What factors influence providers' adoption of evidence-based practices, and what steps can be taken to improve dissemination? These questions were the focus of three teams of investigators, who report their findings in this issue. Joan M. Cook, Ph.D., and colleagues looked at responses of more than 2,600 psychotherapists to a Web-based survey and found that empirical evidence did not have a strong direct influence on their adoption of new treatments. Practitioners tended to stay with the approach learned in their initial training. However, many reported that a mentor's endorsement of a new treatment and a sense of self-efficacy would strongly influence their adoption of it (page 671). In a study by Cameo F. Borntrager, Ph.D., and associates, the attitudes of 59 therapists toward evidence-based practices were assessed. Findings suggest that therapists did not harbor negative attitudes about evidence-based practices per se; rather, they were concerned about inflexible use of treatment manuals that would not permit them to individualize treatment (page 677). In the Open Forum Sandra G. Resnick, Ph.D., and Robert A. Rosenheck, M.D., describe a four-year process undertaken by the Department of Veterans Affairs (VA) to implement an evidence-based practice—supported employment—at 166 VA medical centers across the country. Lessons learned from the VA experience have implications for scaling up dissemination of practices to large systems and long-term time frames (page 682). In the Taking Issue commentary, Lloyd I. Sederer, M.D., notes that such intensive dissemination efforts require "leadership, courage, and commitment" (page 575).