Although there is no clear profile of a sexually abused child, the research indicates that there are symptoms that are frequently present in young survivors. These include anxiety/numbing; hypersensitivity; depression; alcohol or drug use; problem sexual behaviors; and aggression, particularly among male victims. Therapists have identified three stages in working with survivors of childhood abuse: establishing the adolescent's safety, both in his/her home situation and with the therapist; processing traumatic material; and fostering social reconnection. Helping youth explore past abuse is specialized work that requires significant education, training, and expertise. There are some key principles for working with youth who have been sexually abused. First, the therapist must remain neutral in early interactions with abused children; overt attention and concern may be interpreted as seduction and stimulate stress. Second, assist youth in understanding that they are not to blame for the sexual abuse. Third, be nonjudgmental; youth do not respond well to adults who tell them what to do or who are constantly critical. Fourth, focus on telling youth what they are doing that is good. Other treatment principles are to help youth view their feelings without judgment; avoid power struggles; acknowledge their need to be defensive; recognize their risk for further victimization; be aware of the youth's need to be in control; use therapeutic approaches other than talk therapy; help youth change behaviors that cause negative reactions in others; appreciate that children sustain injuries differently; help youth process traumatic material; work with youth to assimilate the information and feelings associated with their prior abuse; work with youth to develop impulse control; and accept that each child is different from every other child. The paper concludes with a discussion of the selection of a therapist.