This overview examines the nature, prevalence, and impact of child sexual abuse. Associations and potential risk factors are identified, thus showing that child sexual abuse is not randomly distributed through the population. Finally, we discuss the ways in which clinicians and researchers have conceptualised the impact of child sexual abuse. A social and developmental model is outlined.

A great deal is at stake for children who are sexually abused; not only in the here-and-now, but also the possibility of long-term blight in their future relationships and mental health. This puts a heavy responsibility on the professionals who are required to investigate, and further assess for treatment or other interventions, cases where sexual maltreatment is confirmed or suspected. The multidimensional, multicomponent elements that make up an assessment (in particular, the ASPIRE process) are described here in terms of their practical and theoretical implications. The difficulties of finding reliable and valid methods (be they interviews or psychometric instruments) for this onerous task are discussed.

Child sexual abuse is a highly prevalent problem that frequently occasions the onset of posttraumatic stress disorder in the victimised youngster. Given the success of cognitive-behavioral interventions with adult trauma victims, it has been suggested that this treatment approach be applied to sexually abused children. We review the empirical support for the efficacy and acceptability of cognitive-behavioral strategies in the treatment of sexually abused children. Several clinical practice and research issues are also noted.

This article describes the application of cognitive behavioural therapy to three sexually abused young people. We emphasise developmental influences and the nuances of the therapeutic approach. An exposure-based treatment approach was used with the youths. A multimodal assessment evaluation was conducted at pretreatment and posttreatment, and at a 3-month follow-up. Results on outcome measures indicated a positive therapeutic effect for the youths.

In this brief commentary, issues associated with the definition, assessment, treatment and prevention of Child Sexual Abuse (CSA) are highlighted. It is concluded that much has been learned regarding CSA in recent years and there is reason to hope that we will do better in the future. Studies presented in this special issue document some of these advances. Still, CSA continues to occur with alarming frequency and our treatment programs are only beginning to address the many issues associated with such traumatic experiences. Furthermore, developmental issues have been largely ignored and prevention of CSA remains an illusory goal. We can, and must, do better.