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   <front>
      <journal-meta>
         <journal-id journal-id-type="DOAJ">15041611</journal-id>
         <journal-title-group>
            <journal-title>Voices: A World Forum for Music Therapy</journal-title>
         </journal-title-group>
         <issn>1504-1611</issn>
         <publisher>
            <publisher-name>GAMUT - Grieg Academy Music Therapy Research Centre (NORCE &amp;
               University of Bergen)</publisher-name>
         </publisher>
      </journal-meta>
      <article-meta>
         <article-id pub-id-type="doi">10.15845/voices.v20i1.2586</article-id>
         <article-categories>
            <subj-group subj-group-type="heading">
               <subject>Research</subject>
            </subj-group>
         </article-categories>
         <title-group>
            <article-title>A Heuristic Inquiry into the Development of Therapeutic Presence as a
               Student Music Therapist</article-title>
         </title-group>
         <contrib-group>
            <contrib contrib-type="author">
               <name>
                  <surname>Mc Guigan</surname>
                  <given-names>Niall</given-names>
               </name>
               <xref ref-type="aff" rid="N_Guigan"/>
               <address>
                  <email>mcguiganniall@gmail.com</email>
               </address>
            </contrib>
         </contrib-group>
         <aff id="N_Guigan"><label>1</label>Vibrations for The Heart Music Therapy, Noord-Holland, Amsterdam, Netherlands</aff>
         <contrib-group>
            <contrib contrib-type="editor">
               <name>
                  <surname>Viega</surname>
                  <given-names>Michael</given-names>
               </name>
            </contrib>
         </contrib-group>
         <contrib-group>
            <contrib contrib-type="reviewer">
               <name>
                  <surname>Muller</surname>
                  <given-names>Bryan</given-names>
               </name>
            </contrib>
            <contrib contrib-type="reviewer">
               <name>
                  <surname>Merrill</surname>
                  <given-names>Theresa</given-names>
               </name>
            </contrib>
            <contrib contrib-type="reviewer">
               <name>
                  <surname>Hinman-Arthur</surname>
                  <given-names>Meghan</given-names>
               </name>
            </contrib>
         </contrib-group>
         <pub-date pub-type="pub">
            <day>1</day>
            <month>3</month>
            <year>2020</year>
         </pub-date>
         <volume>20</volume>
         <issue>1</issue>
         <history>
            <date date-type="received">
               <day>17</day>
               <month>10</month>
               <year>2017</year>
            </date>
            <date date-type="accepted">
               <day>11</day>
               <month>6</month>
               <year>2019</year>
            </date>
         </history>
         <permissions>
            <copyright-statement>Copyright: 2020 The Author(s)</copyright-statement>
            <copyright-year>2020</copyright-year>
            <license license-type="open-access"
               xlink:href="http://creativecommons.org/licenses/by/4.0/">
               <license-p>This is an open-access article distributed under the terms of the
                     <uri>http://creativecommons.org/licenses/by/4.0/</uri>, which permits
                  unrestricted use, distribution, and reproduction in any medium, provided the
                  original work is properly cited.</license-p>
            </license>
         </permissions>
         <self-uri xlink:href="https://voices.no/index.php/voices/article/view/2586"
            >https://voices.no/index.php/voices/article/view/2586</self-uri>
         <abstract>
            <p>This first-person study investigates the role of cognitive and embodied forms of
               knowledge in relation to the development of therapeutic presence as a student music
               therapist. In this paper, I will provide an introduction to the topic reviewing its
               relevance to the practice of music therapy, and I will argue that the development of
               therapeutic presence is a fundamental part of becoming a music therapist. Although
               there are seminal articles in the music therapy literature that discuss the topic of
               therapeutic presence, I have not found any articles relating it to the development of
               being a student music therapist. Using heuristic methodology, I will describe the
               personal process of developing therapeutic presence as a student music therapist. To
               gain a broader perspective on the research topic, and to provide validation and
               transparency in relation to my personal heuristic process, three successive
               theoretical and experiential workshops were carried out with six student music
               therapists. Data, in the form of questionnaires, reflections, and group musical
               improvisations were analysed systematically to validate my experience of the research
               topic and also to discover and evaluate themes and practical methods. The research
               culminated in the synthesis of data gathered during the study in relation to the main
               research question while also reviewing its relevance to music therapy practice and
               implications for further study. </p>
         </abstract>
         <kwd-group kwd-group-type="author-generated">
            <kwd>therapeutic presence</kwd>
            <kwd>cognitive and embodied knowledge</kwd>
            <kwd>heuristic research</kwd>
         </kwd-group>
      </article-meta>
   </front>
   <body>
      <!-- sec lvl 2 begin -->
      <sec>
         <title>Introduction</title>
         <p>This is a heuristic study investigating methods of developing therapeutic presence as a
            student music therapist. According to Rodgers (<xref ref-type="bibr" rid="R1986"
               >1986</xref>), therapeutic presence is an essential component of therapy, yet during
            my Master of Arts (MA) in music therapy educational program I had not experienced any
            specific lectures or practical workshops in relation to this topic. Although the program
            provided theoretical lectures related to psychodynamic (<xref ref-type="bibr"
               rid="A2015a">Adams, 2015a</xref>) and humanistic (<xref ref-type="bibr" rid="N2008"
               >Noone, 2008</xref>) therapeutic approaches in music therapy, while also
            incorporating experiential based psychodynamic musical improvisation workshops (<xref
               ref-type="bibr" rid="A2015b">Adams, 2015b</xref>), the specific topic of therapeutic
            presence had not been directly addressed during my educational program in relation to
            our development as student music therapists.</p>
         <p>Current literature related to the practice of psychotherapy describes the various
            qualities and experiences of therapeutic presence (<xref ref-type="bibr" rid="CP2015"
               >Colosimo &amp; Pos, 2015</xref>; <xref ref-type="bibr" rid="GG2002">Geller &amp;
               Greenberg, 2002</xref>) and provides theoretical frameworks as a means of
            conceptualizing the phenomenon and its application to practice as a therapist. In
            relation to music therapy literature, Bruscia’s (<xref ref-type="bibr" rid="B1998a"
               >1998a</xref>) “being there” for the client, developed from the Bonny Method of
            Guided Imagery and Music sessions with his clients, is a seminal paper in relation to
            the topic of therapeutic presence as a music therapist that will be discussed further in
            this research paper. Bruscia’s paper has also informed Muller’s (<xref ref-type="bibr"
               rid="M2008">2008</xref>) research, which provides phenomenological insight into the
            phenomenon of therapeutic presence. He explored professional music therapists’
            experiences of being present with a client, discussing thematic data gathered from the
            research and argued that “knowing how to be present to a client is essential to being
            effective as a music therapist” (p.2). Fidelibus (<xref ref-type="bibr" rid="F2004"
               >2004</xref>) conducted research using a naturalistic constructivist approach
            developing a working model of therapeutic presence in music therapy practice. The model
            is based on phenomenological analysis of clinical music therapy improvisations and the
            author’s experience of Zen and Buddhist meditation practice. These studies have provided
            a theoretical framework for heuristic discovery in relation to contextualizing both the
            author’s and student music therapists’ experience of developing therapeutic presence
            throughout the research.</p>
         <!-- sec lvl 3 begin -->
         <sec>
            <title>Therapeutic Presence &amp; Music Therapy</title>
            <p>Therapeutic presence is defined as bringing one’s whole self into the encounter with
               clients, by being completely in the moment on multiple levels: physically,
               emotionally, cognitively, and spiritually (<xref ref-type="bibr" rid="GG2002">Geller
                  &amp; Greenberg, 2002</xref>). Although the concept of therapeutic presence is
               central to humanistic traditions (<xref ref-type="bibr" rid="B1987">Baldwin,
                  1987</xref>; <xref ref-type="bibr" rid="R1995">Rodgers, 1995</xref>), historically
               it has been described as originating from Freud’s psychoanalytic approach related to
               his concept of “evenly suspended attention” (<xref ref-type="bibr" rid="GG2012"
                  >Geller &amp; Greenberg, 2012, p.18</xref>). In the context of music therapy
               practice, Priestley (<xref ref-type="bibr" rid="P1994">1994</xref>) described it as
               “a giving of psychic space by the therapist … a listening love …giving of permission
               to be” (p.123) and that the therapist must remain aware, sensitive, and responsive
               when engaging with conscious or unconscious feelings offered by the patient (p. 138). </p>
            <p>As a student music therapist, from my personal experience during my music therapy
               training, lectures related to theories such as psychodynamic (<xref ref-type="bibr"
                  rid="DBS2014">De Backer &amp; Sutton, 2014</xref>) and humanistic approaches
                  (<xref ref-type="bibr" rid="A2005">Aigen, 2005</xref>; <xref ref-type="bibr"
                  rid="B1997">Boxill, 1997</xref>) were taught on an intellectual level through
               informative presentations and conversations, between students and lecturer. Although
               I also experienced practical workshops, role-play, group psychotherapy, and practical
               examinations in other areas, I felt that theoretical lectures could have been
               balanced with an experiential learning approach. In a study reviewing experiential
               learning at Temple University’s music therapy program, Murphy (<xref ref-type="bibr"
                  rid="M2007">2007, p.32</xref>) stated that through experiential learning, students
               acquire self-knowledge, interpersonal skills, and develop understanding of the
               therapeutic process through the active participation. The study found that music
               therapy students who participated in experiential learning felt more prepared for
               real-life situations and were able to reflect on themselves in a way that gave them
               direction regarding their professional and personal lives. They also agreed that
               experiential learning should be assimilated into all levels of music therapy
               education, linking burnout to the lack of experiential learning in their
               undergraduate course. Colosimo and Pos (<xref ref-type="bibr" rid="CP2015">2015, p.
