122 Creds - Leadership

anybody repair it i do not it would not it simply would not matter it actually would not matter okay we’re each in right here hey hey we’re dwell do you need to take us in sure all proper i am felicia welcome to properly welcome to my rd journey truly i am felicia proprietor registered dietitian at pera’s diet now llc and my rd journey increase i am adam producer within the stu aka the studio aka our eating room we’re we’re dwell as soon as once more discover felicia on all socials instagram twitter fb all that stuff are you represented as my rd journey and peralta diet individually sure so at pera’s diet we’re at my rd journey and simply to attract the excellence much more clearly um one is prioritizing basic diet that is perazon diet your shoppers and stuff can be remiss to overlook out on that stuff however my rd journey particular for potential dietitians dietitians within the making college students new dietitians that form of factor yep yeah and what are we speaking about at present on my rd journey so we’ll be speaking in regards to the phases of change or the trans theoretical mannequin wow some form of scientist or one thing possibly just a bit bit that is loopy uh this can be a three half collection that we’ll do although so we’ll speak in regards to the phases of change however then we’ll speak in regards to the first two phases on um this podcast after which do the opposite phases later so okay the entire objective is to form of separate this and simply speak somewhat about what the phases are and and form of easy methods to assist transfer shoppers by the phases and assist them transfer by the phases so it is the trans-theoretical mannequin sure and um and and precisely what do you need to simply kick off ought to we simply get into it what precisely is that yeah so mainly what it’s is it’s how folks change their habits so it explains how folks change behaviors so the the items of it there’s 5 phases primarily which there may be a sixth stage however so it is a pre-contemplation contemplation preparation motion and upkeep after which some folks have a sick stage the place it is termination however the entire concept is that folks form of transfer by these phases of change as they’re altering a habits and that is with any habits so not essentially simply diet or train but additionally like smoke any form of habits simply actually something the place you are trying to assist somebody change their habits or if somebody’s trying to change their very own habits i suppose this may be viable for them to learn about as properly for themselves sure sure so that is actually essential not just for like dietitians or folks which can be working with anyone making a change but additionally the person themselves which is definitely one thing newer that i realized i i assumed that you understand folks should not actually know what the stage that they are in however they should not know what the person behind the scenes is doing it is a trick or two yeah but it surely truly makes extra sense as a result of it helps to elucidate to folks the place they’re at and it is this the phases of the change and why a number of the behaviors that they are doing form of like the way it all form of suits collectively okay yeah it helps clarify you understand the place persons are at however okay um so do you need to get into how you employ it or why it is essential yeah so in case you are a dietitian and even as an intern that is one thing that i realized in my undergrad with like motivational interviewing but it surely’s it is form of glazed over in a way and it actually ought to be form of much more than what’s actually talked about however i did a well being coach certification program and that is like all the pieces in that program is all in regards to the phases of change and motivational interviewing so um having the ability to acknowledge what the stage is and we’ll speak at present about the fitting now the 2 first phases which is pre-contemplation and contemplation and form of serving to folks uh to maneuver by these however um the entire concept although is you possibly can’t actually pressure folks to maneuver by the phases which is one thing that i do not know i suppose i all the time thought as a dietitian like my entire objective is to assist folks go from like pre-contemplation to upkeep however that is actually not one of the best method both so that you need you are trying to information folks by these phases at their tempo no matter they select to do yeah there actually is not like a set time-frame essentially and the opposite factor is even simply transferring somebody from one stage to the subsequent one is success so it isn’t about getting folks all over all of the phases and the opposite factor is that folks will truly form of recycle by the phases too so they do not essentially keep and go all the best way to upkeep after which that is it like they form of recycle by so so are we speaking a few form of macro sense the place this has to do with their entire way of life and and eating regimen usually or can we use this to method particular issues i do know because the dietitian clearly you are specializing in eating regimen and i suppose general well being you understand you’ve a private coach certification you are additionally a private coach you give attention to health as properly however the concept here’s a form of macro method or do you employ is that this one thing used to delve into particular issues as properly form of somewhat little bit of each and that is truly level in eager about wellness as a complete as a result of when you consider you understand your objectives with well being lots of people say they need to be more healthy however that is truthfully fairly obscure you understand what does it truly appear like tremendous obscure what does that even imply precisely and so when i speak to folks about adjustments they need to make it is actually good to have this like large wellness imaginative and prescient of yeah you need to be more healthy when it comes to you need to have extra vitality otherwise you need to eat extra greens you need to management your blood sugar and form of having this overarching wellness imaginative and prescient of one thing long run however breaking it down into smaller items and people smaller objectives can then be utilized utilizing this phases of change so so the the trans theoretical mannequin is so you should use it you should use it as an general method and to gauge the place you might be together with your together with your basic health or well being or consuming objectives after which it’s also possible to use it for those who get away your objectives and and what you are doing you should use it for particular person issues as properly is that sure yeah undoubtedly so i might see that being beneficial to somebody who’s a dietitian a well being coach a private coach actually any form of i imply i do not know psychological well being might be not one thing we need to contact on however i imply i might see this making use of to actually each kind of remedy or teaching yeah for all the pieces precisely i imply teaching is form of time period to make use of as a result of it encompasses form of quite a lot of completely different fields however that is precisely i imply in all of the completely different books i used to be studying it apply to not solely just like the meals you eat but additionally like smoking and actually something you need to change and once we we’ll leap into pre-contemplation first and you may form of begin to see you understand once we’re speaking about what folks say on this stage that somebody may be like that is that is me pre-contemplation being the primary stage so can we need to get into how that is used for teaching as a dietitian particularly yeah i imply so we are able to speak about um you understand how you employ it as like a dietitian and even like a well being coach or you understand relying on the place you are at you understand diet knowledgeable or diet coach however um you understand the very first thing is with these phases of change is you form of need to let go of being an knowledgeable as a dietitian which you understand by my undergrad you are taught all of the science and all this sort of data so you’ve all this data form of bursting as you are prepared to go away and speak with folks and it is actually not method you understand to simply inform folks what to do yeah regardless that that is what folks say they need they all the time inform me simply inform me what to do and that i used to suppose that that was method like i am simply going to inform folks what to eat and easy methods to do it and there is a place so that you can put in you understand give folks data and information in fact however you form of need to unlock what folks already know as a result of they know their behaviors and themselves higher than you’ll ever so i might be afraid of you understand