VATICAN CITY — The unprecedented meeting in Rome on clerical sex abuse in the Roman Catholic Church has drawn participants from around the world. But there is one country with a particularly large stake in what happens at the Vatican this week.

The clergy sex abuse crisis has engulfed the American Catholic Church for months, as leaders contend with growing state and federal investigations, and ordinary Catholics grow weary of waiting for the Vatican to finally resolve the crisis.

The yearning for a response from Pope Francis yielded on Friday a first step to holding bishops accountable for abuse in their dioceses. And it was an American — Cardinal Blase Cupich, the archbishop of Chicago — who presented the proposal. But survivors and law enforcement officials say they doubt that the church’s response so far matches the magnitude of the crisis sweeping the United States.

“Now all they are going to do is set guidelines again?” Mark Belenchia, 63, an abuse survivor and activist in Jackson, Miss., asked on Friday. “That is gibberish as far as I am concerned.”