summary Psychotherapy is a popular treatment for many psychiatric symptoms and disorders. Finding evidence for the effectiveness of therapies and bridging the gap with daily practice are a challenge. The current state of psychotherapy is explored from the perspective of evidence-based medicine. Hundreds of meta-analyses, based on thousands of studies, showed an average effectsize of 0.60. Discussion in this paper focuses on the achievements and limitations of research into methods and specific disorders. Much is known about the specificity of psychotherapies and about other issues relevant to service delivery. If patient-based indication is to be a goal for the future, we will need to have a differentiated spectrum of evidence-based psychotherapies. This approach will require the integration of effective elements taken from a variety of methods, the development of multi-dimensional indicators for patient-based indication, and research into cost-effectiveness to underpin the relevance of psychotherapy for the community at large.