Summary: Saywitz KJ, Mannarino AP, Berliner L, and Cohen JA. "Treatment for sexually abused children and adolescents," American Psychologist vol 55(9): 1040-1049. 2000.

This review article examines research on the effects of sexual abuse on children and the various treatments for abused children and their families. It also discusses gaps in the literature and raises issues that policy makers, researchers, and clinicians should consider in addressing the needs of this population.

The impact of sexual abuse varies from child to child; some children show no negative effects, while others are deeply scarred. Further, child sexual abuse can cause psychiatric and other problems in adulthood, but this is not true for every survivor of sexual abuse. The effects of the abuse are linked to a host of factors. These include not just aspects of the abuse itself, but the child's personality and temperament, family functioning, preexisting conditions-such as prior depression or anxiety in the child-and events that are secondary to the abuse, like divorce or placement in foster care.

While many children who have been victimized by sexual abuse will get better over time without any treatment, research indicates that interventions for these children are more effective than the passage of time. Treatment is most effective when it is targeted to the symptoms of a particular child. In general, however, behavioral therapies appear to be the most valuable treatment overall. Different teams of researchers have found good outcome with cognitive-behavioral therapy for anxiety, coping skills training for depression, and parent management training. Continuing research may show that other types of treatments-like victim groups, family therapy, and eye-movement desensitization and reprocessing-are best used in specific situations.