The psychological problems and difficulties experienced by adults who report having been sexually abused in childhood are reviewed. These long-term effects include damage to the victims' emotional reactions and self-perceptions, relationship problems, problems with sexuality and difficulties in social functioning. Common presenting problems of victims of childhood sexual abuse (CSA) are described. Also discussed are the characteristics of incestuous abuse in terms of the victim, the abusive relationship and its termination; the contributions of the various aspects of CSA to the psychological impact of such abuse; and psychodynamic explanations of the development of long-term effects. The bulk of the published material regarding the long-term effects of CSA refers to female victims only, and this 'bias' is reflected in the review.

This review is concerned with the individual and group treatment of clients who present with a history of sexual abuse in childhood. Almost all of the literature regarding the individual treatment of these clients is based on clinical reports; very little is experimentally based. Most of the reports of group treatment are of a similar nature, although some outcome research data are included. The clinical consensus, in terms of the issues, stages, goals and techniques of therapy, is described. In addition, an overview is provided of the identification of clients who may have a history of CSA, which includes guidelines for assisting disclosure. Finally, the issues raised for therapists in treating these clients are addressed. Much of the material reviewed in this article refers to the treatment of female, and in particular incestuously abused, victims; at the time of writing, very little information was available regarding the treatment of male victims.

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A community program for effective control of alcoholism utilizing obligatory administration of disulfiram (Antabuse) is described. The results over a three-and-one-half-year study period are a reduced rate of rehospitalization, shorter duration of hospitalization in the event of readmission, and reduced morbidity.