Scotland and Wales share the opportunities of devolved government as well as challenges such as urban deprivation and remote rural communities. Such commonalities make a comparison of their approaches to psychological therapies relevant. The Scottish and Welsh governments have both published guidance concerning improved access to psychological therapies and these reveal different approaches. The Scottish Government has provided clear and concrete guidance for services, retains a close overview of progress, and plans training from the centre. The Welsh Government has published guidance which is unspecific, has largely devolved responsibility for implementation to local health boards and has no central plan for training. Scottish guidance provides clear information about who can expect to receive specific evidence-based therapies, the number of sessions they can expect to receive, and crucially the level of training and competence required for therapists. Welsh guidance documents have not yet specified which patient groups can expect to access formal psychological therapies, which psychological therapies are considered to have a sound evidence base, the number of sessions patients can expect, or the level of training and competence required for practitioners. Welsh policy documents make no reference to competence frameworks for therapists.