Constructivist Approaches in Counseling and Psychotherapy: A Philosophical Perspective

Theoretical Models of Counseling
and Psychotherapy, 
2
nd
 Edition
Chapter 12: Constructivist
Approaches
 
Andre Marquis, Ph.D.
University of Rochester
Historical Context
 
A reaction against the prevailing attitude of
narrow empiricism and the search for an
objective truth
The verb 
to construct” comes from the Latin
con struere
, which means to arrange or give
structure; the ongoing nature of structuring
(organizing) processes is at the heart of
lifespan development.
Founders
 
There is not a single founder of Constructivist theory.
There are many different interpretations about what
Constructivist theory looks like in practice:
Some emphasize a cognitive-behavioral legacy.
Others emphasize existential-humanistic, psychoanalytic, or
transpersonal.
Michael Mahoney’s approach includes and integrates aspects
of each of these legacies.
Philosophical Underpinnings
 
The Buddha emphasized the role of minds and thinking in the
creation and maintenance of our experience of reality.
Giambattista Vico: human knowing involves an imaginative
construction of order in experience, and that knowledge must be
understood as a process of construction that takes place in social
contexts.
Immanuel Kant emphasized the power of patterns in our thinking,
and he regarded ideas as regulative principles.
Kant believed that we participate in the construction of a universal
lawfulness.
Hans Vaihinger argued that the primary purpose of mind and
mental processes is not to portray or mirror reality, but to serve
individuals in their navigations through life circumstances.
Philosophical Underpinnings
 
Jean Piaget emphasized that we organize our worlds by
organizing ourselves, and this theme of self-
organization pervades constructive views of human
experience.
George Kelly’s theory of 
constructive alternativism
,
better known as 
personal construct theory
,
emphasized both possibility and pattern in the self-
organization of personality.
Nature of Humans:
Function of Psyche
 
The most primary is to order and organize one’s experience
and thus, to construct meaning.
Mahoney noted a consensual emphasis on five overlapping
themes about human experience and development:
1. Human experiencing reflects continuous and primarily
anticipatory activity
.
2. The ongoing activity of humans is primarily devoted to
ordering processes
 or the organizational patterning of
experience; these ordering processes 
are
fundamentally emotional and tacit
, and they are the
essence of meaning-making.
Nature of Humans:
Function of Psyche
 
3. The organization of personal activity is fundamentally self-referent
or recursive, making the body a fulcrum of experiencing and
encouraging a deep phenomenological sense of 
selfhood
 or
personal identity
.
4. Self-organizing capacities and creations of meaning are strongly
influenced by 
social-symbolic processes
; persons exist in living
webs of relationships, many of which are mediated by language
and symbol systems.
5. Each human life reflects principles of 
dynamic dialectical
development
; complex flows among essential tensions (contrasts)
are reflected in patterns and cycles of experiencing that can lead
to episodes of disorder (disorganization) and, under some
circumstances, the reorganization (transformation) of core
patterns of activity, including meaning-making and both self- and
social relationships.
Nature of Humans:
Structure of Psyche
 
The difference between psychological
functions (which are dynamic and frequently
in flux
) and structures (which are traditionally
presumed to be quite stable) is more
accurately a matter of time scale.
Structures – whether a schema or self – also
can change; they just change more slowly
than functions.
Nature of Humans:
Structure of Psyche
 
Mahoney strongly believed that it is more
accurate to conceive of 
processes
 than
mechanistic 
structures
.
For example, the difference between conceiving
the self as verb, activity, or ongoing 
process
 in
contrast to a noun  or structure
Operating primarily outside of our awareness,
Core Ordering Processes (COPs) are the
organizational processes through which we
perceive stabilities, continuities, and
constancies.
Nature of Humans:
Structure of Psyche
 
COPs involve four overlapping themes:
1.
Reality
 refers to one’s worldview and perceptual
constancies along dimensions such as
possible/impossible, real/unreal, and
meaningful/meaningless.
2.
Value
 refers to emotional judgments (all judgment
requires a valence – positive or negative) along
dimensions such as good/bad, right/wrong, and
approach/avoid.
Nature of Humans:
Structure of Psyche
 
 
3.
 
