Twelve music therapists were observed working clinically in 3 to 5 of their music therapy sessions and subsequently interviewed about their clinical work in order to further examine and define the essential characteristics of therapeutic singing in music therapy clinical practice. Observational and interview data were analyzed separately using procedures consistent with qualitative content analysis and then integrated to provide a comprehensive picture of these singing practices. Analysis of these data revealed 3 interrelated dimensions of therapeutic singing that were integrated into the larger realization of therapeutic singing: (1) foundational vocal skills, (2) vocal engagement, and (3) authenticity. Implications for the education and training of music therapy students, vocal health, and a reevaluation of the American Music Therapy Association’s competencies contextualize these findings for the profession as a whole.