backing up the proverbial dump truck of information and burying them too quick too quickly that causes a form of paralysis for folks i’d think about that is one thing you need to keep away from so so what you are speaking about is form of um listening as a lot as you speak and form of gauging the place they’re at sure to assist inform what you do sure so all through all of those phases of change and starting with working with any shopper you need to pay attention actively which is a bit of motivational interviewing however form of like actually key to the the ttm mannequin you outline motivational interviewing oh so it is mainly um so there’s form of parts of it but it surely’s mainly um it entails lively listening open-ended questions um affirmations reflections and summaries so it is once more form of like a overarching mannequin in a way have we ever coated motivational interviewing i do not suppose so okay in order that’s yeah looks like an essential element to teaching as a dietitian and making use of the the trans theoretical mannequin in order a dietitian you are teaching you are you are actively listening um are we’re we we’re assuming are we assuming that everybody begins with pre-contemplation do typically folks begin in different phases or can we need to begin there first we’re gonna we are able to begin there first however most i’ll say that most individuals that may come you understand to a dietician are in all probability not in pre-contemplation they’re doubtless in contemplation the pre-contemplation stage are normally the individuals who they don’t seem to be inquisitive about altering in any respect they do not need to change they may say like i will not or i am unable to these are just like the buzzwords clear indicators yeah like i am unable to do it they do not consider that the change is feasible um they will not change they like i do know i smoke however i do not need to give it up and they also’re not prepared for change and so they do not need to change and so they’re not even eager about change actually so possibly as a dietitian you are not as a lot actively coping with somebody in pre-contemplation as you’ll be in contemplation usually talking if somebody seeks a dietitian they’re prepared for change however there are some individuals who you find yourself with as shoppers that weren’t initially in search of a change sure and so and and you may form of unlock form of pre-contemplation with shoppers typically in numerous areas of wellness too um so for instance i’ve shoppers who’re in contemplation for altering a diet habits when it comes to like what they eat however they don’t seem to be prepared to vary train they do not need to in order that they’re prepared to vary one factor and never one other which is the place you’ll form of break this out into completely different little micro adjustments i suppose yeah precisely um and typically in pre-contemplation folks do not even know that they’ve one thing happening so like if you consider a well being screening you understand folks do not won’t know that they’ve hypertension as a result of there’s actually no indicators until you get your blood stress measured proper or like even with excessive blood sugar ranges you understand typically folks have signs however some folks do not and so they go to the physician and so they rapidly have excessive blood sugar rapidly they uncover they’ve a critical well being downside that they weren’t already eager about doing one thing to actively assist sure and in that stage it is some folks transfer immediately into contemplation the place they rapidly notice they’ve one thing and now they’re eager about change however they’re simply they’re not likely positive what to do or they keep in that pre-contemplation stage the place they’re like properly is that denial or is it like a lack of awareness that the difficulty is critical yeah so a few of it’s denial like um you understand some folks will say properly i haven’t got an issue with this or um they form of rationalize the habits or like decrease the habits um you understand they will rationalize however like properly i had a tough day so i deserve to do that whoops sorry with with um consuming or with their with their train like with something it could actually actually be with something like i typically have shoppers who will use that form of rationalization to say you understand i had a tough day so i you understand should um eat a cookie or um you understand i cookie normally for me it is like a complete pizza or one thing these folks should be in contemplation in my view if their wager is whether or not or not they eat a cookie however possibly that is simply me we have been like um just like the minimizing you understand um however i’ve had folks say like properly i’ve i might need a problem with this but it surely’s not as large as different folks or i do not do it that usually and so they form of they will say it with like quick meals typically they will say properly i do not do it day-after-day however i do it as soon as every week and they also form of decrease the issue that they are you understand with and so your official take is that quick meals as soon as every week is a no-no is that what you are saying proper now so for those who get sizzling tasty french fries and a bucket of soda as soon as every week that is a that is a no-no okay she’s not a visitor for anybody who’s simply listening okay pre-contemplation it looks like there are quite a lot of ranges quite a lot of phases um somebody will be in pre-contemplation about one factor and contemplation about one other so simply simply to stipulate as a result of this podcast particularly we’re specializing in these first two phases of the transtheoretical mannequin what is the what’s the main distinction between pre-contemplation and contemplation let’s put it in black and white so we all know precisely what the distinction is and what’s one of the best ways of telling whether or not somebody’s in pre-contemplation versus contemplation so pre-contemplation they’re both unaware they’re conscious and so they will not change or suppose they can not change contemplation and so they’re not even eager about doing it quickly in contemplation somebody is considering the change uh they may be ambivalent in order that they’re form of weighing the professionals and the cons and so they’re possibly going to make a change in to illustrate you understand six months in order that they’re they’re pondering somewhat additional out in order that they’re they don’t seem to be able to make the change however they’re eager about it and so they’re form of deciding if they need to if it is price it so it seems like pre-contemplation is both they do not know or they’re in denial and contemplation is like they know and so they’re accepting it and so they’re form of mulling it over i suppose they don’t seem to be all the best way there however they’re getting there yeah in order that they’re um when you consider pre-contemplation the cons um form of outweigh the professionals of what the habits is versus like with pre-contemplation they’re equal it is the opposite means or so the objective is to extend any person’s execs for change after they’re in that stage all proper so if a shopper is in pre-contemplation what are they doing and um i suppose what are you doing in that state of affairs yeah and so i truly get quite a lot of shoppers on this stage if they’ve been informed by their physician to go see a dietitian so um i mentioned i do not usually get folks on this stage however typically i do when it is um one thing like a office profit or you understand their physician is like you’ve hypertension that you must see a dietitian and or the partner typically they will have that too the place they’re like my spouse informed me i have to see a dietician and they also do not suppose they should see a dietitian no so form of the way you method it first must be with empathy that is a bizarre place to start out with somebody i do not actually suppose i would like you or your providers however i am right here anyway like that is yeah and typically particularly if that is a grown particular person like an all the best way grownup that is yeah bizarre and really in personal observe i am you understand i am saying that i do not essentially get quite a lot of shoppers right here however i truly used to see extra shoppers like this in um inpatient within the hospital i guess so you understand in fact they’re like ah dietitian’s right here i need not see you regardless that you are in a hospital yeah and so that there is there’s form of key issues to take action one is actively pay attention so take heed to what they’re saying be empathetic um and never simply listening to reply you understand to have one thing to say again however to simply actually pay attention on what they’re truly saying um it seems like some stephen covey stuff proper there search first to know yeah oh you say