This article examines the identity of music therapy and music therapists, focussing upon the United Kingdom as a case study, but also considering international trends. Milestones in the history of music therapy in postwar United Kingdom and professional development in the 21st century are discussed, drawing upon research and clinical practice. Research outcomes across different specialities indicate that music therapy should be widely available to many populations, such as for people with dementia, autism, stroke and mental health problems and so on. These advancements mean that music therapists need to be clear about their role and identity in both doing the work and communicating about it. The article celebrates advances in research, thinking and provision and emphasis collaboration across multidisciplinary groups through an overview of different identities.

The broad context for this article is the provision of music therapy for children and adults with learning disabilities within the current social, political and economic context. The article explores themes regarding internal and external pressures experienced by the music therapist both inside and outside the therapy room. The external pressures are identified and discussed through literature, with the focus being on the commissioning institution’s expectations of the value music therapy will add and how this value can be measured and predicted. The internal pressures the music therapists can experience concerning their desire to know and understand the client are explored through literature in relation to their professional role and their personal desires when relating to others. The anxieties that these pressures can create, and the impact that they can have on the therapist’s thinking around the work, are considered in detail through a case study with particular reference to the music therapist’s capacity to work fully with not knowing and regression.

This article presents the results from a critical interpretive synthesis that examined the prevalence and presentation of therapeutic boundary themes in music therapy case studies. Conventional boundary theories are often defined as the parameters of practice that encourage the clinician to perform boundary processes in a certain way. These theories pertain to practical and interpersonal elements when negotiating the therapeutic relationship and include features such as boundary crossings and boundary violations. A carefully selected set of case studies were examined and interrogated to determine the presence and type of boundary themes. These were analysed by distilling narrative descriptions from the case studies and comparing them with information about population, age of clients, theoretical approach and cultural setting. Musical intimacy emerged from the analysis as a concept that contained a myriad of boundary challenges, which often appeared to contrast conventional ideas on boundaries. The results of this critical interpretive synthesis are discussed along with recommendations for music therapy practice.

This article describes contemporary music therapy practice within Chelsea and Westminster Hospital National Health Service Foundation Trust in London. The authors revisit an earlier article about the service (‘The whole is greater than the sum of its parts: experiences of co-working as Music Therapists’, Fearn and O’Connor), which described an evolving approach of two Music Therapists based at one Child Development Service, part of Chelsea and Westminster Hospital in London. On this foundation, a team of 10 part-time Music Therapists has developed, working across three London boroughs and a number of multidisciplinary teams. This article will look at how the music therapy practice has developed in this setting over the past decade, in order to provide a practical and theoretical perspective for Music Therapists within multidisciplinary settings. Influences that have shaped the service and the wider music therapy profession will be explored, such as an increased emphasis on a goal-centred, multidisciplinary team approach, the changing needs and volume of the children presenting to the service and the consequent development of the music therapy team.