Sexual abuse of a child is a special form of trauma. As McCarthy (1986) has reported, it probably begins at a much younger age than the child remembers, so that he or she grows up accepting that this is part of life. It is an important part of the environment which affects the child's psychic development. It usually occurs against the background of a cold, sick or absent mother, and a family in which there is little true affection or understanding. It is often accompanied by physical abuse. There may also be an element of psychological abuse which has been called `soul murder' (Shengold, 1979; Miller,1983; Hall, 1987). But even without this-there will always be confusion in the child's mind, `How CAN he do this to me, when he is a grown-up, respected by the other grown-ups, and should love and protect me?' or, `How can my parent ALLOW him to do this to me?' The mystification is increased if the perpetrator is the one person in the family who has given the child any genuine affection.

This article reports on a study of how members of a slow-open analytic group for women survivors of childhood sexual abuse felt about the helpfulness of the group. The respondents' views and comments are analysed and related to their age, their termination of the group, length of follow-up, number of sessions, final stage of depression and overall change in depression since before the group. The proportion of patients who found the group helpful (46 percent) was significantly higher than those who found it unhelpful (19 percent). The length of time since the group made no difference to satisfaction with the group. Satisfied patients tended not to lapse but to plan their departure from the group. They were more likely than dissatisfied patients to have depressive ratings which had improved considerably since before the group and were now within the normal range. A descriptive account is presented of patients' comments, giving an insight into their views on the group and on the therapists, and their thoughts about themselves in the years afterwards. Their views were, on the whole, positive, though negative views were also clearly stated. A quarter of those responding felt they needed further help. Group analysis appeared to be an effective method of treating women survivors who benefited from their acceptance by the group and the mirroring back to them of their worth. Group therapy diminished their sense of isolation, guilt and shame. It increased their well-being and confidence, enabling them to make positive changes in their lives.

We describe a slow-open analytic group for male survivors of childhood sexual abuse and emphasize the importance of having both a male and a female co-conductor The Beck Depression Inventory and the Spielberger State Anxiety Scale were used as an outcome audit before and after the group and at six months follow-up. The results supported the clinical impression of overall improvement. We record similarities and distinguishing features between this group and a group for women survivors in which three of the authors had previously been engaged as co-conductors.

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This article argues for more research and audit by group psychotherapists in order to inform clinical practice and to influence resource allocation. Problems encountered in research are described. The need for careful planning is emphasized. The choice of outcome measures is discussed and also the choice of research protocol by symptom questionnaire or by change in use of psychiatric services. An account is given of the CORE outcome measure. Reasons for missing data are given and ways are suggested of analysing incomplete data that can provide useful information, using as an example figures from our outcome study on a slow-open group of 94 patients.