A growing number of studies support the use of evidence-based treatments in psychotherapy. Empirically derived methods have proven especially useful for certain disorders and may offer cost efficiencies as well. Despite there data, mental health practitioners often express concerns about treatment protocols, reporting that these approaches impede clinician judgment and constrain appropriate care. In reviewing this topic, Addis, Wade, and Hatgis (this issue) describe six domains of common practitioner concerns and offer a series of recommendations for addressing these issues. Building on that work, the present article extends Addis et al.'s formulation, directing attention to broader themes in the rapidly changing health care field. Certain parallels with the experiences of medical practitioners facing challenger of quality and standardization may offer a framework for challenges currently facing psychotherapy practitioners. Skilled mental health clinicians are likely to be especially well suited to meeting these challenges and to guiding advancer in new types of psychotherapy care.