This discussion of key elements involved in the creation and maintenance of a rural coordinated child sexual abuse service system focuses on the special context of services that operate in rural communities, steps needed to build an effective community infrastructure, and the importance of linking investigative and treatment services. The special need for early response or crisis intervention services is also considered. An evaluation of the coordinated child sexual abuse services focuses participating communities, agencies, and clients; staff resources and their deployment; and indicators of the impact of coordinated services. The final section reflects on the development of professional attitudes related to child sexual abuse and offers some conclusions and recommendations. Chapter tables and figures, and 118 references