Reciprocity is a concept that is similar to the concept of mutuality. Reciprocity "is char- acterized as an interpersonal exchange, customarily exchange to be symmetrical or equivalent" (Mendins, 1997, p. 435). The state of being mutual serves as a lexicon definition of mutuality. Webster's New World College Dictionary (Agnes, 2005) defined mutual as"a) done, felt, etc. by each of two or more or toward the other or others; reciprocal. b) of, or having the same relationship toward, each other or one another, c) shared in common, joint" (pp. 951-952). Mutuality appears as a concept in Peplau's(1952), Watson's(1996) and Leddy's(2004) conceptual models in terms of mutual gain in a client-nurse relationship. Leddy expanded the use of the term "mutual" in terms of shared and connected processes humans h with environments.