The purpose of this paper is to examine how clinical improvisation techniques influence the structure of a Huntington's Disease (HD) patient's expressive responses. the paper reviews the literature pertaining to music therapy in the treatment of HD, highlighting that there has been no anecdotal or empirical link made between the specific use of clinical improvisation and the degree of structure in the patient's expressive responses. A case study is then used to illustrate the influence that musical structures have in the organisation of a HD patient's musically expressive and interactive responses. Given the lack of intervention available to meet the expressive and interactive needs of a non-verbal HD patient, this paper argues that music therapy has an important role to play.

This article describes a music therapy process with a 14 year old girl I will call Sara, who had ceased talking for some years. Sara was an in-patient at a Centre for Child and Adolescent psychiatry. During nine months of individual music therapy, Sara presented herself through improvised music and eventually an audible voice. in this article I argue that what I term relating experiences through music has contributed to strengthening Sara's 'self-in-relation' and given her space for increased autonomy. This allowed Sara to perceive herself in new ways, which led to a more permanent sense of her identity.

Vibroacoustic (VA) therapy transmits to the body pre-recorded music, or pre-recorded music combined with sinusoidal low frequency sound, through loud speakers built into a chair, table or bed unit. The development of VA therapy has not been confined to one country or one product and, after examining the theoretical background to VA therapy, the author describes four VA systems. In Europe, music therapy is traditionally seen as a process which develops from an 'active' musical relationship. In contrast VA therapy is a 'receptive' intervention. The author discusses completed and on-going research with VA equipment, and concludes by asking - is VA therapy music therapy? He suggests that the principles of VA therapy can inform active music-making.