Concerned About Unconventional Mental Health Interventions?

Concerned About Unconventional Mental Health Interventions?
Alternative Psychotherapies: Evaluating Unconventional Mental Health Treatments

Sunday, March 15, 2015

Attachment and Trauma Network Defends the Harrises

When anybody gets caught harming children by applying attachment therapy and parenting as proposed by Nancy Thomas, you can bet the Internet wagons will be circled quickly. This was apparent after Connell Watkins and Julie Ponder were convicted in the “rebirthing” death of Candace Newmaker in 2001. The practitioners’ supporters got on line to claim that the 10-year-old had died on purpose in order to cause trouble for the hated adults.

Now, with the latest concerns about the actions of the Arkansas legislator and his wife toward their [briefly] adopted daughters, culminating in “rehoming” and the rape of one young girl, we are beginning to see the same kind of thing. I give you for example http://blog.attachmenttraumanetwork.org/representative-harris-rehoming-controversy/ . This post begins with the mistaken claim that instead of squashing a guinea pig, a three-year-old killed the family cat--  an animal that would take a lot more work to kill than a guinea pig, and would bite and scratch effectively if hurt. (Next week: a German shepherd puppy? That’s the animal that Nancy Thomas most often claims children have killed.)

This little “mistake”, of course, escalates the whole situation and fleshes out this effort to point to the girls as well as the bureaucracy, rather than the Harrises, as the true villains. Incidentally, the former foster parents of the girls denied any such disturbing behavior, but of course a typical explanation of attachment therapy advocates would be that this simply shows how cruel and cunning they were, and how they fooled the naïve foster parents, to have their true natures appear only when the adoptive parents were in range. The ATN blog thus calls the one girl “extremely troubled” in spite of evidence against this assessment. Interestingly, the blog post is unsigned, and the site only says that posts are written by a core of volunteers.

The ATN blog, having set the stage, now takes advantage of the story not to express sympathy with the little girls, but to pity the Harrises, and to propose administrative changes to prevent such problems. They state two problems that I  too strongly agree need correction. One is the use of threats of abandonment charges when adoptive families feel overwhelmed and want to back out; I have certainly heard of such threats being used, and if they were used with the Harrises I consider that regrettable (especially as it has provided a nice red herring to distract from other issues.) The other problem is the requirement that parents relinquish parental rights in order to get state support for mental health care for their children. This is a fight that has been going on for some years and has been supported by the Bazelon Center among others. However, it is not at all clear to me what this has to do with the Harrises’ situation, unless there was some fear that relinquishment would be treated as abandonment and other children in the home would also be taken as a consequence. State laws differ on this point.

The ATN piece goes on to say that there should be uniform provision of Medicaid-paid services for children, including mental health services, and that these should “go with” the child who is placed in a different state. That’s all as may be. May the issue not actually be the wish that Medicaid would pay for the types of services the Harrises used--  attachment therapy methods of various kinds? Members of ATN, like its founder Nancy Spoolstra, are themselves proponents or practitioners of these methods. The methods are “alternative psychotherapies”, implausible, without an evidentiary foundation, and potentially harmful. Medicaid does not pay for such treatments unless practitioners bill dishonestly and give specious descriptions of their services. And Medicaid should not pay for mental health services that are not supported by strong evidence of effectiveness.

ATN has done its collective best to distract attention from the Harrises and to focus it on the claimed disturbed behavior of the girls, and the failure of the bureaucracy to support the Harrises. Let me bring back the focus to what the Harrises actually did to create the situation that led to a range of genuinely traumatic experiences for the little girls.

  • They insisted on adopting the girls in spite of recommendations by the foster parents and others against placing the girls in a home with three boys.
  • Although they stated their concerns about attachment disorders in the girls, and therefore presumably wanted the girls to form emotional attachments to them, neither of the Harrises appears to have spent much time with the girls. According to their babysitter’s testimony, the girls attended the Harris-owned day care center 5 days a week and had a teenage babysitter for the rest of the afternoon after they came home.
  • Rather than seeking help from a knowledgeable, licensed clinical psychologist or psychiatrist, the Harrises called in exorcists and used the treatments recommended by the erstwhile dog-trainer Nancy Thomas. They apparently believed that the girls could communicate with each other telepathically, against all scientific evidence.
  • Given their intention of “rehoming” secretly, the Harrises could have had an assessment of the proposed home done privately, to make sure that their judgment of the appropriateness of the parents was correct; they did not, but relied entirely on their own judgment, beliefs, and personal relationships.
  • They encouraged their sons to be afraid of the girls, as shown by Justin Harris’s report that the boys came to sleep with him, and thus communicated to the girls that there was something very wrong with them.

