An emerging picture based on real-world practice indicates that there is substantial dropout in treatment programs for posttraumatic stress disorder (PTSD). This meta-analysis, together with {1,2}, provides evidence suggesting that greater disorder severity may be an underlying factor that predicts dropout from prolonged exposure and cognitive processing therapy. This is consistent with the observation that randomized controlled trials (RCTs) based on these models have historically consistently excluded patients with major complications, such as the following: homelessness; substance use disorder (especially dependence and drug use disorders); domestic violence; suicidal or homicidal ideation; serious and persistent mental illness; significant medical illnesses such as HIV; mandated treatment; pregnancy; cognitive impairment; current incarceration. This Recommendation is of an article referenced in an F1000Prime Report also written by Lisa Najavits.