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Effects of child sexual abuse Counsellors have a very important role to play in limiting the short-term and long term effect of child sexual abuse. These are as below: i) Feeling of powerlessness; ii) Anger; iii) Anxiety; iv) Fear; v) Phobias; vi) Nightmares; vii) Difficulty concentrating; viii) Flashbacks of the events; ix) Fear of confronting the offender x) Loss of self esteem and confidence xi) Feelings of guilt 41 If childhood sexual abuse is not treated, long-term symptoms can go on through adulthood. These may include: i) PTSD and anxiety ii) Depression and thoughts of suicide iii) Sexual anxiety and disorders, including having too many or unsafe sexual partners iv) Difficulty setting safe limits with others (e.g., saying no to people) and relationship problems v) Poor body image and low self-esteem vi) Unhealthy behaviours, such as alcohol, drugs, self-harm, or eating problems. These behaviours are often used to try to hide painful emotions related to the abuse vii) Issues in maintaining relationships