The Nordoff-Robbins approach was first developed in work with variously disabled children, many of whom would today be considered to be developmentally-delayed. From the outset, the work was music-centered, meaning that the therapists' interventions occurred in the music, the clients' developmental process was ascertained through musical responses, and music was the primary transformative agent in the process. As a result, there was little or no effort to engage the children in interactions outside of the musical exchange. The primacy placed on music resulted more from a belief in the power of music to bypass disability and activate dormant potentials than as a consequence of the serious language and cognitive impairments borne by the children who participated in the genesis of this approach.

In the mid 1970s, following the passing of Paul Nordoff, Clive Robbins took up the work with his wife, Carol Robbins. Together they pioneered a new application of the approach in their work with hearing-impaired individuals. This work was undertaken at the New York State School for the Deaf in Rome, NY. Partly funded by federal funds, this novel application of music therapy resulted in the publication Music for the Hearing-Impaired and Other Special Groups.

Also at this time, the Nordoff-Robbins Centre in London was being established. In the intervening years, the staff of the Centre has developed applications of Nordoff-Robbins in many novel treatment contexts with adults, such as in geriatric and palliative care. The London Lighthouse is one of these palliative facilities and this particular application of Nordoff-Robbins work has been detailed in the publication Music at the Edge: The Music Therapy Experiences of a Musician with AIDS by Colin Lee.

The staff of the London Centre has also worked for many years with adolescents and self-referred adults who have a need for therapy but who are not disabled. Working with articulate individuals without cognitive impairments has allowed for insight into the process from the clients' perspective. It has also stimulated an examination of some of the core beliefs and practices at the heart of Nordoff-Robbins music therapy, particularly as they relate to the practices and processes characteristic of verbal psychotherapy, such as making interpretations, gaining verbalized insight, and examining relationship dynamics.

There is a wide spectrum of beliefs among practitioners in the Nordoff-Robbins approach on the role of such phenomena in music therapy. Some therapists comfortably integrate constructs, theories and practices from psychotherapy into their Nordoff-Robbins based practice. An example of such a perspective can be found in Jacqueline Robarts' portrait of her work with an adolescent girl with an eating disorder, Towards Autonomy and a Sense of Self and in the comprehensive text Music Therapy in Context: Music, Meaning and Relationship by Mercedes Pavlicevic. Other clinicians and theorists believe that the music-centeredness of this approach renders unnecessary or even inappropriate the use of practices and beliefs from verbally-based forms of therapy. This perspective is well represented in Gary Ansdell's book, Music for Life: Aspects of Creative Music Therapy with Adult Clients, a text which integrates clinical practice and theory. Last, some theorists are attempting to integrate the two streams in considering the traditional phenomena of psychotherapy, but primarily in their uniquely musical manifestations. Alan Turry's pioneering study of Transference and Countertransference in Nordoff-Robbins Music Therapy is one such example drawn from contemporary work, and this perspective also supports the explorations of the original Nordoff-Robbins work undertaken in Paths of Development in Nordoff-Robbins Music Therapy by Kenneth Aigen.

These issues receive scholarly discussion in a number of recent publications: Sandra Brown has explored them in an article Supervision in context: A balancing act, published in the British Journal of Music Therapy and Sandra, Alyson Carter, Colin Lee and Robin Howat all published brief essays on this topic in Volume 6(1), 1992 of the British Journal. Three issues of the Newsletter of the International Association of Nordoff-Robbins Music Therapists contain extensive discussions on these topics, June 1995, April 1996 and November 1997. Contained in these volumes are articles and letters by Kenneth Aigen, Gary Ansdell, Jacqueline Robarts, and Clive Robbins. Elaine Streeter (1999) advocates strongly for the necessity of integrating verbal psychotherapy techniques within music-centered music therapy in her article Finding a Balance Between Psychological Thinking and Musical Awareness in Music Therapy Theory: A Psychoanalytic Perspective, also from the British Journal of Music Therapy.

Related to the exploration of the proper relationship between Nordoff-Robbins work and the practices of verbal psychotherapy is the concern with the nature of clinical music-making. Some therapists believe that creating and playing music in the clinical context is fundamentally different from non-clinical forms of musical experience, while others advocate the position that these differences may not be as important as might be assumed. Sandra Brown and Mercedes Pavlicevic (1996) discuss this issue and report on their empirical exploration of it in their article on Clinical Improvisation in Creative Music Therapy: Musical Aesthetic and the Interpersonal Dimension.

One other contemporary development characterizing some of the work at the New York Center, and which bears mention in the present discussion is the application to the group context of the improvisational principles at the heart of Nordoff-Robbins work in individual therapy. The use of a process-oriented, improvisational approach is represented in the publication Here We Are in Music: One Year with an Adolescent, Creative Music Therapy Group and in the videotape Improvised Song in Group Music Therapy.

Complementing these developments is the work of the staff of the Institute for Music Therapy at the University of Witten-Herdecke, an institute devoted to the practice, training and research of Nordoff-Robbins Creative Music Therapy. Because this facility is located in a medical hospital, much of the focus of the clinical work, research, and theoretical writings have as their context individuals with medical needs. Important works have been published detailing music therapy with individuals with particular medical diagnoses, such as A Walk Through Paris: The Development of Melodic Expression in Music Therapy with a Breast-Cancer Patient by Gudrun Aldridge. Two other areas in which the staff have contributed to the knowledge base in music therapy is through writings in the areas of both research methodology and theoretical models. Of particular prominence in these areas is the work of David Aldridge, much of which is summarized in his text Music Therapy Research and Practice in Medicine: From Out of the Silence.