                  102</xref>) argued that if an intellectual approach is overemphasized in practice,
               described as hyper-intellectualization, this can in fact interfere with our ability
               to achieve therapeutic presence that arises from the overuse of theoretical and
               analytical processing. They stated that “when a therapist’s rational system is
               overactive their experiential contact with theirs and their client’s present reality
               is likely weakened, as is their contact with the wisdom that experiential knowing
               provides” (p.103). In relation to this quote, this study will review both cognitive
               and embodied approaches to cultivating the ability to be therapeutically present as a
               student music therapist. I would like to add that this research paper does not seek
               to generalize that the educational approach of all music therapy programs as purely
               intellectual but rather to investigate how a more integrated approach to learning
               could facilitate a more comprehensive educational paradigm in relation to the topic
               of therapeutic presence.</p>
         </sec>
         <!-- sec lvl 3 end -->
         <!-- sec lvl 3 begin -->
         <sec>
            <title>Epistemological Paradigms: Cognitive &amp; Embodied Knowledge</title>
            <p>Gardner’s (<xref ref-type="bibr" rid="G1993">1993</xref>) theory of multiple
               intelligences argues that human intelligence is a multi-faceted phenomenon. In the
               study of skills and abilities, Gardner (p. 73) described two ways of knowing and
               makes a distinction between <italic>know-how</italic> (tacit knowledge of how to
               execute a task) and <italic>know-that</italic> (prepositional procedures in executing
               a task). He stated that prepositional knowledge, which is a primarily cognitive
               function, in comparison to the direct experience of tacit knowledge, is valued in
               some cultures above others. In his critique of modern educational systems, Gardner
               (p. 381) affirmed that in both traditional and modern schools “there has been a
               steady minimization of bodily, spatial, and interpersonal forms of knowledge.” This
               is in comparison to linguistic forms, which he stated are increasingly in favour of
               logical–mathematical and intrapersonal forms of thinking. According to Capra (1975,
               pp. 22–23) the “Cartesian” division has resulted in Western society becoming
               predominantly identified with intelligence of the mind, or cognitive intelligence,
               instead of as a whole organism. </p>
            <p>In contrast to cognitive knowledge, experiential knowledge, also described as
               embodied knowledge (<xref ref-type="bibr" rid="GG2012">Geller &amp; Greenberg,
                  2012</xref>) or tacit knowledge (<xref ref-type="bibr" rid="P1983">Polanyi,
                  1983</xref>), is acquired through direct experience. According to Polanyi this
               knowledge cannot be articulated explicitly and involves our instinctual body
               reactions to situations without the conscious process of thought or pre-cognition.
               Meluea-Ponty (<xref ref-type="bibr" rid="MP1964">1964</xref>) stated that tacit
               knowledge is pre-reflective describing it as “a field of possible, movements, a kind
               of inner map of movements the body ‘knows’ how to perform without having to reflect
               upon such movements” (p. 144).</p>
            <p>According to the following authors, the validity of embodied knowledge is currently a
               neglected form of knowledge in the academic world of psychotherapy (<xref
                  ref-type="bibr" rid="GG2012">Geller &amp; Greenberg, 2012</xref>), clinical
               medicine (<xref ref-type="bibr" rid="H2010">Henry, 2010</xref>), and in general
               caring practices (<xref ref-type="bibr" rid="KN2009">Kontos &amp; Naglie,
               2009</xref>) in Western society. However, there are many exceptions to this claim in
               particular in the creative arts therapies and its work with trauma patients (<xref
                  ref-type="bibr" rid="H2016">Harris, 2016</xref>). Geller and Greenberg (<xref
                  ref-type="bibr" rid="GG2012">2012</xref>) stated that embodied self-awareness or
               somatic awareness is a fundamental aspect of therapeutic presence and that an
               embodied self-awareness gives the therapist a felt sense of what is true in the
               moment, through the emotional, psychical, and sensorial body. </p>
            <p>In the field of radical embodied cognitive science, Keverstein and Miller (<xref
                  ref-type="bibr" rid="KM2015">2015</xref>) argued that our psychological
               functioning is best understood through the perspective of the whole brain-body
               environmental system and that cognition and emotion are inseparable processes in the
               brain. In comparison to an entirely cognitive psychological viewpoint, this embodied
               approach to cognitive science can be understood through the lens of ecological
               psychology and dynamical systems theory. This potentially provides a more balanced
               perspective regarding how emotions and feelings influence both the physical body and
               cognitive functioning. As a result, through a more embodied understanding of the
               brain-body system, our ability as therapists to react to environmental stimuli and
               remain present could be potentially increased. </p>
            <p>In relation to a predominantly intellectualized model of learning in western culture
               and our educational development as therapists, my personal bias regarding the
               formation of knowledge regarding the development of therapeutic presence is based on
               the understanding that embodied practices such as meditation, yoga, and Qi Gong could
               provide us with an alternative theory of knowledge through an increased awareness of
               the body and sensitivity to bodily functions. For instance, a relevant practice for
               student music therapists could be the eight healing sounds, a system of Dao Yin
               health building exercises that are part of the Chinese medical health paradigm. The
               sounds are used specifically to connect with internal organs and positively influence
               the energy flow or Qi in the physical body (<xref ref-type="bibr" rid="TAC2019">The
                  Alternative Clinic, 2019</xref>). I have found this practice to be personally
               beneficial as a means of understanding the influence of sound on the physical body
               and also to increase awareness and sensitivity of changes during practice in relation
               to physical, mental, and emotional well-being. In a qualitative study by Chrisman,
               Christopher, and Lichenstein (<xref ref-type="bibr" rid="CCL2009">2009</xref>), Qi
               Gong as a mindfulness practice has been shown to have positive effects for master’s
               level counselling students. Three of the main themes discussed in the paper included
               psychical, emotional, and mental changes. Students described an increased physical
               awareness of energy level, balance, and body temperatures. On an emotional level,
               feelings of anxiety and nervousness became more relaxed and calm through focused
               breathing and movement. In relation to their mental state, students described having
               a clearer mind and an increased ability to focus and be in the present moment (pp.
               241–245). </p>
            <p>Therefore, an integrated Qi Gong or meditation module in music therapy programs could
               facilitate a more open epistemological outlook for student music therapists as the
               basis of these practices is to question the “origins, nature and limits of human
               knowledge” (<xref ref-type="bibr" rid="R1980">Rorty, 1980, p. 140</xref>). In a study
               conducted by McCollum and Gehart (<xref ref-type="bibr" rid="MCG2010">2010</xref>)
               investigating the effects of mindfulness meditation with student therapists,
               qualitative data gathered suggested that meditation practice helped students to be
               present with themselves and their clients. Key findings of the study revealed that
               students were able to use these techniques in highly stressful therapist–client
               interactions, moments of extreme personal vulnerability, and in instances that they
               would normally react.</p>
            <p>Through the embodied experience, these practices teach us to question the role of the
               cognitive rational mind as the predominant method of obtaining knowledge and provide
               an alternative method for relating to ourselves and our environment. These techniques
               offer interesting opportunities when possibly combined with practical music therapy
               workshops in music therapy educational programs. The combined use of meditation
               exercises with musical improvisation could help increase awareness of the embodied
               experience and potentially enhance music therapy students’ perceptions and awareness
               of their body sensations and the influence on musical and interpersonal interactions
               on our physical body, and emotional state. </p>
            <p>Walsh and Shapiro (<xref ref-type="bibr" rid="WS2006">2006</xref>) described the
               current dichotomy between Eastern meditation practice and Western psychological and
               philosophical methods of therapeutic practice to be in an assimilative integration
               phase in which both are exploring the possible benefits and roles to achieve a
               greater understanding of the human condition. Jung (<xref ref-type="bibr" rid="J1976"
                  >1976</xref>) argued that although thinking and feeling are contrasting methods of
               knowledge, it is by integrating them that we achieve adaptive and wise action of the
               brain. Scheffler (<xref ref-type="bibr" rid="S1965">1965</xref>) stated, in relation
               to the process of learning from experience, </p>
            <disp-quote>
               <p>the ideal education is thus one that connects general ideals with real problems
                  and that stresses their practical bearings. It encourages imaginative theorizing
                  by the student but at the same time insists upon control of such theorizing by the
                  outcomes of active experimentation (p.5).</p>
            </disp-quote>
            <p>From my personal experience of meditation practices, most have been focused on the
               development of a balanced awareness or noticing of our physical, mental and emotional
               state, in the moment, which help us to be more in our physical bodies and therefore
               in the present moment reality. It is therefore; through this authentic state of being
               that embodied knowledge can then be expressed in any given situation. In my opinion,
               these practices could benefit music therapy students in their ability to develop an
               understanding of therapeutic presence in their educational program. The heuristic
               process has also helped to develop a more balanced perspective on the topic through
               the examination of personal bias, reviewing current literature and analyses of
               qualitative information gathered from my fellow music therapy students.</p>
         </sec>
         <!-- sec lvl 3 end -->
         <!-- sec lvl 3 begin -->
         <sec>
            <title>The Heuristic Process and the Development of Therapeutic Presence</title>
            <p>The main research question for this paper asks: how do we as student music therapists
               develop therapeutic presence? As a means of exploring this question I employed a
               heuristic methodology discussing my personal process and the information gathered
               from workshops with my fellow student music therapists. According to Moustakas (<xref
                  ref-type="bibr" rid="M1990">1990</xref>), heuristic inquiry is considered to be a
               movement from “feeling to the word and back to the feeling, from the experience to
               the concept and back to the experience” (p. 16). The introspective nature of
               heuristic inquiry is therefore intrinsically linked to the process of developing
               therapeutic presence as both disciplines are primarily concerned with the examination
               of one’s consciousness and the relationship between cognitive and embodied knowledge.
