Comments on the article by B. E. Karlin and G. Cross (see record 2013-31043-001) on the national dissemination and implementation of evidence-based psychotherapies in the U.S. Department of Veterans Affairs health care system. Greene believes there are at least two related issues that the authors have yet to add to their list of lessons learned: (a) the considerable controversy about what constitutes evidence and the limitations and flaws of randomized controlled trial (RCT) methodology in social science research, and (b) the idea that dialogue between therapist and researcher (Greene, 2012, 2014) rather than unidirectional, top-down dissemination (a word used no less than 80 times in their article) may be a more fruitful way of dealing with the resistances, reluctances, and refusals that clinicians often demonstrate regarding the implementation of laboratory-based treatments. (PsycINFO Database Record (c) 2014 APA, all rights reserved).