The study of psychosocial treatments for posttraumatic stress disorder (PTSD) has improved dramatically in the past decade, with greater rigor, expansion of sampling, and diverse treatment models. At this point it is clear that PTSD treatments work better than treatment as usual; average effect sizes are in the moderate to high range; a variety of treatments are established as effective, with no one treatment having superiority; and both present-focused and past-focused models work (neither outperforms the other). Areas of future direction include the need to better understand therapist training, treatment dissemination, patient access to care; optimal treatment delivery, and mechanisms of action. Methodological issues are also discussed.