Adults who experienced child sexual assault are likely to be present in all parts of the health and welfare systems both as clients and as staff. Research studies and accounts by survivors indicate that their experiences of seeking help are often not positive. In failing to acknowledge and deal with the issue of childhood sexual assault for adult clients and to be aware of its correlation with current problems, the health and welfare system reflects the larger society by avoiding knowledge of the impact of violence and abuse on health and well-being. This paper begins with an overview of studies on the prevalence of childhood sexual assault in adult populations and in clinical populations and of literature on the long term consequences of child sexual assault. It goes on to consider, with particular reference to an Australian context, how service providers can respond to the needs of survivors within their own agencies and notes the resources they may need to do this well.