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Over the last several decades, humanitarian programmes have increasingly sought to preserve not only physical life and health, but also to address psychological needs and to promote the social well-being of people. This can be seen in the development and widespread use of the so-called mental health and psychosocial support (MHPSS) programmes. Despite their proliferation, they have been widely criticised, and the field marked by intense debate. In this paper, the author discusses the evolution of MHPSS programmes and the associated debates by analysing Vanessa Pupavac’s critique of psychosocial programming as constituting ‘therapeutic governance’, or the homogenisation, pathologisation, controlling and depoliticisation of affected communities. In her analysis, she focuses on current practice as represented by the 2007 IASC Guidelines on Mental Health and Psychosocial Support. She argues that the field has made significant progress toward a culturally-appropriate and empowering model of psychosocial programming within humanitarian interventions, but that individual programmes would still benefit from situation-specific evaluation. Though the critiques of homogenisation and pathologisation have been addressed by the IASC guidelines, she argues that there remains the potential for MHPSS programmes to contribute to the controlling and depoliticising nature of broader humanitarian programming.