The authors sought to determine whether counselors working in primary care could be trained to deliver psychodynamic interpersonal therapy (PIT), a more intensive, focused form of therapy shown to be cost-effective in the secondary care setting. Twenty counselors received a 12-week training course in PIT. Performance was assessed using videotaped sessions with simulated patients at 3 points in time: before training, after an intensive first week of training, and at the end of 12 weeks of supervision. Counselors' adherence to the model was assessed in relation to 3 patient scenarios: chronic depression, somatization, and suicidality. Validity of the simulated sessions was verified by reference to counselor behavior with actual patients using audiotaped sessions. After training, counselors' adherence to PIT increased without affecting their basic counseling skills. Patients with chronic depression and those with somatization demonstrated improvement in specific items; there was, however, less evidence of model application among suicidal patients. Ratings of audiotaped sessions with actual patients confirmed that counselors were able to apply the model in a real-life situation. Fifty percent of patients treated by the counselors using PIT during the training period showed clinically significant and reliable change.