Working with sexually abused children and their families requires a number of specific skills, knowledge, and attitudinal changes. Areas which the worker must explore include personal sexuality issues, personal feelings toward child molesters, personal prejudices and taboos, and transference and countertransference issues as they relate to sexually abused children and perpetrators. In treatment, the family must be viewed as a dysfunctional system that cannot be ignored during the different modalities of treatment. Following individual treatment, the worker can move into marital therapy for the spouses, dyadic modalities for the father-daughter or mother-daughter dyad, group therapy for all family members, and finally, family therapy aimed at restructuring family dynamics. During all stages of treatment, the specific dynamics of incestuous families need to be addressed. These include social and emotional isolation, symbiosis, role reversals, and depression. The child victim's behaviors need to be viewed as attempts to cope with anxiety and guilt surrounding the sexual abuse. Methods and treatment plans will have to be adapted to the age of the child, but the major therapeutic goals are to help them relate to others in a nonsexual, caring manner and to relieve feelings of guilt and anxiety. Progress will be erratic and regressions to be expected. However, with competent supervision and consistency, clients can be be helped to move into a healing and healthy life. Included are 19 references. (Author abstract modified)