that quite a bit too properly that is simply one thing i feel is sweet to dwell by with folks usually if you wish to join with somebody and actually perceive what they suppose you possibly can’t affect folks to vary until you perceive their beliefs sure and that is truly a giant a part of it too is knowing what issues to them and what they worth and really serving to folks hook up with that may transfer them from pre-contemplation to contemplation so for those who take heed to them what actually issues um you understand after which having the ability to be empathetic and never push them as a result of for those who push them they’re simply going to be resistant yeah i imply that is the very first thing that occurs for those who attempt to affect somebody in a forceful means in the event that they really feel that they don’t seem to be listened to or understood they do not care what you say yeah and you understand i feel that was additionally a mistake i made when i first began as a dietitian was i used to form of use the scare tactic which is like quite a lot of what docs do or you understand members of the family who care is the scare tactic typically and as a lot as we prefer to suppose that that works and typically it might for folks the overwhelming majority of individuals in the event that they make a change based mostly on like a scare tactic they they fall again into their outdated methods as a result of it isn’t one thing that actually issues to them essentially properly it is unlucky the character of illness that dangerous however poor eating regimen influences as a result of it is it is incremental over the course of years you understand you do not eat a cheeseburger and have a coronary heart assault tomorrow that is not the way it works you incrementally harm the you understand you incrementally construct plaque in your coronary heart and your arteries you incrementally lose your lung capability and your muscle tissue incrementally atrophy you incrementally change into unhealthy over time as a consequence of poor way of life so you’ve an uphill battle on that entrance but additionally i feel that dietitians simply aren’t taken as critically as docs which is form of unlucky within the realm of meals and diet occurs to be your complete training whereas you understand doc we have talked about this earlier than yeah however we do not have to go down that that route if we do not need to however you’ve quite a bit going towards you because the dietitian and you understand meals is a kind of issues the place it is it is emotionally concerned it’s and that is why it is actually essential to love truly take heed to folks and be empathetic about it as a result of and and actually validate how they really feel and what they’re feeling um as a result of that may actually make or break and i have had this even lately with you understand shoppers the place they arrive to me and so they’re not likely prepared for change for sure stuff and if i leap proper into properly it’s best to or this and that they don’t seem to be going to belief me that i’ve their finest pursuits in thoughts i am following my very own agenda not theirs and so the entire level is that i am there for them to assist them in a means of form of guiding nonetheless you understand however you understand yeah you are like strolling a slack line or like a tightrope the place you must stability all this stuff as a result of you understand one of many one of many traces that i really like from when i um in my former life as a supervisor is notion is actuality so if in the event that they if they arrive to understand that you’ve something however their finest curiosity in thoughts that you do not take them critically you are out the window yeah you understand they do not care about something you say yeah in order that that lively listening i feel is is is paramount to influencing anybody with something they’re doing that is form of a basic precept but it surely’s completely a high precedence when it comes to this form of teaching so if we’re in pre-contemplation we’re trying to transfer folks shoppers you’ll be trying to transfer shoppers into uh contemplation can we need to transfer on to that or do you need to spend extra time on pre-cut we simply wished to level out so some methods to truly transfer folks into pre-contemplation which you understand as a lot as you need them to maneuver they will not transfer them into pre-contemplation transfer into the contemplation we have mentioned the phrase contemplation so many occasions it is gonna sound like nothing i am gonna hear that phrase for the subsequent week and i feel it is prefer it’s a kind of issues the place you say a phrase sufficient occasions it simply loses all of its that means sure you understand chair chair chair chair chair like what do you begin to suppose it is like spelled flawed if you write it did you ever do this spell examine anyway um the little pink traces oh oh yeah squiggly traces with pre-contemplation when a shopper is in that first stage um one of many ways in which you moreover actively listening and being empathetic and form of constructing rapport with them and um rapport i suppose poor or it is french the t is silent um not lecturing them can also be actually essential as a result of then that form of places you within the driver’s seat and never them and so they can take a resistant form of method however one actually form of key factor that i’ve discovered that’s useful to maneuver shoppers into contemplation is definitely to 1 ask them what they need to do and what issues to them but additionally ask them if they have been inquisitive about possibly studying about no matter it’s regardless of the change is so possibly studying about blood stress or studying about diabetes to not make a change we’re not forcing change at this stage however simply ask them in the event that they’d be inquisitive about studying about it or speaking to others or studying extra about it so not from a facet of me telling them that you must comply with this this and that however simply say hey are you curious about possibly studying about it um and that may actually assist typically with shoppers okay so i am gonna throw somewhat little bit of a curveball out yeah this isn’t one thing we do not actually rehearse the stuff anyway however that is i am going means off script right here if somebody if somebody does to illustrate a brand new dietitian is teaching somebody and so they make a mistake and so they begin to encounter resistance two questions um what what are the telltale indicators of resistance so what are you on the lookout for to note all proper somebody is is is is a bit immune to what i am saying proper now what are the indicators of resistance and the way do you recuperate from that state of affairs that is a fantastic query so thanks very a lot i considered it myself so first is for those who’re for those who’re head to head with the shopper and in a position to see them just about or or in the identical room their physique language will change so um they may cross their arms um they may begin trying on the clock or they may begin like shifting round disengage or change into visibly uncomfortable sure um i’ve additionally it is typically non-verbal sure that is the most important cue is definitely non-verbal that was not what i used to be anticipating yeah however proper actually cool no i simply i had no concept what that was going to get into however yeah that is truly actually good in order that’s one thing you need to search for and concentrate on yeah um and i have had shoppers like faucet their ft the place rapidly they begin fidgeting and i am i i feel i struck one thing and so normally what i will do is acknowledge it that is truthfully one of the best half is you understand typically i will say it looks like i might need struck a nerve right here or i am sensing that you are a little uncomfortable are you able to possibly inform me somewhat bit extra about what you are feeling proper now or um was there one thing that i mentioned that um triggered somewhat little bit of a disconnect right here truthfully being sincere with them and simply asking it outright however in a means that is not like not confrontational yeah like did i piss you off do not say yeah yeah yeah so in order that’s good as a result of in a means so that you’re you are validating the best way they really feel you are recognizing and validating the best way they really feel and also you’re permitting them to open up about it in the event that they in the event that they select to in the event that they’re snug with doing that and to be sincere anytime that that is occurred persons are normally like oh thanks for thanks for pointing that out or they will they will come out and say it like i am simply not likely prepared for this this and this after which you possibly can form of take a step again and say okay properly what what would you love to do subsequent it means