Self
 refers to that with which we identify and our
processes of establishing a felt-sense of coherence,
continuity, and order to our experience along
dimensions such as me/not me, us/them,
body/world, and worth/worthlessness.
4.
 
Power
 refers to one’s sense of agency along
dimensions such as active/passive,
hopeful/hopeless, in control/out of control, and
engaged/withdrawn.
Role of the Environment
 
The individual is seen as being in a 
dialectic
relationship
 with the environment, which means all
people react to and act on their environment
continually.
People do not develop in isolation; it is the
interaction between environment and self that
provides the building materials for one’s personal
constructs.
Emphasis is given to the individual’s 
interpretation
 of
the environment, especially how he/she can
constructively move forward.
Health
 
Constructivists do not define mental health in
specific 
terms.
However, developmental constructivism does
suggest some general contours of what constitutes
relative health.
Such a trusting engagement in life (in contrast to passive
withdrawal) and having a sense of agency in and
authorship of one’s life
Other aspects of health involve balance and
wholeness (integration).
Unhealth
 
Mahoney depathologized many of the concerns
clients brought with them to counseling. For
example:
Because each person is always engaged in active gestures
of seeking a dynamic balance in his/her life, a "disordered
person" can be viewed as one whose life circumstances
exceed their developed integrative skills.
Much that is termed unhealthy involves imbalance
and segregation of parts from the whole.
Change Process
 
In Mahoney’s
 Human Change Processes
, he
demonstrated that complex, nonlinear processes are
involved.
Although he stressed that 
the particulars cannot be
predicted, s
ome patterns are more likely than others.
Oscillations are common in the development of new skills
and are often apparent in the restructuring of core
ordering processes.
Exploratory behavior is usually suppressed in the presence
of strong negative affect).
Client’s Role
 
Clients hold the primary responsibility for change.
Each client is seen as a collaborator in the change
process.
Their role is not passive; it can best be described as
engaged.
They must be willing to focus on the present and be
active participants in goal-setting and experimenting
with new ways of thinking, feeling, and acting.
Counselor’s Role
 
Creating an atmosphere of safety, openness
Creating a collaborative working alliance
Empathizing with clients’ struggles and suffering
Helping clients realize that they are capable of
making positive changes in their lives
Promoting change by co-creating various
experiments in new ways of thinking, feeling, and
behaving that clients practice between sessions
Capacity for Change
 
According to developmental constructivists, the
resilience and resourcefulness of the human system
is much greater than is generally appreciated.
Without ignoring the profound negative influence
that genetics or neglectful or abusive early
childhoods may exert, we can considerably influence
the course of our development throughout the
lifespan. At the same time, our potentials for
transformation are surely not limitless.
Capacity for Change
 
According to Mahoney, most counseling theorists
have grasped part of this issue, but not its
complexity:
 
“People do express their genetic inheritance, but they do it in
highly contextual and individualized ways. Early experiences make
big differences in developmental trajectories, yet many people
transcend them. Environments do select patterns, yet we select
and change our environments. Human potential may not be
limitless, but it is much greater than most psychological models
have yet appreciated.” (2003, p. 170)
Resistance
 
What is usually referred to as 
clients’ resistance
involves the experience, or potential threat, that too
much of their core is changing too quickly.
Resistance
 
is not merely an intrapsychic function of
the client, but rather, a product of the intersubjective
field between client and counselor – with the
counselor’s actions always playing a role.
Characteristics of Effective Counselors
 
1.
Prepare for each session in private reflection
.
2.
Honor the complexity and uniqueness of each
      client
.
3.   Give yourself and your client permission not to know
and not to fully understand. 
Life is much more than
figuring things out; effective therapy does not require
complete understanding or definitive explanations.
4.   Let clients set the pace, and honor their process
.
5.   Encourage (but do not force) emotional expression
.
Characteristics of Effective Counselors
 
6. Allow and invite yourself to feel emotional in the
process of counseling. 
Let your heart lead your
helping
.
7. Trust that your clients can endure their pain and be
strengthened by the process
.
8. Emphasize safety and offer as much structure as your
client needs
.
9.  Affirm and encourage experimentation and
exploration
.
10. Teach compassion, forgiveness, and self-care.
(Mahoney, 2003 p. 262-263, italics in original)
Stages
 
