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While highly effective, psychotherapy outcome studies suggest 5?14% of clients worsen while in treatment and that therapists are unable to identify a substantial portion of such cases. Methods to systematically track client mental health functioning over the course of treatment and adjust treatment through the use of problem-solving tools are described. We summarize meta-analyses of the effects of a feedback system indicating that the number of psychotherapy patients who deteriorate can be cut in half. We conclude with a series of practice implications, including that clinicians seriously consider making formal methods of collecting client feedback a routine part of their daily practice.