Good stuff in this thread.
It's about adapting and being resourceful on these little cricks. You size up your spot, and do what you need to get to it. Also, you look what you might mess up and decide if you're going to fish it or pass on it for the greater good. So many times I look at a spot, and know that's THE spot, but realize what I've got to do to get to it is gonna send those gossipy wild rainbows telling the whole stream I'm coming. Or, a lot of times I'll go way out of my way to approach from a different angle. After you've fished a while, you'll learn the ways to approach without doing so much back tracking.
Bow and arrow is the very last resort for me because, as easy as it looks, I never know where the heck it's going. Usually about 3 feet off the rod tip is a good bet. The other techniques mentioned are all useful. Basically -- whatever you can do to get your fly to the spot without spooking the fish is OK. The long, graceful casts are mostly for spectators or photographs.
I always drilled this into my kids heads: Don't count on luck to keep your fly out of the trees. Look around you and adapt your cast to the situation at hand. Flies in trees wastes time and money, and generally screws up your good time.