Clinical and Wellness Center

CBT Treatment
Manhattan/Westchester NY

Clinical and Wellness Center

CBT Treatment

Manhattan/Westchester NY

At CBC’s Clinical and Wellness Centers

we are committed to providing compassionate evidence – based treatment programs to address a wide range of emotional, behavioral, lifestyle management and personal development issues.

CBC’s Cognitive Behavior Therapy Programs (CBT) are compassionate, evidence-based psychotherapy treatments for individuals with a wide range of problems such as stress, anxiety, depression, habits, attentional and behavioral problems, parent-child conflicts, couple conflicts, and more. CBT is structured, problem focused, and time-limited. The CBT therapist works collaboratively with the client and uses specific techniques to improve the client’s well being and overall functioning.

We offer general CBT programs for Adults, Young Adults, Adolescents and Children. These programs may include individual therapy, our CBT groups, and/or our specialized and innovative CBT programs. Please find a description of our general CBT program below.

 
Contact Us To Make An Appointment Or To Make A Referral
Contact Us To Make An Appointment Or To Make A Referral

| The Adult CBT Program |

Phase One - Assessment and Conceptualization

CBT has been shown to be effective for a wide range of problems and conditions. To begin treatment with CBT, the therapist must first get a thorough and nuanced understanding of the client’s problem or problems. Hence, at the outset of treatment, clients have a one 90-minute or two separate 45 minute consultation sessions with one of our therapists. Depending on the nature of the problem(s) or the age of the client, this consultation may involve parents, spouses, or other caregivers. The purpose of this initial meeting is to assess the client’s presenting problem(s), the history of the client’s difficulties, current and prior treatments, and pertinent family history. In addition, the therapist gathers information about other aspects of the client’s life, including relationships, medical history, academic and work history, as well as recent and long-term stressors that may be affecting the client’s life and mood.

The client will also be asked to complete a variety of symptom questionnaires based on their presenting problem. If neuropsychological testing is requested or indicated, clients may be referred to our neuropsychological assessment program.

Finally, the therapist works with the client to understand how their problems are affecting their functioning and assesses the client’s expectations for therapy. At the conclusion of the consultation, the therapist provides the client(s) with his or her initial impressions, offers a detailed conceptualization of the problems, and makes recommendations for treatment.

At this point, the therapist and client(s) determine whether the current provider and the proposed treatment plan is a good fit for the client’s needs and goals. If the client and therapist collaboratively agree to start treatment, a treatment contract is developed outlining goals and timeframes for treatment.

The therapist and client collaboratively identify the client’s valued life goals so that they may begin working towards them. Based on these life goals, the therapist and client set specific, achievable goals to lessen the client’s symptoms of distress, resolve problems, and improve functioning.

Depending on the client’s presenting problem(s), the therapist may recommend that the client begin one or more types of therapeutic modalities such as individual therapy, family therapy, couples counseling, group therapy, and/or specialized, therapeutic parenting skills training. Should the therapist and/or client determine that another provider would be more effective in addressing the client’s needs, a referral would be made at this time.

Phase Two - Psychoeducation/Socialization.

Prior to starting treatment, the therapist provides the client with education regarding his or her presenting problem(s), diagnosis, if relevant, and treatment. The therapist may provide the client with recommendations for articles, books, and other readings that will provide additional information regarding symptoms, prognosis, and treatment options.

This phase, usually completed in one or two sessions, helps clients fully understand and de-stigmatize the nature of the problems they are experiencing, orients the client to the components of the treatment plan, and helps build the necessary commitment for the treatment plan.

Given the collaborative nature of cognitive behavioral therapy, the therapist emphasizes the need for the client’s participation and feedback, as well as the completion of therapy assignments in-between sessions. Performing these skills in-between sessions ensures that treatment goes faster and helps ensure that skills learned in the session are readily transferred to the client’s day-to-day life.

