Treatment issues in child sexual abuse

Child sexual abuse is a commonly encountered and often emotionally damaging experience, maintained by secrecy and followed by denial after disclosure. Treatment in this field involves both the child and the family in a variety of treatment settings and modalities, often proceeding in parallel. Child developmental considerations dictate that treatment often proceeds in phases. It aims to protect the child from further abuse and the consequences of disclosure, and address the trauma and context of the abuse. Careful planning and co-operation is required by the many professionals working in this stressful area in order to avoid confusion, conflicts, and splits which may mirror relationships in the family. The heterogeneity of the problem is reflected in the fact that treatment cannot be offered in a uniform programme. Legal issues may influence the treatment process. Evaluation of treatment modalities, the identification of protective factors and achieving long-term adjustment in the least detrimental manner offer challenges in this newly developing field.