Summary Mental health remains a significant issue among young people in the US and elsewhere. Evidence of the beneficial role Hip Hop-based approaches can play in this space is growing. The value of such approaches centers on links to community, culture, and the therapeutic potential of practicing certain Hip Hop elements. Yet, while there has been a steady growth in Hip Hop-based approaches, little work has explored how they can overlap, complement, or reinforce each other. In response, this article explores the theoretical synergies between two established Hip Hop-based models – “Hip Hop and Empowerment” (HHE) and “Therapeutic Beat Making” (TBM) – to offer an integrated approach that draws on the complementarity between and uniqueness of each. Findings Authors identify an integrated HHE–TBM model for supporting youth mental health which forefronts sense of community, cultural relevance, social justice, and empowerment. Authors outline a practice model, which leverages the best of activities, reflections, and discussions, and indicate its potential in working adaptively with diverse communities of young people. Applications When engaging Hip Hop for therapeutic means, whether for health promotion or complex therapy, it is a dynamic, creative, culturally sensitive, regulating, and developmental means for finding common ground and creating rapport. It bridges creative and insight-oriented practices. It embraces the ability to generate emotional responses from creating and analyzing music, including esthetic emotions (i.e. appreciation (of qualities)), utilitarian emotions (i.e. functional, motivational, relevant to immediate well-being, goal-oriented), and epistemic emotions (i.e. gained knowledge or insight, awareness).