Phase Three - Treatment

Depending on the specific presenting problem(s), therapists choose from a variety of evidence-based cognitive behavioral therapies to help clients address their difficulties and improve the quality of their lives. In general, these evidence-based CBT treatments draw from the CBT techniques outlined below and are uniquely adapted to fit the needs of the individual client based on the assessment and case conceptualization.  (25-30 sessions or more based on presenting problem(s))

  • Cognitive Strategies: Clients learn skills to notice unhelpful, negative thoughts, be present in the moment, understand the impact of thoughts on the way they feel and behave, and accept these thoughts when they are painful. Clients also learn skills to distance themselves from their negative thoughts, to reduce the power of their negative thoughts, and learn how not to instinctively believe what their habitual, negative thoughts are telling them. Clients learn skills to change rigid thoughts that are inaccurate, unhelpful, causing emotional pain, or negatively affecting relationships, and learn to think in a more helpful, flexible manner. Depending on the problem, clients may also learn attention strengthening exercises, and learn skills to change compulsive, and ruminative thinking that they may be using to cope with their negative emotions.
  • Behavioral Strategies: Clients may learn a variety of strategies such as problem solving training to effectively solve problems, decision training to make effective decisions, time management strategies to manage time effectively, complete tasks, and overcome procrastination, and exposure and response prevention to effectively confront situations that they currently fear or avoid. They may learn receive skills training, such as social skills training, negotiating skills and assertiveness training, communication and interpersonal skills training. Depending on the problem, clients may learn anger management strategies, or receive habit reversal training to change unhelpful habits they have developed.
  • Physiological Strategies: Clients may learn skills to tolerate and counteract the effects of unpleasant physical symptoms associated with different feelings by tensing and relax various muscle groups, performing breathing exercises, and learning other meditative techniques to reduce tension and improve well-being.

The skills described above are applied within a range of therapeutic modalities, including individual, group, family, couples, and specialized parenting skills training. By adopting a comprehensive understanding of the client’s problems and including group, couple, parent, or family therapy as needed, therapists help clients to generalize skills learned in therapy, and help caregivers learn how they may be inadvertently contributing to or maintaining their problems, and learn skills to help clients practice skills and overcome their problems.

Phase Four - Maintenance/Relapse Prevention

Once the active treatment is completed, mutually agreed upon goals have been met, and clients have demonstrated that they can adequately apply strategies to daily life, the maintenance/relapse prevention phase is initiated. During this phase, sessions are gradually tapered, as needed from weekly to biweekly, to monthly, and so on. The therapist reviews the client’s progress in treatment, skills learned, and teaches the client and caregivers tools to help youth continue to utilize and maintain gains made in therapy.

The therapist and client collaboratively work on relapse prevention by discussing potential stressors and factors that may cause symptoms to get recur, and develop plans for coping with these stressors and factors. During this phase, the therapist, client and their caregivers will also discuss conditions under which the client may consider ‘booster sessions’ to review and reinforce skills.

| The Child/Adolescent CBT Program |

| The Child/Adolescent CBT Program |

Phase One - Assessment

CBT has been shown to be effective for a wide range of problems and conditions. To begin treatment with CBT, the therapist must first get a thorough and nuanced understanding of the client’s problem or problems. Hence, at the outset of treatment, child and adolescent clients have a one 90-minute or two separate 45 minute consultation sessions with one of our therapists. This consultation also involves parents, and other caregivers, and siblings, if relevant.

The purpose of this initial meeting is to assess the client’s presenting problem(s), the history of the client’s difficulties, current and prior treatments, and pertinent family history. In addition, the therapist gathers information about other aspects of the client’s life, including relationships, medical history, academic and work history, as well as recent and long-term stressors that may be affecting the client’s life and mood. The client will also be asked to complete a variety of symptom questionnaires based on their presenting problem(s).

If neuropsychological testing is requested or indicated, clients may be referred to our neuropsychological assessment program.

Finally, the therapist works with the client to understand how their problems are affecting their functioning and assesses the client’s expectations for therapy. At the conclusion of the consultation, the therapist provides the client(s) and caregivers with his or her initial impressions, offers a detailed case conceptualization of the client’s problems, and makes recommendations for treatment.

At this point, the therapist and client(s) and their caregivers determine whether the current provider and the proposed treatment plan is a good fit for the client’s needs and goals. If the client and therapist collaboratively agree to start treatment, a treatment contract is developed outlining goals and timeframes for treatment. With input from parents, the therapist and client collaboratively identify the client’s valued life goals so that they may begin working towards them. Based on these life goals, the therapist and client then set specific, achievable goals to lessen the client’s symptoms of distress, resolve problems, and improve functioning.

