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There is a growing body of literature which suggests that it is possible to provide safe therapeutic encounters without reference to non-music derived theory (Lee 1996), and that music therapy theory should preferable spring form an understanding of creative musical processes alone (Ansdell 1995). The writer sets down a number of critical objections to this 'absolutist' position (outlined by Pavlicevic 1996) and proposes that music therapy theory needs to derive as much from psychological thinking as it does from musical awareness and, indeed, from an understanding of the connections between the two. Psychoanalysis offers just one psychological perspective on which to draw. There are many equally useful perspectives, such as developmental theory which the writer first introduced to the music therapy literature (1979) as a result of her early research (1978). This paper focuses on basic psychoanalytic concepts in an attempt to identify how awareness of musical experience alone cannot provide the music therapist with the means to ensure safe, effective therapeutic practice. The practical application of these concepts is then illustrated with extracts from two case studies.

his paper provides an overview of the needs of children receiving care in hospital, including a review of the research and case-study literature addressing music therapy practice with this population. The use of music therapy in individual programs to address pain, pyschosocial needs and anxiety in hospitalised children is described. A brief case study outlines the ways in which the therapist must be flexible and adaptive in approaching the time and space dimensions of work in this context.

Many improvisational models of music therapy involve therapist and client improvising spontaneously together. This is widely described as a form of musical relationship. However, whilst there is much discussion of the client's musical input in the literature, the therapist's music attracts less attention. The author considers reasons why this may be the case and seeks evidence, from the music therapy literature and beyond, as to whether the therapist's musical input is of significance for the therapeutic process. An example of detailed analysis of the author's own clinical work is presented, in order to establish whether the therapist's musical input has an observable impact on the shared musical experience and might thus be judged to be significant for the therapeutic musical relationship. Concluding that it is indeed significant, the author goes on to consider the implications for the way music therapists consider their work.