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Perepletchikova and Kazdin (this issue) reviewed the extant literature on the relationship between treatment integrity and therapy outcomes. The empirical literature on this relationship is inconsistent, and the authors note existing limitations in current research strategies and provide recommendations for future research efforts. This commentary explores the implications that a focus on treatment integrity has for training. As such, comments are offered on a number of conceptual, methodological, and practical issues relating to treatment integrity, instruction in empirically supported treatments, competence, and the training of future clinical psychologists.