Childhood sexual assault (CSA) is a prevalent societal issue that can have long-term negative effects on the survivor. Adult survivors of CSA frequently seek therapy from mental health professionals. However, mental health professionals are not necessarily aware of, or trained, in working with CSA. This lack of knowledge can result in considerable negative consequences for the survivor. This study aimed to explore the experiences and needs of CSA survivors who engage in therapy, and identify helpful and unhelpful mental health professional practice. This was achieved qualitatively, with data gathered by a semi-structured interviewing style and evaluated via thematic analysis, guided by a social constructionist epistemology. Three survivors of CSA, who had previously engaged in therapy with a mental health professional, as well as 13 mental health professionals, participated in the current study. This study found that despite mental health professionals’ lack of education and training about CSA, they did not need to be particularly knowledgeable to be considered effective. Specifically, the ability to listen was crucial, as this indicated the professional was comfortable with the disclosure. However, an inability to listen was commonly cited and demonstrated to the survivor in a variety of ways. The issue of referral upon disclosure of CSA was identified as problematic, as well as considered a professional ethical dilemma. Whilst mental health professionals are bound by a professional responsibility of working within their realm of expertise, it could also be perceived as negative in terms of the messages it sent to the survivor. An ideal solution was suggested to circumvent this problem. The implications of mental health professional practice on CSA survivor wellbeing is discussed.