Objective: This is a randomized controlled trial (NCT03056157) of an enhanced adaptive disclosure (AD) psychotherapy compared to present-centered therapy (PCT; each 12 sessions) in 174 veterans with posttraumatic stress disorder (PTSD) related to traumatic loss (TL) and moral injury (MI). AD employs different strategies for different trauma types. AD-Enhanced (AD-E) uses letter writing (e.g., to the deceased), loving-kindness meditation, and bolstered homework to facilitate improved functioning to repair TL and MI-related trauma. Method: The primary outcomes were the Sheehan Disability Scale (SDS), evaluated at baseline, throughout treatment, and at 3- and 6-month follow-ups (Brief Inventory of Psychosocial Functioning was also administered), the Clinician-Administered PTSD Scale (CAPS-5), the Dimensions of Anger Reactions, the Revised Conflict Tactics Scale, and the Quick Drinking Screen. Results: There were statistically significant between-group differences on two outcomes: The intent-to-treat (ITT) mixed-model analysis of SDS scores indicated greater improvement from baseline to posttreatment in the AD-E group (d = 2.97) compared to the PCT group, d = 1.86; −2.36, 95% CI [−3.92, −0.77], t(1,510) = −2.92, p <.001, d = 0.15. Twenty-one percent more AD-E cases made clinically significant changes on the SDS than PCT cases. From baseline to posttreatment, AD-E was also more efficacious on the CAPS-5 (d = 0.39). These differential effects did not persist at follow-up intervals. Conclusion: This was the first psychotherapy of veterans with TL/MI-related PTSD to show superiority relative to PCT with respect to functioning and PTSD, although the differential effect sizes were small to medium and not maintained at follow-up. What is the public health significance of this article?: Warzone-related posttraumatic stress disorder (PTSD) is a highly multifarious clinical problem, partly because combat trauma can entail extensive traumatic loss and moral injury, either from personal transgressive acts or bearing witness to or being victimized by others' transgressions. Adaptive disclosure (AD) is an evidence-based psychotherapy that was designed to help service members and veterans with war-related PTSD. We applied lessons learned from previous research on AD and enhanced AD to better help war veterans with loss- and moral-injury-related PTSD. We compared the enhanced AD (AD-E) with present-centered therapy (PCT) in a clinical trial of 174 veterans with PTSD. We found AD-E to be superior to PCT with respect to helping veterans function better and in terms of reducing PTSD symptom burden. [ABSTRACT FROM AUTHOR]