Music therapists use several types of receptive methods, in which the client takes in live or recorded music as a listener and responds in some fashion. In one form, called song discussion, the client and therapist listen to a pre-selected song together and then discuss the meaning and relevance of the song to the client's life. Song discussion reportedly has been widely used as a form of music psychotherapy toward a variety of aims related to the restoration and/or maintenance of psychological health. However, in spite of the apparent clinical popularity and broad application of song discussion, the extant literature offers little guidance regarding the critical decisions that the therapist makes as she moves through the procedural steps of this experience. Accordingly, the purpose of this article is to highlight several of these key decisions. First, the psychological processes of identification and empathy are defined and song discussion is presented as a projective method. In the next section of the article, decisions related to song selection, preparation, presentation, and facilitation of discussion are underscored. To conclude, therapist countertransference and its potentially negative impact on song discussion is examined with the hope of heightening awareness of this potent therapeutic dynamic. With increased attention to the myriad details of this important clinical intervention, the therapist can provide an experience that is as beneficial, meaningful, and satisfying as possible for the client.