that you can recalibrate your method and go from there so um nonverbal communication taking note of nonverbal communication in order that’s form of one of many essential issues of having the ability to see somebody if you coach them what if you cannot see them yeah so truly most of my periods proper now have been quite a lot of uh cellphone periods so i do not see my shoppers so afraid to attempt to pay attention extra for the tone of the voice and the way that adjustments and in addition be very conscious of my tone um so their inflection if there’s quite a lot of pausing so if i strike a nerve with any person on the cellphone um typically there’s only a lengthy silence positive or they may form of change the subject abruptly and relying on what it’s um typically i simply form of roll with it and typically i handle it so if it is one thing possibly somewhat out of my scope i would form of like let it go like if they only form of say one thing somewhat off yeah if it is one thing that i really feel like will probably be worthy to carry up or once more if it is one thing i mentioned that i struck a nerve on i’ll handle it um however typically it’s form of good i do not know for those who’ve heard of the time period or phrase rolling with resistance so typically you simply form of like you do not problem any person however you form of roll with their resistance and once more validate and form of be with them in that and rolling with resistance yeah i prefer it it is a motivational interviewing time period truly there we go yeah so resistance is the primary signal of somebody having a problem with what you are doing or saying and for those who do not handle resistance some old skool tony robbins stuff it develops and uh the subsequent stage i feel is uh uh resentment yeah one thing like that the place for those who preserve working with somebody time and again and that is your methodology the place you simply battle their resistance head-on they start to not such as you yeah and and for you understand uh somebody who’s like a dietitian and even in personal observe most occasions folks then will not schedule with you you understand and you might inform very a lot on the finish of the session if you speak about scheduling and what’s subsequent and you understand i will get again to you typically after which they by no means do they do not reply your emails or your cellphone calls after which you understand it is one thing yeah not dealing with resistance properly not rolling with resistance if you’ll can typically lead to you dropping your shopper and um that may be a little bit of a failure so it is even you understand actually actually essential to handle it head-on or at the least concentrate on it cognizant of resistance in any respect in any respect ranges and phases yeah and what’s unlucky too is eight and i have had shoppers who do not schedule follow-ups and it isn’t essentially as a result of i did one thing flawed or i mentioned one thing flawed per se however they may simply not be prepared or they’re it is one thing else that does not need to do with me so it isn’t all the time about me um however what’s unlucky typically is when folks do not schedule the follow-up or you do not ask you do not know that that is what occurred and so then you possibly can’t form of right so like i am positive there was tons of issues that occurred to start with when i first began counseling as a dietitian as a result of i used to be nonetheless studying quite a bit the place i might need mentioned issues that you understand i assumed had been useful however not and so properly if you’re new at something you are extra in your personal head than you might be current and conscious of of the area and the opposite particular person or what’s taking place round you you are extra involved with what you are doing that is that is a typical quote-unquote rookie transfer for it doesn’t matter what you are doing yeah i would not blame i would not you understand beat your self up about that no dietitian should not you understand you do be taught first your first shopper and your first you understand session are in all probability going to be your worst sure and you bought to be taught one way or the other precisely and that is why it is good too to form of you understand after a session you understand take a second to form of replicate and say like what labored what did not what would i need to enhance for subsequent time so i might actually be useful and even with like working by shoppers with phases of change you understand it may very well be actually be useful typically to simply form of like take a step again and say okay what labored properly on this or what what do i have to possibly enhance upon and use it as like a studying alternative um you understand to to present okay so so coping with resistance one of many main issues in all probability an important factor is to pay attention to the non-verbal communication that is taking place together with your shopper for those who can see them and work together bodily in any means for those who can see them and you may and also you’re in the identical room particularly being conscious of physique language tics adjustments and habits for those who can solely hear them however even for those who can see them too vocal tonality inflection issues like that altering you understand they are saying 93 % of communication is non-verbal yeah it is like quite a bit being being conscious of the non-verbal adjustments is a very great way of coping with or recognizing and calibrating your method in relation to resistance i feel that may be a truthful evaluation yeah okay undoubtedly cool so um we we talked quite a bit about pre-contemplation um we could transfer on to contemplation sure one factor i do need to point out is for those who discover that you understand somebody is form of actually not prepared for change they do not need to speak to you about it they don’t seem to be inquisitive about scheduling typically you simply go away the door open plant the seed and say you understand you understand how can we keep related so if sooner or later you’d prefer to schedule we are able to you understand and you understand give them your card give them your data and so you permit it of their palms that they are the knowledgeable they you understand have the autonomy to do what they need mainly however you form of go away it open so then you definately’re like hey if i am i am right here for those who want me so yeah um plant the seed sure plant the seed watch it develop wow that was tacky it’s best to consider a line to rhyme that make somewhat little poem tune factor that you just say if you speak about these items simply saying plant the seed for what you want wow okay that is not what i used to be speaking about oh my god we’re off the charts with cheese proper now we’re gouda ranges of tacky we we shot straight previous cheddar and monterey jack we’re all the best way gouda proper now sorry we’re arising on blue cheese okay anyway what’s subsequent contemplation so stage two so now we’re transferring into uh contemplation so at this stage somebody is conscious of the issue i preserve sitting on my my core how dare you uh my headphone wire it is effective anyway uh so somebody’s conscious of the issue and so they’re bidding starting to contemplate the change we have gotten them from pre-contemplation to contemplation by lively listening sure and what else empathy constructing the rapport uh listening validating their emotions after which we additionally possibly you’ve got helped with elevating their consciousness of what the issue is that they see and the way there’s possibly a disconnect between what they’re doing and what they’d like after which additionally um serving to them to determine you understand that there may be some change that they’d prefer to make that they worth and also you improve the professional of change so at this level now execs and cons are form of equal persons are contemplating in pre-contemplation in pre-contemplation the cons are quite a bit increased and the professionals are low in contemplation they’re about even the professionals and cons sure okay so the time period is um ambivalent you you hear that on a regular basis and contemplation somebody’s ambivalent about change in order that they’re detached i suppose yeah they’re form of like the professionals of change equal the cons of change so they may take into consideration how you understand consuming a vegetable goes to present them and simply earlier than we dig into contemplation an excessive amount of over the course of what time frame may we count on to have somebody transition from pre-contemplation to contemplation truthfully it some folks can keep in pre-contemplation for years um and the identical truly for for contemplation so pre and and contemplation folks can keep there eternally so there’s not there should not be an expectation of getting somebody from p pre-contemplation