Depending on the client’s presenting problem, the therapist may recommend that the client begin one or more types of therapeutic modalities such as individual therapy, family therapy, or group therapy. The therapist may also recommend that caregivers attend family therapy, couples therapy, and/or recommend specialized, therapeutic parenting skills training using Parent Management training or Parent-Child Interaction Therapy. Should the therapist and/or client determine that another provider would be more effective in addressing the client’s needs, a referral would be made at this time.

Phase Two - Psychoeducation

Prior to starting treatment, the therapist provides the child or adolescent and his or her caregivers with education regarding the youth’s presenting problem(s), diagnosis, if relevant, and treatment. The therapist may provide the client and caregivers with recommendations for articles, books, and other readings that will provide additional information regarding symptoms, prognosis, and treatment options.

This phase, usually completed in one or two sessions, helps clients and their caregivers fully understand and de-stigmatize the nature of the problems the clients are experiencing, orients them to the components of the treatment plan, and helps build the necessary commitment for the treatment plan.

Given the collaborative nature of cognitive behavioral therapy, the therapist emphasizes the need for the client’s participation and feedback, caregiver participation and feedback, as well as the completion of therapy assignments in-between sessions by clients, and the performance of skills learned by caregivers to help youth practice these new skills. Performing skills in-between sessions ensures that treatment goes faster and helps ensure that skills learned in the session are readily transferred to the client’s day-to-day life.

Phase Three - Treatment

Depending on the specific presenting problem(s) therapists choose from a variety of evidence-based cognitive behavioral therapies to help clients address their difficulties and improve the quality of their lives. In general, these evidence-based CBT treatments draw from the CBT techniques outlined below and are uniquely adapted to fit the needs of the individual client based on the assessment and case conceptualization. (25-30 sessions or more based on presenting problems)

  • Cognitive Strategies: Depending on the age of the youth, clients learn skills to notice unhelpful, negative thoughts, be present in the moment, understand the impact of thoughts on the way they feel and behave, and accept these thoughts when they are painful. Clients also learn skills to distance themselves from their negative thoughts, to reduce the power of their negative thoughts, and learn how not to instinctively believe what their habitual, negative thoughts are telling them. Clients learn skills to change rigid thoughts that are inaccurate, unhelpful, causing emotional pain, or negatively affecting relationships, and learn to think in a more helpful, flexible manner. Depending on the problem, clients may also learn attention strengthening exercises, and learn skills to change compulsive, and ruminative thinking that they may be using to cope with their negative emotions.
  • Behavioral Strategies: Clients may learn a variety of strategies such as problem solving training to effectively solve problems, decision training to make effective decisions, time management strategies to manage time effectively, complete tasks, and overcome procrastination, and exposure and response prevention to effectively confront situations that they currently fear or avoid. They may learn receive skills training, such as social skills training, negotiating skills and assertiveness training, communication and interpersonal skills training. Depending on the problem, clients may learn anger management strategies, or receive habit reversal training to change unhelpful habits they have developed.
  • Physiological Strategies: Clients may learn skills to tolerate, manage, and counteract the effects of unpleasant physical symptoms associated with different feelings by tensing and relax various muscle groups, performing breathing exercises, and learning other meditative techniques to reduce tension and improve well-being.

The skills described above are applied within a range of therapeutic modalities, including individual, group, family, couples, and specialized parenting skills training. By adopting a comprehensive understanding of the client’s problems and including group, couple, parent, or family therapy as needed, therapists help clients to generalize skills learned in therapy, and help caregivers learn how they may be inadvertently contributing to or maintaining their problems, and learn skills to help clients practice skills and overcome their problems.

Phase Four - Maintenance/Relapse Prevention

Once the active treatment is completed, mutually agreed upon goals have been met, and clients have demonstrated that they can adequately apply strategies to daily life, the maintenance/relapse prevention phase is initiated. During this phase, sessions are gradually tapered, as needed from weekly to biweekly, to monthly, and so on. The therapist reviews the client’s progress in treatment, skills learned, and teaches the client tools to help them continue to utilize and maintain gains made in therapy.

The therapist and client collaboratively work on relapse prevention by discussing potential stressors and factors that may cause symptoms to get recur, and develop plans for coping with these stressors and factors. During this phase, the therapist and client will also discuss conditions under which the client may consider ‘booster sessions’ to review and reinforce skills.

