There is a need for research that explores the effects of music lesson on intellectual, behavioral, and emotional functioning of at-risk students who attend regular public school. Some students might benefit more from a direct approach utilizing therapeutic goals and interventions in music therapy while others may be more profoundly impacted by an indirect approach such as piano instruction. It is worthwhile to compare the effects of music lessons and music therapy incorporating music instruction on non-musical behaviors of at-risk students. The purpose of this study is to compare the effects of piano instruction and music therapy incorporating piano instruction on academic achievement, classroom behaviors, and self-esteem in at-risk students. Participants were 32 at-risk elementary school students (2nd, 3 rd, and 4th graders). They were randomly assigned to one of 10 weeks of 30 minute, one-to-one training conditions: music therapy incorporated piano instruction (n=11), piano instruction (n=11), and no-training (n=10). Participants’ language and math scores, Teacher’s Ratings of Classroom Behaviors (TRCB), and Coopersmith Self-Esteem Inventory were measured. There was no statistically significant difference between the training conditions. The present study investigated the effect of two different forms of music instruction; music therapy and piano instruction for at-risk students. With the breadth of variables to be considered and the conclusions drawn by some studies that music may indeed have a significant impact on this particular population, further research is warranted