There is a growing body of literature that investigates the value of music therapy for people with emotional and behavioural disorders such as attention deficit disorder. These studies often focus on overt behavioural change as the indication of successful outcomes. The instrumental case study reported here challenges this focus and provides a description of music therapy for one young man that emphasises the importance of power in his experience. A grounded theory analysis of this single case reveals that both individual and small-group music therapy provided important opportunities for the young man to express himself and to control what he and others did. This example is intended to stimulate the contemplation of different understandings of the potential role for music therapy, with an emphasis on emotional needs and quality of life as the primary focus.