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Researchers are studying clients in Ecuador who are receiving psychotherapy for common mental health problems to understand how their psychological distress changes during treatment and what factors affect their outcomes. This observational study is conducted in real-world mental health clinics and aims to track therapy progress and results using routine outcome monitoring. The study includes adolescents and adults starting psychotherapy at participating centers. Participants continue their usual psychotherapy sessions while completing questionnaires before each session to report on their well-being. Data is collected at three levels client distress and satisfaction, therapist intake and style, and service operational context. The study is naturalistic, reflecting typical clinical practice, and aims to support broader adoption of outcome measurement systems in Ecuador and Latin America. During the study, participants provide information through questionnaires at the start, throughout, and at the end of therapy, usually spanning about 10 weeks. Researchers measure changes in psychological distress using tools like CORE-OM, CORE-10, and YP-CORE, along with emotional outcomes and treatment satisfaction. This approach helps monitor progress and informs improvements in mental health services over time.