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[00:00:00] Dr. Sharp: Hey y’all, this is Dr. Jeremy Sharp. This is The Testing Psychologist podcast, episode 17.

Welcome everybody to another episode of The Testing Psychologist podcast. Today, I am talking with Dr. Erika Martinez, who’s a licensed psychologist in Florida. Erika and I initially got introduced by Kelly Higdon who I have talked about and who was just on our podcast not too long ago. So Kelly, in addition to being a private practice consultant is also a great networker. She has introduced me to a bunch of great folks and Erika is one of those people.

When I first talked to Erika, I was really struck by how she has a lot of training in neuropsychological assessment, which we’ll [00:01:00] talk about, but she has also taken that and shaped it to fit her practice in a different way than most classically trained neuropsych folks have, so I’m excited about our conversation today.

I will introduce Erika here and then we will dive into our talk about neuropsychological testing and how that can take a little bit of a different approach. Dr. Erika Martinez is a Florida licensed psychologist and certified educator. She specializes in the assessment and treatment of a variety of mental health conditions in young adults. Using her expertise in neuropsychological testing, she helps others explore life’s challenges and brainstorm solutions using their personal strengths. With greater self-awareness and confidence, they are able to move forward and lead personally and professionally rewarding lives.

Dr. Martinez provides psychotherapy to high-achieving teenagers and professional millennials facing quarter-life crises, relationship meltdowns [00:02:00], and existential dilemmas that can present as a myriad of symptoms like anxiety, destructive behaviors, self-sabotage, depression, burnout, poor self-esteem, and poor social skills.

She previously worked in graphic design, human resources, and community mental health. Prior to entering private practice, she worked in secondary and university public education settings for about 10 years helping parents and educators better understand and serve students with ADHD, Giftedness, and learning disorders.

So Erika, welcome to the podcast.

Dr. Erika: Thanks for having me on, Jeremy. I appreciate it.

Dr. Sharp: Yeah, of course. That is quite a biography, goodness. As I was reading through all of that, I recognize you have done a lot of stuff over the years, so that’s pretty incredible.

Dr. Erika: Yeah, I got started early.

Dr. Sharp: I guess so. I know that people take different paths to getting their doctorate and getting into private practice, did you go [00:03:00] straight from undergraduate to graduate school and then straight out?

Dr. Erika: Yeah, I did. I did undergraduate here in Miami and I was one of those high achievers myself. I was about 19, maybe just about to turn 20 when I graduated with my undergraduate thanks to some accelerated courses in high school. And so I was one of, if not the youngest graduate student in my program at Carlos Albizu where I graduated eventually from with my doctorate. So I have done a lot but it’s also because I got started pretty early.

Dr. Sharp: It sounds like it, goodness, so you were ready to go?

Dr. Erika: Yeah.

Dr. Sharp: Ready to get out there and do it

Dr. Erika: Yes.

Dr. Sharp: When we talked before we were recording, you mentioned that psychological testing and neuropsychological testing has been [00:04:00] in your blood, so to speak. Could you talk about that just a little bit?

Dr. Erika: Yeah, absolutely. My dad is a psychologist as well. He’s also a trained neuropsychologist, but he’s also a physician. When he was in his 30s, he had a heart attack and decided to stop practicing medicine because of the stress and those sorts of things. And so he got into psychology and as he was going to school, I was a little girl. I must have been about eight or nine years old.

One afternoon, he had an old DSM. I think it was an old DSM-IV. It wasn’t even the DSM-IV-TR at that point. And he had it lying in the backseat and I was in the backseat and we were stuck in Miami traffic, which is pretty hard. [00:05:00] And curious bookworm that I always was, I opened up the DSM thinking it was a novel, and it wasn’t.

I had opened up to histrionic personality disorder and read through the snippet with all the box with all the criteria. Here’s me, eight or nine years old, from the backseat, telling dad, hey dad, I think so and such has this histrionic thing and I’m sounding it out as little kid would.

I must’ve really scared my dad because he pulled over as soon as he could and leans back and turns around into the backseat and says real slow, okay, yes, you’re right but we can’t say that to people. [00:06:00] And then he launches into this whole explanation about the book you’re holding is very important, and he’s trying to break it down for me that it’s not a kosher to run around diagnosing people.

