Efficiency or quality? Which one should be assured in the future?

The confusion of scientific, economic, juridical and professional contexts is the reason for the present uneasiness within therapeutic culture. The au thor pleads for autonomy of these contexts to defend the profession reasona bly against powerful overdetermination by other contexts. The debate about EST ("empirically supported therapy") is being drawn upon to show that the list of criteria for differentiation of effective and ineffective therapies is not warranted. Scientific or economic dominance claims might have deter iorating effects in the professional fields, as well-known researchers mean while fear. In economic contexts the aim is efficiency, in professional con texts it is quality. To develop own quality measures has the aim to promote the profession as a learning organization. Proposals are made. This could help to rise professionals' self-confidence.