In this era of accountability, therapists and other mental health professionals are expected to employ evidence-based interventions to achieve therapeutic change. Case conceptualization is an intervention that many consider one of the most essential clinical competencies. A useful case conceptualization approach, at a minimum, should explain the presenting problem and guide the planning and implementation of treatment. Approaches that are more clinically valuable will include a third function: anticipate and predict challenges in the treatment process. Analogous to the paradigm shift toward personalized treatments in precision medicine based on biomarkers is a similar shift occurring in psychotherapy practice. It will be based on behavioral markers like the ones in the pattern-focused case conceptualization approach and can explain, guide, and predict treatment challenges, as well as optimize treatment outcomes. A case example illustrates key points.