to contemplation in a session or every week or a month it isn’t a failure if that particular person lives in pre-contemplation for an extended time frame that is not a failure success is having them transition however you are form of in a perpetual state of trying for those who’re in a single stage versus one other you should not take into account your self to have failed if they’re in pre-contemplation on the finish of a session or a number of periods nonetheless sure you simply have not cracked that nut but you bought to determine what works and and preserve preserve preserve at it preserve attempting i suppose yeah preserve serving to them to form of unlock what is going on to form of make it click on for them you understand as to why this modification actually issues and why they they need to do it however they should come to the conclusion on their very own however there is not any time-frame and that is that is one thing i feel when folks get hung up is that they are like oh properly i’ve to get them to contemplation you understand by subsequent session after which to form of transfer by this this you understand entire change mannequin and that is to be sincere what’s the issue with a lot of the applications which can be out there may be that they don’t seem to be designed for people who find themselves taking their time you understand most applications are arrange with a sure time interval yeah proper like a predetermined time interval and so they’re principally motion stage the place folks like have to take motion proper now most individuals are simply not prepared yeah that form of one-size-fits-all method actually shouldn’t be relevant to this form of factor yeah and so the entire level with the phases of change and using this in observe is having the ability to be okay with not having a time-frame you understand serving to folks transfer by these phases you understand at their tempo not your tempo that is all about them however you might be there to assist information them and form of you understand assist them to maneuver by these phases however there is not any time-frame and and establishing a time-frame form of units it up for failure to be sincere and also you may be in contemplation on some issues in pre-contemplation on others so as an example even when you’ve got a session that covers a number of a number of subjects you might have that particular person keep in pre-contemplation on some issues and transfer into contemplation on others or within the different phases that we’ve not coated but i am positive some folks possibly skip contemplation even typically however i am saying it is in all probability um the case that if it is one thing if it is general well being and also you’re working with health objectives and sleep and eating regimen and possibly some psychological well being stuff too it is greater than conceivable that somebody might go from pre-contemplation and to contemplation on some issues however keep in pre-contemplation for others completely i imply i’ve some shoppers who’re actively planning their meals out and prepping their meals and that was one in every of their objectives they get there and so they’re this they’re within the motion stage they’re doing it they’re doing what they’re however then when they consider different items like added sugar you understand and uh like sugary espresso or one thing like that they are like properly it isn’t that dangerous you understand i am not like different folks the place i’ve a 24 ounce after which they’re in that pre-contemplation mode and so me pushing them on the sugar shouldn’t be actually good properly at that time do you simply not let have do not do not you simply let folks have their vice or one thing ultimately i imply if they don’t seem to be smoking cigarettes or one thing loopy like if they don’t seem to be binge ingesting i do not know at a sure level you must form of do you count on everybody to hit the optimum human eating regimen is that that is and that is a kind of issues that is form of just like the little bits of diet to the place and like wellness as a complete is you understand typically i’ve individuals who they need to preserve their sugary espresso within the morning like that is what they prefer it begins their day yeah however they will say to me you understand if it turns into an issue the place i am not losing a few pounds or my blood sugar’s uncontrolled then i will take into consideration altering it in order that they’re they’re form of pondering at it as a way that prefer it’s not as large of a deal as different issues that they need to change and give attention to and so in actuality they might change it sooner or later however they’re actually not eager about doing it now or like chocolate right here and there like these aren’t issues that folks i am like by no means have sweet once more as a result of yeah you understand there is definitely stuff that you just as a dietitian do not help however there there must be some there must be some form of give i imply you possibly can’t you are not a robotic no as a dietitian you do not eat just like the stuff that you just eat is general i’d say such as you’re within the like .01 percentile for like wholesome consuming and way of life however you’ve you understand your bizarre vegan pizzas each on occasion or you understand you make popcorn that is not that unhealthy i do not know there are little little you understand issues right here and people pumpkin spice gluten-free vegan cookies that i had there you go or that bizarre vegan cheesecake oh yeah we nonetheless have it i feel it’s best to in all probability eat a few of that tonight i do not know possibly i put within the freezer as a result of it was both defrosted yeah there’s a complete cheesecake within the freezer truly candy quote-unquote cheesecake all proper so um simply to make clear too the subsequent stage is motion after contemplation we’re not going to speak about that however no it is preparation so it is preparation so preparation and motion are phases three and 4 sure okay stage 5 is upkeep after which the termination and in order that’s form of a giant stage as a result of um we’ll speak about like relapse and collapsing and that is why i form of see podcasts so some folks go from pre-contemplation straight to motion relying on like i went vegan in a single day for like three years that is one thing like that as i suppose you simply blow by it is in all probability not typical however yeah it isn’t typical however one factor i will say and that you just introduced up level there may be that not everyone’s to spend a bunch of time in all these phases and so they could spend a ton of time in contemplation after which leap proper into motion in the event that they’re prepared they’re prepared you do not need to carry them again and be like properly you did not put together sufficient yeah wait a minute we did not get to contemplation but if somebody needs to you understand do this yeah you need to transfer you the i the top objective is to have somebody up into the like motion slash upkeep stage i’d assume so whereas these two preliminary phases are extraordinarily essential to acknowledge and work folks by they might not even be a part of the equation for some folks yeah and truthfully um preparation is one which we’ll speak about on the subsequent podcast however that is the one the place you in all probability are going to get probably the most shoppers so contemplation i get quite a lot of shoppers in for different issues however preparation is form of the one the place most of my shoppers are in order that’s you understand even so it is equally essential to know all of those phases as a result of you’ve to have the ability to acknowledge the place somebody is and assess that precisely and if you cannot or do not chances are you’ll be making use of issues inappropriately otherwise you will not be optimizing their regime for them or no matter you are teaching them on may very well be off monitor yeah you possibly can push them an excessive amount of or you possibly can create resistance like we simply talked about so for those who do not acknowledge the place they’re at within the stage phases of change you might push them into an motion stage which is form of what once more quite a lot of the main target with objective setting is however typically these objectives of like okay i began consuming extra broccoli or you understand extra greens some folks aren’t there but and so having the ability to work with folks like like in contemplation discovering recipes and simply form of doing just like the you understand burling consciousness is in itself objective you understand so i do not like to make use of the time period objective typically with folks in these phases as a result of it form of units up like a an excessive amount of of like oh i am not prepared but um i feel i’ve used the time period with you experiments that is one okay yeah it is somewhat