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Improvisation is a fundamental aspect of music therapy practice but until recently was much neglected by researchers. This article outlines hitherto unpublished findings from doctorate research completed in 2001, at a time when few investigations were being undertaken. The findings stand the test of time and are detailed in the article as well as updated within the current literature context. The strength of the research is in consideration of underlying temporal, relational aspects of improvisation, which show how improvisations in music and in everyday conversation have both similarities and differences at deeper, structural levels. This research is of interest to current researchers, improvisers and Music Therapists.