This chapter’s purpose is to monitor the progress of clients in therapy and determine next steps. We are reminded that effective therapy begins with a commitment to routine outcome monitoring (ROM). It explores how feedback-informed treatment (FIT) provides a means for responding to information gleaned from both outcome and alliance measurement, which in this case is the Outcome Rating Scale (ORS) and Session Rating Scale (SRS), respectively. Of particular importance is how therapists respond to clients who are unimproved or deteriorated. The chapter includes strategies for responding to clients’ lack of progress as well as how to change the intensity, dosage form, and type of therapy, to prepare clients for transition when maximum benefit has been achieved. The role of supervision will be explored as a tool for monitoring the benefit of therapy.