This commentary discusses the strengths and limitations of internet-based cognitive-behavioral treatments (ICBT) for anxiety disorders, as highlighted by the case studies described in Ciuca, Berger, and Miclea (2017), and in Schulz, Vincent, and Berger (2017). In comparing the course of treatment for patients with contrasting clinical outcomes, the authors offer insights into the many benefits and challenges of ICBT. Suggestions for improving ICBT interventions for anxiety disorders, implications for implementation and dissemination, and ethical considerations are discussed.

Sustaining evidence-based practices after initial training and support has ended is necessary to ensure lasting improvements in youth mental health services. This study examined factors impacting community clinicians' decisions to sustain a transdiagnostic youth intervention following participation in a study. The aim of the study was to identify potentially mutable factors impacting sustainability to inform future implementation efforts. Thirteen clinicians (85% women, 92% Caucasian, M age ϭ 35.6) completed interviews after participating in an open trial of an evidence-based intervention for depression, anxiety, and conduct disorders. Interviews were analyzed using thematic analysis methods. All (100%) clinicians reported current use of the intervention. Four themes emerged related to sustainability. Clinicians (100%) reported that making modifications, alignment with prior training, and relative advantage influenced their current intervention use. Clinicians (100%) reported that knowledge transfer from treatment developers was vital to sustainability. They (92%) noted a number of logistical, inner-organizational, and client-level barriers to sustainability. Lastly, clinicians (92%) identified factors related to scaling up the intervention. A variety of personal, organizational, logistical, and client variables influence the sustainment of new interventions, and could be leveraged in future implementation efforts. Public Significance StatementThis study interviewed community mental health clinicians about the factors related to sustaining evidence-based practices following participation in a research trial. Clinicians indicated that a number of personal, organizational, logistical, and client variables influence the sustainment of new interventions, and could be leveraged to sustain evidence-based practices over time.