Thirty-seven families whose children were victims of sexual abuse by a nonfamily member were evaluated and treated during a nine-month period. The average age of the children was 5.36 years. The youngest children were boys, and all the adolescents were girls. A theoretical framework adapted from Ferreira's and Byng-Hall's work was developed to assess and treat child victims of sexual molestation and their families. The format consists of three concepts. First, the trauma from sexual abuse, being outside the realm of usual human experience, creates a breach in the family's adaptive and protective shield, including its shared values and beliefs. Second, the trauma has a "derailing" effect on the child's and family's predicted passage through their world. And third, issues that arise as a consequence of disclosure are intimately tied to preexisting family myths and beliefs. Evaluation, treatment, and short-term outcomes are discussed.

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Evaluating allegations of sexual abuse when the alleged victim is preverbal or minimally verbal and when the alleged perpetrator is a parent or caregiver is one of the most difficult areas in clinical and forensic work. This paper describes a multimodal assessment process and decision-making characteristics that provide a much needed relationship-oriented approach to the problem, especially in light of recent research on the suggestibility of young children. The theoretical and clinical underpinnings for this approach are described. Two cases highlight the assessment process and decision-making characteristics.

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