               Kleining and Witt’s (<xref ref-type="bibr" rid="KW2000">2000</xref>) qualitative
               heuristic framework uses four rules to optimize the chance of discovery in the
               heuristic process. These include the following methods:</p>
            <list>
               <list-item>
                  <p>the researcher’s awareness and declaration of personal bias and willingness to
                     change preconceptions if data are not in agreement with them, </p>
               </list-item>
               <list-item>
                  <p>the topic as a preliminary guideline to the research process that can be
                     subject to change,</p>
               </list-item>
               <list-item>
                  <p>the collection of data to maximize the perspective gained on the topic,</p>
               </list-item>
               <list-item>
                  <p>and the direction of analysis towards the discovery of similarities resulting
                     in concrete themes. </p>
               </list-item>
            </list>
            <p>In conjunction with these rules of enquiry I followed a heuristic research design
               moving through six phases of investigation that included, “the initial engagement,
               immersion into the topic and question, incubation, illumination, explication, and
               culmination of the research in a creative synthesis” (<xref ref-type="bibr"
                  rid="M1990">Moustakas, 1990, p. 27</xref>). In keeping with these protocols, I
               documented personal bias and experiences related to the research question on a
               continual basis throughout the research using auto-biographical reflection and
               documenting the process in a reflexive journal (<xref ref-type="bibr" rid="E2004"
                  >Etherington, 2004</xref>). As a means of gaining a deeper perspective on the
               research topic, theoretical and experiential workshops were carried out with my
               fellow music therapy students as a means of exploring the contrasting epistemological
               paradigms of intellectual and embodied knowledge discussed above. These workshops
               were heuristic in design, functioning to facilitate both a cognitive and embodied
               experience of therapeutic presence for student music therapists that will be
               explained in further detail in the methodology section. This experience of
               therapeutic presence could therefore potentially be applied by student music
               therapists during future music therapy sessions and in everyday interactions as a
               means of both personal and professional development. The information gathered during
               the workshops also served to provide me with a deeper understanding of how, as
               student music therapists, we can develop therapeutic presence using both cognitive
               and embodied approaches. This research method is similar to <xref ref-type="bibr"
                  rid="BACCHMT2005">Bruscia et al.’s (2005)</xref> heuristic analysis of the Bonny
               Method Guided Imagery and Music Program (BMGIM) as the research combines not just one
               researcher studying themselves but also other participants as part of the heuristic
               research process.</p>
         </sec>
         <!-- sec lvl 3 end -->
      </sec>
      <!-- sec lvl 2 end -->
      <!-- sec lvl 2 begin -->
      <sec>
         <title>Literature Review</title>
         <p>The literature review is divided into three sections as a means of providing continuity
            and clarity to the reader, a theoretical basis for the research, a review of the
            researcher’s main argument, and research question. </p>
         <p>The first section evaluates current research on the phenomenon of therapeutic presence
            and its role in psychotherapy and music therapy practice. The second section will
            provide a review of literature in relation to the researcher’s main argument examining
            the contrasting epistemological paradigms of cognitive and embodied knowledge in
            relation to health care settings and our development as student music therapists. The
            third section provides insight into the relationship between the selected methodology
            and the research topic discussing their commonalities and their significance to the
            research.</p>
         <!-- sec lvl 3 begin -->
         <sec>
            <title>Current research: Therapeutic Presence, Psychotherapy &amp; Music Therapy</title>
            <p>In conducting the literature review in relation to the topic of therapeutic presence,
               I was not able to find articles containing practical guidelines specifically for
               student music therapists to refer to as a means of developing therapeutic presence as
               a part of their development as student music therapists. However, research from the
               field of psychology and music therapy formed a basis to understand the phenomenon and
               provided insight into experiential, theoretical, and practical aspects of cultivating
               therapeutic presence as a student music therapist.</p>
            <p>Geller and Greenberg’s (<xref ref-type="bibr" rid="GG2012">2012</xref>)
                  <italic>Therapeutic presence</italic> provides a comprehensive account of the
               phenomenon in relation to the field of psychology. It enables the reader to
               conceptualize therapeutic presence using an empirical model constructed from
               qualitative data (<xref ref-type="bibr" rid="GG2002">Geller &amp; Greenberg,
                  2002</xref>), which includes three domains related to the understanding and
               application of therapeutic presence in clinical practice. These domains include the
               preliminary stage of preparing the ground for presence, the process of presence, and
               the in-session experience of being present. Geller and Greenberg’s practical and
               experiential methods of cultivating therapeutic presence are focused on how to be
               with a client in contrast to traditional models of psychotherapeutic interventions,
               which focus on “what to do” or “how to respond” to a client’s distress. </p>
            <p>Building on the work of Geller and Greenberg, Colosimo and Pos (<xref ref-type="bibr"
                  rid="CP2015">2015</xref>) developed an integrative rational model of expressed
               therapeutic presence mapping four modes of presence that can be associated with the
               in-session experience. The model provides researchers and practitioners with an
               assessment of objective, concrete behaviours that can be assessed in relation to the
               four modes of presence “being here, being now, being open and being with and for the
               client” (p.100). </p>
            <p>These practical guidelines offer music therapists a conceptual framework and
               practical methods to cultivate therapeutic presence as a therapist. Many music
               therapists have described therapeutic presence in theoretical and clinical contexts
               either implicitly or explicitly as a foundational aspect of music therapy practice
                  (<xref ref-type="bibr" rid="BS1998">Bart-Scheiby, 1998</xref>; <xref
                  ref-type="bibr" rid="BO1997">Borczon, 1997</xref>; <xref ref-type="bibr"
                  rid="P1994">Preistly, 1994</xref>). Austin (<xref ref-type="bibr" rid="A1996"
                  >1996</xref>) described how the music itself can facilitate presence stating that
               musical improvisation is a “pure experience in the here and now” (p. 31). </p>
            <p>Bruscia (<xref ref-type="bibr" rid="B1998a">1998a</xref>) developed a theory of
               “being there” for the client using phenomenological and heuristic data gathered from
               his work with male clients during BMGIM sessions. This is one of the first major
               studies in the field of music therapy into the topic of presence, developed from the
               complexities of listening experiences using the BMGIM. He described moving between
               three worlds, when being there for the client, in the music: his personal world, the
               client’s world, and his world as a therapist. Within these worlds, the therapist
               moves between sensory, affective, reflective, and intuitive layers of experience or
               “modes of consciousness” (<xref ref-type="bibr" rid="B1998b">Bruscia, 1998b</xref>)
               and that by moving in and out of different modes and comparing them, the therapist is
               able to gather an ever increasing comprehension of the client’s needs. Muller (<xref
                  ref-type="bibr" rid="M2008">2008</xref>), in a phenomenological study of music
               therapists’ experiences of being present with clients, argued that more clinical
               research is needed in relation to the direct experience, the structure of the
               experience in the music therapy setting, and how the experience varies from one
               therapist to another. Muller also highlighted “modes of consciousness” that current
               research does not provide a clear understanding of the numinous forces that a
               therapist must surrender to as a means of becoming or maintaining presence.</p>
            <p>In the context of our development as student music therapists, Summer (<xref
                  ref-type="bibr" rid="S2001">2001</xref>) stated that without an open state of
               awareness and an ability to observe, the student music therapist can be prevented
               from “circumventing honest communication” (p. 73) with a client. Fidelibus (<xref
                  ref-type="bibr" rid="F2004">2004</xref>) provided a model for music therapists to
               conceptualize the cultivation of therapeutic presence within the music therapy
               framework grounded in Buddhist philosophy and mindfulness. The model is based on
               phenomenological analysis of clinical music therapy improvisations and the author’s
               experience of Zen and Buddhist meditation practice. Fidelibus described the
               interconnectedness of both practices and the role of mindfulness in maintaining the
               ability to be therapeutically present during clinical musical improvisation. He
               argued that spiritual systems, such as Buddhist philosophy, are implicitly linked to
               music therapy theories of practice (<xref ref-type="bibr" rid="F2004">Aigen, 1996, as
                  cited in Fidelibus, 2004</xref>; <xref ref-type="bibr" rid="K2006">Kenny,
                  2006</xref>; <xref ref-type="bibr" rid="R1998">Robbins, 1998</xref>; <xref
                  ref-type="bibr" rid="RU1998">Ruud, 1998</xref>) as the primary objective within
               these frameworks is for the therapist to be attentive and present to the self and the
               client through the musical improvisation.</p>
            <p>In relation to one of the music therapy theories referenced by Fidelibus, although it
               is beyond the scope of this research paper to go into it in depth, Kenny’s (<xref
                  ref-type="bibr" rid="K2006">2006</xref>) model is primarily focused on a state of
               being for and with the client rather than doing to the client. The model is based on
               fields or conditions that relate to the music therapy experience. These include
               primary fields such as the aesthetic, the musical space, and the field of play.
               Within these primary fields are contained secondary fields that include, ritual,
               particular state of consciousness, power, and creative process. All seven elements
               represent a particular environment containing various conditions. The primary fields
               are considered stages through time (not necessarily chronological) whereas the
               secondary are considered a four-fold interactive set. Its aim being to enable the
               music therapist to recognise shifts in particular states of consciousness and fields
               of existence within the therapeutic context. </p>
            <p>Although both psychology and music therapy literature provide conceptual guidelines
               related to the cultivation of therapeutic presence, in a clinical context, I have
               found that as a student music therapist, even with a conceptual understanding of
               therapeutic presence, it cannot be realized in a therapeutic context on a purely
               cognitive level. It is therefore necessary to explore other methods of understanding
               the phenomenon and its application to music therapy practice. </p>
         </sec>
         <!-- sec lvl 3 end -->
         <!-- sec lvl 3 begin -->
         <sec>
            <title>Epistemological Paradigms and the Development of Therapeutic Presence</title>
            <p>Henry (<xref ref-type="bibr" rid="H2010">2010</xref>) and Loughlin (<xref
                  ref-type="bibr" rid="L2010">2010</xref>) discussed the relationship between
               epistemology and tacit knowing in clinical medical practice. Henry argued that
               clinicians who incorporate tacit knowing into their clinical decision making are able
               to think more clearly in relation to the relationships between medicine, healthcare
               the patient as an individual and have a more robust medical epistemology, providing a
               more holistic and person-centred perspective. He believes that this helps clinicians
               avoid the pitfalls associated with a purely reductionist scientific perspective.
