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This article describes aspects of long-term work with a learning disabled adult over the period of time during which he made use of a story. This is given in detail from a point at over 5 years into the therapy when an initial question about the story was presented to the therapist. The article shows the ways in which the story was incorporated into the overall musical work. These sessions are placed into the context of the therapy as a whole, the ways in which story and music were combined, the central place that this work took and how this resonated with the client's life. The article concludes with thoughts about work with learning disabled clients and how the use of story can bring about new spaces in the clinic room. the concept of institutionalisation, along with broader questions about social change and the potential impact upon learning disabled clients will also be explored, with questions raised for the music therapy profession to consider further. The article is illustrated with colour plates from the book used during the therapy.

The subject of death is one that is not easily addressed. Learning disability (and in particular profound learning disability) throws up uncomfortable issues which also are not easily dealt with. Therefore there is often a struggle in addressing the needs of this client group when bereaved. I believe that the arts therapies have an important role in assisting the grieving process of adults with a profound learning disability. This paper focuses on bereavement sessions, jointly run by a music therapist and an occupational therapist. These are set in the context of our interventions address aspects of grief. Case examples are drawn from the author's 25 years' experience in this field, in providing music therapy and wider bereavement services to adults with complex needs.

This article describes a research project undertaken to explore the framework and efficacy of endings in the music therapy process when working with adults with a learning disability. A review of the literature is presented incorporating texts from the related discipline of psychotherapy. Data from a questionnaire and from three semi structured interviews is also presented, followed by a discussion of the findings and clinical implications. The article concludes that the issue of therapeutic endings when considered in the context of adults with a learning disability is as varied as the needs of this client group. There is a marked difference between what therapists aspire to achieve in their clinical practice and what they are able to achieve in the context of their different work settings. Therapists approach the management of therapeutic endings in different ways when considering the range of needs presented by this client group. [4] ‘Four Quartets’ by T. S. Eliot (2001: 13)

This article grew out of experiences while training and is viewed from the perspective of a number of post-training years. The focus is the underlying processes at work in organisations and their effect on music therapy work. A brief chronological summary of literature is given, including the theories of Klein and Bion in relation to organisational dynamics. The dynamics between clients, staff and the organisation are considered particularly in terms of anxiety and envy, and how defences are put in place in order to manage these feelings. A case study from short term work in a psychiatric intensive care unit undertaken as part of the author’s music therapy training is given to illustrate these points.