Please contact our Director of Intake Services at 212-595-9559 (ext.5) or 914-385-1150 (ext.1), or fill out the form above, with any questions regarding eligibility, for further information, or to make a referral.  If you are a current patient at CBC, please speak to your individual therapist to see how this group may be of added benefit to you.

At CBC’s Clinical and Wellness Centers

we are committed to providing compassionate evidence – based treatment programs to address a wide range of emotional, behavioral, lifestyle management and personal development issues.

CBC’s Cognitive Behavior Therapy Programs (CBT) are compassionate, evidence-based psychotherapy treatments for individuals with a wide range of problems such as stress, anxiety, depression, habits, attentional and behavioral problems, parent-child conflicts, couple conflicts, and more. CBT is structured, problem focused, and time-limited. The CBT therapist works collaboratively with the client and uses specific techniques to improve the client’s well being and overall functioning.

We offer general CBT programs for Adults, Young Adults, Adolescents and Children. These programs may include individual therapy, our CBT groups, and/or our specialized and innovative CBT programs. Please find a description of our general CBT program below.

 

Contact Us To Make An Appointment Or To Make A Referral

| The Adult CBT Program |

Phase One - Assessment and Conceptualization

CBT has been shown to be effective for a wide range of problems and conditions. To begin treatment with CBT, the therapist must first get a thorough and nuanced understanding of the client’s problem or problems. Hence, at the outset of treatment, clients have a one 90-minute or two separate 45 minute consultation sessions with one of our therapists. Depending on the nature of the problem(s) or the age of the client, this consultation may involve parents, spouses, or other caregivers. The purpose of this initial meeting is to assess the client’s presenting problem(s), the history of the client’s difficulties, current and prior treatments, and pertinent family history. In addition, the therapist gathers information about other aspects of the client’s life, including relationships, medical history, academic and work history, as well as recent and long-term stressors that may be affecting the client’s life and mood.

The client will also be asked to complete a variety of symptom questionnaires based on their presenting problem. If neuropsychological testing is requested or indicated, clients may be referred to our neuropsychological assessment program.

Finally, the therapist works with the client to understand how their problems are affecting their functioning and assesses the client’s expectations for therapy. At the conclusion of the consultation, the therapist provides the client(s) with his or her initial impressions, offers a detailed conceptualization of the problems, and makes recommendations for treatment.

At this point, the therapist and client(s) determine whether the current provider and the proposed treatment plan is a good fit for the client’s needs and goals. If the client and therapist collaboratively agree to start treatment, a treatment contract is developed outlining goals and timeframes for treatment.

The therapist and client collaboratively identify the client’s valued life goals so that they may begin working towards them. Based on these life goals, the therapist and client set specific, achievable goals to lessen the client’s symptoms of distress, resolve problems, and improve functioning.

Depending on the client’s presenting problem(s), the therapist may recommend that the client begin one or more types of therapeutic modalities such as individual therapy, family therapy, couples counseling, group therapy, and/or specialized, therapeutic parenting skills training. Should the therapist and/or client determine that another provider would be more effective in addressing the client’s needs, a referral would be made at this time.

Phase Two - Psychoeducation/Socialization.

Prior to starting treatment, the therapist provides the client with education regarding his or her presenting problem(s), diagnosis, if relevant, and treatment. The therapist may provide the client with recommendations for articles, books, and other readings that will provide additional information regarding symptoms, prognosis, and treatment options.

This phase, usually completed in one or two sessions, helps clients fully understand and de-stigmatize the nature of the problems they are experiencing, orients the client to the components of the treatment plan, and helps build the necessary commitment for the treatment plan.

Given the collaborative nature of cognitive behavioral therapy, the therapist emphasizes the need for the client’s participation and feedback, as well as the completion of therapy assignments in-between sessions. Performing these skills in-between sessions ensures that treatment goes faster and helps ensure that skills learned in the session are readily transferred to the client’s day-to-day life.

