This case study focuses on the clinician’s experience of fear during the in-home treatment of in-home incest. The experience of in-home therapy does not provide the same sense of safety that a clinician usual feels in an office or agency setting. The clinician’s inability to focus during treatment as well as her inability to form a working alliance with her client’s family presented as challenges to treatment. Social workers may experience vicarious trauma in cases of sexual abuse, especially when they come in contact with a perpetrator who makes them feel powerless. Here, one can find holes in the system of social work that leave both clients and clinicians feeling unsafe.