Audit is found increasingly in clinical settings, and attempts are being made to extend its impact and effectiveness. This has given rise to debates about its relevance as a form of intervention into professional practices in spheres as different as accountancy, engineering, medicine, and psychoanalysis. These debates are examined, together with attempts to develop forms of `clinical audit' relevant to psychotherapy services in general. A case is made that psychoanalytic psychotherapy has not been subject to successful or convincing audit processes. This is especially true of couple psychoanalytic psychotherapy. A case is made for the development of forms of `conceptual research' in psychoanalytic modalities - particularly ones which respect the unique nature of the psychoanalytic `clinical fact' and the influence of the practitioner's pre-conscious. The development of couple psychoanalytic psychotherapy in the UK from its early roots in the Family Discussion Bureau to its current institutional practice at the Tavistock Marital Studies Institute and its private practice within the Society of Psychoanalytic Marital Psychotherapists is examined to show how couple psychoanalytic psychotherapy has developed as a discrete modality of psychoanalytic treatment. A research project is described which attempted to survey the field of couple psychoanalytic psychotherapy. A questionnaire gathered demographic data, theoretical orientation and conceptual orientation data, and approaches to clinical material and concepts. The analysis of the research data (utilising quantitative and qualitative methods including those of Grounded Theory) showed that within the field of couple psychoanalytic psychotherapy there are clear groupings of practitioner, with a good degree of congruence between their self-reports and their practice when approaching clinical material. The reasons for, and make-up of, these groupings is described. Recommendations are made in three areas of couple psychoanalytic psychotherapy practice: audit, training and research. The need for audit processes to be developed out of the psychoanalytic experience is underlined as part of a way of developing reflexive couple psychoanalytic psychotherapy practitioners.