Phase Three - Treatment

Depending on the specific presenting problem(s), therapists choose from a variety of evidence-based cognitive behavioral therapies to help clients address their difficulties and improve the quality of their lives. In general, these evidence-based CBT treatments draw from the CBT techniques outlined below and are uniquely adapted to fit the needs of the individual client based on the assessment and case conceptualization.  (25-30 sessions or more based on presenting problem(s))

  • Cognitive Strategies: Clients learn skills to notice unhelpful, negative thoughts, be present in the moment, understand the impact of thoughts on the way they feel and behave, and accept these thoughts when they are painful. Clients also learn skills to distance themselves from their negative thoughts, to reduce the power of their negative thoughts, and learn how not to instinctively believe what their habitual, negative thoughts are telling them. Clients learn skills to change rigid thoughts that are inaccurate, unhelpful, causing emotional pain, or negatively affecting relationships, and learn to think in a more helpful, flexible manner. Depending on the problem, clients may also learn attention strengthening exercises, and learn skills to change compulsive, and ruminative thinking that they may be using to cope with their negative emotions.
  • Behavioral Strategies: Clients may learn a variety of strategies such as problem solving training to effectively solve problems, decision training to make effective decisions, time management strategies to manage time effectively, complete tasks, and overcome procrastination, and exposure and response prevention to effectively confront situations that they currently fear or avoid. They may learn receive skills training, such as social skills training, negotiating skills and assertiveness training, communication and interpersonal skills training. Depending on the problem, clients may learn anger management strategies, or receive habit reversal training to change unhelpful habits they have developed.
  • Physiological Strategies: Clients may learn skills to tolerate and counteract the effects of unpleasant physical symptoms associated with different feelings by tensing and relax various muscle groups, performing breathing exercises, and learning other meditative techniques to reduce tension and improve well-being.

The skills described above are applied within a range of therapeutic modalities, including individual, group, family, couples, and specialized parenting skills training. By adopting a comprehensive understanding of the client’s problems and including group, couple, parent, or family therapy as needed, therapists help clients to generalize skills learned in therapy, and help caregivers learn how they may be inadvertently contributing to or maintaining their problems, and learn skills to help clients practice skills and overcome their problems.

Phase Four - Maintenance/Relapse Prevention

Once the active treatment is completed, mutually agreed upon goals have been met, and clients have demonstrated that they can adequately apply strategies to daily life, the maintenance/relapse prevention phase is initiated. During this phase, sessions are gradually tapered, as needed from weekly to biweekly, to monthly, and so on. The therapist reviews the client’s progress in treatment, skills learned, and teaches the client and caregivers tools to help youth continue to utilize and maintain gains made in therapy.

The therapist and client collaboratively work on relapse prevention by discussing potential stressors and factors that may cause symptoms to get recur, and develop plans for coping with these stressors and factors. During this phase, the therapist, client and their caregivers will also discuss conditions under which the client may consider ‘booster sessions’ to review and reinforce skills.

| The Child/Adolescent CBT Program |

Phase One - Assessment

CBT has been shown to be effective for a wide range of problems and conditions. To begin treatment with CBT, the therapist must first get a thorough and nuanced understanding of the client’s problem or problems. Hence, at the outset of treatment, child and adolescent clients have a one 90-minute or two separate 45 minute consultation sessions with one of our therapists. This consultation also involves parents, and other caregivers, and siblings, if relevant.

The purpose of this initial meeting is to assess the client’s presenting problem(s), the history of the client’s difficulties, current and prior treatments, and pertinent family history. In addition, the therapist gathers information about other aspects of the client’s life, including relationships, medical history, academic and work history, as well as recent and long-term stressors that may be affecting the client’s life and mood. The client will also be asked to complete a variety of symptom questionnaires based on their presenting problem(s).

If neuropsychological testing is requested or indicated, clients may be referred to our neuropsychological assessment program.

Finally, the therapist works with the client to understand how their problems are affecting their functioning and assesses the client’s expectations for therapy. At the conclusion of the consultation, the therapist provides the client(s) and caregivers with his or her initial impressions, offers a detailed case conceptualization of the client’s problems, and makes recommendations for treatment.

At this point, the therapist and client(s) and their caregivers determine whether the current provider and the proposed treatment plan is a good fit for the client’s needs and goals. If the client and therapist collaboratively agree to start treatment, a treatment contract is developed outlining goals and timeframes for treatment. With input from parents, the therapist and client collaboratively identify the client’s valued life goals so that they may begin working towards them. Based on these life goals, the therapist and client then set specific, achievable goals to lessen the client’s symptoms of distress, resolve problems, and improve functioning.

