The role of object relations as a predictor of outcome was evaluated in inpatient posttraumatic stress disorder (PTSD) treatment. Cohort outcome at discharge on psychometric indices was mixed, with limited evidence of reliable or clinically significant change. Treatment was associated with an overall reduction in utilization of inpatient psychiatric and residential domiciliary services. However, moderate (vs. low) levels of object relations were predicted of reliable change outcome, independent of demographics. Axis II diagnosis, symptomatic severity, or early childhood or war zone trauma exposure. . The findings suggest that consideration should be give both to the manner in which patients seeking treatment for PTSD are screen and matched with a range of treatment or rehabilitation services and how treatment outcome is conceptualized beyond symptom reduction. Rehabilitation of chronic posttraumatic symptomatology and associated psychosocial impairment may be facilitated by assessment, treatment design and client-treatment matching on the basis of multidimensional psychological indices.