Centering the client in PTSD treatments: Commentary on Rubenstein et al. (2024)

We offer commentary examining conclusions that may be drawn from Rubenstein et al.'s (2024) perspective on the need for exposure-based posttraumatic stress disorder (PTSD) treatments. Here, we employ our shared expertise in implementing and evaluating exposure-based group therapy to reconsider the following impressions garnered from the referenced article: (a) exposure is not necessary for successful PTSD treatment; (b) clients do not want to talk about traumatic memories and will drop out of treatment; (c) exposure may be destabilizing to clients; and (d) clients will spontaneously expose, rendering exposure in therapy unnecessary. In this commentary, we focus on data that center clients' perspectives and acknowledge client choice in the use of exposure. As did Rubenstein et al. (2024), we conclude that exposure is useful for a diverse range of clients, frequently preferred over other forms of treatment, and highly effective for treatment of PTSD. We support efforts to increase access to efficacious PTSD treatments, urging that exposure-based treatments be offered to clients alongside other evidence-based therapies. (PsycInfo Database Record (c) 2026 APA, all rights reserved).