This systematic review and meta-analysis evaluates the efficacy of various psychological treatments for chronic post-traumatic stress disorder (PTSD). The study included 38 randomized controlled trials, assessing the effectiveness of trauma-focused cognitive-behavioural therapy (TFCBT), eye movement desensitisation and reprocessing (EMDR), stress management, and group cognitive-behavioural therapy. The results indicate that TFCBT and EMDR were more effective than waiting-list or usual care, with limited evidence that they also improved depression and anxiety. Stress management showed some benefits, but other therapies were less effective. The review suggests that TFCBT and EMDR are the first-line treatments for chronic PTSD, with TFCBT being particularly effective. However, there is heterogeneity in the studies, and higher-quality studies showed better outcomes. The review also highlights the need for further well-designed trials to validate these findings and explore the tolerability and adverse effects of different treatments.This systematic review and meta-analysis evaluates the efficacy of various psychological treatments for chronic post-traumatic stress disorder (PTSD). The study included 38 randomized controlled trials, assessing the effectiveness of trauma-focused cognitive-behavioural therapy (TFCBT), eye movement desensitisation and reprocessing (EMDR), stress management, and group cognitive-behavioural therapy. The results indicate that TFCBT and EMDR were more effective than waiting-list or usual care, with limited evidence that they also improved depression and anxiety. Stress management showed some benefits, but other therapies were less effective. The review suggests that TFCBT and EMDR are the first-line treatments for chronic PTSD, with TFCBT being particularly effective. However, there is heterogeneity in the studies, and higher-quality studies showed better outcomes. The review also highlights the need for further well-designed trials to validate these findings and explore the tolerability and adverse effects of different treatments.