No one could reasonably contend that children from the background the girls had would be emotionally and behaviorally the easiest to care for. Neither can anyone deny that the bureaucracy surrounding adoption is often inconsistent, prejudiced, hostile to parents, and downright Kafkaesque.  But those facts do not outweigh the reality that the Harrises insisted on having their own way, for their own reasons, and made a series of decisions contrary to what any well-educated mental health professional would have told them. They knew they were right because they knew they were right. The girls have paid and continue to pay the price for this, but that seems to be the least of the problems as far as the Harrises and the Attachment and Trauma Network are concerned.



19 comments:

  1. Little kids -- ALL kids, not just adopted ones! -- need to be supervised really, really closely around animals. Toddlers can be grabby and it's incumbent upon grownups to teach them how to treat animals (kindly, gently). My dog is the sweetest, gentlest, most patient retriever ever... and requires protection from my littlest, who is (thankfully) emerging from the Longest Biting Phase Ever.

    The girls were all 2-5 years old when they arrived in the Harris home as foster kids -- I'm willing to bet that guinea pig died due to lack of adult supervision. It is within the realm of possibility that a very young, inadequately supervised kid hugged/snuggled a 1/2 lb guinea pig so hard it died.

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    1. Suzanne, thanks-- exactly right! After I posted this, I realized that I should have put on the list failure to supervise the little girl with the guinea pig, PLUS labeling her a "killer" when this lack of oversight led to the animal's death. I can't imagine that her meth-cooking parents had offered her any guidance about being gentle around animals, and although the foster parents had said the girls were fine with their dogs, and it's a whole 'nother thing to be safe with a small, defenseless creature.

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    2. I am glad that this issue with pets is being focused on here. I am a former foster parent and now a clinician. In both capacities I have shuddered to read case notes on children in my care accusing small children of sadistic behavior, often involving injury or death of just such a small animal as referenced above. It really angered me to see these incidents caused by lack of adult supervision of a preschooler follow the child into adolescence! Also, many times a child can voice understanding regarding safety rules for themselves, pets and others, long before they can be expected to reliably follow the guidelines 100 per cent of the time. For this reason, for example, when walking with a three-year-old near a street, the child's hand is held, even though the child may vocalize that they know not to dash into the street. They may be able to assert their grasp of safety concepts theoretically, but they aren't yet equipped to put their own brakes on at all times. I have though, seen older children in public classroom settings for non-diagnosed children purposely try to harm aquatic pets, so this sort of sadistic behavior does happen and is a concern. Huge difference between that behavior and an overly excited young child holding a parakeet! It bothers me though that it seems anything a foster child, labelled child, or child of a family receiving services does is pathologized, when the behaviors are actually within the range of typical for the child's age. e.g. a mild shoving between eleven-year-old boys walking home from school becomes indicative of some major disturbance. I can't help but notice that if the child involved with the scuffle is from a poor family that may all ready be involved with various voluntary or involuntary agency services, the push is to label that child with some dreadful ailment or other. And I will bet the farm if the same mild scuffle occurred between children from families with higher economic status, the behavior of the children would be interpreted through a non-pathological lens. Spirited lads! Let's get them into Martial Arts! etc.
      Jean, I want to express how grateful I am for your work. I recently discovered you when I stumbled across the Advocates for Children in Therapy website. You are saying the things I have been wanting to say for years, even down to the exact concern about children blamed for the untimely death of rodents! As I mentioned, I used to provide foster care for children and some of them had this RAD diagnosis. However, I certainly didn't subscribe to any of this so-called Attachment Disorder stuff then, nor any other harsh or punitive approaches. The program I worked with didn't use Attachment Therapy, however the program was somewhat behavioristic and its cultural attitude towards children was not as humanistic as mine was. However, they gave me latitude to interpret the behavioral plans for the children liberally, and since the children did quite well with me I was free to implement humanistic, nurturing care. This is why I can attest that you are quite correct in one of your blogs when you stated that mild rewards and mild "punishments" are more effective. I have hundreds of examples of children with severe diagnoses responding to very low- key guidance techniques. I won't say much more because, I am afraid I am off-topic, and secondly, I would want to be very vague and disguise details of the many benign interventions I discovered in my foster parent stint, for privacy reasons. I will just attest that yes, supposedly very difficult children behaved within the range of age-appropriate normal cooperation and were as happy as they could be most of the time, using gentle re-direction, respect, common-sense structuring of their days to include fun, rest, humor, nourishment, fresh air, learning, creativity, responsibility in balance.