Solution-focused therapy:
1.
Identify problem/set goal
2.
Designing Interventions and Tasks
3.
Stabilization and termination
Narrative Counseling:
1.
Telling of the story
2.
Exploring pieces of the story
3.
Exploring alternatives
4.
Writing new stories
Therapeutic Relationship
 
Use the therapeutic relationship as a safe and secure
base (sometimes referred to as a 
holding
environment
) in and from which the client, with the
help of the therapist’s sustained empathic
attunement and inquiry, can learn to explore and
experiment with his or her emotional experiencing
processes.
Change occurs 
not
 through the mechanical
implementation of techniques, but through an
intersubjective 
experience.
Techniques
 
Developmental constructivism is less a matter
of the specific techniques used than it is a
compassionate sensibility grounded in the
developmental pacing of individually tailored
interventions to help people organize and
reorganize their lives.
Care and compassion are at the heart of all
our efforts to help.
Techniques
 
Mahoney stressed that “
the power to change lies in processes
rather than specific procedures
 (2003, p. 58, italics in original)
Mahoney conceived of interventions as addressing three
interwoven levels: 
problem, pattern, and process
.
Problem
-focused work focuses on solving specific problems and
usually emphasizes behavioral and cognitive interventions.
 Because specific problems very rarely exist in isolation, it is often
more effective to focus on the patterns and relationships among
specific problems.
Mahoney thought of pattern work as involving a “dance” between
experiencing (immediate, emotional work) and explaining (reflective,
cognitive work).
Some of the techniques Mahoney used to address pattern-level work
included: personal journaling, bibliotherapy, unsent letters, life
review exercises, and narrative reconstructions.
Techniques
 
Despite the value of both problem- and pattern-level work,
Mahoney believed that the level of focus that held the most
promising potential for enduring, significant change was that of
process
, which is always done in the immediate moment (very
here-and-now). Some process-level techniques include:
Fantasy and dreamwork
Stream-of -consciousness, mirror time, and varieties of
meditative practices
 
In all of these cases, clients are instructed to “look inward” with as
little judgment as possible; to attempt to simply observe the many
activities – from physical and emotional to mental and spiritual –
that constitute their moment-to-moment experience.
Interface with Recent Developments in
the Mental Health Field
 
Nature/Nurture
Constructivists see the role of nature and nurture as
mutually constitutive, yet still open to the choices,
perceptions, stories and constructions of the
interpreting person.
Pharmacotherapy
Constructivists do not view medication as a
necessary component in the resolution of many
clients’ psychological issues.
More important is the client’s opinion of medication
and the role it could play.
Interface with Recent Developments in
the Mental Health Field
 
DSM 5 Diagnosis
Constructivists do not rely heavily on an
objective criteria system such as the DSM.
How the client weaves the symptoms --
particularly the 
meanings
 the symptoms have
for him/her -- into his/her story is seen as
much more important and instructive than the
symptoms themselves
.
Interface with Recent Developments in
the Mental Health Field
 
Managed Care/Brief Therapy
Constructive forms of therapy fit nicely into brief counseling
models
Technical Eclecticism
Because constructive counseling is not defined by the use of
specific techniques, but rather by a commitment to
developmentally pace interventions that help them create
meaningful, engaged lives, constructivist approaches are
ideally suited to technical eclecticism.
Interface with Recent Developments in
the Mental Health Field
 
Diversity Issues
Constructivist theories are philosophically
well-positioned to honor cultural differences
in clients.
Because the individual is seen as an active
agent, it is the individual’s perspective and
interpretations that are given the most power
and weight in the counseling relationship.
 
Interface with Recent Developments in
the Mental Health Field
 
Effectiveness of Psychotherapy
Numerous studies demonstrate the
effectiveness of constructivist approaches.,
especially Solution-focused brief therapy.
Solution-focused is considered an Empirically
validated approach.
Weaknesses
 
Many constructivist approaches are relatively
new.
Many beginning students are attracted to the
(much simpler) solution-focused approach,
which emphasizes asking questions; this can
can seemingly give counselors-in-training
“permission” to ask many questions and give
advice.
Distinguishing Additions
 
Mahoney’s developmental constructivism is
one of the most comprehensively integrative
approaches to counseling and psychotherapy.
As such, it is capable of brief, pragmatic work
(cognitive behavioral) as well as deeper
process work (existential-humanistic and
transpersonal).
References
 
