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The importance of clients’ agency and involvement in therapy has been emphasized in music therapy as well as in the broader interdisciplinary field of mental health and psychotherapy. Although the quickly growing discourse and research base of music therapy in mental health care increasingly include user perspectives, most of the existing research and literature focus on the therapists’ interventions. This article reports a qualitative multiple case study of clients’ contributions within therapeutic collaborations in the field of adult mental health care. Data were collected through semi-structured interviews with clients and therapists including an adapted procedure of interpersonal process recall (IPR). Through a thematic analysis four main categories of clients’ agency in the therapeutic process were identified taking initiatives, exerting control in sessions, commitment to the relationship and engagement across contexts. The findings documented clients’ actions as well as their intentions and reflexivity regarding such actions.
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