The paper considers whether the ideal of a ‘national psychotherapy service’ is a realistic or desirable possibility. In its origins community psychiatry was inextricably linked with psychoanalysis and group psychotherapy. Today the links between community psychiatry and psychotherapy are much more tenuous, despite the evidence for the effectiveness of many psychological interventions in psychiatric disorders. Future psychotherapies will explore the links between brain and mind, integrate the different psychotherapeutic modalities, consider the wider costs of not providing psychotherapy, and be more client responsive. How will this come about? Authority in the field depends partly on seniority, partly on evidence, partly on popular appeal, and partly on psychotherapeutic narratives which accurately reflect the needs of society and those who suffer from psychological distress.