extra let’s experiment with yeah it isn’t like a objective you hit it otherwise you imply it you you understand experiment yeah did it work you understand what went properly you understand positive that form of factor can we can we need to get into contemplation somewhat extra closely and speak about like what that’s particularly we form of already did however like what your shoppers are like in the event that they’re in contemplation what to search for what behaviors we talked about that with pre-contemplation so what would you what would you count on to see from a shopper in the event that they’re within the contemplation stage yeah so at this stage once more they’re form of eager about the change they are a bit ambivalent like i discussed in order that they’re form of weighing the professionals and the cons right here however they’ve accepted that they may have to make a change so they may say i do know my blood sugar ranges are excessive and i would like to vary my eating regimen however they’re not likely positive what to do easy methods to do it and so they’re not likely positive if altering their eating regimen will change their blood sugar you may know that as a dietitian however they’re uncertain if that is actually going to assist in order that they’re on the fence they do not even consider these items is legit half the time or a number of the time possibly i they’re simply not even there that is i like that i am on the fence that is precisely what they’re and what you do in that stage can push somebody into the subsequent stage which might be the preparation or form of go away them on this perpetual state of contemplation which to be sincere folks can keep caught like this eternally about change so this this possibly is a stage the place persons are somewhat extra receptive to information or one thing that leads them to know or assess their dangers and that they should change sure they’re somewhat extra receptive to that in contemplation than in pre-contemplation i’d assume yeah persons are extra receptive normally on this stage you do not need to push too onerous however form of serving to folks as i discussed like growing the professionals for change so why is it useful to make the change however nonetheless acknowledging the cons of change so why it is higher to remain the best way that they’re um for those who have a look at it from like all completely different views and ultimately finish with the optimistic um after which give attention to including positives and execs for change that may push somebody into the subsequent stage of preparation so so so what precisely what our shoppers truly what are they saying to you what is the dialog like if um a shopper is in contemplation so normally it they are saying quite a lot of i could i could change i could change my eating regimen i could begin exercising and like they don’t seem to be saying like i am gonna begin exercising however i could or i would so their language could be very coded with indifference sure yeah quite a lot of the issues they are saying should not strongly indicating one habits or one other sure and so they may even say like properly i like my chocolate however and so they’re form of just like the butt afterwards quite a bit so yeah um i could i would i might i ought to yeah that form of factor and will typically form of overlap between pre and contemplation as a result of folks like my spouse informed me i ought to change i ought to change i suppose i ought to so they don’t seem to be there mentally in order that’s as much as you to evaluate with their tone and their physique language what that ought to truly imply precisely and that is the place form of asking the open-ended questions and by open-ended for those who’re not acquainted these are um you understand these listening i suppose you understand open-ended can be one thing that is not a sure or no reply so like did you eat breakfast at present is a sure or no reply typically folks elaborate however sure it is usually written i feel we’re all fairly conversant in open-ended questions from faculty oh a phrase downside is mostly open-ended and that is form of the factor that you really want yeah as a result of if you you do not you don’t need the you don’t need the top objective of a query to be a useless finish and it is a sure or no black or white an open-ended query permits any time you permit somebody the chance to elaborate or communicate extra on one thing you may normally get extra out of them that means i imply you would be stunned what folks offers you for those who give them the chance and oftentimes being quiet after they’re achieved speaking and simply giving it a second permits them to speak much more they will preserve going yeah that is one in every of um one of many phrases for that’s referred to as a pregnant pause i do not know why it is even referred to as a pregnant place however the entire concept is that you just earlier than you leap into analyzing or reflecting or something you you pause and other people just a bit bit longer than what may be like okay yeah yeah and other people do usually begin to proceed speaking and so they they often the entire level with asking these open-ended questions is folks speak themselves within the change and that is what you need as a result of if they arrive to the conclusion that the change is essential it issues to them they’re extra more likely to do it than for those who inform them to do it yeah you need them to need to change i do know that is cliche and that is like a form of psychology cliche factor the place like you understand how many psychologists does it take to vary a lightweight bulb properly just one however the mild bulb has to need to change like that is that is the joke however i forgot about that i imply it form of does apply to just about all the pieces and particularly this if if somebody would not need to change and so they’re not motivated to vary in fact they don’t seem to be going to and no mat no no quantity of stuff you inform them goes to trigger them to vary i suppose typically docs and their scare techniques can work however that is not likely preferrred for what we’re doing no and it isn’t preferrred for long-term change as a result of one of many issues is like folks may begin and begin taking these steps however then in the event that they run right into a barrier typically they get pissed off and that is that is one thing that occurs with pre-contemplation folks might need tried making adjustments previously and so they quit as a result of they’re simply so pissed off and so i am unable to do it you understand and and it isn’t as a result of they hadn’t tried it is simply you understand they bumped into the obstacles they weren’t prepared for the change after which they you understand they and that i hate to make use of the time period failure however they they really feel like they failed and it is often because nobody actually helped them to form of get to that stage that you understand they had been prepared and so they had been ready so you understand all proper so if we if we’re in if we’re if we have now a shopper that is within the you’ve a shopper that is in that is within the contemplation stage what are you listening for what do you count on from them how do they act i suppose we talked somewhat bit about could and may um is there anything that involves thoughts with what you’d count on from a shopper from contemplation so the could and the may are form of large issues there after which additionally the ambivalence is the form of the spotlight characteristic right here so the place they’re weighing the professionals and cons so they may say you understand just like the butt you understand or and so they may say like properly i might do that however and so all proper that is what we’re on the lookout for the language that is the important thing giveaways there yeah all proper so what do you do for those who you acknowledge a shopper is on this stage how do you assist them put together to or how do you assist them transfer into the subsequent stage which is preparation proper sure so the primary factor right here once more the open-ended questions however permitting folks to have an elevated consciousness so the extra you speak to them about what the change may be that they are inquisitive about so once more they’re eager about it in six months in order that they have already got an concept of what the change may be they’re simply unsure if it is useful so the entire level is to extend the good thing about change so that you speak to them about properly what what may very well be useful about this modification so the best way you do it um the worksheet that i’ve used known as a decisional stability tree and there is there’s quite a lot of strategies for this however the entire level is that you just begin with the professionals of staying the identical and then you definately transfer into the cons of staying the identical and then you