               Loughlin agreed with many of Henry’s arguments in relation to the validity of tacit
               knowledge, in particular the biological process of gaining knowledge from our
               environment. However, he critiqued Henry’s description of the mystical nature of
               tacit knowledge being something that is ultimately beyond clear and coherent
               articulation. Loughlin argued that this viewpoint contradicts the purpose of giving
               the topic theoretical attention and validity in a medical context. </p>
            <p>In relation to these contrasting epistemological paradigms and our development as
               student music therapists, Geller and Greenberg (<xref ref-type="bibr" rid="GG2002"
                  >2002</xref>) described the paradox that therapists face in being therapeutically
               present,</p>
            <disp-quote>
               <p>therapeutic presence requires the therapist to let go of theoretical knowledge,
                  and yet to allow this knowledge to inform intuitive responses when it resonates
                  with the experience of the moment. The therapist must also be open and receptive,
                  yet maintain consistent focus. The therapist is also spontaneous, but only as it
                  directly relates to or benefits the client (p.83).</p>
            </disp-quote>
            <p>According to Taoist philosophy (<xref ref-type="bibr" rid="C1972">Cooper,
               1972</xref>), simplicity and acceptance foster spontaneity. This is described as a
               “comprehensive intelligence” (p. 60), which requires a total acceptance of life as it
               is, without condescension, judgment, and resignation, and a seeking of an internal
               meaning from our experience of life. This total acceptance of life helps us to
               generate wisdom in our lives, as our environment becomes a mirror for us to learn
               about ourselves and others in every moment. According to this philosophy, although
               Western logic is useful for exact science, it is too rigid and static to reflect the
               actual fluidity of life and wide range of possibilities and perspectives. Bonde
                  (<xref ref-type="bibr" rid="B2001">2001</xref>) argued that in the discipline of
               music therapy it is necessary to broaden our minds theoretically. This broadening
               enables music therapists to find flexible frameworks that can be integrated into the
               whole spectrum of pathologies, therapeutic models, and self-development goals. He
               argued that it also requires openness to the spiritual and transpersonal domains of
               life. La Torre (<xref ref-type="bibr" rid="LT2002">2002</xref>) stated that an
               Eastern approach, related to Buddhist philosophy, “can help to promote a greater
               sense of quiet, centred presence within the therapist, expanding awareness and
               enhancing effectiveness” (p. 34) allowing for non-judgement and total acceptance of
               the client. This is in comparison to psychological theoretical models and approaches
               in therapy that originate from a tendency to “want to fix things, to make them
               better” (p. 35). </p>
            <p>As Pemberton (<xref ref-type="bibr" rid="P1976">1976</xref>) argued, a therapist who
               wishes to be present must begin with their own experience of being embodied with
               sensation, emotion, and thought. In parallel to Loughlin’s (<xref ref-type="bibr"
                  rid="L2010">2010</xref>) argument, critiquing Henry’s (<xref ref-type="bibr"
                  rid="H2010">2010</xref>) statement that tacit knowledge is ultimately something
               that cannot be described in an academic context, it is my personal opinion that the
               academic and cognitive process of explicating an implicit phenomenon such as
               therapeutic presence, which is a foundational aspect of accessing tacit knowledge, is
               an essential factor in validating embodied forms of knowledge in educational,
               healthcare settings and in music therapy practice. As suggested above, a more
               comprehensive intelligence that balances both cognitive and embodied knowledge could
               be relevant to a music therapy context. In relation to my personal experience of
               embodied practices such as Qi Gong, it is my personal opinion that embodied practices
               could provide student music therapists with a broader epistemological framework that
               helps to develop a more comprehensive intelligence. In relation to the fluidity,
               flexibility, and qualities of acceptance and spontaneity described in the Taoist
               philosophy, from personal experience, this philosophy fits with the actual experience
               of music therapy sessions. During a music therapy session, due to the constant flux
               and personal dynamic between therapist and client one must be constantly fluid,
               flexible, and spontaneous to the client’s needs and the creative space offered in the
               musical interaction in contrast to a purely reductionist scientific approach. </p>
         </sec>
         <!-- sec lvl 3 end -->
         <!-- sec lvl 3 begin -->
         <sec>
            <title>The Heuristic Process and the Development of Therapeutic Presence</title>
            <p>When reviewing key articles related to the heuristic process (<xref ref-type="bibr"
                  rid="E2004">Etherington, 2004</xref>; <xref ref-type="bibr" rid="KW2000">Kleining,
                  &amp; Witt, 2000</xref>; <xref ref-type="bibr" rid="M1990">Moustakas, 1990</xref>;
                  <xref ref-type="bibr" rid="SS2002">Sela-Smith, 2002</xref>) and the research topic
               of therapeutic presence (Geller &amp;Greenberg (<xref ref-type="bibr" rid="GG2002"
                  >2002</xref>), I found the methodology of heuristic enquiry to be the most
               appropriate to this research project. In comparison to objectivist research
               paradigms, which are predominantly concerned with a cause and effect relationship
               with the research topic, heuristic enquiry aims to discover the nature and meaning of
               the phenomenon in question using the direct first-person account of the researcher
               and individuals who have directly encountered the phenomenon in experience (<xref
                  ref-type="bibr" rid="DM1985">Douglass &amp; Moustakas,1985</xref>). Sela-Smith
                  (<xref ref-type="bibr" rid="SS2002">2002</xref>) critiqued the Moustakas heuristic
               method, arguing that many heuristic enquiries based on this framework are not
               authentic as one’s experience cannot be validated by the experience of another.
               However, from personal experience of the heuristic process and the development of
               therapeutic presence, it is through authentic and open self-reflection and
               relationship with others that we can achieve a deeper understanding of ourselves as
               therapists and as human beings. Therefore, an honest heuristic enquiry is achieved
               through the uncovering of bias and patterns of conditioning that can provide
               authentic research, a factor that is explored further in the following section. </p>
            <p>Although the researcher has also considered a phenomenological approach, which
               requires a kind of detachment from the subject, heuristic research recognizes
               participants in the study as whole persons and not as separate objects. This connects
               the research with a more person-centred humanistic philosophical framework that aims
               to “retain the essence of the person in the experience” (<xref ref-type="bibr"
                  rid="DM1985">Douglass &amp; Moustakas, 1985, p. 43</xref>). Aigen (<xref
                  ref-type="bibr" rid="A1993">1993, p. 19</xref>) described the client-centred,
               humanistic approach as the type of clinical approach to music therapy practice and
               research that is most suitable for a qualitative research design. The intrinsic links
               between qualitative heuristic enquiry, therapeutic presence, person-centred therapy,
               music therapy, and personal development suggest that the process of developing as a
               student music therapist is already a heuristic one. Therefore, the understanding of
               therapeutic presence through heuristic enquiry can be based on valuing the
               therapist’s creativity, flexibility, intuition and self-awareness, having a profound
               respect for the client and client’s needs as the main directive to the therapeutic
               process, recognition of the therapeutic relationship as a fundamental factor in the
               therapeutic process, and an awareness of music therapy as an autonomous process
               allowing for musical expression and aesthetic experience.</p>
         </sec>
         <!-- sec lvl 3 end -->
         <!-- sec lvl 3 begin -->
         <sec>
            <title>Conclusion</title>
            <p>As the review of current literature in psychology and music therapy suggests, there
               is a variety of theoretical, philosophical, and practical methods available to enable
               therapists to cultivate therapeutic presence in clinical practice. Although the topic
               of therapeutic presence is discussed in the music therapy literature, for student
               music therapists, the literature is lacking clear structured methods in relation to
               applying these concepts to a music therapy context. The second section of the review
               highlighted the contrasting epistemological paradigms in healthcare practice and the
               possible benefits to a more holistic and balanced approach to incorporating tacit or
               embodied knowledge into caring practices. The literature also suggested a more
               comprehensive intelligence is needed in order for student music therapists to balance
               the paradox between cognitive and embodied understanding of therapeutic presence, an
               ability that may be achieved through the development of mindfulness practice. As a
               means of evaluating both cognitive and embodied methods of developing therapeutic
               presence, a heuristic enquiry has been selected as a means of discovery as it
               reflects the process of both cognitive and embodied process of developing an
               understanding of therapeutic presence as a student music therapist.</p>
         </sec>
         <!-- sec lvl 3 end -->
      </sec>
      <!-- sec lvl 2 end -->
      <!-- sec lvl 2 begin -->
      <sec>
         <title>Methodology</title>
         <p>This section will discuss the methods, procedures, and limitations in conducting this
            study. It will describe the process of collecting, organizing, analysing, and
            synthesising the data, delineating the various forms of personal journaling and
            literature, which informed the five phases of heuristic systematic process, initial
            engagement, immersion into the topic and question, incubation, illumination, and
            explication (<xref ref-type="bibr" rid="M1990">Moustakas, 1990, p. 27</xref>). In
            relation to the selected heuristic methodological framework (<xref ref-type="bibr"
               rid="BACCHMT2005">Bruscia et al, 2005</xref>; <xref ref-type="bibr" rid="KW2000">Kleining,
               &amp; Witt, 2000</xref>), which validates introspection as a key method in
            psychological research, I will describe how this has informed the design and structure
            of heuristic workshops carried out during the study. Details regarding the organizing,
            analysing, and synthesising of qualitative data will also be provided in relation to the
            selected thematic analysis process (<xref ref-type="bibr" rid="TPF2014">Tsiris,
               Pavlicevic, &amp; Farrant, 2014</xref>).</p>
         <!-- sec lvl 3 begin -->
         <sec>
            <title>Ethical Consent</title>
            <p>Due to the use of human participants, ethical consent was required from the
               university’s research ethics governance committee for the commencement of the
               proposed study. Consent was granted on the condition that I provided a “gatekeeper”
               (an elected representative not part of students MA course) as a mediator between
               myself and possible participants so that they did not feel obliged to take part in
               the research. To provide further distance from my fellow student music therapists, a
               consent form and information letter were sent to the elected student representative
               who forwarded the forms via email to possible participants for the research. </p>
         </sec>
         <!-- sec lvl 3 end -->
         <!-- sec lvl 3 begin -->
         <sec>
            <title>Heuristic Process &amp; the Phases of Heuristic Enquiry</title>
            <p>
               <bold>Personal heuristic process.</bold> The first section of the heuristic process
               describes my personal experience of developing an understanding of therapeutic
               presence as a student music therapist through the heuristic phases of discovery.
