Culture and ethnicity are increasingly reflected in multicultural societies worldwide. Many therapeutic modalities are now addressing issues related to cultural awareness, cultural sensitivity, and cultural competence within the therapeutic context. This paper uses an heuristic approach to explore issues of culture applied to the use of music and imagery in the context of the Bonny Method of Guided Imagery and Music (BMGIM). It integrates reflective therapist perceptions, relevant practice knowledge from literature, and therapeutic perspectives with a pilot investigation of client-derived semiotically-oriented data. Results from this retrospective qualitative analysis suggest five areas of concern for BMGIM practice, which are 1) language and expression, 2) relationship and context, 3) cultural connotations and icons, 4) cultural values and spirituality, and 5) the role of music and culture. Final recommendations include the recommendation for BMGIM clinicians to embrace cultural sensitivity and cultural competence in order to better meet the needs of clients and facilitate the therapeutic process.