This paper discusses some of the issues that arise when working with sexually abused clients. It highlights a number of factors that appear to be common to this client group's manipulation of the medium of music therapy; the symbolic use of the instruments; the preoccupations with mess and containers; the use of boundaries; and the power of the secret. Material form a number of case studies (both adults and children) is used to illuminate many of the points made. Many of the issues discussed are pertinent to a wider range of client groups - particularly those prone to eating disorders and substance abuse. It does not refer to the wealth of literature regarding work with abused clients with learning difficulties.

This paper describes, chronologically, aspects of music therapy sessions with a 22-year-old man. Observations of Sean in other environments are included as well as some background details. The discussion section of the paper briefly examines the use of music in sessions, as well as the influence of psycho-dynamic informed thinking. All names have been changed.