Those were some of the questions asked in a recent interview with Dr. Suzanne M. Sgroi, executive director of the New England Clinical Associates in West Hartford, Conn., a private practice that focuses on helping victims of trauma, including victims of sexual abuse, families and abusers as well.

Sgroi, who is Catholic, is the author/editor of several books on child sex abuse, including the 1981 "Handbook of Clinical Intervention in Child Sexual Abuse," which addresses the conceptual framework of coping with sexual abuse of children. Sgroi is currently working on a new book that addresses the same topic. She also consults, teaches and provides treatment in matters of child abuse.

"There are no short and easy answers," she said. "I could say in 1980 that we needed to have a better response ... I can say the same thing in 2002. We've made improvements, but we need to continue to work on this."

What are the improvements since the 1980s?

"An increase in the number of reported cases," Sgroi said. "A vastly improved response in terms of 24-hour availability of child protective services. Twenty-four hour availability of the emergency placement (of children) - to a much greater extent than was true in the 1980s."

Other improvements over the last 20 years, she said, include a shift in public awareness of sexual abuse of children as well as the initiative to prosecute suspected abusers.

In Missouri, the original statute on child abuse and neglect was passed in 1975, according to Jerrie Jacobs-Kenner, deputy director of the Missouri Division of Family Services. The original law included a clause on mandated reporting and the establishment of a hotline to report cases of abuse and neglect. Those members of the archdiocese required to make such reports began doing so that year.

In 1990, the archdiocese began publishing a handbook on policies, procedures and guidelines on child abuse. Archbishop Justin Rigali has said that the archdiocese, when there is an allegation of abuse of someone who is currently a minor, has contacted and will in the future continue to report the allegations to the Missouri Division of Family Services for further investigation and possible criminal charges.

In the "Handbook of Clinical Intervention in Child Sexual Abuse," Sgroi addresses power as a reason why an adult sexually abuses a child. Sgroi said her attitude on that description has expanded since she wrote that in 1981.

"I used to think about it in a very literal way, about the person being in control of the child and being in control of the situation," Sgroi said. Now she feels that the abuser feels comfort because of the non-intimidating nature of a child compared to another adult.

"I think it's at least as much a sense of being in control of yourself and not feeling as if you have a partner who can challenge and intimidate you and be in charge of you," Sgroi said.

However, she noted that each case of child sexual abuse does not have a black-or-white answer. "I have an expanded view of it in comparison to before."

Sgroi believes society has gone from one extreme to another when it comes to handling cases of child sexual abuse.

"We've gone from one extreme of lack of awareness and disbelief and minimization to a kind of hyper-reactive 'Oh my God, this is the worst thing in the world.' Which is where I think we are now."

Neither extreme is good for the victim or the community, she noted. "We don't do kids any good by communicating to them, 'Something unspeakably bad has happened to you, and you're damaged for life.' I think that's just a horrible message to give."

So how do we find a middle ground?

"Sexual abuse of children is a bad thing," Sgroi reiterated. "It shouldn't happen. We should be doing things to protect children. We should be fostering a climate in which if children are victimized, they can speak out."

Instead of focusing on the great evil of child sexual abuse, we should instead focus on the child's strength and resiliency, Sgroi said, and that "this is something a person can cope with and get through. It doesn't have to be a life-changing or life-shattering experience."

As for the issue of connecting abusive priests to their requirement of celibacy, Sgroi said, "I don't buy it. I think that it's very far-fetched."

First and foremost, this claim ignores clergy abuse in other religious denominations where celibacy isn't a requirement, she noted.

"I also think it's important to be aware that when we are talking about adults who sexually abuse children, we are talking about a large and highly diverse population," Sgroi said. "It's not a very good idea to make sweeping generalizations."

Adults who sexually abuse children can be defined in one of two general categories, she noted. The first is a person who has had a "lifelong sexual orientation to children, and that's really their preference." These are the people Sgroi believes deserve to be called pedophiles. While the number of pedophiles is small, she said, they are most notable for their many victims.

The majority of adults who sexually abuse children are not preferentially attracted to children, she said. "They are people who are preferentially attracted to adults, and they turn to children for a variety of reasons. And they usually have much smaller numbers of victims."

Treatment for pedophiles is difficult, she said. The second group, however, "are people who for the most part can be successfully treated, and with the appropriate kinds of safeguards, are OK to be in society."

Sgroi said in cases of sexual abuse by clergy, it is not feasible to let these priests remain in a ministry that has access to children, "simply because the access is so great. By the same token, if the person who sexually abused a child was a layperson who happened to be an elementary school teacher or a principal, I would say this is probably somebody who needs to do a career change."

When it comes to handling cases of clergy sex abuse, Sgroi made clear the difference between the response of the Church and a legal response to their abusive behavior.

"If we're punishing laypeople for sexually abusing children from positions of trust, we should be even handed about how we do this, and we should do something comparable for priests," Sgroi said.

The Church should look at developing a better plan for handling cases of abuse by clergy and other religious, she stressed. This model, she noted, is separate from the responsibility to punish those who commit the crime.