Applying results of experiential work to problem-solving

and productive action.

IV. Process-Experiential Treatment Principles:

Please rate how well you feel you applied each of the treatment principles below, using this rating scale:

1 Much improvement in application needed: I felt like a beginner, as if I didn't have the concept.
2 Moderate improvement needed: I felt like an advanced beginner, who is beginning to do this, but needs to work on the concept more.
3 Slight improvement in application needed: I need to make a focused effort to do more of this.
4 Adequate application of principle: I did enough of this, but need to keep working on improving how well I do it.
5 Good application of principle: I did enough of this and did it skillfully.
6 Excellent application of principle: I did this consistently and even applied it in a creative way.
1 2 3 4 5 6 1. I was empathically attuned to the client's experiencing (by letting go of presumptions, entering client’s world, resonating from own experience, sorting through variety, grasping what is important and readjusting understandings as experiencing evolves).
1 2 3 4 5 6 2. I expressed empathy/understanding, presence/genuineness, and prizing/caring to my client.
1 2 3 4 5 6 3. I facilitated client-therapist collaboration and mutual involvement in goals and tasks of therapy, through experiential teaching, goal/task identification and negotiation.
1 2 3 4 5 6 4. I facilitated different client micro-processes at different times in the session, as appropriate to the client’s tasks or subtasks. (Circle: internal attending, experiential search, active expression, interpersonal contact, containing/distancing, self-reflection, action-planning)
1 2 3 4 5 6 5. I facilitated progress on central therapeutic tasks by identifying, tracking, and offering opportunities to return to them, within and across sessions.
1 2 3 4 5 6 6. I facilitated client self-development through reflecting/supporting/ symbolizing new experiencing, inner strength, client agency, or empowerment.
1 2 3 4 5 6 7. Overall Rating: In general, I carried out PE principles and tasks.

 

 

 

V. Task Resolution and Intervention Scales

Instructions. For each therapeutic task on the following pages, rate each of the following using the scales provided:

*Resolution Scales: Rate how far the client got on each therapeutic task, regardless therapist task intervention; circle the furthest point reached on the scale.

*Presence Rating Scale: Use this scale to rate the extent to which you attempted to engage the client in each of the therapeutic task activities listed below.

*Quality Rating Scale: Use this scale to rate how well or skillfully you think you facilitated (vs. interfered) with each of the therapeutic tasks listed.

Note that tasks may overlap; it is possible to work on two tasks at the same time (e.g., Empathic Exploration and Focusing or Two chair dialogue; Empathic Prizing and Meaning Creation).

 

1. General Empathic Exploration for Problem-Relevant Experience:

A. Task Resolution:

0

Marker absent.

1

Marker present: Problem-relevant experience; client expresses personal interest in an experience that is (circle & describe:) powerful, troubling, incomplete, undifferentiated, global, abstract or primarily in external terms: _________________________

2

Discusses problem in an external or abstract manner.

3

Turns attention to internal experiencing; may re-experience previous events; searches edges of awareness; differentiates or elaborates global or missing aspects of experiencing.

4

Experiences some clarification of experience, including clear marker for another task (such as a conflict split). What got clearer: _______________________________

5

Expresses a sense of more fully understanding, appreciating and owning the experience in its complexity or richness (“Now I know what that’s all about”).

6

In addition to the above, feels a marked, general sense of relief, empowerment or determination about the experience (such as knowing what to do about it).
B. Task Intervention: Facilitate client re-experiencing; reflect unclear, emerging experience, encourage differentiation or elaboration of experience.
PRESENCE QUALITY

1

Clearly absent

1

Significant interference with task

2

Possibly present

2

Moderate interference

3

Present but brief

3

Slight interference; more needed/missed marker

4

Present, moderate length

4

Neutral; not applicable

5

Present, extended in length

5

Slightly skillful facilitation
 

6

Moderately skillful facilitation

7

Excellent facilitation of task

 

2. Empathic Affirmation of Vulnerability:

A. Client Task Resolution:

0

Marker absent

1

Marker: Mentions strong negative self-related feeling and expresses distress about it; describe form of vulnerability: ___________________

2

Describes deeper feelings in response to therapist's empathic affirmation.

3

Expresses more intense vulnerability.

4

Seems to touch bottom; expresses dreaded emotion or painful aspect of self in full intensity.

5

Describes or expresses reduced distress, greater calmness.

