Many issues are raised by the use of third-party mechanisms such as health insurance to pay for psychotherapeutic services. These include such questions as confidentiality, diagnostic and reporting practices, the medical versus the nonmedical model, and transference-countertransference relationships. The role of peer review and other quality control mechanisms will undoubtedly increase as psychiatry is asked to document more fully than in the past the criteria for various forms of psychotherapy and to demonstrate their effectiveness.Abstract Teaser