But it certainly intrigued me enough that there is this labeling and categorization system out there that we can use to better understand people. And I think that’s what fed my desire to know more about testing and quizzes and that sort of thing. So I was definitely a quiz junkie growing up. And that got me started.

Dr. Sharp: Well, yeah, that’s super early. So diagnosing family members with personality disorders is not something that we all do.

Dr. Erika: No. I think we all know it in the back of our mind, but it’s precocious for an eight or [00:07:00] nine-year-old to chime in from the backseat and say, I think so and such has this.

Dr. Sharp: Right. I’m sure your dad was just like, oh my goodness, we got to take care of this.

Dr. Erika: Yes, pretty much.

Dr. Sharp: File under stories of psychologists’ kids.

Dr. Erika: Yes, definitely.

Dr. Sharp: That’s funny. Literally and figuratively, it sounds like you got an early start with diagnostic work. How did you take that then? So moving through undergraduate and then going to graduate school, did that stick with you? How did you pick to go the neuropsychology route once you got into formal training?

Dr. Erika: I had no intention of doing neuropsychology. I think once I got older and I was a teenager and I saw what dad was doing, it’s totally the opposite, I don’t want to be a neuropsychologist. Are you crazy? [00:08:00] That’s what dad does. That’s so boring.

So it was totally on the other end of the spectrum. I had said, well, when I go to graduate school, I’m going to focus on forensics. I want to go into profiling and chasing criminals. Back at the time, there was a popular show called Profiler on TV. I loved that show. And of course, Silence of the Lambs, one of my favorite movies. So I was totally into that. That’s what I was going to go to school for. That’s what I was going to do.

And then when I was in school, picked up my non-terminal master’s and that’s about the time when the recession was about to hit back in 2007, 2008. I was working at a local program for kids that had emotional disturbances within the school system. And when [00:09:00] that economic downturn hit, they had to do something with us but they were defunding that program. And so the school system said, well, these people have educational degrees. We have a teacher shortage. We’ll put them in the classroom.

And so that’s what they did with me. They put me in the classroom. And in working with those kids with these special needs, I realized that there is such a huge need for better-understanding autism and learning disorders and all these that are now in the DSM called neurodevelopmental disorders, and that’s what shifted my focus more towards the neuro track and I’ve never looked back at forensics since.

Dr. Sharp: It sounds like a defining moment for you and push you in a different direction then. So then did you go that formal neuropsychological route through graduate school and [00:10:00] internship and postdoc and everything?

Dr. Erika: Yeah, I did, gosh, I’m trying to recall. You’re making me go back ways. I went through the neuropsychology concentration in my program and then when it came time to do an internship, I got accepted to interview at some pretty Snazzy internship sites but unfortunately, personal life circumstances kept me from being able to accept those internship positions. So I realized that I had to take a generic, I guess, for lack of a better term, community mental health setting internship.

I just reconciled myself to the fact that I would be doing an extended postdoctoral stint for neuropsychology. And so that’s what I wound up doing. I did my internship and then [00:11:00] my postdoc, I was very picky about which one I took. I found a great local neuropsychology practice that I stayed with after my graduation and I did all my postdoc work with them and I’m actually still been with them. This month is my last month with them because …

I’ve stayed with them for quite a while doing work with, there’s a lot of, geriatric population that we work with there and I’ve enjoyed that work as well but I’ve stayed with them for quite some time and learned a lot along the way.

Dr. Sharp: Yeah, absolutely. I know that you’re in private practice, so have you been building your practice on the side over the years or how does that work?

Dr. Erika: I did my postdoc with them, once I was a full licensed clinician, I knew that [00:12:00] I wanted to do private practice and that’s why I chose that particular postdoc because it was a private practice and I could learn both sides of it. I could get my neuropsychological training but I could also get an insider’s look at private practice and how it’s run and that sort of thing. Once I got licensed, I started very slowly building my private practice, which has resulted in a very different-looking private practice but nonetheless, the experience that I got there has been invaluable.

Dr. Sharp: Let’s jump into that. That’s one of the really interesting things for me. Like I mentioned at the beginning of the show is that you have taken this neuropsychology training but now you’re doing a little bit of a different path. Can you talk about that?