               Regarding the heuristic methodology, personal data was used to inform each of the
               phases of heuristic discovery described by Moustakas (<xref ref-type="bibr"
                  rid="M1990">1990</xref>) such as initial engagement, immersion, incubation,
               illumination, and explication. Data sources included, personal research journal,
               previous research conducted in the field of ethnomusicology (<xref ref-type="bibr"
                  rid="MG2013">McGuigan, 2013</xref>), self-reflective journals from meditation and
               shamanic practices, self-reflective journal from heuristic workshops, and literature
                  (<xref ref-type="bibr" rid="DMS1992">De Mello, &amp; Stroud, 1992</xref>; <xref
                  ref-type="bibr" rid="T2004">Tolle, 2004</xref>). The heuristic phases culminate
               into a creative synthesis section that highlights my personal understanding of the
               research topic and insights gathered from the heuristic process that will be
               described in further detail in the next section. </p>
            <p>
               <bold>Music therapy student workshops. </bold>The workshops conducted with fellow
               music therapy students are detailed in the validation of heuristic research section.
               In these workshops, six music therapy students participated in workshops as a means
               of creating further insight into the development of therapeutic presence as a student
               music therapist. This section seeks to provide an objective frame of reference
               outside my personal experience of the development of therapeutic presence. The data
               gathered served as an opportunity for practical experience and reflexive discussion
               between fellow students on the topic of therapeutic presence. The workshops provided
               qualitative data gathered via questionnaires and a discussion group that helped to
               validate and expand the subjective material gathered in relation to my personal
               heuristic process and the topic in general. Three 1-hour individual workshops were
               facilitated over a 3-week period. Each workshop was recorded via audio and visual
               equipment. I used lecture rooms in the university where students regularly attended
               lectures and conducted practical musical activities including group musical
               improvisations. The room was booked in advance, and signs stating “Do Not Disturb”
               were added to the door to avoid interruptions. Yoga mats were supplied for the
               experiential workshop and all instruments used for musical improvisation were
               borrowed from the university. Each participant was allocated random numbers to
               provide anonymity in relation to answers provided in the questionnaires during the
               workshops. </p>
            <p>All data from the workshops was secularly stored at a private location for
               organization and analysis. Data organization followed a thematic analysis process
               (Tsiris, Pavlicevic, &amp; Farrant, 2014, pp. 116–121). Qualitative data gathered
               from questionnaires and workshops was transcribed to a word document for analysis.
               The raw data was first coded to extract natural segments related to the phases of
               heuristic discovery. These segments were then categorized to extract larger meaning
               units in relation to the experience of developing therapeutic presence as a student
               music therapist. Categories were then used to construct themes in relation to the
               research topic and its relevance to the practice of music therapy. These themes
               informed the validation of heuristic research section as they displayed valuable
               insights into the benefits of both cognitive and embodied forms of knowledge
               regarding the research topic and the heuristic process.</p>
            <p>
               <bold>Workshop structure.</bold> Workshops were both didactic and experiential and
               structured in a heuristic format based on Moustakas’s (<xref ref-type="bibr"
                  rid="M1990">1990</xref>) phases of heuristic discovery. Participants were given a
               general overview of the heuristic process at the beginning of the first workshop.
               Participants were also provided with a general overview of the structure of the
               workshops provided in the information letter but were not given details in relation
               to the main research topic and argument to prevent researcher bias influencing the
               participants experience and also to enable a more natural process of discovery.</p>
            <p>Workshops one and two provided initial engagement and immersion into the topic.
               Incubation periods of one week separated the first two workshops followed by a
               two-week break before the final workshop. The final workshop facilitated the
               application of techniques learned in previous workshops in relation to the
               development of therapeutic presence in a group musical improvisation. Questionnaires
               were used throughout as a means of engaging participants in a process of
               introspective discovery, in keeping with qualitative heuristic protocol (<xref
                  ref-type="bibr" rid="KW2000">Kleining &amp; Wit, 2000</xref>), and also to provide
               the research with information regarding their process of discovery. Workshops
               provided student music therapists with a heuristic framework, similar to my journey
               of discovery in relation to the research topic, to develop an understanding of
               therapeutic presence through the evaluation of their own experience during
               theoretical and experiential workshops.</p>
            <p>Workshop one gathered base-line information regarding the student’s initial
               understanding of therapeutic presence using a semi-structured questionnaire. This
               workshop reflected the academic process of discovery and the intellectualization of
               presence providing a theoretical lecture on the fundamental features of therapeutic
               presence in psychology and its relevance to music therapy. The workshop was concluded
               with a group musical improvisation. Each participant then completed a self-reflective
               questionnaire describing their experience.</p>
            <p>Workshop two was primarily experiential. Participants experienced Vipassana
               meditation techniques, Taoist breathing and body awareness techniques, guided
               awareness meditation, Qi Gong ‘Standing like a tree’ meditation, and active listening
               techniques. Following the experiential section of the workshop the group then
               participated in a musical improvisation. Each participant then completed a
               self-reflexive questionnaire describing their experience. </p>
            <p>In workshop three, participants were asked to watch the previously recorded group
               musical improvisations. Participants were instructed to watch in silence and then to
               answer a structured question comparing any differences they had perceived in the
               musical improvisations in relation to the first two contrasting workshops. I then
               entered into reflexive dialogue with the participants, first discussing the general
               experience, and second, discussing key topics of interest including the contrasting
               epistemologies of cognitive and embodied knowledge and the application of practical
               techniques to cultivate therapeutic presence in current music therapy practice as
               student music therapists. The group was then encouraged to apply anything they had
               learned in the previous workshops to the final group musical improvisation. Each
               participant completed a final structured questionnaire asking if their perception of
               therapeutic presence had changed over the course of the workshops and if they had
               found any of the techniques useful for future practice.</p>
         </sec>
         <!-- sec lvl 3 end -->
         <!-- sec lvl 3 begin -->
         <sec>
            <title>Heuristic enquiry into the development of therapeutic presence as a student music
               therapist</title>
            <!-- sec lvl 4 begin -->
            <sec>
               <title>Personal Process &amp; the Phases of Heuristic Enquiry</title>
               <p>My initial engagement with the topic of therapeutic presence began during a
                  shamanic experience in 2013 (<xref ref-type="bibr" rid="MG2013">McGuigan,
                     2013</xref>). During this shamanic ritual, I was captivated by the music played
                  by the shaman and found it to be a profoundly interesting and healing experience.
