Abstract: As a multinational group of clinicians and researchers focused on including family in veterans’ and military members’ care for posttraumatic stress disorder (PTSD), we wrote this commentary to raise specific considerations related to the revised Department of Veterans Affairs (VA)/Department of Defense (DoD) Clinical Practice Guideline (CPG) for PTSD and Acute Stress Disorder regarding couple- and family-based treatment. We discuss concerns regarding: (a) insufficient guidance about the role of intimate partners and families, (b) issues with using and defining specific treatments in the CPG evidence rubric, and (c) algorithm and recommendations for guiding patient preference toward individual interventions. Interpersonal relationship factors are among the most potent predictors of who goes on to have PTSD, initiates treatment, completes treatment, and responds to frontline evidence-based PTSD treatment, yet the CPG offers little guidance about their role in the treatment and assessment of PTSD. To parallel data on medications, it was decided with this revision to consider all psychotherapy packages (e.g., prolonged exposure) separately versus combining them in classes of psychotherapies (e.g., trauma-focused psychotherapies). The CPG rightly emphasizes the importance of honoring patient preferences to improve engagement, adherence, and outcomes, and patient preferences and values were identified as one of the four domains used to inform the strength of each recommendation. We propose that when there are quality data for an individual's preferred treatment, honoring their preference is actually more important than insisting they try one of the limited number of CPG-recommended treatments first. We recommend that patients be routinely asked whether they want their loved ones involved in their care. If so, a family-inclusive therapy might be the optimal choice if that therapy has demonstrated evidence of safety and efficacy in at least one RCT as well as effects on par with CPG-recommended frontline individual treatments for PTSD.