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    3. Laura, thanks so much for these comments "from the trenches"! You are not off the broader topic here, which is basically how not to interpret childish behavior as pathological when it isn't (while at the same time being aware of anything that is genuinely concerning). I understand your concern about confidentiality-- but if it ever turns out that
      you can tell about some specific incident without violating that requirement, I would be very interested and I'm sure that other readers would, too.

      To go back to the pets for a moment, I do wonder how many of Nancy Thomas's "kids who have killed" actually killed a small animal or bird by accident.

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    4. Hi Jean

      My reply was long and wouldn't fit. It is perhaps unnecessarily long, but I have been reading the terrible stories on the Advocates for Children in Therapy site, and perhaps hearing about a different approach will be a pleasant change. But I have to put my reply in several different postings. I can probably disguise a couple of events to use as anecdotes. Let me preface my narrative with this: People who seek to work with children, or to be foster or adoptive parents do well to understand themselves as deeply as possible and some of the motivations, as to how the adult may be hoping the work will meet their needs. So, putting myself on the metaphorical couch, at the time I took on children with multiple diagnoses I was dealing with being in a life transition, as a new empty- nester. I believe I wanted to prove I was a great mother, that I was looking back on mistakes with my biological children and had some kind of desire to do make amends, and that I had rescue fantasies. I was also paid for this work. That is as deep as I want to go on a public forum. Nevertheless, whatever my own inner wounds, I still had empathy, energy and parenting skills to offer and in the long run at the least, I was able to provide a period of relative happiness for my charges.

      It was summertime and I had two children with me fulltime and others who came for respite. I ran the house a bit like a summer camp, and I had a college student helping me. All the children had previously been institutionalized and had various serious diagnoses. This is how the day went and what was expected of the children, some who had the dreaded RAD, some with ODD, some had had brief psychotic episodes and other such things:
      Schedule: Get up at some reasonable time and make a reasonable effort to straighten your room. This isn't the military though. It is your space, just make it hazard free. Then have breakfast after which I open an art room for free art. Create whatever. Then the town community center opens, so I brought the children to access the games, books and such there until the pool opens. (During this entire time, I am right there guiding and coaching regarding conflicts, frustrations, etc.) Play in the pool until exhausted. I am watching and coaching all of this. However, if your behavior isn't within the lifeguard's standards, the lifeguard will give you a stern lecture and make you sit out. (That's life. No need to be harsh and lock a child in a "scream room", but then again, if you are going to play in a pool, you are going to have to follow the lifeguard's rules. To me this is an appropriate, light "punishment". After lunch return home and work on the children's garden. They each had their own patch and happily dug in the mud for hours. It was THEIRS. They could do anything they liked with it. Trying to grow huge pumpkins was a popular theme. Again, although preteens, they needed to be coached like preschoolers much of the time. They needed help resolving arguments about garden tools and all kinds of little things. They needed strong direction and choices, but again, no need to be harsh. Conclusion to follow

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    5. Approach to RAD foster children continued:
      Dinner was often served buffet style. Preteenagers often need to eat quite a bit. I should say that they controlled their own food intake and could have snacks as wanted. Just as long as they don't drink milk out of the carton or take one bite out of each piece of fruit and put it back! No one has to eat anything, and no one should be deprived of food. Unless there is a medical condition, children this age can decide if they are hungry or not, what foods they like and don't like. If they don't like what I make, I don't make a whole other entrée, but they can eat from the other offerings, which was often buffet anyway.