                  The ceremonial and musical experience resulted in a newfound curiosity on the
                  concept of music and healing. Although I did not know why this experience had
                  affected me on such a profound personal level, during or after the experience, it
                  began a journey of discovery towards the phenomenon of therapeutic presence and my
                  introduction to the practice of music therapy. </p>
               <p/>
               <p>According to Moustakas (<xref ref-type="bibr" rid="M1990">1990</xref>), through
                  encounters with the self, autobiographical reflection and the consideration of
                  social context, the initial engagement period involves the formulation of a
                  research question based on an intense interest in a chosen topic. In 2014, due to
                  an autoimmune illness that affected my physical, mental, and emotional health, I
                  began a 2-year exploration of healing practices that I found to be a heuristic
                  process in itself. This involved research into shamanic healing practices (<xref
                     ref-type="bibr" rid="MG2013">McGuigan, 2013</xref>), experiences with Vipassana
                  meditation (<xref ref-type="bibr" rid="IVT2016">Irish Vipassana Trust,
                  2016</xref>) practice, and a 10-day silent meditation retreat, that helped to turn
                  my attention inwards and began the process of reconnecting with my body through
                  the observation of visceral sensations and development of self-awareness. During
                  the initial 10-day intensive meditation retreat, I was overwhelmed by the
                  influence that my thought patterns had on my ability to remain focused and
                  present. The experience heightened my self-awareness as I began to re-evaluate
                  self-concepts, re-connect with my physical body, and turn my attention inwards to
                  experience a deeper understanding of the human condition through the observation
                  of my own.</p>
               <p>During this period of exploration, I became interested in many other spiritual
                  practices and teachings including Buddhist and Taoist philosophies (<xref
                     ref-type="bibr" rid="K2007">Kornfield, 2007</xref>; <xref ref-type="bibr"
                     rid="R1989">Reid, 1989</xref>) and spiritual teachers such as Ekart Tolle
                     (<xref ref-type="bibr" rid="T2004">2004</xref>), Sadghuru (<xref
                     ref-type="bibr" rid="V2008">Vasudev, 2008</xref>), and Mooji (<xref
                     ref-type="bibr" rid="M2014">2014</xref>). The MA course in music therapy
                  provided access to Qi Gong lessons and the following insight into my personal
                  process during this experience:</p>
               <disp-quote>
                  <p>Through Qi Gong practice I have begun to become more aware of my breath in
                     these moments. These difficult emotions seem to bring me out of the body and
                     into my head, which affects my breathing making it erratic and irregular. As
                     soon as I become aware of this, I focus on my breath, breathing in through the
                     nose with focus on bringing the breath to the lower abdomen and back up in a
                     smooth continuous action. This grounds me again allowing me to observe
                     objectively. (Elective module diary, 13-03-2015)</p>
               </disp-quote>
               <p>
                  <bold>Immersion</bold>. According to Moustakas (<xref ref-type="bibr" rid="M1990"
                     >1990</xref>), during the immersion phase, the researcher must completely
                  commit to the question engaging every opportunity for new knowledge and
                  understanding. As I realised that I had already been immersed in the topic during
                  my personal healing process and interest in meditation practices, I began to
                  reflect on my understanding of therapeutic presence in relation to my development
                  as a student music therapist. When I formed my research question, how do we as
                  music therapists develop therapeutic presence? I engaged fully in self-dialogue,
                  questioning my own perspectives on the topic and personal belief systems. This
                  process of questioning and introspection provided new perspectives on the
                  similarities between the heuristic process and the development of therapeutic
                  presence as I found that they both fundamentally involve the search for meaning
                  and truth. Through the development of qualities such as curiosity, openness, and
                  honesty, I was able to evaluate both positive and negative aspects of my own
                  conditioning, personal perspectives, and bias on the topic of therapeutic
                  presence. This evaluation resulted in feelings of intense vulnerability and
                  humility as the nature of being truthful and honest with oneself resulted in me
                  facing difficult emotions, challenging personal ideologies and behaviour patterns
                  that had influenced my perception of myself, my environment and also my intentions
                  and assumptions regarding the research topic. </p>
               <p>During the immersion phase, I also found that the self-awareness, created through
                  my Qi Gong and meditation practices, began to influence my orientation as a
                  student music therapist, as I felt that in many ways I was discovering unconscious
                  parts of myself that I had previously been unaware. I noticed that some
                  uncomfortable unconscious mental patterns and feelings of doubt and anxiety were
                  also accompanied by uncomfortable physical sensations in my stomach and feelings
                  of tension and pain in the body. I realised that by resting or focusing attention
                  of awareness internally as I interacted in my day to day life, I began to feel, in
                  a more embodied sense, more natural and authentic in my interactions. I was also
                  able to notice my thoughts and thinking process along with feelings in my body
                  simultaneously. This awareness helped me to see that these physical and emotional
                  experiences were not fixed realities and therefore were continuously changing and
                  moving in my experience. As a student music therapist, I found the realisation of
                  objectivity through awareness to be a very beneficial insight into the functioning
                  of my psychological mind and its influence on my psychical body and my ability to
                  be present. Through the immersion of the topic of therapeutic presence, I became
                  more aware of the moments that I was not being present, spaced out, lost in
                  thought or physical discomfort. As a result, I was able to find a feeling of rest
                  or peacefulness in a more natural expression of “being,” a term that I relate to a
                  feeling of internal relaxation that occurred for me when I was able to fully feel
                  the physical sensations in my body without closing down, resisting, or having an
                  intellectual opinion or judgement on what was happening in that moment. I began to
                  notice that this state of peace or internal well-being was constantly being
                  influenced by my thought processes, belief systems, and my reactions to my
                  external environment. As a student music therapist, the realisation of an
                  objective awareness helped me to distinguish the difference and subtleties between
                  feeling and interacting from a more authentic sense of self, a factor that became
                  very useful when I was on placement and discovering how to connect with a variety
                  of different clients. Although I had glimpses of this authentic expression and
                  sense of internal peace during this immersion period, I began to understand that
                  it required a continuous orientation towards a feeling of truth in myself. This
                  feeling of truth was related to feeling natural in my interactions by embracing a
                  greater sensitivity, vulnerability, honesty, acceptance, and deep questioning of
                  how I was relating in the moment, both on an intellectual and embodied level. In
                  humanistic philosophy, Carl Rodgers emphasised that to be effective therapists we
                  must develop qualities such as authenticity as it helps us generate unconditional
                  positive regard and empathic understanding (Rodgers, 1986, pp. 135–136) towards
                  our clients, which are foundational aspects of developing therapeutic presence. </p>
               <p>
                  <bold>Incubation.</bold> I found that periods of incubation occurred naturally
                  through the research as a result of immersion in the topic. According to Moustakas
                     (<xref ref-type="bibr" rid="M1990">1990</xref>), during the incubation phase
                  the researcher is removed from the topic to enable spontaneous and tacit insight
                  to emerge. Through the meditation process, which is fundamentally an exercise in
                  being open, aware and present, I was therefore able to take a metaphorical step
                  back from the research, to detach from the experience of immersion and observe the
                  mental processes and bias towards the research. In this meta-awareness state, new
                  perspectives began to arise spontaneously. As I applied this meta-awareness to my
                  everyday activities and interactions, I found that I was in a constant process of
                  immersion, incubation, and illumination.</p>
               <p>
                  <bold>Illumination.</bold> Moustakas (<xref ref-type="bibr" rid="M1990"
                     >1990</xref>) described the illumination phase to result in “corrections of
                  distorted understandings” (p. 28) and “synthesis of fragmented knowledge”
                  (p.30).Although the illumination was also a non-linear process, and in constant
                  flux with the immersion and incubation phases, a feeling of synthesis began to
                  emerge between the topic of developing therapeutic presence as a student music
                  therapist and the spiritual journey towards authenticity and the discovery of a
                  more authentic self. From my personal experience, I felt that they were in fact
                  the same thing as both processes require a seeking for internal truth and greater
                  authenticity through understanding and clarity. The questioning nature and
                  combination of the heuristic process and meditation techniques regarding the
                  development of self-awareness and introspection resulted in the discovery of
                  underlying bias towards a predominantly embodied understanding of therapeutic
                  presence. The illumination phase also helped to show me the many ways that my
                  ability to be present could be influenced by the psychological mind. As a result,
                  I was able to form a deeper and more comprehensive understanding of the phenomenon
                  and its relevance to music therapy practice, </p>
               <disp-quote>
                  <p>In my music therapy placement, I have experienced the initial fear of not
                     knowing and the over application of theory and techniques. However, as a result
                     of being reflexive, staying open, and non-judgmental these experiences have
                     become valuable lessons resulting in further insights into personal
                     conditioning and methods of practice. The possible answer to the paradox faced
                     by student music therapists is a heart centred awareness where the mind becomes
                     a servant and not the master. I find that when my awareness is focused on an
                     intention from the heart, which feels more intuitive and grounded in the body,
                     that this guides my thinking and I feel more authentic, flexible and natural in
                     both clinical contexts and my everyday interactions. (Reflexive Journal,
                     02-01-2016)</p>
               </disp-quote>
               <p>The illumination therefore helped to discover the importance of a more balanced
                  approach to the development of therapeutic presence through a heart centred
                  willingness to remain open and connected with ourselves and others on a mental,
                  physical and emotional level. It has also helped to consolidate many factors of
                  fragmented knowledge related to spiritual practice as the qualities of
                  authenticity; compassion and love are inherent aspects of discovering our natural
                  state of being. This natural state, also described in some traditions as
                  emptiness, is simply when we see beyond our mental concepts and psychological mind
                  and come into alignment with a deeper sense or feeling of internal truth through
                  authentic self-inquiry. </p>
               <p>
                  <bold>Explication.</bold> According to Moustakas (<xref ref-type="bibr"
                     rid="M1990">1990</xref>) the explication phase fully examines what has arisen
                  in consciousness and provides further clarity through the expression of
                  “awareness, feelings, thoughts, beliefs, and judgments as a prelude to the
                  understanding that is derived from conversations and dialogues with others” (p.
                  31).As I was now engaged in a continual non-linear engagement with the phases for
                  discovery, the process of immersion, in which I maintained a disciplined
                  dedication to the topic; incubation, that I entered into through meta-awareness
                  and illumination, which resulted in the cognitive reflection of my present moment
                  experiences, the next stage of the heuristic process, explication occurred
                  naturally as a result of an unplanned incident during the workshops. </p>
               <p>During the group musical improvisation, in the second workshop, a member of staff
                  interrupted the session to request the video camera that was still in use to
                  record the improvisation, a factor that completely changed the dynamic of the
                  musical improvisation. I immediately began to experience emotions of anger and
                  feelings of heat in my body as I felt the incident had ruined the validity of the
                  research. Although the intensity of these emotions and feelings were almost
                  overpowering, I was able to remain in a meta-awareness state, noticing the
                  reaction and how it was influencing my thought patterns, my ability to remain
                  present, and also in my interaction with the person after the event. I moved from
                  immersion, incubation, and illumination throughout the incident. As a result, the
                  continual interaction between direct experiencing and reflexive processing had
                  enabled me to stay aware and focused and to contain and stabilize a complex and
                  intense emotional experience without it negatively affecting my relationship with
                  the member of staff or with my fellow student music therapists. Following the
                  incident, the explication phase occurred spontaneously, and I had a complete
                  reversal on my perspective of the event. This deeper insight occurred due to the
                  previous illumination discussed earlier in the section, and I uncovered a much
                  larger bias regarding my expectations of the research. I found that my
                  preconceived expectations and opinions of how the study would turn out had
                  prevented the authentic and open engagement with the heuristic process. This
                  unconscious belief system prevented me from seeing the circumstances surrounding
                  the incident more clearly. As a result, I no longer felt anger towards the member
                  of staff but gratitude. This transformation from anger to gratitude provided me
                  with a much deeper understanding of myself and the topic. The incident had shown
                  me that my perception of events in my life can be manipulated by my conditioning,
                  reactions, and personal ideologies. Through awareness, I have the ability to see
                  with more clarity how the unconscious can influence how I relate to myself and my
                  environment bringing me into a more present state. </p>
               <p>As a result of my new perspective of gratitude I could now perceive the incident
                  in a much more balanced context. I reflected on how the music had significantly
                  changed when the incident occurred becoming instantly louder, gradually faster,
                  more intense, and connected. The incident therefore provided me with an embodied
                  understanding of how music can reflect our emotional state and also how a change
                  in energy or environment (member of staff entering the room) can be observed in a
                  musical improvisation. Although I was not participating in the musical
                  improvisation, I found that the increase in musical intensity reflected the
                  feelings that I was experiencing in my body at that moment. It also reflected the
                  group connectivity as the music became more rhythmically connected and structured
                  as a result of the interruption.</p>
               <p>
                  <bold>Creative synthesis.</bold> As Moustakas (<xref ref-type="bibr" rid="M1990"
                     >1990, p. 32</xref>) described the creative synthesis of heuristic research to
                  be a reflection of the researcher’s internal frame of reference based on
                  experience, feelings, perceptions, beliefs and judgments, connected between self,
                  other and the world, the creative synthesis is therefore a reflection on how, as a
                  student music therapist, I have come to understand and experience the phenomenon
                  of therapeutic presence. </p>
               <p>Through the non-linear process of initial engagement, immersion into the topic,
                  incubation, illumination, and explication I have found the topic of developing
                  therapeutic presence to be a deeply complex and rewarding process. As a student
                  music therapist, it has shown me that developing an intellectual understanding of
                  therapeutic presence is not the same as fully experiencing it, as both aspects are
                  needed in a therapeutic context when working with clients. According to Muller
                     (<xref ref-type="bibr" rid="M2008">2008</xref>), “immersion in the moment is
                  not enough. The therapist must also reflect upon, and evaluate, what is happening.
