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This study attempted to examine patterns over time in treatment preferences of 65 veterans who completed a 4 month inpatient posttraumatic stress disorders (PTSD) program in order to reveal potentially more beneficial types of treatment. Veterans rated the severity of their symptoms and degree of benefit of 35 different treatment components at discharge, and at 4 and 12 months follow-up. Veterans rated their symptoms as having not changed at discharge, and worsening by 4 months. Veterans initially perceived components that were high in Vietnam content, exploratory in purpose, verbal in modality, and personally focused as most effective, but by 12-month follow-up they perceived these as less effective than components that were low in Vietnam content, educative, action oriented, and externally focused. These effects were strongest among veterans with higher levels of PTSD symptomatology. Combat exposure, childhood abuse, and race were generally not significant predictors of response. These results underscore the importance of further inquiry into the relative value of rehabilitative-oriented and psychotherapeutic-oriented treatments for veterans with severe and chronic PTSD.