Therapists talk about the engagement process.

'Engagement' and 'treatment engagement' are terms that frequently appear in the mental health literature, and are operationalized differently across studies. A clearer understanding and conceptualization of engagement would enhance research and practice. Six focus groups were conducted with community mental health therapists (n = 41) to learn how they define engagement, the barriers to engagement they experience, and the strategies they use to enhance engagement. In some aspects, their definition of engagement was similar to the helping alliance. However, therapists viewed engagement as much more than the relationship; it is a complex process that is affected by many factors, including agency policies and practices. Suggestions are made to advance the study of how clinical and organizational factors affect engagement.