Child sex abuse refers to sexual contact between a child and an individual in a position of power and authority. The critical aspects of the sexually abusive relationship are the child's powerlessness relative to the perpetrator, the perpetrator's role as the child's caretaker, and the perpetrator's use of that position to exploit the child. Members of therapy groups for adult survivors of child sexual abuse are encouraged to discuss their experiences and feelings resulting from those experiences. In addition, it is appropriate for the group to focus on the present and group interactions that reflect members' mistrust of others and their tendency to isolate themselves. Convening the group, deciding on membership criteria, setting rules and establishing a group culture are critical responsibilities of the leader. In addition, the leader sets an example of appropriate behavior by his or her own conduct. The therapist must constantly monitor group dynamics, to ensure that members' interactions and their responses to one another are facilitating, not undermining, the work of the group. References