ABSTRACT
The consequences of child abuse and child sexual abuse are equally protean, and appear to be influenced by the environment and the availability of good experiences with other parents or carers. Abused children often have to contend with a host of other difficulties as well; child disability or ill health, parenting problems, parental history of being a child victim of abuse, parental mental ill health or emotional impairment, parental substance misuse, domestic violence, poverty. Sexual abuse may be classified as non-contact or contact, with contact sexual abuse divided into penetrative and non-penetrative forms. Associated with child sexual abuse are high rates of physical abuse of children, exposure to domestic violence, and verbal abuse. Historically, learning disability has been considered an exclusion criterion for talking therapies generally and psychodynamic psychotherapy in particular. Psychotherapy, informed by trauma knowledge, revealed that this was hypervigilance.
