Most of these cases are managed badly because of an inadequate knowledge and understanding of the problem and the reluctance of responsible agencies to become involved or to train staff properly. The basic premises on which case management should rest are that all sexual misuse of children is abusive, that the consequences are serious and longlasting, and that the laws assert the legitimacy of intervention. Other premises are that child sexual abuse is mainly a disorder of power rather than a sexual aberration and that effective intervention can only occur in an authoritative fashion and from a position of power. A problem-oriented model can be readily applied to case management. It should begin with a comprehensive history from the child. Case management should rest on a comprehensive assessment of the case, with the client as the main data source; assessment should encompass the identification of all pertinent problems and flexible intervention and treatment planning. Intervenors must be knowledgeable about the dynamics and mechanics of child sexual abuse, the relevant statutes, elements of validation, and local resources. The essential case management tasks are reporting, investigation, validation, child protection assessment, initial management planning, diagnostic assessment, developing a problem list, formulating a treatment plan, treatment intervention, and monitoring and reassessment. Initial management tasks include the report to the police, a medical examination, decisions regarding family separation, provision of total life-support services, anticipatory guidance, and preparation for court. Details on each task are included.