Dr. Erika: Sure. I think what happens when you come to a profession so young is that you’re also not fully [00:13:00] formed and you don’t know what you don’t know, so to speak. As I’ve grown as a person and as I’ve grown as a professional, I’ve realized there’s this whole other world of psychology that because I was so immersed in neuropsychological training that I didn’t get to explore as a professional.

And so I think that has been the path of my private practice to explore those things and to come to an understanding of that side of the work. I love my testing but I realized that I don’t necessarily love report writing.

Dr. Sharp: I’ve heard that before.

Dr. Erika: It’s tedious, it’s time-consuming and while I love testing, I don’t necessarily love the report writing that [00:14:00] comes along with it. So what I’ve done is that I’ve racked my brain and found a way that allows me to still do the testing that I love, understand, and conceptualize cases in a way that fits for me, but that doesn’t necessarily require psychological testing. And that’s what we were talking about earlier before we started the recording.

Now I have a name for it. I didn’t know there was a name for it. Thank you, Jeremy. Now I know it’s called therapeutic assessment. I was doing it and I just didn’t know that there was a nomenclature for it.

So what I do is when I onboard new therapy clients, I have certain tests that I administer, things like the Beck scales but depending on what they’re presenting with, I might administer Kristin Neff’s self-compassion scales, [00:15:00] I might administer an MMPI. It just depends on what the presentation is. I’ll administer those tests and I’ll use that to help conceptualize the trajectory of the therapy that I’m doing with that person.

It’s very much collaborative. I’m the stage on the stage kind of thing. I’m the one, here’s all this information, and here’s where we’re going with your therapy. I do take probably two or three sessions to work with that client, help them understand what the testing says, and where I think there’s room for us to explore, where there’s room for growth. And then really engage and have that conversation with the client about what their goals are for therapy and how this impacts their goals for therapy.

So that’s what I’ve been doing and it seems to [00:16:00] work really well. It definitely accelerates therapy because we don’t go into therapy blind to see just what comes up in conversation. It does give us a clear goal as we’re working together and it brings awareness to the concerns that perhaps might show up as obstacles. So it definitely accelerates therapy, which is good for the client.

I know I’ve gotten a lot of resistance and a lot of pushback from other clinicians as I’ve shared this model with them because their concerns are more financial in nature. They’re concerned that if the client goes through therapy so quickly and it’s so effective, what do you do from a business perspective when you’re doing that? [00:17:00] I’ve personally haven’t found that to be an issue.

Dr. Sharp: Okay. Let’s dig into that a little bit. I’m really curious about some of the details about how you do this. Actually, before I jump into all those questions, I’m just curious, I think for me, it would be hard to leave behind all of this formal training. It’s even hard for me sometimes to think about cutting tests out of my current battery which is already pretty comprehensive. So I’m like, oh my gosh, how do you let go of all that data and all that training and experience? Was that hard for you at all or was it natural?

Dr. Erika: Well, no, I wouldn’t say it’s natural at all.

Dr. Sharp: Okay.

Dr. Erika: What I realized, and I think this is more of an exercise in personal growth is I liked the testing because of the [00:18:00] certainty. The numbers were the numbers, the data was the data, and all I was was a steward and an interpreter of the data. As I’ve grown as a person, as I’ve grown as a clinician, I realized that certainty is an illusion, control is an illusion, and it’s all kind of BS.

I’ve also realized that testing is just a glimpse. It’s a snapshot of a moment in time for a person. It’s a tool for information but it’s not an ultimate or a defining tool. So I use them in that way. I don’t use them as this definitive here’s a picture of this person, here’s what’s going on with this person and this is how we define this person [00:19:00] which I think in a lot of cases people who specialize in testing do. They have that clear picture and then they just pigeonhole the individuals that get tested based on the parameters of a test.

Again, as I’ve grown as a person, I’ve realized that one test does not define me and I’ve had all those tests done on me because dad used me as a guinea pig going through graduate school. As I look back at those tests and the results of those tests because he was generous enough or insane enough to let me look at them in hindsight, I realized that who I was then is not who I am now day and night. So [00:20:00] I like to afford people the same courtesy.

Dr. Sharp: I like that. I feel like we could certainly go down that path for a long way. I’m always struck by how I’ll test folks even like five years, maybe 10 years after their initial evaluation and things can be pretty different. So I think that’s a good point. It sounds like making peace with that for you was a big part of the process and being able to let go of some of the more formal testing and move to doing more in the moment or brief evaluation. Is that fair?