      I do remember once that a new child was staying with me and he froze up at the buffet, holding a piece of bread in his hand, trembling as he waited for my instructions. " Do I have to put egg salad on it?" I answered, "No, whatever you want, you don't even have to have a sandwich if you don't want. Just fill your plate how you like." He was much relieved. I wondered what kind of treatment centers he had been in where his food was controlled.
      Also of course, anyone could go to the bathroom or get a drink of water at any time. Although only one person can be in the bathroom at a time! Anyway, they generally gardened and puttered in the yard until dusk, always supervised, with me available to engage in conversation if they wanted to talk. In the evening I showed encouraging movies. I tried to rent a lot of movies with happy endings and encouraging themes. At a reasonable bedtime for their age in summer, they go off to bed, but can read or listen to music quietly. If frightened, doors open with light coming in, of course! If they think there are dangers outside, I take a flashlight and make sure that nothing frightening is lurking outside their windows. If they are really having a bad night I sat outside the room in a rocking chair and reassure them that they are safe until they fall asleep. So, that's how the summer went. The children were generally quite cooperative with this schedule. I may have had to use the PRN medications once or twice, as agitation and extreme anxiety could still occur. It took a lot of energy to redirect and create better choices, but it did work most of the time. The next posting talks about some interventions that seemed to work.

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    6. Continued. Interventions that helped manage foster children with various behavioral issues and diagnoses: The children were generally quite cooperative with this schedule. I may have had to use the PRN medications once or twice, as agitation and extreme anxiety could still occur. It took a lot of energy to redirect and create better choices, but it did work most of the time. As for examples of interventions I tried, some of them were directed by their behavior plans, but I often cheated a little by adding something. For instance, let's say there is an argument about who got to sit in what chair. They were supposed to have a time out for verbal arguments, but I changed it that they were given paper and pen and asked to come out of their rooms with a suggestion on how to solve the problem we could talk about. Another time when the general mood in the house was angry and unpleasant (this sounds cheesy but.. ) I gave them gift bags and magazines and told them to imagine they were giving themselves presents. They were to tear out things they would love to have in their life. Then they came out (when they were ready! Not hours or weeks later!) and we talked about their dreams and wishes. I really don't know what I was aiming for, except to get the mood away from whining and complaining and teasing and into dreaming and imagining. Although this seems like a cheesy exercise as I said, they seemed to like it and it did shift the mood. In a way it seems kind of sad, because they couldn't have the things they chose for their gift bags, but then, none of us can have a lot of things we want and it doesn't seem to hurt people to imagine pleasant things.

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    7. Continued: anecdotes/interventions with difficult foster children:
      Another intervention that worked was the "I will turn this car around." Only I really did! Raising my bio children I probably threatened it but didn't do it, and if I did do it, I would have joined in the pouting about the ruined outing. Having learned from earlier fails as a young parent, I followed through with my foster children . I explained the expectations for the outing before hand.. Seatbelts on, hands to yourself, follow all safety and appropriate public behavior requests by the adults. So, let us say it was a terribly hot day and we were going to go to the beach, get corndogs and pop, and then later rent a movie everyone was wanting to see. But we get two blocks down the road and someone has their seatbelt off and is over on the other side of the seat pulling their neighbor's hair. Unfortunately for the innocent party, the outing is cancelled immediately, due to the aggressor's behavior. (Although in these cases, often the innocent party may have sneakily poked or pinched the aggressor.) But there is no need to lock children in a hot room with nothing to do. It just means instead of a day at the beach with junk food, we will have a nice day running through the sprinkler in the backyard. With some healthy sandwiches and smoothies. And for the evening's movie, on hand we have a black and white educational film with Donald Duck explaining the Dewey Decimal system. So, they still have food, exercise, fresh air and some mild entertainment/education. It just isn't as fun as the outing would have been. And I didn't pout. I sat in the back yard cheerily reading a magazine. One of the children walked up to me and said, "I know what you're doing." I thought it was kind of cute actually, that he said that. Anyway, I don't think this "punishment" hurt anyone at all and future outings were without incident. So, those are some of the anecdotes that I remember. The children I had in my home had very rough histories, and I don't have high expectations for the eventual outcome of their lives. Van Morrison has a song where he sings about the "Youth of a thousand summers in my soul". I hope that some memories of a reasonable person being reasonable with them, and offering them some childhood pleasures has left an echo of the "youth of a thousand summers" in their hearts. There is another song, by Rod Stewart, "And when you finally fly away, I'll be hoping I served you well, and in my heart you'll be forever young."