6

Expresses sense of self as whole, acceptable or capable.
B. Task Intervention: Provides genuine, empathic, affirming presence as client descends into dreaded vulnerability, then supports re-emergent client growth-oriented experiencing.
PRESENCE QUALITY

1

Clearly absent

1

Significant interference with task

2

Possibly present

2

Moderate interference

3

Present but brief

3

Slight interference; more needed/missed marker

4

Present, moderate length

4

Neutral; not applicable

5

Present, extended in length

5

Slightly skillful facilitation
 

6

Moderately skillful facilitation

7

Excellent facilitation of task

 

 

3. Developing and Maintaining a Safe Working Alliance (Especially first 5 sessions or after break, transition or crisis in therapy.)

A. Rate current level of client working alliance:

0

Client drops out of therapy or announces decision to stop because of alliance problems.

1

Client physically present but safe, working environment not yet achieved.

2

Work on trust/bond: Begins therapy, but worried that therapist will misunderstand, judge, or be insincere, intrusive or untrustworthy.

3

Work on therapeutic focus: Trusts therapist and begins to engage in therapy process, but has difficulty finding and maintaining a focus, is scattered or generally defers to therapist.

4

Work on goal agreement: Therapeutic focus located but ambivalent about change, not firmly committed to working toward goals related to main therapeutic focus; sees the causes of his/her problems differently from therapist.

5

Work on task agreement: Committed to change, but has difficulty turning attention inward; questions the purpose and value of working with emotions/experiencing; has expectations about tasks and process that diverge from those of therapist.

6

Productive working environment: Client trusts therapist, engages actively in productive therapeutic work.
B. Task Intervention: Facilitate alliance formation through meta-communication, demonstration of caring, empathy; negotiation of therapeutic focus, goals, and tasks.
PRESENCE QUALITY

1

Clearly absent

1

Significant interference with task

2

Possibly present

2

Moderate interference

3

Present but brief

3

Slight interference; more needed/missed marker

4

Present, moderate length

4

Neutral; not applicable

5

Present, extended in length

5

Slightly skillful facilitation
 

6

Moderately skillful facilitation

7

Excellent facilitation of task

 

4. Relationship Dialogue for Repair of Alliance Difficulties

A. Client Task Resolution:

0

Marker absent (therapeutic work proceeds without difficulty)

1

Marker: Implies or mentions complaint or dissatisfaction about nature or progress of therapy, or therapeutic relationship. (Withdrawal: disengages from process; Confrontation: challenges, questions therapy); describe: ____________________

2

Accepts task, presents complaint or dissatisfaction directly or in more detail. (Withdrawal difficulty: Admits to difficulty)

3

Explores nature, possible joint sources of complaint/dissatisfaction/difficulty; seeks both to understand therapist side and to elaborate, understand own part in difficulty.

4

Develops, describes shared understanding of source of difficulty.

5

Reaches a new view of general nature or mutual roles in therapy; explores practical solutions with therapist.

6

Expresses genuine satisfaction or obvious renewed enthusiasm for therapy.
B. Task Intervention: Raise and facilitate mutual dialogue about difficulty.
PRESENCE QUALITY

1

Clearly absent

1

Significant interference with task

2

Possibly present

2

Moderate interference

3

Present but brief

3

Slight interference; more needed/missed marker

4

Present, moderate length

4

Neutral; not applicable

5

Present, extended in length

5

Slightly skillful facilitation
 

6

Moderately skillful facilitation

7

Excellent facilitation of task

 

5.Clearing a Space for Attentional Focus Difficulty:

A. Client Task Resolution:

0

Marker absent

1

Marker: Attentional Focus Difficulty: Reports or evidences being stuck, overwhelmed, or blank.

2

Attends to internal “problem space.”

3

Lists concerns or problematic experiences.

4

Sets concerns or problems aside; uses imagination to contain or create psychological distance from problems, may identify most important concern to work on.

5

Appreciates cleared internal space; enjoys relief, sense of free or safe internal space.

6

Generalizes cleared space; develops general appreciation for need, value or possibility of clear/safe space in his/her life.
B. Task Intervention: Helps client clear an imagined internal/bodily space, list, set aside problems; helps client appreciate cleared space or identify concern to work on.
PRESENCE QUALITY

1

Clearly absent

1

Significant interference with task

2

Possibly present

2

Moderate interference

3

Present but brief

3

Slight interference; more needed/missed marker

4

Present, moderate length

4

Neutral; not applicable

5

Present, extended in length

5

Slightly skillful facilitation
 

6

Moderately skillful facilitation

7

Excellent facilitation of task

 

6. Experiential Focusing for an Unclear Feeling:

A. Client Task Resolution:

0

Marker absent

1

Marker: Unclear feeling: Presents or confirms vague/nagging concern, or discusses concerns in global, abstract, superficial, or externalized (circle one) manner.

