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Interest in presence within a caring relationship has gained renewed attention in the past decade. For five decades, presence has been implicit and explicit in nursing theory. Recognizing caring presence as important to nursing, the 13th Annual Caring Research Conference in 1992 spotlighted the topic. Yet few publications appeared in nursing literature between the years 1980 to 1991. Since that time, interest in and literature about the topic has greatly increased. The elusive nature of the phenomenon, however, makes it difficult to define. This article presents a review of literature of presence and suggests a working definition that could be used as the basis for research. Placing presence within the context of caring provides a way for the holistic nurse to offer caring-healing ways of being and relating.

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.