Rising rates of stress, anxiety, and depression—fueled by rapid sociocultural and economic shifts, digital overexposure, and the lasting impact of COVID-19—are accelerating investment in scalable tools aimed at enhancing resilience and wellbeing. Music-based digital therapeutics (MDTs) hold promise given music’s unique ability to modulate core dimensions of health—affect, anxiety, and reward, as well as autonomic and social functioning—through a medium that is universal, intuitive, and increasingly accessible. To assess the current state of MDTs targeting stress, anxiety, and depression in adults, we conducted a scoping review using a modified Population, Intervention, Comparison, Outcome (PICO) keyword framework to structure Google search results. Twenty-two commercially available MDTs were identified for inclusion. We organize these MDTs into five principal categories based on underlying treatment strategies: (1) Preference-based music selection; (2) Affective Parameterization; (3) Affect Matching and Compensation; (4) Neural Entrainment; and (5) Biofeedback. We review general evidence supporting each strategy from music neuroscience and therapy research, as well as limited applied research testing specific MDTs. We conclude that, while general evidence supporting musical-based interventions for stress, anxiety, and depression is substantial, evidence for MDTs specifically is presently too limited to draw conclusions about real world effectiveness. Determining whether MDTs are likely to fulfill their potential will require increased focus on rigorous laboratory studies testing specific treatment strategies and randomized double-blind placebo-controlled trials conducted in ecologically valid settings. To support progress in this field, we make recommendations to support the sustainable development of MDTs as evidence-based tools to support mental health and wellbeing.

Auditory beat stimulation in the delta–theta frequency range (0–7 Hz) is gaining interest as a non-invasive intervention for anxiety. This study investigated the effects of a relatively understudied form—monaural beats—and whether they produce acute changes in anxiety and mood when presented alone or embedded harmonically within music. Participants (n = 308) were randomly assigned to one of three 30-min listening conditions: (1) Monaural Beats + Music, (2) Monaural Beats-Only, or (3) a Pure Tone Control. Psychological effects were assessed via changes in self-reported anxiety (State–Trait Anxiety Inventory, state subscale) and mood (bipolar Likert scales for emotional valence, arousal, and energy). The results showed that only the Beats + Music condition significantly reduced anxiety from before to after listening with a medium effect size anxiety from before to after listening (p < 0.001, d = −0.58). Furthermore, only the Beats + Music significantly increased emotional valence from before to after listening (p < 0.001, d = 0.48). Finally, the Beats-Only condition showed a significant reduction in energy from before to after listening (p < 0.05, d = −0.28). These findings indicate that monaural beats can be harmoniously integrated into music without diminishing the anxiolytic properties of the latter, whereas presentation of beats alone has different effects. This suggests that integrating monaural beats within music may be a viable approach for targeted auditory neuromodulation.