A long-standing trend to differentiate and even oppose psychodynamic and ecological approaches to practice can be identified in the UK music therapy literature. This is complicated by the way in which ecologically oriented thinking is associated with practice identified to be music-centred. While the trend to differentiate and separate approaches is most apparent in the literature, it is also evident that in practice, therapists have long integrated different perspectives and ways of working, this integral trend having its roots in the work of the UK music therapy pioneers. This article explores how the ecologically oriented thinking associated with the Community Music Therapy movement, and introduced soon after the turn of the 21st century, served in part to broaden the scope of UK practice in a progressive, integrally oriented way. However, the article also discusses the rejection of psychotherapeutically oriented thinking made by some ecologically oriented authors to make space for the new way of thinking. It is suggested that this rejection has been less helpful for the development of the profession as a whole, as the different ways of working in music therapy can be understood to address different types and levels of need. This means that psychodynamic, developmental, ecological, neurological and other perspectives are all potentially important. Case vignettes are used to illustrate this and an integral approach to working, with music-centredness discussed in a way that embraces the full spectrum of UK practice.