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    8. Thanks so much for these descriptions. I hope I managed to post them in the right order. You seem to be reporting that you used commonsense parenting methods with "bad" kids, and those methods worked very well for the time being, although you don't claim that you have cured them of all that ailed them, as attachment therapists do.

      While reading your comments, I was thinking that your attitude is so different from that of the "trauma mamas". You saw nurturing and guiding the children as your job, a valuable one and one to be done with as much intelligence and compassion as possible. You may have chosen the work for your own personal reasons (who doesn't?), but you didn't choose it to prove how lovable you were or how awful anyone else was.

      One of the problems I think exists with foster care today is that many do not see it as a job to be done well, but simply as a side activity. In my own state, New Jersey, there are foster parents who have regular work outside the home and place the foster children in day care, creating additional tension and confusion all around. I have heard of kids who did not get to a doctor or dentist unless the CASA took them.

      I also note the number of parents, both foster and bio, who seem to believe that appropriate care for children does not preclude plenty of time for parents to go out with friends, have nails done, etc. etc. Is this the result of the constant admonition to "take care of you first"? I don't know, but it seems to me to be a road to disaster when people really believe this. It's like a newly pregnant couple saying "this baby won't change our lives".Not only is this totally unrealistic, but why have the baby or take the foster children if it won't change your lives? Surely these decisions are about wanting to change your life, as well as the children's lives?

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    9. Thanks Jean, for hearing me. This all occurred a very long time ago, but the memories still occupy my thoughts. I agree, it is kind of cute when the pregnant couple seems to think the baby will almost be kind of an accessory, that will be carried along like a handbag! Well, fortunately, most people let go of that idea the minute they meet the baby. The baby is a person, not a accessory, and they begin to express their opinions immediately. I can't blame one for not knowing what it will be like. I don't regret parenting, but if I had really known, if anyone really knew ahead of time, about the decades of challenge, even with a perfectly typical child, would they agree to do this? And my bio children are close to middle-age themselves now. I was an adolescent mother, how could I have known? I don't know if there'd be any more people if onr knew in detail, in advance the decades of sacrifice that you would happily assent to! I wanted to add that, while doing the foster care work I had all ready earned an undergrad degree with a lot of child development, so I had a lot of tools about child guidance, there was no magic in this. I then decided, that since I had such strong opinions on child development, diagnosis and therapy, I ought to become a clinician, so I did. Regarding the lack of time for self, during that period of time, of intense foster care, I did not have time for myself, but I knew I had agreed to it, kind of like a stint in the army or something. We did have respite plans. The families in the program took turns, having a day or two off now and then, with the program's permission. So some of us might have more children now and then in the house in exchange for a vacation. But going to respite, didn't mean going somewhere where the other family would be mean to you. It was like going to an aunt's house or something. There was a tacit understanding I think though, that going to my house for respite was kind of a reward, as I was the only one doing the full on recreational program. Thanks again, Lots of memories, somewhat painful.

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    10. I also want to add Jean, that this was a comprehensive treatment foster care program. The requirement was that one person be a full-time parent, without another job, and that if single, have another source of income, be it from investments or whatever, so that people didn't do it just for money. They paid me enough that I could have a middle- class life and be a full time parent (although certainly not what a 24/7 job doing that was really worth!) I was required to bring the children to various meetings and appointments, medical, psychiatric, educational etc. and any occasional childcare was arranged through the program with trained and approved persons. Home visitors came over regularly to monitor the situation. I did disagree with some of the program's theoretical paradigms and culture of patholigizing everything, and I can't claim to be free of defensive ideas about being the good one or rather the "right" one. This goes back to putting me on the couch though. Anyway, the solution seemed to be for me to become a child psychotherapist, and even in that regard my supervisor pointed out that my advocacy for children seemed to be with a "vengeance". I also wonder, if as some suggest, that the whole idea of foster care for children needs to be rethought. Perhaps humane child-centered group homes would provide more stability and less loss in the long run.

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    11. Hmm, I seem to get only one "reply" to both of these comments-- so, to start with the first-- your point about respite being like going to an aunt's house is such an important one. I am regularly enraged at the term "therapeutic respite care"-- used primarily by AT advocates-- which positions respite as time for exceptionally severe treatment, rather than for the extra support and nurturing needed by foster children who are temporarily away from their most familiar caregiver. The level of education you mention is also very relevant-- we need to get away from the idea that a foster or adoptive parent needs just to be "loving" and to have taken care of a lot of kids.