2

Attends to the unclear concern, including whole feeling.

3

Searches for potential descriptions (felt quality words, images) for unclear feeling; checks descriptions for accuracy) (without feeling shift)

4

Feeling shift: Explores labeled feeling more deeply, until bodily sense of discomfort eases and experienced lack of clarity disappears.

5

Receives feeling shift: stays with, appreciates, consolidates feeling shift; keeps self-criticism at bay.

6

Carrying forward: develops new in-session task, explores implications for change outside of therapy.
B. Task Intervention: Encourages focusing attitude, search for label/handle, exploration of labelled feeling, receiving of feeling shift, and carrying forward.
PRESENCE QUALITY

1

Clearly absent

1

Significant interference with task

2

Possibly present

2

Moderate interference

3

Present but brief

3

Slight interference; more needed/missed marker

4

Present, moderate length

4

Neutral; not applicable

5

Present, extended in length

5

Slightly skillful facilitation
 

6

Moderately skillful facilitation

7

Excellent facilitation of task

 

7. Facilitating Expression of Feelings with Emotional Expression Difficulties:

A. Client Task Resolution:

-

(No zero point)

1

Prereflective reaction to situation without awareness; emotion blocked from awareness ("I have no feelings.").

2

Limited conscious awareness of emotion ("I'm not sure if I'm feeling something.").

3

Unclear feeling ("I don't know what I'm feeling."); or prepackaged description ("I know what I'm feeling without having to check.").

4

Negative attitude toward emotion ("Feelings are dangerous or irrelevant.").

5

Difficulty with appropriate level of emotional expression to therapist/others: Excessive or premature disclosure ("I’ve told you too much about myself already!”); or perception of therapist/others as unreceptive ("You can’t be interested in what I'm feeling.").

6

Successful, appropriate expression of emotion to therapist/significant others.
B. Task Intervention: Encourages emotional expression with appropriate response modes, tasks (e.g., evocative/exploratory response, Focusing, Empathic Exploration, Chairwork).
PRESENCE QUALITY

1

Clearly absent

1

Significant interference with task

2

Possibly present

2

Moderate interference

3

Present but brief

3

Slight interference; more needed/missed marker

4

Present, moderate length

4

Neutral; not applicable

5

Present, extended in length

5

Slightly skillful facilitation
 

6

Moderately skillful facilitation

7

Excellent facilitation of task

 

8.Retelling/Re-experiencing of a Traumatic/Painful Experience (non-PRP)

A. Task Resolution:

0

Marker absent (abstract, superficial or prepackaged descriptions of an event/experience).

1

Marker present: Refers to a traumatic/painful experience about which a story could be told (e.g., traumatic event, disrupted life story, nightmare). Nature of experience: _____________________________________________

2

Elaboration; begins detailed, concrete or factual narrative of particular event/experience; describes what happened from external or logical point of view.

3

Dwells on important moments or aspects of trauma, re-experiences parts of it in session.

4

Differentiates personal, idiosyncratic, newly emerged meanings of the experience from an internal point of view.

5

Thoughtfully weighs and tentatively evaluates alternative, differentiated views of the experience.

6

Integrates previously unconnected or inconsistent aspects of the experience; expresses broader or more integrated view of self, others or world.
B. Task Intervention: Facilitate client re-telling/re-experiencing through unfolding and exploration process.
PRESENCE QUALITY

1

Clearly absent

1

Significant interference with task

2

Possibly present

2

Moderate interference

3

Present but brief

3

Slight interference; more needed/missed marker

4

Present, moderate length

4

Neutral; not applicable

5

Present, extended in length

5

Slightly skillful facilitation
 

6

Moderately skillful facilitation

7

Excellent facilitation of task

 

9. Unfolding Problematic Reactions:

A. Client Task Resolution:

0

Marker absent

1

Marker: Describes unexpected, puzzling personal reaction (Circle: behavior, emotion reaction). Describe: ____________________________________

2

"Reenters" the scene, recalls and re-experiences the time when the reaction was triggered.

3

Recalls salient aspects of stimulus situation. Explores both own internal affective reaction to situation and own subjective construal of potential impact of stimulus situation.