                  The more the therapist reflects upon experience, however, the less immersed she/he
                  is in the moment” (p. 31). I have experienced these difficulties on clinical
                  placement as feelings of being present can quickly be extinguished by the variants
                  and unpredictability when working with vulnerable clients. However, I have also
                  learned as a student of this topic, that therapeutic presence is something that we
                  develop over time, through our experience as therapists and also through our
                  direct experience of life. As Rodgers (<xref ref-type="bibr" rid="R1961"
                     >1961</xref>) stated:</p>
               <disp-quote>
                  <p>Experience is, for me, the highest authority. The touchstone of validity is my
                     own experience … Neither the Bible nor the prophets – neither Freud nor
                     research – neither the revelations of God nor man – can take precedence over my
                     own direct experience. My experience is not authoritative because it is
                     infallible. It is the basis of authority because it can always be checked in
                     new primary ways. In this way frequent error or fallibility is always open to
                     correction (pp. 23–24)</p>
               </disp-quote>
               <p>In relation to Rodgers’ statement, I would argue that it is through our own direct
                  experience that we actually learn the most. Through this process, we begin to
                  discover who we really are, beyond our psychological and social conditioning,
                  through a more direct experience and questioning of our reality. Therefore, the
                  possibility to be more authentic and present can become a way of life. This
                  possibility is something that spiritual teachers such as Adyashanti (<xref
                     ref-type="bibr" rid="A2013">2013</xref>) or J. Krishnamurti (<xref
                     ref-type="bibr" rid="K1973">1973</xref>) speak clearly about, as their message
                  is fundamentally about beginning to investigate ourselves from the focus of our
                  own direct experience. In many ways, these teachings have helped me to understand
                  that I cannot use the psychological mind to understand the nature of reality,
                  however, through an open awareness it is possible to begin to see the mechanisms
                  of our own psychological and social conditioning that prevent us from seeing
                  ourselves and environment with more clarity. </p>
               <p>Through the examination of bias, academic process, and an openness to change my
                  perspective in relation to the research topic, I discovered that both cognitive
                  and embodied approaches are necessary components to cultivate therapeutic
                  presence. However, I have also found that without a sincere intention to be
                  authentic and remain open to every experience as it is, especially those that are
                  difficult, both cognitive or embodied attempts to be present are void of the
                  simplicity of “being,” being yourself, authentic and real in the moment, a factor
                  that I believe is felt either consciously or unconsciously by the people we meet
                  in our everyday interactions, our clients, and also in ourselves. </p>
               <p>Therefore, it is through a sharp intellect and embodied sense of being, that
                  equally balances the heart and mind, that access to tacit knowledge and intuitive
                  action can be found. Although I believe that this access is not something that is
                  only accessible to meditators, my experience of embodied practice has shown me
                  that these practices can provide many benefits in relation to personal and
                  professional development and in relation to the understanding of the development
                  of therapeutic presence. However, it is also true that you do not need to meditate
                  to be authentic and that therapeutic presence can be found in the ability to be
                  oneself, which is natural, in the moment, and expressed through the natural human
                  capacity for compassion and love.</p>
            </sec>
            <!-- sec lvl 4 end -->
         </sec>
         <!-- sec lvl 3 end -->
         <!-- sec lvl 3 begin -->
         <sec>
            <title>The Validation of Heuristic Research</title>
            <p>According to Moustakas (<xref ref-type="bibr" rid="M1990">1990</xref>), the process
               of validation in heuristic research can facilitate verifying the essences and
               meanings and provide objective material as a frame of reference outside of the
               researcher’s experience. Themes gathered from the qualitative heuristic data revealed
               further underlying bias and understanding of how we develop therapeutic presence as
               student music therapists.</p>
            <p>
               <bold>Examination of bias.</bold> Initial questionnaires revealed that students had
               already an intellectual and experiential understanding of the phenomenon and had
               already used meditation techniques such as mindfulness in their music therapy
               placements. As I had not experienced specific embodied techniques of therapeutic
               presence in my music therapy course, I had neglected to acknowledge the value of
               relevant lecture material (although not specific to therapeutic presence),
               self-tuition, and previous life experience of the students in their own personal
               development and understanding of therapeutic presence. In regard to the
               intellectualization of therapeutic presence, data reflected my re-evaluation of the
               importance of the cognitive process in the development of therapeutic presence.
               However, the data also validated my personal opinion that the intellectualization of
               the experience is not the actual experience itself.</p>
            <p>
               <bold>Benefits of embodied practice for student music therapists.</bold> In relation
               to my own experience of the benefits of therapeutic presence to my personal healing
               process, during the embodied workshop (workshop 2) three students had a direct
               experience of self-healing. An example of this was verified through a reduction in
               physical pain (migraine headache) for one student validating embodied practice as a
               viable form of self-care. The students’ experiences of a variety of meditation
               techniques provided insight into a more embodied awareness. They described how
               placing their awareness in their body helped to maintain a feeling of being grounded
               when experiencing altered states of consciousness during deep relaxation meditation.
               These characteristics of embodied practice mirrored my own experience and practice of
               embodied techniques in relation to meditation practices and personal health
               issues.</p>
            <p>Qualitative data regarding the musical improvisations revealed parallels in my
               experience of adapting embodied practice to the practice of music therapy. Students
               described an increased spatial awareness and an awareness of self and others as a
               result of applying embodied techniques to musical improvisations. An interesting
               aspect to the data suggests that for some students reflexive cognitive processing
               facilitated through the focus group (workshop 3) was required to consciously adapt
               embodied techniques to the group musical improvisations, again suggesting the
               importance of the cognitive process in the development of therapeutic presence. </p>
            <p>
               <bold>The value of developing therapeutic presence through heuristic enquiry &amp;
                  musical improvisation. </bold>In relation to the musical qualities of the
               intellectual (workshop 1) and embodied workshop (workshop 2), I found that findings
               reflected my previous bias to beginning the study. Students described the
               intellectual musical improvisation in workshop one to have a strict metronomic beat
               or pulse that remained steady and structured like clockwork. I believe the musical
               expression in this workshop to be an interesting reflection on the mechanical
               cognitive process and mental state of the students. In comparison, students described
               the embodied workshop two to be more intense, mindful, spiritual, and insightful.
               These musical characteristics mirror my own experience of the rigidity of more
               rational cognitive methods of learning compared a more open interactive platform
               enabled through a combination of cognitive and embodied practice as a more immediate
               and direct learning experience.</p>
            <p>Overall, I found the most interesting musical insight occurred when the member of
               staff interrupted the session during workshop two. After the embodied meditation
               session, the musical improvisation by the group had a very free, meditative, and
               experimental feeling with a slow tempo and sporadic rhythmic structure, which was in
               direct contrast to the 4/4 beat mechanical and structured improvisation in workshop
               one. However, this immediately changed when the staff member entered the room during
               the improvisation, as the music became more intense increasing in volume and also in
               group synchronicity. I found this to be a very interesting phenomenon, as although I
               was not participating in the musical interaction, I felt that the shift in intensity
               of the music reflected my internal reality at that moment, which was a feeling of
               anger towards the interruption. The shift towards musical synchronicity seemed to
               reflect the group’s cohesiveness and camaraderie as the music continued despite the
               awkward interaction as I tried to silently communicate to the member of staff that
               the workshop was not yet finished. To further validate the importance of a
               self-reflexive perspective, during the reflexive third workshop, after watching the
               video footage of this incident, a fellow student commented how she felt that the
               music seemed to be used to protect the space through its increase in intensity and to
               communicate that the person was not welcome in the room at that moment.</p>
            <p>These experiences helped to demonstrate the importance of practical workshops and
               experiential learning in this area as a means of providing both cognitive and
               embodied aspects of developing therapeutic presence for student music therapists in
               an educational context. In particular, through musical improvisation, as it is
               through the medium of music that we as student music therapists must become most
               aware of the subtle changes in musical qualities that provide us with so much
               information regarding ourselves as therapists and our clients.</p>
         </sec>
         <!-- sec lvl 3 end -->
      </sec>
      <!-- sec lvl 2 end -->
      <!-- sec lvl 2 begin -->
      <sec>
         <title>Summary, Outcomes of the study &amp; Implications for future research</title>
         <!-- sec lvl 3 begin -->
         <sec>
            <title>Summary</title>
            <p>The aim of this research was to evaluate the role of both cognitive and embodied
               forms of knowledge in the development of therapeutic presence as a student music
               therapist and its relevance to the practice of music therapy. Literature on the topic
               suggests that although there are specific guidelines to developing therapeutic
               presence in the field of psychology, there is a current gap in music therapy
               literature in relation to clear and structured guidelines for student music
               therapists. The research has shown that although both cognitive and embodied forms of
               knowledge are necessary in the development of therapeutic presence, embodied
               knowledge is currently a neglected epistemological paradigm in the majority of
               educational and healthcare settings (<xref ref-type="bibr" rid="GG2012">Geller &amp;
                  Greenberg, 2012</xref>; <xref ref-type="bibr" rid="H2010">Henry, 2010</xref>;
                  <xref ref-type="bibr" rid="KN2009">Kontos &amp; Naglie, 2009</xref>; <xref
                  ref-type="bibr" rid="M2017">Medcalf, 2017</xref>). However, the researcher would
               again like to state that this may not be the case in all music therapy educational
               programs, as there are currently many mindfulness-based music therapy programs
               already being integrated into music therapy practices (<xref ref-type="bibr"
                  rid="L2016">Lesiuk, 2016</xref>; <xref ref-type="bibr" rid="R2018">Rynex,
                  2018</xref>). In relation to developing therapeutic presence as a student music
               therapist and incorporating meditative and embodied practice into music therapy
               programs, experiential learning has great potential to provide an educational
               framework, discussed further by Murphy (2007, pp. 51–53),bringing cognitive insight
               and emotional understanding together. According to Murphy (2007, pp. 53–54), this
               type of learning helps music therapy students to develop the ability to be more
               responsive and empathic towards the needs of their clients in the present moment.
