This article explores the ways in which the expectations of clients and referrers can impact the music therapy process. The setting is one of a self-employed music therapist working for a music therapy provider. The referrals for this therapist come from the community via the provider’s website. A room in a community centre is used for sessions. Three case studies are presented, through which the relationship between the client’s or referrer’s expectations of music therapy and the actual outcomes of the work is explored. The first case study illustrates a scenario in which a client’s expectations were different from what the therapist could offer, but an informed decision to continue music therapy on the part of the client was reached. The second case study considers how the communication between the therapist and referrer about the referrer’s expectations enabled a client’s needs to be met through a challenging therapy process. The third case study looks at how a previous experience of therapy for the referrer may have led to high expectations of the therapy for a client she referred. The paper examines how these expectations influenced the therapy process. The author argues that the expectations of the person referring a client can have a significant influence on the therapy process and must be accounted for.

This article describes a pilot open art and music therapy group which took place on an assessment ward in a Medium Secure Unit for patients detained under the UK's Mental Health Act. The aim was to offer an optional therapeutic space to patients who had limited access to off-ward therapy and activities, and to see whether this would be of value in this setting.The ward environment is described, the need for onward therapy outlined and relevant literature surveyed The planning, setting up and evaluation of two phases of the work are then detailed, with particular focus on the rationale for the ways in which sessions were run and the roles of the two therapists (one a music therapist, the other an art therapist). Changing group membership and its impact on the therapy is described, and modifications to the original approach explained.Feedback from staff and patients is presented and discussed, leading to reflections on the value of this kind of therapeutic experience in such a setting.