In perceiving all rap and hip-hop music as violent, misogynistic, and sexually charged, are we denying the way in which it is attentive to the lived experiences, both positive and negative, of many therapy clients? This question is explored in great depth in this anthology, the first to examine the use of this musical genre in the therapeutic context. The contributors are all experienced therapists who examine the multiple ways that rap and hip-hop can be used in therapy by listening and discussing, performing, creating, or improvising. The text is divided into three sections that explore the historical and theoretical perspectives of rap and hip-hop in therapy, describe the first-hand experiences of using the music with at-risk youth, and discuss the ways in which contributors have used rap and hip-hop with clients with specific diagnoses, respectively. Within these sections, the contributors provide rationale for the use of rap and hip-hop in therapy and encourage therapists to validate the experiences for those for whom rap music is a significant mode of expression. Editors Susan Hadley and George Yancy go beyond promoting culturally competent therapy to creating a paradigm shift in the field, one that speaks to the problematic ways in which rap and hip-hop have been dismissed as expressive of meaningless violence and of little social value. More than providing tools to incorporate rap into therapy, this text enhances the therapist’s cultural and professional repertoire.