The sexual exploitation of a child by one who has been recognized as a representative of God is a sinister assault on that person's psychosocial and spiritual well-being. Many survivors of such abuse present with a range of symptoms consistent with Posttraumatic Stress Disorder as well as common co-occurring problems, including substance abuse, affective lability, and relational conflicts. Yet there are additional themes, particularly the impact of the abuse and institutional betrayal on the family, profound alteration in individual spirituality, and changes in individual and family religious practices, which differentiate this abuse from other traumas. Understanding the profound and multidimensional effects of clergy perpetrated sexual abuse and the betrayal of trust by religious leaders on individuals, families and communities requires the collective wisdom of many voices. This book brings together the perspectives of survivors, practitioners and scholars to examine this unique form of interpersonal violence from theoretical, clinical and spiritual perspectives with consideration given to future research needs.This book was published as a special issue of the Journal of Child Sex Abuse.