Marginalized individuals are routinely subjected to oppression-based stress experiences, which are linked to negative mental health outcomes, including posttraumatic stress disorder (PTSD) and a myriad of interrelated psychiatric symptoms that exacerbate distress and complicate effective treatment. However, oppression-based stressors that do not fit Criterion A of PTSD in the Diagnostic and Statistical Manual of Mental Disorders-5 are routinely overlooked or not sufficiently incorporated in PTSD assessment or treatment, limiting clinicians’ ability to be responsive to these concerns and undermining affirming and patient-centered care. Recent scholarship highlights the need for principle-driven application of cognitive processing therapy (CPT) and other culturally responsive adaptations to this protocol to make it more effective for the range of presenting oppression-based stressors and interlocking concerns stemming from them when treating PTSD among marginalized people. In this chapter, we review literature that supports cultural adaptations to CPT and overview strategies for implementing these adaptations in patient-centered ways, particularly racial and ethnic minorities as well as sexual and gender minorities, and illustrate these recommendations in a case example.