Fall, K. A., Holden, J. M., & Marquis, A. (2016).
Theoretical models of counseling and
psychotherapy
. New York: Routledge.
Mahoney, M. J. (2003). 
Constructive
psychotherapy: A practical guide
. New York:
Guilford.
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Constructivist approaches in counseling and psychotherapy emphasize the ongoing process of structuring experiences to create meaning. This perspective involves philosophical underpinnings from thinkers such as the Buddha, Immanuel Kant, and Jean Piaget, highlighting the role of individual construction in understanding reality. Founders of Constructivist theory integrate cognitive-behavioral, existential-humanistic, psychoanalytic, and transpersonal legacies. The nature of humans in this framework focuses on the emotional and tacit processes involved in organizing experiences to construct meaning.

  • Constructivist approaches
  • Counseling
  • Psychotherapy
  • Philosophy
  • Human development

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  1. Theoretical Models of Counseling and Psychotherapy, 2ndEdition Chapter 12: Constructivist Approaches Andre Marquis, Ph.D. University of Rochester

  2. Historical Context A reaction against the prevailing attitude of narrow empiricism and the search for an objective truth The verb to construct comes from the Latin con struere, which means to arrange or give structure; the ongoing nature of structuring (organizing) processes is at the heart of lifespan development.

  3. Founders There is not a single founder of Constructivist theory. There are many different interpretations about what Constructivist theory looks like in practice: Some emphasize a cognitive-behavioral legacy. Others emphasize existential-humanistic, psychoanalytic, or transpersonal. Michael Mahoney s approach includes and integrates aspects of each of these legacies.

  4. Philosophical Underpinnings The Buddha emphasized the role of minds and thinking in the creation and maintenance of our experience of reality. Giambattista Vico: human knowing involves an imaginative construction of order in experience, and that knowledge must be understood as a process of construction that takes place in social contexts. Immanuel Kant emphasized the power of patterns in our thinking, and he regarded ideas as regulative principles. Kant believed that we participate in the construction of a universal lawfulness. Hans Vaihinger argued that the primary purpose of mind and mental processes is not to portray or mirror reality, but to serve individuals in their navigations through life circumstances.

  5. Philosophical Underpinnings Jean Piaget emphasized that we organize our worlds by organizing ourselves, and this theme of self- organization pervades constructive views of human experience. George Kelly s theory of constructive alternativism, better known as personal construct theory, emphasized both possibility and pattern in the self- organization of personality.

  6. Nature of Humans: Function of Psyche The most primary is to order and organize one s experience and thus, to construct meaning. Mahoney noted a consensual emphasis on five overlapping themes about human experience and development: 1. Human experiencing reflects continuous and primarily anticipatory activity. 2. The ongoing activity of humans is primarily devoted to ordering processes or the organizational patterning of experience; these ordering processes are fundamentally emotional and tacit, and they are the essence of meaning-making.

  7. Nature of Humans: Function of Psyche 3. The organization of personal activity is fundamentally self-referent or recursive, making the body a fulcrum of experiencing and encouraging a deep phenomenological sense of selfhood or personal identity. 4. Self-organizing capacities and creations of meaning are strongly influenced by social-symbolic processes; persons exist in living webs of relationships, many of which are mediated by language and symbol systems. 5. Each human life reflects principles of dynamic dialectical development; complex flows among essential tensions (contrasts) are reflected in patterns and cycles of experiencing that can lead to episodes of disorder (disorganization) and, under some circumstances, the reorganization (transformation) of core patterns of activity, including meaning-making and both self- and social relationships.

  8. Nature of Humans: Structure of Psyche The difference between psychological functions (which are dynamic and frequently in flux) and structures (which are traditionally presumed to be quite stable) is more accurately a matter of time scale. Structures whether a schema or self also can change; they just change more slowly than functions.

  9. Nature of Humans: Structure of Psyche Mahoney strongly believed that it is more accurate to conceive of processes than mechanistic structures. For example, the difference between conceiving the self as verb, activity, or ongoing process in contrast to a noun or structure Operating primarily outside of our awareness, Core Ordering Processes (COPs) are the organizational processes through which we perceive stabilities, continuities, and constancies.

