Dr. Thomas Gildea, a psychologist who runs a general practice in Newark, Del., said perpetrators of child sexual abuse often are highly adept at getting children not to talk.

“There’s a lot of manipulation of the child to try to get them to believe that somehow, even though this feels wrong, saying something about it is even worse,” said Gildea, who estimated a quarter of his adult clients over the past 25 years were sexually abused as children.

The abuse shatters their self-esteem and their trust in other people, he said.

“It takes people a long time to get strong enough to be able to trust that someone they tell is going to believe them,” he said. “And often the case is that they’re told no, this didn’t happen.”

Religion makes telling harder

The powerful force of religion in the lives of people abused by clergy often makes it even more difficult to come forward, especially to devout family members.

“What a lot of survivors are afraid of is that if their parents believe them, it’s going to be devastating to them, or that their parents are going to say, ‘That could never happen, a priest could never do that,’ ” said Gildea.