definately speak in regards to the cons of fixing after which the professionals of fixing and it isn’t so simple as identical to asking these questions you fill out like a like a chart form of factor or a field and nothing nothing is form of weighted and it is non-judgmental we simply form of put it out on paper and by doing this folks can assist speak themselves into change and so once we speak in regards to the execs then what i normally ask about is okay so what can form of get you there or what’s helped previously constructing on their strengths that is a that is an enormous one i take advantage of quite a bit is you understand what’s what helped you to make this modification earlier than you understand not why did you fail why are you right here however you understand what what helped you to vary earlier than what was completely different about then versus now what might allow you to make this modification um one factor to actually keep away from are why questions although um the why typically makes folks resistant and that i really feel such as you’re uncomfortable yeah yeah so you understand inform me extra about this or um you understand what may very well be useful these sorts of questions are normally means higher than y what and when i suppose are a lot better than why yeah why folks get tremendous defensive and tone actually issues too however you understand like why did you do that it is virtually such as you’re in bother yeah it is like an accusation yeah yeah it isn’t not a great way to place somebody on their heels and make the very last thing you’ll need to do i assume on this state of affairs is make somebody defensive sure as a result of then they they do not actually belief you you form of lose a few of that rapport that you just’re speaking about so um so having the ability to do this so that you form of have a look at the the professionals and the cons equally after which asking questions and form of encouraging them to possibly take small steps so not setting these big objectives however simply to illustrate possibly their objective is to eat extra greens so that you may say properly what may very well be some you understand new recipes that you might strive possibly they if they’re inquisitive about cooking typically cooking scares folks so i would you understand if somebody’s inquisitive about cooking i would say you understand what may very well be some possibly recipes that you just may strive or if they’ve um in the event that they do the grocery procuring i would say properly what may very well be a brand new vegetable that you just may be inquisitive about buying i suppose too one thing that you just talked about already was like what what greens they’ve eaten previously you might like what what greens have you ever loved prior what what what’s your favourite vegetable sure i i get so many consumers who say that they are choosy eaters or they do not like greens after which i would say okay you understand after which i would say they may speak about a vegetable like corn and that i’ll say oh you understand corn what different greens have you ever had possibly this week or what different ones have you ever tried previously do you want and typically i will begin jotting down a listing after which i will say to them properly you’ve got acquired 10 completely different greens right here that is form of quite a bit yeah and so typically folks you understand have the mindset of oh i am a poor eater i am not this and i am not that and so they get caught on this field of who they form of labeled themselves as after which that form of limits their development it is a limiting perception oh that is a that is one other a kind of one other a kind of buzzwords limiting perception yep that is up there however the extra you possibly can mainly get folks excited in regards to the change um the extra they’re more likely to transfer into the subsequent stage of preparation so that you form of improve their consciousness you assist them improve the professionals you get them excited and once more in a means that issues to them so for those who simply say like it’s best to strive a brand new recipe this i all the time like cooking it is like that is not you bought to give attention to what issues to them yeah if they do not like cooking that is meaningless to them so do you’ve an instance that you can imagine of a time the place you had somebody in contemplation and what the dialog was like and the way you helped them transfer to preparation any particular instance you possibly can draw upon uh one lately was uh with a shopper who had young children and one of many issues that had been they had been inquisitive about including train however one of many issues with including within the additional they wished so as to add train however they had been ranging from zero sedentary that they had a i feel a current damage um and so one of many issues was they had been just like the time constraint you understand and the truth that they’ve work all day and doing all so that they had all these obstacles mainly of like why they could not slot in train and so one of many issues that we first began with was why it is essential for them to train so we recognized some motivators so private motivators for themselves you understand they know that it gave them extra vitality and so they you understand know that they felt higher all through their day after which um they tied within the household facet you understand i do know that this could make me a job mannequin for my children i need them to get enthusiastic about i really like knocking that microphone um so step one was form of growing the you understand what are the motivators so why do they need to make this modification in order that was like form of like the first step after which we talked about okay so what might this appear like so we did not set a objective for the week we mentioned like what what might this doubtlessly appear like you understand and um one factor that truly introduced the dialog again to was what that they had achieved previously so earlier than surgical procedure um and one of many issues that that they had talked about and i have seen this with a couple of shoppers was um you understand that they used to rise up early and go for a run or a motorcycle journey um and in eager about it now that would not essentially work in order that that was a part of the issue um and why they had been form of caught on this stage was that they had one thing they did previously did not actually work with their way of life now however transferring ahead they nonetheless wished to train so how did we get to that place so then you understand the subsequent form of dialog was okay properly what what sorts of workouts might you possibly see your self doing and so we’re simply envisioning this however we’re not placing it into motion simply an experiment sure and typically that is the place these like small steps can are available in so we would say um like for this shopper we use you understand for those who can possibly take into consideration completely different elements of your week the place you may be capable to match an train jot them down you understand and and see the place these time frames are and you understand typically you may have shoppers and i have had a couple of shoppers on this state the place they they begin taking steps to train so they really will come again and say like i slot in a stroll on you understand at the present time or they may say you understand i’ve seen there’s a couple of days the place i might have slot in train i simply wasn’t positive what to do after which now you’ve okay they discovered the time-frame now it is determining what that’s and so it is form of constructing on these little layers however the entire the entire thing is you are constructing their aware consciousness for it you understand that they are studying about what their behaviors what their patterns are however not from a judgmental view however simply form of let’s simply have a look again and see and there is not any like set objective there essentially just like the objective is to remember um yeah and that i discovered you understand speaking in regards to the the motivators the professionals seeing the place they’ll realistically do it form of brainstorming however not an excessive amount of the place it is overwhelming simply form of leaving it open for them can actually simply form of push somebody proper into that okay now i feel i am able to make this modification and we begin to put together after which that is stage three so it is so it is creating a brilliant low stress open-ended setting it is you understand recognizing resistance not pushing somebody like i like the thought of drawing upon their strengths reasonably than it is a lot simpler to um draw upon strengths that exist already than to create new ones yeah after which this stage two you understand i discussed that the professionals and the cons are equal