The importance of music for adolescents is well-documented. While music therapy has been used to support adolescents who are experiencing mental health and other challenges, applications of Extreme music are rarely addressed in the literature even though it is a preferred genre of many adolescents. The purpose of this study was to investigate the perspectives of music therapists on the use of Extreme music in their music therapy sessions with adolescents. Three certified music therapists participated in qualitative interviews that were analyzed using directed content analysis techniques. Several themes emerged within three pre-determined categories: (a) Using Extreme Music in Music Therapy with Adolescent Clients, (b) Identified Clinical Benefits of Extreme Music for Adolescent Clients, and (c) Contraindications for the Use of Extreme Music in Music Therapy with Adolescent Clients. Implications of the results for practice, education, and future research are presented along with limitations of the study. It is the researcher’s hope that this study will encourage music therapists to gain new and enhanced understandings on how they might incorporate Extreme music into their practice with adolescents when clinically indicated.