The purpose of this paper was to examine current literature regarding therapy practices with gay and lesbian clients. The author chose the selected articles based on their suitability for application to music therapy practice, and reviewed them in the following four categories: (a) General Issues and Approaches, (b) Attitudes Towards Therapy, (c) Choice of Therapist, and (d) Straight Therapists working with Gay and Lesbian Clients. Based on the reviewed articles, and a cultural competency model, implications for music therapy clinical practice are provided.