so the obstacles are normally very obvious folks speak about like not having time or not understanding like they determine all these completely different obstacles you understand wholesome cooking takes too lengthy or you understand wholesome meals would not style good there’s all these completely different obstacles that they form of arrange and so a few of that’s is form of reframing and difficult it not you essentially however saying okay um you understand time is a is a constraint are there elements of your days um that you have seen that you just might need a while or you understand even that is form of a number one query in a way you understand to make them really feel like as a result of then folks can come again and say properly no i haven’t got any time yeah lots of people say that as a form of knee-jerk response to actually all the pieces persons are the identical means with cash you understand folks haven’t got their price range damaged out they will say they’re broke they can not afford something after which for those who truly sit down with them to interrupt their price range out they discover they’re losing cash right here they’d have this a lot cash to save lots of per thirty days no matter like i discover lots of people do this form of with their time as properly yeah and so typically when i’ve folks like that what i will say is would you be inquisitive about possibly taking the week to determine what your what your day appears to be like like when it comes to time blocks and so you are not saying such as you do have time and you are not making it however to say you understand would you have an interest on this and also you form of pose it and i’d say like 99 of the time folks had been like yeah i imply i may give {that a} strive or they may say yeah i haven’t got any time however i will see after which they virtually all the time come again with they will uncover that they’ve yeah a while or that they might at the least enhance on their time administration or one thing yeah or we speak about methods as a result of typically folks have an unrealistic expectation of like health i am utilizing the instance of like that you must train for an hour and so typically the barrier is like i simply haven’t got the time or i do not know i haven’t got i imply not lots of people are going to the fitness center now however i imply i do not i do not like going to the fitness center and there is all these obstacles like i do not really feel snug with this and typically having the ability to simply discover that somewhat bit and break these obstacles aside will be actually useful too okay so yeah that is good so let’s let’s let’s attempt to spherical it out right here so we’re speaking in regards to the trans theoretical mannequin sure of um teaching phases of of change sure the stage so the prospect trans theoretical mannequin ttm or phases of change sure um on this on this podcast we coated pre-contemplation and contemplation a fast synopsis being you understand pre-contemplation is um persons are uncertain they’re not likely on board they’re form of not likely respecting you and your place i suppose at this level yeah they don’t seem to be prepared for change they don’t seem to be inquisitive about change or they do not suppose that they’ll change or they’re utterly unaware that they should change okay after which contemplation is form of the fence sitter they’re ambivalent they’re detached they do not actually see this as a giant factor however they’re open to exploration and maybe are extra receptive to data that might affect their ideas on altering yeah they’re eager about that change they don’t seem to be able to make it however they’re eager about it in order that’s the place you might be probably the most of assist with out pushing them an excessive amount of and these two phases are the primary two of 5 – 6 relying on the way you view this and the place issues are at i suppose yeah or possibly what the experience you are making use of it to is and the subsequent phases can be preparation and motion mm-hmm yeah yeah in a in a later episode of the my rd journey podcast we’ll be speaking about preparation and motion is there something we should always do to spherical out this part um i feel all in all um simply remembering that the shopper is the knowledgeable and also you’re in a way partnering with them you’ve experience and it definitely has a spot however the entire level of recognizing the phases of change is having the ability to determine the place the shopper is to have the ability to tailor what you do and the way you do it to raised help them of their journey so form of taking a step again from what your agenda is as a dietitian or a coach and being conscious of what the shopper wants and what they’re able to do okay and um i ideally i suppose we’re um you understand it is you say such as you’re the knowledgeable you um have the experience the technical information however i suppose the the form of stability is that they’re the knowledgeable on their lives and that is their notion it is you understand for those who change into too authoritative that is like an on the spot flip off sure yeah that is i preserve utilizing the phrase knowledgeable however that is precisely what i imply is that you understand they’re the knowledgeable of their very own lives so that you’re bringing you understand some experience to it however they know what’ll work finest and typically it is unlocking you understand different issues that they don’t seem to be conscious of and it is it is an actual disgrace i i really feel as if docs can simply get they do not even want half of these things and as a dietitian you must be way more conscious of this however a physician can simply straight up say that you must do that that you must do this as a result of they’ve a lab coat and a clipboard and so they have dr in entrance of their names that simply offers them much more credibility you simply you’ve quite a bit much less of that i really feel as a dietitian which is why this form of factor is extra uh needed yeah it is reasonably unlucky however you understand as issues go on and other people begin to acknowledge the significance of wholesome residing diet dietetics usually and the truth that their way of life is a serious contributor to their well being and the key causes of dying in you understand first world international locations it is form of the primary factor your way of life is the key affect what are we at coronary heart assault most cancers stroke diabetes and issues from weight problems i imply these are the massive main killers in first world international locations and the most important most extremely contributive issue to these shouldn’t be genetics it is way of life it is way of life and your dietitian is in fact going that can assist you with that your eating regimen is likely one of the largest contributors to your well being when it comes to way of life affect it is it is it is uh eating regimen train and sleep proper i imply what what else issues yeah not a complete lot no no and eating regimen and dietetics and your your eating regimen what you eat is might be the toughest of these to handle it’s yeah particularly with our meals provide yeah precisely there’s there’s so many transferring elements with diets so you understand it is reasonably unlucky the state of affairs that i i commend anybody who’s watching or listening that’s pursuing dietetics as a occupation you’re the unsung heroes of well being in my view however who am i i am just a few man and my spouse is a dietitian so you understand i’ve a little bit of bias however um i i feel it is secure to place a pin on this right here yeah no i feel undoubtedly all proper properly thanks a lot for listening or watching you understand we do put these on youtube for those who’re listening in your uh your sensible gadget proper now by way of a podcast app you possibly can see the video on youtube.com slash my already journey i consider or possibly we do not have a customized url but however both means these go on youtube um hyperlinks will probably be within the bio for those who’re listening hyperlinks to the podcasts and all the pieces like that wherever we are able to go away hyperlinks for socials they will be there so please examine the outline for all related information as you’ll my rd journey parasitonutrition.com felicia peraza of peraz diet llc llc with a bunch of letters after her title as a result of she has hit the books fairly a bit form of is aware of her stuff thanks once more for listening and watching we’ll be again subsequent time with preparation and motion the subsequent two phases of the trans theoretical mannequin yep nailed it or take us out anything yeah thanks for watching and listening for those who’re doing one or the opposite or each um and yeah we’ll leap into the preparation and motion subsequent subsequent episode cool thanks a lot hello

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