Dr. Erika: Yeah, definitely fair. I still do neuro testing. I still do comprehensive evaluations. It’s just that is not my every day. I [00:21:00] equate it to fishing, Jeremy. To me, those kinds of testing cases, it’s like fishing for marlin as opposed to fishing for yellow snapper. To me, therapy is more like your snappers. Snappers come in all the time but every once in a while, I’ll catch a marlin, a marlin will be on the hook and that’s how I run the practice.

Dr. Sharp: Got you. Spoken like a true Floridian. I like this. That’s a good way to think of it.

Dr. Erika: Yeah.

Dr. Sharp: Okay. So that’s good to know. You still have some comprehensive evaluations in there but it sounds like you’ve moved to this more therapeutic assessment model for the main part of your practice. So let me ask about that. I’m curious, just detail [00:22:00] oriented, how do you present that to clients, and how does that factor into the cost of therapy? Let’s just start there and see where we go.

Dr. Erika: Sure. When I was kicking this idea around about a year and change ago, in fact, I was kicking it around with Kelly. I sat down with her and she helped me figure out how much time this would entail, how to structure it, and how to charge accordingly for it. What I came up with is that I just needed to increase my rates slightly ever so to justify the amount of time that it would take me to do the additional interpretation.

A lot of the tests that I use [00:23:00] like an MMPI or an MCMI is a lot of it is automated. A lot of it is done for us and you know that. We put in the information into the computer, the computer spits out a report to us, and that’s what I sit and I work with clients using.

So because I was cutting out the report writing and the clients understand that I’m not doing a report, it’s not a formal report sort of thing, I wasn’t able to increase my rates, not in a very drastic way so that it wouldn’t, make me cost prohibitive to clients, especially the clients that I serve. That’s also really important to me.

When you’re working with millennials and millennial professionals, these are people that are pretty early days into their careers. They’re not senior-level executives or anything like that. They’re not making a [00:24:00] lot of money and so I wanted to always remain cognizant of that and provide a really unique service for a really reasonable value. I think I’ve figured that out.

Dr. Sharp: It sounds like you don’t necessarily bill for a “separate assessment”, the assessment process and is just billed into your therapy session rate. Is that right?

Dr. Erika: That’s right.

Dr. Sharp: Got you. Okay. Fair enough. So when you say, and you don’t have to talk details necessarily, but kind of relative to the market cost of therapy there in Miami, where do you think your rate falls then to incorporate these assessment pieces?

Dr. Erika: I think it puts me right at the average level, actually. I think I’m right on par with the going rate [00:25:00] in the community where I’m at, which is in central Miami, it’s somewhere between 150 to 170. So I’m right there. I’m right in that range. It’s not like clients are paying more than they would normally pay in terms of a going rate, but they get this added benefit to the kind of therapy that they’re doing and it’s much more targeted and in alignment with where they want to go in terms of their self-exploration.

Dr. Sharp: When do you incorporate the assessment, is that during the intake session or do you do it over the first two or three sessions or how does that work?

Dr. Erika: So there’s a few assessments that I always give initially. So the Becks, those kind of screeners are always, [00:26:00] I always tell clients to come in a little bit early just so that I can fill out those. Besides that, the other stuff gets tailored in as needed within the first four weeks, usually of therapy.

So usually they’ll come in once a week. And for the first four weeks, as I’m getting to know them, really understanding the clinical picture, by the fourth week, I’ll have administered most of the assessments that I’ll usually need to really make an informed case conceptualization and approach the client with a plan or a strategy for their therapy.

Dr. Sharp: And do you do this with every client?

Dr. Erika: I do this with most of my clients at this point. I have very few clients that I see right now that I haven’t implemented this model with, these are the clients that were with me before I started [00:27:00] using this model and they come in for maintenance, I call them tune up sessions. They come in as needed basis. So those are the only clients that I haven’t done this with at this point.

Dr. Sharp: How do you incorporate the results from these assessments into the session? Is it a formal feedback process or do you just throw it in there when it feels appropriate as you’re doing typical therapy or how does that look?

