The authors assessed the readiness of adult psychiatry residency programs to train residents in cognitive-behavioral therapy (CBT) prior to the January 2001 revision of program requirements by the Accreditation Council for Graduate Medical Education (ACGME). Adult residency training program directors were surveyed. Data analysis evaluated relationships between directors' confidence in CBT training and the program and faculty characteristics. Responses were received from 54.2% of programs. Half had no requirement for resident-performed CBT. Directors' confidence in CBT training was significantly related to didactic hours (P=0.041), psychotherapy hours (P=0.007), and ACT-certified faculty (P=0.035). A substantial lack of required training in CBT exists in least 25% of accredited programs. Assessing faculty credentials and working with specialty organizations recommended in this article could assist in developing better programs in CBT.