  10. Nature of Humans: Structure of Psyche COPs involve four overlapping themes: 1. Reality refers to one s worldview and perceptual constancies along dimensions such as possible/impossible, real/unreal, and meaningful/meaningless. 2. Value refers to emotional judgments (all judgment requires a valence positive or negative) along dimensions such as good/bad, right/wrong, and approach/avoid.

  11. Nature of Humans: Structure of Psyche 3. Self refers to that with which we identify and our processes of establishing a felt-sense of coherence, continuity, and order to our experience along dimensions such as me/not me, us/them, body/world, and worth/worthlessness. 4. Power refers to one s sense of agency along dimensions such as active/passive, hopeful/hopeless, in control/out of control, and engaged/withdrawn.

  12. Role of the Environment The individual is seen as being in a dialectic relationship with the environment, which means all people react to and act on their environment continually. People do not develop in isolation; it is the interaction between environment and self that provides the building materials for one s personal constructs. Emphasis is given to the individual s interpretation of the environment, especially how he/she can constructively move forward.

  13. Health Constructivists do not define mental health in specific terms. However, developmental constructivism does suggest some general contours of what constitutes relative health. Such a trusting engagement in life (in contrast to passive withdrawal) and having a sense of agency in and authorship of one s life Other aspects of health involve balance and wholeness (integration).

  14. Unhealth Mahoney depathologized many of the concerns clients brought with them to counseling. For example: Because each person is always engaged in active gestures of seeking a dynamic balance in his/her life, a "disordered person" can be viewed as one whose life circumstances exceed their developed integrative skills. Much that is termed unhealthy involves imbalance and segregation of parts from the whole.

  15. Change Process In Mahoney s Human Change Processes, he demonstrated that complex, nonlinear processes are involved. Although he stressed that the particulars cannot be predicted, some patterns are more likely than others. Oscillations are common in the development of new skills and are often apparent in the restructuring of core ordering processes. Exploratory behavior is usually suppressed in the presence of strong negative affect).

  16. Clients Role Clients hold the primary responsibility for change. Each client is seen as a collaborator in the change process. Their role is not passive; it can best be described as engaged. They must be willing to focus on the present and be active participants in goal-setting and experimenting with new ways of thinking, feeling, and acting.

  17. Counselors Role Creating an atmosphere of safety, openness Creating a collaborative working alliance Empathizing with clients struggles and suffering Helping clients realize that they are capable of making positive changes in their lives Promoting change by co-creating various experiments in new ways of thinking, feeling, and behaving that clients practice between sessions

  18. Capacity for Change According to developmental constructivists, the resilience and resourcefulness of the human system is much greater than is generally appreciated. Without ignoring the profound negative influence that genetics or neglectful or abusive early childhoods may exert, we can considerably influence the course of our development throughout the lifespan. At the same time, our potentials for transformation are surely not limitless.

  19. Capacity for Change According to Mahoney, most counseling theorists have grasped part of this issue, but not its complexity: People do express their genetic inheritance, but they do it in highly contextual and individualized ways. Early experiences make big differences in developmental trajectories, yet many people transcend them. Environments do select patterns, yet we select and change our environments. Human potential may not be limitless, but it is much greater than most psychological models have yet appreciated. (2003, p. 170)

  20. Resistance What is usually referred to as clients resistance involves the experience, or potential threat, that too much of their core is changing too quickly. Resistance is not merely an intrapsychic function of the client, but rather, a product of the intersubjective field between client and counselor with the counselor s actions always playing a role.

  21. Characteristics of Effective Counselors 1. Prepare for each session in private reflection. 2. Honor the complexity and uniqueness of each client. 3. Give yourself and your client permission not to know and not to fully understand. Life is much more than figuring things out; effective therapy does not require complete understanding or definitive explanations. 4. Let clients set the pace, and honor their process. 5. Encourage (but do not force) emotional expression.