Dr. Erika: Initially it looks more like a feedback session, I would say, depending on when I’ve administered these and it really just depends. So in some cases, I’ll know just from the initial free phone consult that I need to administer an MMPI. I’ll know it just from that conversation. So I’ll tell the client, listen, you need to [00:28:00] come in either an hour before or plan to stay an hour later to do this particular test. It takes about an hour to do. And then we’ll discuss the results. It’ll help us.

I know you explain why, that’s really big with millennials. You really have to explain why we’re doing this. So I’d like to be really clear with them. Usually, yes, it’ll look like a feedback session initially but then as we’re in therapy and we’re going through the different sessions of therapy, we’re always referring back to the testing and is this possibly what the results were indicating? We’re always having a conversation about that, so it’s a bit of a dual process, if you will, going on.

Dr. Sharp: Sure. Going back just a little bit, could you give me your script for how you explain why this is necessary? Whether you say that out [00:29:00] loud or it’s on your website, how do you explain that this is just part of your process?

Dr. Erika: It is on the website. So most people aren’t too shocked when I have that conversation with them initially. I always frame it as sometimes there’s things that we’re not aware of that even with our best efforts and with somebody who’s very insightful and self-aware may not be aware of some underlying processes. Lucky for us, we have these tests that are able to access certain underlying processes that we may not even be aware of or be able to verbalize.

So when I explain that to clients, they get it. Usually, they say, okay, yeah, let’s do this. I [00:30:00] want to grow. I want to obliterate the psychological obstacles that I have in my way. If this is the way to do it, then I trust you. Let’s do it.

Dr. Sharp: That’s great. I like that way that you phrase that we can uncover processes that we might not be aware of and we have these instruments that allow us to do that pretty quickly.

Let me switch gears just a little bit. I know we’re getting a little bit close timewise, but how do you market these services? And then does that look different than marketing just a typical therapy practice?

Dr. Erika: Most of the clients find me organically. They find me when they’re doing a Google search. They find me on Psychology Today, by word of mouth. I would say those are the majority of my [00:31:00] referral sources. These sources have served me well for the last few years since I’ve been in private practice.

Could I do more marketing? Yeah, I could. I could definitely start talking to all sorts of other ancillary professionals that might come into contact with my ideal clients. Absolutely. I don’t know that I’m there yet and I don’t want to grow the practice so fast that it would become overwhelming for me to be able to manage that many cases.

I like to see about 15 clients a week and that’s my sweet spot as far as therapy clients. I don’t like to do more than that simply because there is the testing that I do for vocational rehab that I do love [00:32:00] and it’s really rewarding for me. So between those evaluations and the 15 therapy clients, I pretty much have a full plate and so I haven’t ventured off into marketing more for that very reason.

There is coming a day very soon where I will probably start marketing more and I will probably start taking on independent contractors to handle the overflow of clients.

Dr. Sharp: That’s great. Congratulations. It sounds like you’re in a good spot. If you’re seeing 15ish therapy clients, if you tack on an evaluation there, that’s gets you right up to full time pretty quickly. I totally understand that. Well, before I let, oh yeah, go ahead.

Dr. Erika: I was going to say about 15 therapy clients and maybe one to two evaluations [00:33:00] and that’s a full plate for me.

Dr. Sharp: No, that sounds about right. I’m a little bit jealous. I have more than I need. So being down at that level sounds pretty good right now.

Before I let you go, I wanted to ask you, any resources for the assessment process that you use, any books, any websites, and also any books or resources that are helpful, particularly with millennials that you could recommend.

Dr. Erika: The majority of my work in therapy revolves around perfectionism, codependency, shame, vulnerability, so I think that the work of Brene Brown, and the books by Brene Brown are really instrumental and key for that. I’ll refer a lot of my clients to her books and also now to her new website, courageworks [00:34:00] where she’s got some online courses for people to take to help them in the therapeutic process.

I find that when clients do those courses, some of them are free, some of them are paid, but they’re really reasonable, it really helps springboard the work that we do in therapy. It’s like homework, so to speak, so it just reinforces what we’re doing in therapy. So that’s really helpful.

I really love the work by Tara Brach on self-compassion, Kristin Neff’s work on self-compassion. She’s got some great resources on her website for meditations and exercises and journaling that people can do when they’re struggling with self-worth and self-compassion, which a lot of these millennials are struggling with.

