The lead article describes disappointing findings from an aftercare protocol for veterans with posttraumatic stress disorder (PTSD) treated in residential rehabilitation programs. The U.S. Department of Veterans Affairs (VA) provides its most intensive PTSD treatment in such programs, but many veterans continue to have difficulties after discharge. The randomized controlled trial, conducted by a team led by Craig S. Rosen, Ph.D., assessed the effects of adding telephone care management to usual aftercare. More than 800 veterans from five residential programs were randomly assigned to usual aftercare or to aftercare enhanced with telephone care management. For the first three months, the latter group received biweekly calls from mental health specialists that involved brief assessment and support. Data from four- and 12-month follow-ups did not support any of the team’s hypotheses about improved treatment engagement and outcomes. One reason for the negative findings, the authors note, was that the intervention was based on an incorrect assumption that poor outcomes are attributable to poor outpatient adherence. The study participants were high utilizers of postdischarge care, and there may have been little incremental value in providing a telephone contact every 14 days (page 13). In Taking Issue, B. Christopher Frueh, Ph.D., calls on VA leaders “to reflect on why veterans with PTSD are not benefiting from treatment, especially when civilians with PTSD do.” He notes that most of the veterans in the study were receiving VA cash disability payments and that “virtually all patients have a powerful secondary-gain incentive to remain symptomatic” (page 1).