This case study research explores the impact of a musical performance event—the Coffee House—held bi-annually at an adolescent mental health treatment facility in Southwestern Ontario, Canada. Any client or staff member is welcomed to perform at this event, which is organized by the facility’s music therapist and framed here as an example of community music therapy. Drawing upon Turino’s (2008) ethnomusicological perspective on performance, I will argue that the Coffee House’s success within this context is due to its participatory ethos, wherein success is primarily defined by the act of participation. Here, performance takes place within an inclusive and supportive atmosphere in which participants can overcome anxiety, engage in the risk-taking of performance, and experience increased self-efficacy and confidence. This ethos also naturally affords a “levelling” of institutional relationship dynamics. Resonant with Aigen’s (2004) vision that “performances as community music therapy can forge a new type of art, one that creates meaning and invites participation” (p. 211), the Coffee House exemplifies the ways in which the values within participatory settings are indeed different and new in comparison to presentational settings that are the norm in Western society.