349 Journal of Child & Adolescent Trauma, 1:349–364, 2008 Copyright © 2008 by The Haworth Press. All rights reserved. ISSN: 1936-1521 print / 1536-153X online DOI: 10.1080/19361520802505891 WCAT 1936-1521 1536-153X Journal of Child & Adolescent Trauma, Vol. 1, No. 4, October 2008: pp. 1–32 Journal of Child & Adolescent Trauma Cultural Understandings of Child Sexual Abuse from Aid Workers and Parents at the Guatemala City Dump Community Cultural Understandings of Child Sexual Abuse K. M. Putman et al. KATHARINE M. PUTMAN, 1 JEANETTE I. LANTZ, 1 AMY A. POTTS, 1 AUTUMN M. GALLEGOS, 1 SOFIA HERRERA, 1 CYNTHIA B. ERIKSSON, 1 MARK STEENWYK, 2 AND DAVID W. FOY 3 1 School of Psychology, Fuller Theological Seminary 2 Wabash Valley Hospital, West Lafayette, IN 3 Graduate School of Education and Psychology, Pepperdine University This study documents Guatemalan aid workers’ and parents’ definitions of child sexual abuse (CSA), understandings of indicators and etiology of CSA, and training needs. Focus groups were conducted with aid workers and parents living in the Guate- mala City dump. Conceptualizations of CSA included rape, contact molestation, and noncontact molestation. Aid workers and parents identified emotional and behavioral symptoms as indicators of CSA. Parents reported systemic understandings of CSA, such as poverty and the cycle of violence. Parents requested education on positive parenting; aid workers wanted training about working effectively with the legal system. Prevention and intervention implications are discussed. Keywords child sexual abuse, Central America, definitions of CSA, symptoms of CSA, cultural understandings of CSA Introduction Rates of violence, including family violence and child maltreatment, are high in post- civil-war Guatemala, and child sexual abuse (CSA) is an area of particular concern. Guatemala recently held its first Congress Against Child Maltreatment in 2007, which concluded that child maltreatment, including CSA, has become a public health problem and estimated that about 7 out of 10 children in Guatemala are victims of maltreatment, including CSA (Palma, 2007). It is estimated by the Commission Against Child Maltreatment (CONACMI) that in the year 2006 there were a total of 335 female children and 441 male children who were abused sexually (La Nana Agency News, 2007). However, a nongovernmental organization (NGO) that legally represents cases of children who have been sexually abused estimates that 90% of domestic violence and rape cases in Guatemala go unreported (International Justice Mission, 2008). NGOs that serve Guatemalan fami- lies and children are challenged to develop programming to prevent CSA in a country that has varied cultural and ethnic groups who have a history of war exposure and live within Submitted May 16, 2007; revised April 2, 2008; accepted September 23, 2008. Address correspondence to Katharine M. Putman, School of Psychology, Fuller Theological Seminary, 180 N. Oakland Avenue, Pasadena, CA 91101. E-mail: kputman@fuller.edu