The British Journal of Psychiatry

Abstract

BACKGROUND This article aims to inform clinicians of current thinking in the area of victims and perpetrators of child sexual abuse. It covers prevalence data as well as identification, effects and interventions with victims, and also characteristics, assessment and treatment of perpetrators.

METHOD The review is based on manual searches and the authors' own clinical experience.

RESULTS All clinicians should be aware of signs and symptoms that raise the possibility that someone has been or is being sexually abused, and also of the possibilities of abuse of boys and of women as abusers. Methods of intervening are discussed, both in relation to victims and perpetrators. The importance of thoroughness when assessing perpetrators is emphasised because of their tendency to deny and/or minimise their offending. The demands of this work are underlined in a section on the necessary qualifications and characteristics of therapists working in this area.

CONCLUSIONS Despite the lack of agreement in definitions and outcome measures used in research there are some positive findings in relation to clinical efficacy. In particular, the need for long-term treatment with those offenders who are more seriously deviant has been supported by recent research. There is a need for continuing attempts to standardise definitions and measures to aid realistic comparison of research results.