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Much as it is the prevailing paradigm within the NHS and the ideology underpinning the outcome measurement agenda, psychotherapy continues to question whether the evidence-based model represents a suitable methodology for complex psychological processes. Outcome measurement is antithesis to the psychotherapeutic project - or at least many within the discipline continue to argue this position. However, if providers of psychotherapy services are to survive in the ‘real’ world of evidence-based medicine, then the onus is upon them to side-step the ‘paradigm wars’ and find new ways of engaging with the mandate to measure. This paper proposes that psychotherapists can engage meaningfully with outcome measurement by asking two important questions of the time they spend with their patients: ‘Is this treatment working for this individual presentation?’ and, if not: ‘What immediate action can be taken in order to remedy the situation?’ The paper goes on to illustrate how the patient-reported outcome measure (PROM), when incorporated into routine clinical practice can act as the mediator of this important self-evaluative process.