               Through experiential learning, students can come to a deeper appreciation of what it
               means to be human, a factor that is a foundational aspect of developing therapeutic
               presence as student music therapist.</p>
            <p>The selection of a heuristic methodology functioned to validate both cognitive and
               embodied knowledge as a fundamental aspect in the development of therapeutic
               presence, and I would argue, in the context of this research, that both forms of
               knowledge have equal importance in relation to our development as student music
               therapists. The similarities between the academic process of heuristic enquiry and
               embodied practices demonstrated the benefits of a more balanced approach to the
               formation of knowledge. This balance between cognitive and embodied knowledge was
               reflected and validated in relation to qualitative data gathered in heuristic
               workshops with fellow student music therapists.</p>
            <!-- sec lvl 4 begin -->
            <sec>
               <title>Outcomes of the study</title>
               <p>According to Polanyi (<xref ref-type="bibr" rid="P2009">2009</xref>) “having made
                  a discovery, I shall never see the world again as before. My eyes have become
                  different; I have made myself into a person seeing and thinking differently. I
                  have crossed a gap, the heuristic gap, which lies between problem and discovery”
                  (p. 143). </p>
               <p>From a music therapy educational perspective, I felt that the theme regarding the
                  value of developing therapeutic presence through heuristic enquiry and musical
                  improvisation to be the most enlightening aspect of this research project. The
                  unplanned incident created a direct educational experience through being present
                  and also heuristic enquiry. The continual introspective focus of the research
                  provided me with new perspectives as a result of personal introspection and group
                  dialogue that helped to clarify the importance and value of developing therapeutic
                  presence as a student music therapist. As the research has demonstrated, it is
                  through developing this ability to be aware of our physical, mental and emotional
                  state through both a cognitive and embodied awareness that we can effectively
                  navigate difficult situations, emotions and circumstances in our therapeutic
                  practice remaining available, connected and flexible to whatever is happening in
                  the moment. </p>
               <p>Rodgers (<xref ref-type="bibr" rid="R1957">1957, p. 174</xref>) described the
                  search for truth as a therapeutic process where scientific and therapeutic gains
                  could be made at the same time. In reviewing both cognitive and embodied
                  experiences of developing therapeutic presence and in relation to the process of
                  becoming a music therapist, the heuristic process facilitates the discovery of
                  truth through a focus of seeking self-awareness, self-dialogue and self-discovery,
                  as the researcher engages fully in a transformational process. As a result,
                  heuristic research can provide a framework for the development of authenticity as
                  a person, researcher, and music therapist. Through continuous questioning and
                  self-reflection, it enables the researcher to search deeper into a chosen topic
                  and themselves, uncovering maps of meaning, connections, complexities and
                  similarities, in an effort to find greater clarity and understanding. This
                  internal and external focus is also a fundamental principle of meditation practice
                  as one is guided towards truth or an authentic state of “being,” by seeing,
                  through their own direct awareness, the aspects of the human psyche that prevent
                  us from being in the present moment. Through the clarity of awareness, personal
                  ideologies, identifications, and personal and social conditioning can be
                  questioned at the deepest level, through our own direct experience as we relate to
                  ourselves and our environment. This type of deep questioning can help us as
                  students to move beyond the psychological boundaries, seeing greater possibilities
                  and potential, opening new spaces for creative thinking and innovation. In
                  relation to the similarities between the heuristic process and meditation
                  practice, it is an interesting parallel between the fields of academic research
                  and spirituality, a paradigm that in my opinion has incredible potential for
                  future development in health care, business, research, and therapeutic
                  practices.</p>
               <p>In relation to our development as student music therapists, Aigen (<xref
                     ref-type="bibr" rid="A1993">1993</xref>) stated it is in fact the music
                  therapist’s "Being" or personal attributes, rather than any particular technique
                  that determines the efficacy of any one course of therapy. I would argue that this
                  natural state of being has become difficult to access or directly experience due
                  to the pressures and distractions of modern society. The current increase in
                  technologies and continuous access to media entertainment increasingly separate us
                  from a sense of inner stillness. This research therefore suggests that the theme
                  regarding the benefits of embodied practice from my personal experience, academic
                  research, and also my fellow music therapy students, discussed above, demonstrate
                  that an integrated module bringing both cognitive and embodied practices together
                  into a music therapy educational context could have many positive outcomes. In
                  particular, regarding increased physical, emotional, and mental awareness but also
                  in terms of self-care and the nurturing of a calm and focus mind (<xref
                     ref-type="bibr" rid="CCL2009">Chrisman, Christopher &amp; Lichenstein,
                     2009</xref>; <xref ref-type="bibr" rid="MCG2010">McCollum &amp; Gehart,
                     2010</xref>).</p>
            </sec>
            <!-- sec lvl 4 end -->
            <!-- sec lvl 4 begin -->
            <sec>
               <title>Implications</title>
               <p>The implications of the study suggest a more balanced and integrated approach
                  could be adopted in both educational and healthcare settings towards embodied
                  practice, a factor that is relevant to our development as music therapists.
                  Lectures, similar to the workshop format, could be provided in music therapy
                  educational programs, adopting a more integrated format engaging students with
                  both cognitive and embodied epistemological theoretical, philosophical, and
                  experiential workshops through experiential learning systems. These workshops
                  could be designed to include current music therapy theories of practice. For
                  example, Bruscia’s (<xref ref-type="bibr" rid="B1998a">1998a</xref>) theory of
                  “being there” for the client discussed in this research paper could be adapted to
                  a theoretical and experiential lecture design. Bruscia’s theories could therefore
                  be explored both cognitively and experientially through lecture material, breaking
                  down the various aspects of the experience, sensory, affective, reflective, and
                  intuitive layers of experience and applying relevant embodied techniques as a
                  means of providing students with that experience. Theoretical and experiential
                  concepts could then be applied to role-play scenarios, reflecting music therapy
                  clinical interventions. Through the development of this tacit knowledge through
                  experiential learning, student music therapists could then employ these techniques
                  during clinical interventions when appropriate on placement and in their future
                  practice.</p>
               <p>Although it was beyond the scope of this research, more in depth musical analysis
                  could be conducted providing both quantitative and qualitative data on the topic
                  of therapeutic presence and music therapy in particular in music therapy
                  educational programs. Further qualitative data could also be gathered from
                  experienced practitioners in both the fields of music therapy and integral
                  psychotherapy in relation to their perspective and use of therapeutic presence in
                  their clinical practice. Further quantitative studies on the topic of therapeutic
                  presence could review the current use of embodied techniques by music therapists
                  in clinical practice. This further research could provide specific data on the
                  prevalence of use, specific techniques and the populations where mindfulness-based
                  practices or embodied practice such as Qi Gong are currently being applied in a
                  music therapy context and integrated into a music therapy educational program.</p>
               <p>The outcome of this study has provided an increased awareness in relation to the
                  value and validity of both the cognitive and embodied process in developing
                  therapeutic presence as a student music therapist. The process of heuristic
                  enquiry has been a demanding undertaking as it has required an intense dedication
                  related to continuous self-reflection and the questioning of the validity and
                  authenticity of experience. I have found that it is through present moment
                  awareness that therapeutic presence is developed, a phenomenon that has provided
                  me with a deeper understanding of the human condition and methods to enhance life
                  skills related to self-care, balance, compassion, empathy, and personal insight.
                  As the basic function of music therapy is to connect with our clients, therapeutic
                  presence enables us to make that connection by first authentically connecting with
                  ourselves. Through the acceptance of everyone as a teacher and every experience as
                  an opportunity for learning, therapeutic presence can teach us to be more aware,
                  authentic, honest, reflexive, and compassionate to ourselves and towards
                  others.</p>
            </sec>
            <!-- sec lvl 4 end -->
         </sec>
         <!-- sec lvl 3 end -->
      </sec>
      <!-- sec lvl 2 end -->
      <!-- sec lvl 2 begin -->
      <sec>
         <title>About the author</title>
         <p>Niall Mc Guigan is an Irish musician and practicing music therapist with an MA in
            ethnomusicology and music therapy. He has worked in the areas of Autism, Acquired brain
            injury, Dementia and Alzheimer's, working in schools, hospitals, and nursing homes in
            Ireland. He has spent many years researching and participating in a variety of
            meditation and self-inquiry practices. Niall is currently working in the Netherlands as
            a music therapist with the GGZ-NHN in the area of forensic psychiatry.</p>
      </sec>
      <!-- sec lvl 2 end -->
   </body>
   <back>
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