4

Reaches "meaning bridge." Discovers link between problematic reaction and own construal of potential impact of stimulus situation.

5

Recognizes this as example of broader aspect of own mode of functioning that is interfering with personal needs, wants, views, or values.

6

Full resolution: Develops broad new view of important aspects of own mode of functioning and what self-changes wants to make. Begins to feel empowered to make change(s).
B. Task Intervention: Systematic evocative unfolding: helps client review in detail perceptions and emotions involved in problematic reaction; helps client explore broader implications.
PRESENCE QUALITY

1

Clearly absent

1

Significant interference with task

2

Possibly present

2

Moderate interference

3

Present but brief

3

Slight interference; more needed/missed marker

4

Present, moderate length

4

Neutral; not applicable

5

Present, extended in length

5

Slightly skillful facilitation
 

6

Moderately skillful facilitation

7

Excellent facilitation of task

 

10. Creation of Meaning for Meaning Protest:

A. Client Task Resolution:

0

Marker absent (emotional arousal with vagueness or confusion).

1

Marker: Describes an experience discrepant with cherished belief; in an emotionally aroused state. (Life event: ____________________________

Cherished belief: _______________________)

2

Clarifies, specifies nature of cherished belief and emotional reactions to challenging life event.

3

Searches for origins of cherished belief; develops hypothesis.

4

Evaluates and judges continued tenability of cherished belief (in relation to present experience); expresses desire to alter cherished belief.

5

Revision: Alters or eliminates cherished belief.

6

Describes nature of change needed or develops plans for future.
B. Task Intervention: Facilitates client meaning work; helps client symbolize felt meaning of painful life event and describe and ultimately re-examine challenged cherished belief(s).
PRESENCE QUALITY

1

Clearly absent

1

Significant interference with task

2

Possibly present

2

Moderate interference

3

Present but brief

3

Slight interference; more needed/missed marker

4

Present, moderate length

4

Neutral; not applicable

5

Present, extended in length

5

Slightly skillful facilitation
 

6

Moderately skillful facilitation

7

Excellent facilitation of task

 

11. Two-Chair Work for Conflict Splits:

A. Client Task Resolution:

0

Marker absent

1

Marker: Describes split in which one aspect of self is critical of, or coercive toward, another aspect. Describe two aspects, whether attributed or somatic form: ________________________________________

2

Clearly expresses criticisms, expectations, or "shoulds" to self in concrete, specific manner.

3

Experiencing chair agrees with critic (“collapses”); primary underlying feelings/needs begin to emerge in response to the criticisms. Critic differentiates values/standards..

4

Clearly expresses needs and wants associated with a newly experienced feeling.

5

Genuinely accepts own feelings and needs. May show compassion, concern and respect for self.

6

Clear understanding of how various feelings, needs and wishes may be accommodated and how previously antagonistic sides of self may be reconciled.
B. Task Intervention: Facilitates client dialogue between conflicting aspects of self.
PRESENCE QUALITY

1

Clearly absent

1

Significant interference with task

2

Possibly present

2

Moderate interference

3

Present but brief

3

Slight interference; more needed/missed marker

4

Present, moderate length

4

Neutral; not applicable

5

Present, extended in length

5

Slightly skillful facilitation
 

6

Moderately skillful facilitation

7

Excellent facilitation of task

 

12. Two-Chair Enactment for Self-Interruption Splits:

A. Client Task Resolution:

0

Marker absent

1

Marker: Engages in or describes how one part interrupts another part. (Interrupted emotion, incl. attributed form, person: ________________________)

2

Actively enacts own possible self-interruptive process, in concrete, specific manner.

3

Contacts and differentiates feelings of passivity and resignation.

4

Clearly expresses interrupted emotion.

5

Self-assertion. Clearly expresses need associated with the emotion.

6

Feels empowered, envisages or plans new actions in the world in order to meet need.
B. Task Intervention: Helps client enact self-interruption or blocking process, including voicing of suppressed aspect of self.
PRESENCE QUALITY

1

Clearly absent

1

Significant interference with task

2

Possibly present

2

Moderate interference

3

Present but brief

3

Slight interference; more needed/missed marker

4

Present, moderate length

4

Neutral; not applicable

5

Present, extended in length

5

Slightly skillful facilitation
 

6

Moderately skillful facilitation

7

Excellent facilitation of task

 

13. Empty-Chair Work for Unfinished Business:
A. Client Task Resolution:

0

Marker absent

1

Marker: Blames, complains, or expresses hurt or longing in relation to a significant Other. (person: ___________________)

2

Speaks to imagined Other and expresses unresolved feelings (e.g., resentment, hurt).

