Childhood sexual abuse is a problem that leads to serious psychological disturbances evidenced through the symptoms of post-traumatic stress disorder (PTSD). This article discusses the treatment of sexual abuse survivors within a psychoanalytic framework. Different theoretical perspectives including classical Freudian, ego-psychological, object-relational and self-psychological are presented. Several relational treatment models, including feminist psychodynamic approaches, are offered. Themes include the importance of developing a strong therapeutic alliance and analyzing transference responses.