We can never eradicate child sexual abuse. But we can reduce it substantially, along with the numbers of women and men, girls and boys who suffer lifelong pain, distress and stigma as a result. There are already many past and current models of good practice, and this book demonstrates some of them. Harnessed to imaginative use of new technologies, which can meet the considerable and growing challenges in the online world, these can significantly reduce a serious crime which inflicts such costs on the whole of society.

A lack of promising models and initiatives, which can be adapted, are thus are not the problem. Rather it is lack of priority and political will, it is complacency, denial or mere embarrassment, a failure of courage, and continuing prejudice against the most vulnerable young people and those who try to support them. It is the size and power of lobbies which support and protect networks of abusers. Their threadbare theories minimising or denying CSA have been swallowed with relief, in preference to confronting realities which at the extremes excite horror, but which more often are mundane, squalid and distressingly widespread.

This is why those of us who have campaigned for decades against CSA have been pressing many of the same arguments for 20 or 30 years. And why there are so often two steps forward, then two back, in sexual abuse work. Time is overdue now to ask policymakers, managers and practitioners in particular why unsustainable things have continued to happen for many decades, and why obvious changes have not.

Pick a few examples from many: why does the criminal justice system still rely so heavily on children disclosing sexual abuse, when we know most children do not? Why have possible indicators of sexual abuse long been written into child protection guidelines if hardly anyone acts on them? Why does the medical model still dominate in mental health when psychiatric wards have always been filled with the victims of child sexual abuse?

The urgency of prevention is one key message of this book, not just from the chapters on children, but at times even more powerfully from the chapters on the consequences for adult survivors. That wide range of mental and physical distress, suicidal feelings, at times addictions and even offending will happen to many of today's and tomorrow's children if preventive action is not taken. But it can be.