The pope’s bishop-focused approach carries real risks both for him and the church he leads. While Vatican officials believe it is the right course, it is one in which change may come more slowly than the faithful in some countries ravaged by the abuse crisis have begun to demand.

The Roman Catholic Church has been devastated, and Francis’ legacy threatened, by a cascade of investigations by civil authorities into clerical sexual abuse. There have also been accusations from within his own hierarchy that he covered up the misconduct of a top prelate, Theodore McCarrick, a former cardinal and archbishop of Washington who has been defrocked.

Francis has begun to be unsparing in the language he uses to describe the problem. On Sunday, he compared the abuse of minors to “sacrificing human beings, frequently children, in pagan rites.”

“Consecrated persons, chosen by God to guide souls to salvation, let themselves be dominated by their human frailty or sickness and thus become tools of Satan,” he said. “In abuse, we see the hand of the evil that does not spare even the innocence of children. No explanations suffice for these abuses involving children.”

But high-profile cases involving the negligence by bishops, the abuse of nuns and other misconduct added to the pressure on Francis to do more than just talk.

Francis had sought to tamp down expectations about the Vatican meeting, fostered by some of his own bishops, that the conference would deliver instant remedies to end the scourge. He said the meeting was intended to educate all the bishops on the gravity of the problem of sexual abuse.

Still, at times, the four-day summit did seem like a significant turning point for the church.

Outside the Vatican walls, abuse survivors marched and held rolling news conferences.