This commentary on Rubenstein et al. (2024) applauds their sensitive historical exploration of exposure therapy for posttraumatic stress disorder (PTSD) and balanced review of the strengths and weaknesses of that approach. I offer five points to expand on their contribution. (a) Stringent exposure therapy workforce requirements limit scalability, thus restricting access for the large number of patients in need of PTSD treatment. (b) There are additional non-trauma-focused approaches that show efficacy for PTSD. (c) Results of exposure therapy trials should be interpreted in light of how much the study designs align with real-world conditions. (d) Some surprising results from the subfield of PTSD/substance use disorder could suggest new treatment options. (e) There is a need for stronger reporting of clinical worsening (iatrogenesis) outside of clinical trials. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
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