The Diagnostic and Statistical Manual of Mental Disorders IV ‐ TR (DSM) is currently employed by the Mental Health Services of the Netherlands as the basis of an integrated system of keeping track of clients and their progress through psychotherapy. Using a story from a narrative therapy practice to illustrate the current situation, concerns about the use of the DSM and Routine Outcome Monitoring as policing strategies will be discussed. Ethical and moral issues relating to the medicalisation of psychotherapy practice in the Netherlands under this regime are considered.