Trauma-Informed Guilt Reduction Therapy Compared to Prolonged Exposure

Inclusion Criteria: * U.S. Veterans age 18 or older who served in the military since the start of Operation Enduring Freedom/Operation Iraqi Freedom; OEF/OIF) * meets diagnostic criteria for PTSD; * a score of 2 or higher ("true" to "extremely true") on feeling trauma-related guilt much or all of the time or scoring 3 or higher ("very true" or "extremely true") on at least one guilt cognition factor (hindsight bias/responsibility, wrongdoing, or lack of justification) on the Trauma Related Guilt Inventory * not currently receiving trauma-focused treatment such as PE or CPT * willingness to attend psychotherapy and assessment sessions Exclusion Criteria: * current risk of suicidal/homicidal behavior that requires immediate intervention * current severe substance use disorder (in the past two months) based on DSM-5 criteria * current unmanaged psychosis or mania * life threatening or unstable medical illness * inability to read