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There is an ever-increasing effort among metal health professionals from many countries all over the world to exchange information on all aspects of child sexual abuse and it is widely acknowledged that there is a need for knowledge of therapeutic techniques in addressing the many issues involved in such abuse. In the light of this, thee has been considerable interest in the use of art therapy with such a population, among both American and British social workers, psychologists and mental health workers. Based on ten years of clinical work in both the United States and the United Kingdom, this work presents a discussion of therapeutic issues and the use of art therapy with sexually abused children, their families, and both adult and adolescent sex offenders. Although internationally there have been theoretical and cultural differences in approaches to this form of therapy, the author argues that regardless of the theoretical model of choice, methods in art therapy can be effectively adapted to address the many difficulties experienced by abused children and their families.