The Washington State TF-CBT and CBT+ Initiative offers training in Cognitive Behavioral Therapy (CBT) for clinicians working in public mental health across Washington State. While CBT has been shown in previous studies to be an effective therapy for anxiety, depression, behavior problems, and Post-Traumatic Stress Disorder, its use is limited in public mental health because of the lack of available training. The purpose of the study is to examine whether clinician orientation affects clinician learning of CBT for anxiety, depression, behavior problems, and PTSD. Our first hypothesis is that clinicians with a cognitive behavioral orientation will have a higher skill level before training in comparison to clinician of other orientations. The second hypothesis is that clinicians of other orientations will have a higher skill level after the training than those clinicians with a cognitive behavioral orientation due to a higher rate of improvement. Clinician self-reported efficacy in elements of CBT for anxiety, depression, behavior problems, and PTSD, was assessed before the three-day training, after training, and after 6 months of bi-weekly phone consultations with a CBT expert, and will be compared for each theoretical orientation. The participating clinicians in this study vary in theoretical orientation, including integrative/eclectic, biological, interpersonal, cognitive behavioral, psychodynamic/analytic, systems, humanistic/existential and others. We plan to integrate the results of the study implications for future clinician training of CBT. If our hypotheses are supported, it will suggest that clinicians with a cognitive behavioral orientation may need specialized training in CBT that takes into account their previous knowledge and offers more advanced training options for those with past experience in CBT.