The goal of the study was to characterize older adults' experience with psychotherapy and examine its impact on engagement in psychotherapy. The study included 50 adults over age 60 who screened positive for depression and participated in the BRIGHTEN Program, an interdisciplinary geriatric mental health program. Qualitative analyses revealed five themes leading to treatment initiation: health concerns, family issues, the experience of depressive symptoms, beliefs about what participants could get from psychotherapy, and positive outcomes seen in others. Those without a history of mental health treatment were more likely to endorse health concerns as a treatment motivator and were more likely to terminate treatment early. Future research is warranted to determine how to effectively engage older adults seeking mental health treatment for the first time.