The author developed a questionnaire that solicited respondents' information about themselves, their training, and their practice. Respondents also were asked to estimate how often they encountered a list of 15 symptoms among their clients who were adult survivors of child sexual abuse and how often they dealt with clients who reported 15 different types of abuse experiences. The dependent measures were a list of 21 statements that describe a variety of personal reactions. The respondents were 177 mental health professionals who specialized in working with adult survivors of child sexual abuse in Maryland. The completed questionnaires showed that the most common responses to working with adult survivors of child sexual abuse were feelings of being overwhelmed by the work; vulnerability in personal relationships; and rage, sadness, and horror regarding survivors' abuse. Virtually none of the characteristics associated with the therapists themselves, their practice settings, or their caseload influenced their reactions. Subjects' affective reactions did vary by several characteristics associated with the survivors and their victimizations. This was particularly true of survivors diagnosed with multiple personality disorder, those who had been abused beginning at a young age, and survivors presenting themselves for treatment as perpetrators. 7 tables and 29 references