ABSTRACT: Sexual abuse is one of the most common traumatic events that occurs throughout the history of mankind all over the world, in all societies and cultures. purpose of the article is focus on and understand the role of improvisational music therapy in working with clients who experienced sexual abuse in their childhood. Special attention is given the role of improvisation in exposing, dealing with and healing the trauma. nature of the trauma, the function of the therapeutic process, the role of the therapist and the role of improvisation in working with traumatized clients are being described and discussed. This is followed by a case example that presents two years of work with a 32 year-old woman, who came music therapy due an inability make meaningful connections in her adult life and other problems as well. therapeutic process is divided and examined in four developmental stages that include description of the process and therapist's reflections. examination of the process indicates the powerful role that improvising music might have in bringing up, dealing with and integrating memories of sexual abuse into the client's conscious existence. Introduction Sexual abuse is one of the most common traumatic events that occurs throughout the history of mankind all over the world, in all societies and cultures (Forward, 2002; Sorensen & Snow, 1991). Reported cases of child sexual abuse reached epidemic proportions, with a 322 percent increase in the United States alone from 1980 1990 (Sorensen & Snow, 1991). It is estimated that there are 60 million survivors of childhood sexual abuse in America today (Forward, 2002). is a kind of wound. When we call an event traumatic, we are borrowing the word from the Greek where it refers a piercing of the skin, a breaking of the bodily envelope (Garland, 1998, p. 9). mind can also be pierced and wounded by events (Freud, 1920). Trauma can be a wound that stays inside a person for a long time. Sutton (2002) explains that there is a complexity of influences that reaches far beyond the place and time when the trauma actually happened. Traumatic events are often not shared with others. Most of the time, they are totally suppressed. The inability rehearse, through thinking, talking or writing about our traumatic experiences is instrumental in the genesis of traumatic forgetting, says Whitfield (1995, p. 20). In the case of sexual abuse in childhood, dissociation is often employed by children who cannot escape from the threat of abuse, as a means of mentally withdrawing from a horrific situation by separating it from conscious awareness. secret is being created and its power allows the victim feel detached from the body or self, as if what is happening is not happening (Widom, 1995). Music therapy can play an important role in exposing, dealing with, and healing the trauma. Musical improvisations are musical acts that can bring out hidden, unconscious material and make it conscious and available the client. By using analytic-musical techniques the trauma of the past can be discovered and dealt with. Nature of the Trauma Sexual abuse that originated in childhood can be such a traumatic experience that one typically cannot really deal with it and it is therefore pushed away from the conscious awareness and denied. However, it continues be active in a different form, such as a disturbance in the function of the ego or a neurosis. denial of abuse is described by Summit (1983) as a getting used to syndrome of a child who was sexually abused. It means that the child tries turn a threatening situation, person or environment into a less threatening one. This is done as a way survive, and a secret is being created. Children and adults keep the secret a long time after the abuse stopped. On one hand, the unconsciously internalized figure of the terrifying and punishing abuser makes sure that the anxiety and the emotions that have do with the abuse exist in a very alive form in the unconscious, while on the other hand keeping the secret in the unconscious allows the continuation of accepting love from the abuser on a conscious level. …