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Background: University students are a population commonly experiencing significant mental health challenges. Therapeutic songwriting is a recognized music therapy technique that facilitates emotional expression by engaging clients in lyrics writing and music composition, thereby promoting self-reflection and psychological insight.

Objectives: This study aims to investigate how interbrain synchronization (IBS) during therapeutic songwriting underlies therapist-client interaction and correlates with intervention effects and the strength of the therapeutic alliance.

Methods: Using dual-EEG recording, we measured IBS across five frequency bands during baseline, co-creation of an original song (songwriting), and listening to preferred vs. original music.

Result: Results revealed that compared to baseline and preferred music, listening to the participant’s composed song elicited stronger delta-band neural coupling between the therapist and the client, and the songwriting phase showed greater gamma band synchronization. Psychological measures indicated a clinically meaningful reduction in state anxiety on the STAI-State and a strong therapeutic alliance.

Conclusion: These findings suggest that listening to original music enhances therapist-client neural alignment more than listening to preferred existing music, potentially facilitating anxiety regulation through increased IBS and supporting the establishment of a strong therapeutic alliance. In addition, heightened gamma band synchronization may reflect increased joint attention between therapist and client during the songwring process. This study highlights the value of IBS as a biomarker for music therapy processes and underscores the need for larger controlled trials to examine therapeutic songwriting’s therapeutic mechanisms. Also, this study demonstrates how neuroscientific methods can capture music therapy’s dual capacity to foster both neurophysiological and experiential connection.