Contemporary developments in psychotherapy include mindfulness-based interventions and metacognitive therapy. Both of these approaches incorporate attentional training exercises and meditative activity designed to help clients cope better with rumination, worry, and over-analytical conceptual thinking. Notably, they also use focused listening exercises within established, demonstrably effective treatment protocols. These related practices collectively highlight the promising role of listening, sonic awareness, and mindfulness of sound/music as a means to enhance psychological functioning. Moreover, the paradigm provides a cognitive-attentional framework for understanding the well established, salutary benefits of music listening and may appeal to those many professionals who work in cognitive-behavioral modalities. Examples of clinical materials based on these models are included.