Introduction: Functional neuroimaging has already provided important insights into the cerebral mechanisms of psychopathology. It is now increasingly being used in the investigation of the cerebral effects of therapy as well. Changes in brain function and metabolism following drug therapy and, increasingly, psychotherapy, have been documented. Methods: Selective literature review. Results: The ... [Show full abstract] most widely replicated effects include the reduction of limbic and paralimbic activity after behavioural therapy for phobia, and the normalisation of striatal hyperactivity in obsessive compulsive disorder. The pattern of results in depression is more patchy, with some results suggesting hyperactivity in the subgenual cingulate. This finding triggered a recent study of deep brain stimulation to the subgenual cingulate. However, the clinical efficacy of this technique in depression requires assessment in further studies. Discussion: The role of functional neuroimaging in the discovery of faulty cerebral feedback loops and the monitoring of treatment protocols appears promising, but studies to date are limited by methodological problems. New technical developments in imaging-based neurofeedback may result in the use of functional imaging as a therapeutic tool.