South African child sexual abuse workers active in low-income communities bear witness to stories of sexual and physical abuse, neglect, pervasive deprivation, and violence. North American, British, and European workers' emotional experiences have been captured in the literature, and a gap remains to be filled by those of their South African colleagues. This research aims to focus on the emotional experiences of social workers who engage therapeutically with sexually abused children in the Helderberg basin of the Western Cape, and resonate in some way with readers working in situations of poverty and trauma in other parts of the world. This study employed an explorative inductive research method, and followed a critical realist and contextual constructionist approach. Multiple-case study data collection took place by means of semi-structured interviews with social workers who engage therapeutically with sexually abused children. Data were examined by means of thematic analysis, and psychoanalytic theory was employed to analyse defences that surfaced during interviews. There were similarities in emotional experiences between South African participants and their abovementioned counterparts. The research also identified salient features of working with child sexual abuse in South Africa. The emotional experiences of doing such work, coupled with participants' ways of managing sexually abused children's material, gave rise to possible vicarious traumatisation symptoms and allowed for a psychoanalytic understanding to be put forward. The research also reports on useful measures that might enable individuals to continue interventions. To enable ongoing effective therapeutic engagement, social workers should have access to opportunities for acknowledging countertransferences and processing dynamic material defended against. The research contributes to knowledge of working in South Africa by exploring the emotional experiences of those who help sexually abused children daily, and by investigating the psychological impact prolonged therapeutic engagement has on workers active in Western Cape low-income communities.