      I would say that whatever is worth doing, is worth doing "with a vengeance", as well as with constant questioning of one's own and everyone else's thinking. And I can see that you are doing the questioning when you counter the present established wisdom with the proposal that well-run group homes could have many advantages. Unfortunately, the zeitgeist is going the opposite direction, as people have uncritically accepted the conclusions of the randomized BUT poorly designed research on the Romanian orphanages-- I even heard Marty Moss-Coane on NPR the other day, talking as if this was a foregone conclusion!

      There is much work left to do--

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    12. I don't know the answer, other than obviously prevention. Neither institutions nor families are by nature free of abuse. We have all seen the images of rows of cribs filled with depressed babies. I do think though that the insistence that the nuclear family offers some kind of inherent panacea is rooted in the reification and romanticizing of the family and in particular, the dyad, so beloved by the Attachment Therapy true believers. The truth is, neither the dyad, nor the nuclear family are the only possible contexts for the development of meaningful relationships that yield basically healthy personalities. I had a really lovely dyadic period with my infants, and the bliss of infant/mother eye gazing is a precious memory to me. However, that particular intensity I think is glorified by our society with its romantic notions of One True Love Forever and Ever and its attendant blissful biological family. Honestly, when I hear what some of these women are saying, and their need to know their child's thoughts, or dictate their child's thoughts, or stare into their child's eyes I can't help but notice the sexual undertones, actually, not even that disguised. It is like the stereotypical image of let's say a heterosexual couple, with the female partner demanding hand-holding and eye gazing and wanting complete fidelity and needily worrying and wondering about every thought the male partner has! And sometimes the male is just thinking about something entirely unemotional and wants to be left alone. People just don't have to like or love us that much for us to survive, actually, children, spouses, whoever. And, after all, the children grow up and do their own thing and they aren't going to be saying, "I love you Mother, dearest" forever. So, perhaps it is time for women feeling the need for attachment to find another hobby or source of gratification.

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    13. The romance of mother and child-- a pretty scary idea, unless we recognize that it will modulate over years until the child is ready to enter a similar relationship with someone else-- at which time, as you say, the mother should herself have done some modulating and be not only ready but eager to engage with life in some other way. But of course women in groups that permit them no life but family life can't really achieve this--

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    14. Yes. In a sense I think of the years of individuation as the child grows and separates as kind of a long divorce, that is hopefully as amicable as possible.

      I am afraid I will be reading every one of your blogs and tempted to respond to each with a long essay. This whole thing is such a hot button issue for me. And I disagree with you just enough on a minute point or two to want to kick up some dust. Anyway, signing off until my next advocacy with a vengeance episode riles me up for an essay marathon. Thanks much for this and the ACT website.

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    15. Well, sometimes I disagree with me too. I'll be interested to see your comments!

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  2. Justin Harris sent his two adopted daughters to live with another family, where one of them was later sexually abused. These are consequences of the death of a hamster? Even if the unfortunate hamster "heroically" died .... that should worry SPCA but not Department of Human Services. Who is responsible for children? I do not understand the American laws :(
    Demons, dead kittens, hamsters ....... The world has gone mad (((
    Adoptive parents were afraid that the adoptive daughters want to rape boys?
    I'm surprised the scale of the impact of creativity Nancy Thomas on people.

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    1. Well,it makes very little sense to me,either,Mihail!
      But it's not about the laws-- it's about decisions made by bureaucrats who are empowered to affect lives, and not very much constrained by law. When those bureaucrats are influenced by ideologues, disaster can strike as a result.

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  3. I think natural bestvie already happened. Holds no sympathy for traumatized children, but the demonization of these children. The article says that the police do not have time to deal with complaints against foster children. Too many foster families are afraid of adopted children, and cry out for help. They do not know how to educate foster children. I underestimated the scale of the disaster. It reminded me of the ridiculous story when the cook fed orphans pea soup and potatoes with stewed beans before daytime sleep. Children in the bedroom began to fart and laugh. General merriment gradually turned into a fight. Mentor went into the bedroom to the boys and began to find out who started and look for the guilty among children. This is not funny. This is sad.
    https://www.youtube.com/watch?v=q2aHji3xLR8

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