Due to increased demands placed on university counseling centers (UCCs) in recent years, there is a need for these centers to enhance the efficiency and effectiveness of their psychological services. Regularly monitoring client progress is one approach to increase the likelihood of positive clinical outcomes. This article describes the use of the Behavioral Health Measure-20 (BHM-20; Kopta & Lowry, 2002) in monitoring the progress of 13,803 clients at 23 UCCs across the United States from 2006-2011. Results show that the BHM-20, via the CelestHealth System-MH (CHS-MH), is an effective instrument for the electronic administration, scoring, and tracking of client progress. Overall, clients improved over the course of treatment and the benefit from treatment peaked between 7 to 10 sessions. Three case vignettes using the CHS-MH in patient care are presented. Implications for continuing the use of monitoring individual client change at UCCs are discussed.