To design and provide responsive and effective sexual assault services, it is important to grasp the varied and complex impact of sexual violence. This paper will consider the practices of rape crisis centers and coalitions as they act, engage, and remember with adult survivors of child sexual abuse. It will discuss the incidence and dynamics of child sexual abuse, trauma-informed services, and strategies in crisis intervention, counseling, holistic healing, and advocacy for adult survivors of child sexual abuse. These strong, resilient, and creative survivors have unique needs that must be met with knowledgeable, specialized responses.