Introduction

The concepts of quality assurance and quality management (here used synonymously), which were originally developed by the business community, are now seen as being of increasing importance in the health services of today (see Schramm, 1994; Riordan and Mockler, 1997). Quality assurance is intended to be of benefit not only to the interests of the patients, but also to the contractors in health services. For the insurance companies for example, financial considerations are of primary concern: they only want to reimburse that diagnostic or therapeutic work which has been recognized by the profession as justifiable and appropriate. For the professionals (providers), here in particular those from the discipline of Child and Adolescent Psychotherapy, the most important issues are to have the diagnostic and therapeutic procedures which they see as being necessary recognized, and to work towards an improvement in the standards of their practice which will further benefit patients. Quality assurance should protect the patient from inappropriate management and treatment by unquali- fied personnel. Each patient should be provided with the best treatment available, within the known limitations of the system. As a result of the different interests of the providers and the contractors, conflicts are not uncommon. When planning and trying to implement quality assurance measures, it is necessary to bear these potential conflicts of interest in mind and to attempt to balance them in an appropriate manner.