Sexual abuse programs in a large county (El Paso County), a medium-sized county (Boulder County), and a rural county (Moffat County) are described. The El Paso County Department of Social Services developed an adult diversion program for incest offenders; this program has been widely accepted by members of the community, and the agency has been pleased with the program's results. The Boulder Sexual Abuse Program emphasized the investigative process; all investigations were conducted within 1 day, and all family members were interviewed separately. The program took primary responsibility for the investigative, treatment, community, and research components of the project. The Moffat County Department of Social Services launched a community-organized program to educate agencies dealing with sexual abuse families and to educate the community about the program. The program has been in effect for 2 years and continues to treat families successfully. Procedures developed by a county case worker and a detective in the police department in Aurora, Colo., are discussed, and the need to aid a child witness in relating the events surrounding a crime is cited. Research in the field of child sexual abuse is reviewed, and issues that should be addressed by physicians and psychiatrists of child abuse victims are identified. Case studies of abusive families are included, as are 36 references and 2 tables.