The current study sought to determine whether trauma-focused treatments for posttraumatic stress disorder (PTSD) improve psychosocial functioning outcomes, and whether treatment gains are maintained over a long-term follow-up (LTFU) period (5–10 years). The relationship between symptoms of PTSD and depression and psychosocial functioning also were explored. A sample of 154 female rape victims who received cognitive processing therapy (CPT) or prolonged exposure therapy (PE) were assessed at pretreatment, posttreatment, 9 months, and 5–10 years following treatment. Hierarchical linear modeling demonstrated significant improvements in overall functioning, social/leisure adjustment, family unit adjustment, and economic adjustment in both treatment conditions, with gains maintained over the LTFU. Lower household income at baseline was associated significantly with poorer overall functioning, social/leisure adjustment, and economic adjustment over time. Structural equation modeling revealed that poorer overall functioning at posttreatment was associated significantly with higher levels of depressive symptoms at 9 months, whereas higher levels of depressive symptoms at 9 months were associated significantly with poorer levels of overall functioning at LTFU. Findings suggest that both cognitive and exposure-based treatments for PTSD have the potential to impact functioning outcomes over a long period of time. (PsycINFO Database Record (c) 2014 APA, all rights reserved).