A psychiatric referral of a sexually abused child should address five areas: (1) are either the parents or the child suffering from an emotional disorder; (2) has an appropriate immediate intervention been made to protect the child from further trauma; (3) what is the likelihood of a recurrence of the situation if the family remains intact; (4) are there any means of confirming the occurrence or extent of the sexual experience; and (5) are there psychological considerations that are important to the long-term planning for the child's care. A primary consideration in conducting the evaluation is to provide a setting in which the child can feel safe. Assessment of the child's developmental age is important, as is observing the child's differential response to being with each parent. Intelligence and projective tests may be helpful. An important consideration in assessing incestuous families is the issue of family loyalty. This evaluation must explore parental pathology, since several pathological characteristics have been ascribed to parents who permit overt incestuous relationships to develop. The psychiatrist must establish whether the child and parents need therapy and help them deal with the immediate reactions of guilt and intense anger. Two factors are crucial in assessing whether future sexual abuse may occur: documenting the family's history and evaluating the parents' personalities and motivation and capacity for change. While the consequences of sexual abuse are not clear, it is known that isolated incidents are less damaging than abuse occurring over a long period of time. Finally, a supportive team approach is an effective vehicle for helping these children and families. The paper includes 18 references.