The recent movement toward evidence-based practice in mental health services has highlighted the importance of research evidence in treatment decisions. However, the fact that many treatments with strong research support are not widely used in clinical settings suggests that practitioners' decisions are not based on research alone but rather are influenced by other considerations. This study examines the relative importance of various considerations on practitioner treatment selection using a national survey of mental health practitioners including doctoral-level psychologists, master's-level psychologists, and master's-level clinical social workers (N = 206). Results indicate that practitioners are influenced by a range of considerations including empirical evidence from applied field studies, the perceived flexibility of a treatment, and the appeal of a treatment to colleagues and clients. These findings are discussed within the context of efforts to design, evaluate, and disseminate treatments with research support into clinical settings.