  22. Characteristics of Effective Counselors 6. Allow and invite yourself to feel emotional in the process of counseling. Let your heart lead your helping. 7. Trust that your clients can endure their pain and be strengthened by the process. 8. Emphasize safety and offer as much structure as your client needs. 9. Affirm and encourage experimentation and exploration. 10. Teach compassion, forgiveness, and self-care. (Mahoney, 2003 p. 262-263, italics in original)

  23. Stages Solution-focused therapy: 1. Identify problem/set goal 2. Designing Interventions and Tasks 3. Stabilization and termination Narrative Counseling: 1. Telling of the story 2. Exploring pieces of the story 3. Exploring alternatives 4. Writing new stories

  24. Therapeutic Relationship Use the therapeutic relationship as a safe and secure base (sometimes referred to as a holding environment) in and from which the client, with the help of the therapist s sustained empathic attunement and inquiry, can learn to explore and experiment with his or her emotional experiencing processes. Change occurs not through the mechanical implementation of techniques, but through an intersubjective experience.

  25. Techniques Developmental constructivism is less a matter of the specific techniques used than it is a compassionate sensibility grounded in the developmental pacing of individually tailored interventions to help people organize and reorganize their lives. Care and compassion are at the heart of all our efforts to help.

  26. Techniques Mahoney stressed that the power to change lies in processes rather than specific procedures (2003, p. 58, italics in original) Mahoney conceived of interventions as addressing three interwoven levels: problem, pattern, and process. Problem-focused work focuses on solving specific problems and usually emphasizes behavioral and cognitive interventions. Because specific problems very rarely exist in isolation, it is often more effective to focus on the patterns and relationships among specific problems. Mahoney thought of pattern work as involving a dance between experiencing (immediate, emotional work) and explaining (reflective, cognitive work). Some of the techniques Mahoney used to address pattern-level work included: personal journaling, bibliotherapy, unsent letters, life review exercises, and narrative reconstructions.

  27. Techniques Despite the value of both problem- and pattern-level work, Mahoney believed that the level of focus that held the most promising potential for enduring, significant change was that of process, which is always done in the immediate moment (very here-and-now). Some process-level techniques include: Fantasy and dreamwork Stream-of -consciousness, mirror time, and varieties of meditative practices In all of these cases, clients are instructed to look inward with as little judgment as possible; to attempt to simply observe the many activities from physical and emotional to mental and spiritual that constitute their moment-to-moment experience.

  28. Interface with Recent Developments in the Mental Health Field Nature/Nurture Constructivists see the role of nature and nurture as mutually constitutive, yet still open to the choices, perceptions, stories and constructions of the interpreting person. Pharmacotherapy Constructivists do not view medication as a necessary component in the resolution of many clients psychological issues. More important is the client s opinion of medication and the role it could play.

  29. Interface with Recent Developments in the Mental Health Field DSM 5 Diagnosis Constructivists do not rely heavily on an objective criteria system such as the DSM. How the client weaves the symptoms -- particularly the meanings the symptoms have for him/her -- into his/her story is seen as much more important and instructive than the symptoms themselves.

  30. Interface with Recent Developments in the Mental Health Field Managed Care/Brief Therapy Constructive forms of therapy fit nicely into brief counseling models Technical Eclecticism Because constructive counseling is not defined by the use of specific techniques, but rather by a commitment to developmentally pace interventions that help them create meaningful, engaged lives, constructivist approaches are ideally suited to technical eclecticism.

  31. Interface with Recent Developments in the Mental Health Field Diversity Issues Constructivist theories are philosophically well-positioned to honor cultural differences in clients. Because the individual is seen as an active agent, it is the individual s perspective and interpretations that are given the most power and weight in the counseling relationship.

  32. Interface with Recent Developments in the Mental Health Field Effectiveness of Psychotherapy Numerous studies demonstrate the effectiveness of constructivist approaches., especially Solution-focused brief therapy. Solution-focused is considered an Empirically validated approach.

  33. Weaknesses Many constructivist approaches are relatively new. Many beginning students are attracted to the (much simpler) solution-focused approach, which emphasizes asking questions; this can can seemingly give counselors-in-training permission to ask many questions and give advice.

  34. Distinguishing Additions Mahoney s developmental constructivism is one of the most comprehensively integrative approaches to counseling and psychotherapy. As such, it is capable of brief, pragmatic work (cognitive behavioral) as well as deeper process work (existential-humanistic and transpersonal).

  35. References Fall, K. A., Holden, J. M., & Marquis, A. (2016). Theoretical models of counseling and psychotherapy. New York: Routledge. Mahoney, M. J. (2003). Constructive psychotherapy: A practical guide. New York: Guilford.

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