Depending on the client’s presenting problem, the therapist may recommend that the client begin one or more types of therapeutic modalities such as individual therapy, family therapy, or group therapy. The therapist may also recommend that caregivers attend family therapy, couples therapy, and/or recommend specialized, therapeutic parenting skills training using Parent Management training or Parent-Child Interaction Therapy. Should the therapist and/or client determine that another provider would be more effective in addressing the client’s needs, a referral would be made at this time.

Phase Two - Psychoeducation

Prior to starting treatment, the therapist provides the child or adolescent and his or her caregivers with education regarding the youth’s presenting problem(s), diagnosis, if relevant, and treatment. The therapist may provide the client and caregivers with recommendations for articles, books, and other readings that will provide additional information regarding symptoms, prognosis, and treatment options.

This phase, usually completed in one or two sessions, helps clients and their caregivers fully understand and de-stigmatize the nature of the problems the clients are experiencing, orients them to the components of the treatment plan, and helps build the necessary commitment for the treatment plan.

Given the collaborative nature of cognitive behavioral therapy, the therapist emphasizes the need for the client’s participation and feedback, caregiver participation and feedback, as well as the completion of therapy assignments in-between sessions by clients, and the performance of skills learned by caregivers to help youth practice these new skills. Performing skills in-between sessions ensures that treatment goes faster and helps ensure that skills learned in the session are readily transferred to the client’s day-to-day life.

Phase Three - Treatment

Depending on the specific presenting problem(s) therapists choose from a variety of evidence-based cognitive behavioral therapies to help clients address their difficulties and improve the quality of their lives. In general, these evidence-based CBT treatments draw from the CBT techniques outlined below and are uniquely adapted to fit the needs of the individual client based on the assessment and case conceptualization. (25-30 sessions or more based on presenting problems)

  • Cognitive Strategies: Depending on the age of the youth, clients learn skills to notice unhelpful, negative thoughts, be present in the moment, understand the impact of thoughts on the way they feel and behave, and accept these thoughts when they are painful. Clients also learn skills to distance themselves from their negative thoughts, to reduce the power of their negative thoughts, and learn how not to instinctively believe what their habitual, negative thoughts are telling them. Clients learn skills to change rigid thoughts that are inaccurate, unhelpful, causing emotional pain, or negatively affecting relationships, and learn to think in a more helpful, flexible manner. Depending on the problem, clients may also learn attention strengthening exercises, and learn skills to change compulsive, and ruminative thinking that they may be using to cope with their negative emotions.
  • Behavioral Strategies: Clients may learn a variety of strategies such as problem solving training to effectively solve problems, decision training to make effective decisions, time management strategies to manage time effectively, complete tasks, and overcome procrastination, and exposure and response prevention to effectively confront situations that they currently fear or avoid. They may learn receive skills training, such as social skills training, negotiating skills and assertiveness training, communication and interpersonal skills training. Depending on the problem, clients may learn anger management strategies, or receive habit reversal training to change unhelpful habits they have developed.
  • Physiological Strategies: Clients may learn skills to tolerate, manage, and counteract the effects of unpleasant physical symptoms associated with different feelings by tensing and relax various muscle groups, performing breathing exercises, and learning other meditative techniques to reduce tension and improve well-being.

The skills described above are applied within a range of therapeutic modalities, including individual, group, family, couples, and specialized parenting skills training. By adopting a comprehensive understanding of the client’s problems and including group, couple, parent, or family therapy as needed, therapists help clients to generalize skills learned in therapy, and help caregivers learn how they may be inadvertently contributing to or maintaining their problems, and learn skills to help clients practice skills and overcome their problems.

Phase Four - Maintenance/Relapse Prevention

Once the active treatment is completed, mutually agreed upon goals have been met, and clients have demonstrated that they can adequately apply strategies to daily life, the maintenance/relapse prevention phase is initiated. During this phase, sessions are gradually tapered, as needed from weekly to biweekly, to monthly, and so on. The therapist reviews the client’s progress in treatment, skills learned, and teaches the client tools to help them continue to utilize and maintain gains made in therapy.

The therapist and client collaboratively work on relapse prevention by discussing potential stressors and factors that may cause symptoms to get recur, and develop plans for coping with these stressors and factors. During this phase, the therapist and client will also discuss conditions under which the client may consider ‘booster sessions’ to review and reinforce skills.

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