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Previously explored as separate phenomena, this phenomenological-hermeneutic study integrated caring and presence with the experience of caring presence described within the context of a shared nurse practitioner-patient relationship. The results suggest that caring presence is (1) mutual trust and sharing; (2) transcending connectedness; and (3) experience. Research related to caring presence within the nurse practitioner-patient relationship in the context of a managed care outpatient system provides another basis from which to develop nursing knowledge that guides practice within the boundaries of and barriers to care in the technologic world of healthcare.

Many patients with psychiatric disorders struggle with poor skills in coping, communication, socialization, and self-expression that may result in dysfunctional behavioral, cognitive, and emotional responses. Therapeutic music offers a noninvasive approach to strengthen these skills and effect behavior change. At a regional inpatient psychiatric hospital in Colorado, a program of therapeutic music was developed using Rogers' theory of unitary human beings as the theoretical framework. This article describes the approach used to strengthen coping skills in communication, socialization, and self-expression. Suggestions are made for developing a program of music with similar patient populations.

1. Music, a universal language with many purposes, can be used in the health care setting to aid in stress reduction and anxiety. 2. When used in the psychiatric setting, music can elicit emotion and affect behavior change. 3. Nurses in the psychiatric setting can include music in a group session that evokes thoughts, feelings, and memories for the clients.