This case report details how avant-garde musical interventions helped to nurture the attentional skills of eight pediatric patients admitted to a small 12-bed acute psychiatric unit. The music therapist encountered two major obstacles while working on the small psychiatric unit. First, hospital administration strongly recommended that all eight patients attended the music therapy groups together, regardless of a lack of space, and differences in ages, cultures, and diagnosis. Second, when music therapy interventions were centered on tonal harmonies, melodies, or counterpoint, including predictable rhythms or time signatures, the patients repeatedly lost focus, concentration, and attention, making it difficult to work on improving prerequisite skills, such as following directions and keeping safe boundaries, or to explore emotions and feeling-states. As an alternative to typical diatonic interventions, the music therapist created three novel sound-based interventions informed by the avant-garde composers Pauline Oliveros, John Cage, and Luigi Nono. The novel musical interventions not only helped the eight patients to improve attentional skills, but, unexpectedly, it helped to (a) build a strong therapist-patient bond built on trust, (b), allow the patients to struggle, explore, discover, and create within a safe therapeutic environment, (c), reveal unexpressed feeling-states nonverbally and (d) share their novel musical experiences with newly admitted patients.