3

Differentiates complaint into underlying feeling; experiences and expresses relevant emotions (e.g., sadness, anger) with a high degree of emotional arousal.

4

Experiences unmet need(s) as valid and expresses them assertively.

5

Comes to understand and see Other in a new way, either in a more positive light or as a less powerful person who has/had problems of his/her own.

6

Affirms Self and lets go of unresolved feeling, either by forgiving Other or holding Other accountable.
B. Task Intervention: Helps client express unresolved hurt, anger, unmet needs to imagined other; may help client enact role of other.
PRESENCE QUALITY

1

Clearly absent

1

Significant interference with task

2

Possibly present

2

Moderate interference

3

Present but brief

3

Slight interference; more needed/missed marker

4

Present, moderate length

4

Neutral; not applicable

5

Present, extended in length

5

Slightly skillful facilitation
 

6

Moderately skillful facilitation

7

Excellent facilitation of task

 

 

VI. Experiential Response Modes:
Use this scale to rate the degree to which each of the items below was present in this session:

 

Absent

Occasional

(1 - 5% of responses)

Common

(10 – 20% of responses)

Frequent

(25 - 45% of responses)

Extensive

(³ 50% of responses)

1

2

3

4

5

1 2 3 4 5

1. Personal Disclosure: Share relevant information about self.

1 2 3 4 5

2. Process Disclosure: Share own here-and-now reactions, intentions or limitations.

1 2 3 4 5

3. Awareness Homework: Foster experiencing outside of session.

1 2 3 4 5

4. Action Suggestion: Encourage client to try things out in the session (“coaching”: feeding lines, proposing mental actions, directing attention).

1 2 3 4 5

5. Structuring Task: Set up and offer specific help for continued work within a specific therapeutic task (including proposing, creating context, or offering encouragement for task engagement).

1 2 3 4 5

6. Experiential Teaching: Provide general information about nature of experiencing or treatment process/tasks.

1 2 3 4 5

7. Experiential Formulation: Describe the client’s specific difficulties in PE terms, such as emotional avoidance or action on the self.

1 2 3 4 5

8. Empathic Refocusing: Offer empathy to what the client is having difficulty facing, in order to invite continued exploration.

1 2 3 4 5

9. Empathic Conjecture: Tentative guess at immediate, implicit client experience (usually with Fit Question).

1 2 3 4 5

10. Process Observation: Nonconfrontationally describe client in-session verbal or nonverbal behavior (usually with Exploratory Question).

1 2 3 4 5

11. Fit Question: Encourage client to check representation of experience with actual experience.

1 2 3 4 5

12. Exploratory Question: Stimulate client open-ended self-exploration.

1 2 3 4 5

13. Evocative Reflection: Communicate empathy while helping client to heighten or access experience, through vivid imagery, powerful language or dramatic manner.

1 2 3 4 5

14. Exploratory Reflection: Simultaneously communicate empathy and stimulate client self-exploration of explicit and implicit experience, through open-edge or growth-oriented responses.

1 2 3 4 5

15. Empathic Affirmation: Offer validation, support, or sympathy when client is in emotional distress or pain.

1 2 3 4 5

16. Empathic Reflection: Accurately represent most central, poignant or strongly-felt aspect of client's message.

 

 

VII. Content Directive Interventions:
Use this scale to rate the following items:

Clearly Absent

Possibly present

Present but very brief and"in-mode" (e.g., tentative, in answer to question)

Present, brief, in "expert" manner

Present, extended, "expert" manner

1

2

3

4

5

1 2 3 4 5

1.Give News: Responses intended to tell the client something new about self or others (i.e., interpretations).

Describe:

1 2 3 4 5

2. Offer Solutions: Responses intended to modify client behavior with regard to presented problems (i.e., general advisements).

Describe:

1 2 3 4 5

3. Offer Expert Reassurance: Responses directly intended to make the client feel good or less bad, given from an "expert" position.

Describe:

1 2 3 4 5

4. Disagree/Confront: Responses intended to correct, criticize or point out discrepancies.

Describe:

1 2 3 4 5

5. Nonexperiential Task/Content Direction : e.g., introduce new subject/task such as problem-solving or client analysis of third parties.

Describe:

1 2 3 4 5

6. Purely informational questions: gather specific information without encouraging exploration.

Describe:

 


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