It’s really surprising this generation, [00:35:00] how much they struggle with that and how that shows up in their relationships, especially their romantic relationships, because that’s really important. They’re in that Ericksonian stage of intimacy versus isolation and to watch them go through that and how they struggle and how self-worth interferes with their ability to form healthy, long-lasting relationships.

Dr. Sharp: So important.

Dr. Erika: So a lot of that work by those ladies are key.

Dr. Sharp: Absolutely. I remember, gosh, I think I was on my internship at UT Austin and my then girlfriend, now wife passed along Tara Brach’s Radical Acceptance and I remember that was a game changer in my life and so nice to start to get into that world, and since then the self-compassion [00:36:00] realm has really blown up in our field. And so totally on board with all of that. I think those are great resources.

Dr. Erika: Yeah. I know that’s more on the therapy side but as far as the testing side, I think that’s more along the lines of some of the listeners, I love the resources from the Wiley books, I call them the red, white and blue books. I always refer back to those books for different testing measures and especially refreshing my knowledge when I haven’t used a test in a while or a new test has come out, I always turned to that series of books for that.

Pearson’s got some great webinars by some of the test developers themselves [00:37:00] that come to mind. So if people haven’t signed up for those webinars or for those notices and emails, I’ve found those to be really helpful too.

Dr. Sharp: Okay. That’s good to hear. I get those emails for those webinars often, but to be honest, I’ve never jumped on and taken one. So that’s good to hear a little endorsement for the Pearson resources as well.

Dr. Erika: Yeah, I did one on the MCMI when the new version of it came out, especially the behavioral medicine one, that was helpful as well as the MMPI-2-RF. That was another one that I did and I found those helpful, especially just as primers for these new tests that were coming out just to better understand what the changes were, how the focus shifted within the measure themselves.

Dr. Sharp: Yeah, absolutely. That’s great. Well, thanks. And thanks for the [00:38:00] time. This has been a great conversation. I really appreciate you being willing to sit with me for a little bit and talk through this cool approach to using neuropsychological training in a different way in your practice.

If folks want to get in touch with you or learn more about your practice or about you, what are the best ways to do that?

Dr. Erika: The best ways to probably do that is online at my website, which is www.envisionwellness.co. You can always find me on Instagram, which is the millennials go to social media profile and you can find me @envisionwellnessco and that’s the same on Pinterest and I think that’s about it. If you go to the website, you’ll see all the social media links. So you can always find me through the website. It’s probably the easiest.

[00:39:00] Dr. Sharp: Erika, thanks so much for coming on the podcast. This has been a great conversation and I really hope that our paths cross again in the future sometime soon.

Dr. Erika: Yeah, absolutely. My pleasure. And thank you so much for having me on. This has been really fun.

Dr. Sharp: Yeah, same here. Take care.

Dr. Erika: Thanks. You too.

Dr. Sharp: All right. Thanks again so much for listening to that interview with Dr. Erika Martinez down there in Miami. I think it’s really cool how Erika has really built her practice to use assessment in a way that feels good for her and that follows her passion. I’m in a little bit of admiration that she was able to just turn her back on all that neuropsychology training, not entirely but for the most part, and has chosen to go a way that fits more with what she likes to do. That’s fantastic. So I hope you learned something there.

Thanks again for tuning in as always, is really exciting to see things continue to grow; podcast downloads, people joining the Facebook community. [00:40:00] It’s been great to reach out and connect with so many folks around testing. It seems like this is something that we need to be talking about.

So if you do want more information or want to join our community, you can go to the website, which is thetestingpsychologist.com, and there you can check out past podcast episodes, blog articles. You can find our Facebook community, which is The Testing Psychologist community on Facebook. That is a little different than the business page. So if you’re looking for it, just make sure you add that community to it if you’re searching.

I hope to continue to reach out and talk with you all week to week. Next week, I’ve got an interview with Allison Puryear coming up. She’s one of the best private practice consultants and she’s going to talk with us about networking even for introverts how that might work and how you can do that to build your testing practice. After that, I have a great interview scheduled with Aimee Yermish [00:41:00] who is a psychologist over on the East Coast and specializes in assessment with gifted and twice-exceptional kids. So I’m really excited for that conversation as well.

All right. Hope y’all are doing well, enjoying spring, whatever that looks like where you are, and hope to talk to you next time. Take care.

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