This article focuses on an attempt to integrate evidence-based engagement interventions into “real world” outpatient child mental health settings in order to increase access to care for urban youth and their families. More specifically, empirical support for introducing engagement interventions into child clinical settings will be reviewed. Then, specific engagement interventions that are delivered during the initial telephone contact with a child's adult caregiver or during the first face-to-face contact with a child and family are described with attention paid to the training necessary to assist service providers in adopting this change in practice. Factors that serve to facilitate or impede adoption of evidence-based engagement interventions are also reviewed. Finally, preliminary evidence for the effectiveness of integrating such evidence-supported approaches is presented.