Child sex abuse changed with the advent of the Internet (Quayle, 2016). Suddenly, a predator no longer needs to physically gain access to a child to abuse the child. All the person needs is a device that can connect to the Internet (Binford et al., 2015). Once online, predators can choose whether to start trafficking in child sex abuse material (CSAM) or attempt to lure or groom new potential victims for either in-person or digital crimes or both, often by posing as another child to gain trust (Mitchell et al., 2010).

Some people view digital crimes as lesser crimes or even victimless crimes, usually due to a lack of knowledge and understanding about how such crimes unfold and the impact on victims and survivors (Hamilton-Giachritsis et al., 2021). For example, some people misperceive trafficking in CSAM to be a “victimless” crime, but many survivors strongly disagree (Canadian Centre for Child Protection (CCCP), 2017). Indeed, some survivors report that the trafficking in their CSAM is worse than the original hands-on abuse (Binford et al., 2015). Whereas the physical sex abuse usually ends eventually, the online abuse can last the rest of the victims’ lives, creating an endless cycle of complex trauma implicating not only the original hands-on abuser, but also the countless individuals worldwide who perpetuate the abuse without ever touching the victim physically (Von Weiler et al., 2010).

Indeed, in the modern world of child sex abuse, it is increasingly common for there not to be any physical contact during the abuse, as is often seen in modern livestreaming of children by predators (Drejer et al., 2023). Even in the case of physical child sex abuse, research suggests that most, if not all, cases of child sex abuse today have at least one technological element (Palmer, 2014). However, because frontline professionals are usually older and less familiar with digital environments, they lack the confidence and capacity necessary to address fully and effectively the increasingly common hybrid nature of modern child sex abuse (Hamilton-Giachritsis et al., 2021).

With so many more points of access to potential child victims by predators and so many more forms of child sex abuse and exploitation, law enforcement is challenged to triage investigations. They often prioritize which cases to investigate by identifying those cases where children are more likely to be physically in immediate danger (Cullen et al., 2020), marginalizing technology-facilitated child sex abuse victims, even though frontline professionals acknowledge the impact on victims might be the same (Hamilton-Giachritsis et al., 2021). Even when investigators prioritize technology-facilitated child sex abuse, the borderless nature of the Internet is such that the predator and the child are often not in the same location and the coordination of law enforcement across multiple jurisdictions is required (Terre Des Hommes, 2013). Thus, these cases are especially difficult to investigate, prosecute, and ensure access to the legal remedies and therapeutic supports victims and survivors are legally entitled to receive (Binford, 2015).

Moreover, privacy protections on many technology platforms and a lack of cooperation by some technology companies—even when served with subpoenas—make it difficult for law enforcement to investigate child maltreatment online (Cullen et al., 2020), compelling even greater reliance on children to disclose. Recent research suggests that children are hesitant to disclose when they are being lured or even abused online, and that even when they do disclose, many are not believed (CCCP, 2017). This constellation of challenges highlights the need to ensure that frontline professionals are well-prepared to combat the prevalence and changing nature of child sex abuse in the twenty-first century.

What Frontline Professionals Need

An increasing number of studies in recent years have surveyed behavioral health providers, law enforcement, prosecutors, social workers, and educators to determine what they need in order to successfully protect and support children subject to technology-facilitated child abuse. The research shows that frontline professionals frequently feel frustrated and ineffective in their professional roles because of the unique nature of modern child sex abuse (von Weiler et al., 2010).

Over a decade ago, a study of German therapeutic professionals found that they were ill-equipped to provide effective treatments for victims of CSAM due to the complexity of the experience resulting from the permanency of their abuse material being trafficked online. Victims and survivors of CSAM have “a higher susceptibility to post-traumatic stress disorder, depression, and psychoses” (von Weiler et al., 2010). Indeed, two-thirds of therapeutic professionals working with this population felt “deep feelings of hopelessness” and one-third considered healing in this situation to be impossible (von Weiler et al., 2010). Many therapeutic professionals experienced secondary trauma because of their inability to treat this population effectively (von Weiler et al., 2010).

Little has changed in the intervening years. A recent study of mental health providers in Canada indicated that the overwhelming majority (83 percent) worked with a client impacted by grooming, luring, sex abuse, or CSAM distribution in the previous year. However, the participants reported more training, confidence, and fewer barriers with regard to identifying and responding to contact sex abuse compared to the other crimes. Similar to the German therapeutic professionals in the von Weiler study a decade earlier, Canadian mental healthcare providers generally lacked confidence in their ability to consistently recognize and treat online child sex abuse, as well as to determine whether digital tools were being used to lure or groom their clients (Dimitropoulos et al., 2022). The researchers in Canada indicated that more training is still needed for therapeutic professionals to be able to effectively serve this rapidly growing population and that proven therapeutic frameworks need to be researched, developed, and widely deployed (Dimitropoulos et al., 2022).

A study of frontline professionals (child protection, law enforcement, education, and therapeutic) conducted around the same time in the UK made similar findings (Hamilton-Giachritsis et al., 2021). The authors warned that this gap in knowledge among frontline professionals can lead to professionals experiencing feelings of failure or even blaming victims for their abuse (Hamilton-Giachritsis et al., 2021). Moreover, the UK researchers found that many frontline professionals took online or technology-facilitated child sex abuse less seriously than contact abuse (Hamilton-Giachritsis et al., 2021). Thus, it was recommended that new language needs to be used to describe the nature of these crimes and that policies, practices, and legislation need to be implemented to provide effective evidence-based support to victims and survivors of technology-facilitated sex abuse and to end the victim-blaming that appears to result from a lack of understanding among some frontline professionals (Hamilton-Giachritsis et al., 2021).

Similar trends were seen among Canadian educational professionals surveyed. A significant percentage reported working in the previous year with a student affected by sex abuse (28 percent), grooming (25 percent), luring (17 percent), or CSAM (14 percent) (Lindenbach et al., 2021). However, only a minority reported having received training and being confident in their ability to recognize when the Internet or social media was being used to exploit or abuse their student (Lindenbach et al., 2021). Since fear of making an incorrect report was the leading reason why an educational professional did not report a concern of child sexual exploitation or abuse (Lindenbach et al., 2021), it is critical that educational professionals join other frontline professionals in receiving training to ensure they understand the changing digital landscape that children commonly navigate and the role that technology is increasingly playing in facilitating child sex abuse and exploitation.

Researchers who studied the confidence of Canadian Child Advocacy Center staff in responding to common forms of modern child sex abuse (grooming, luring, CSAM, and contact sex abuse) found that the majority of participants (54 percent) had dealt with cases that involved these crimes (Lindenbach et al., 2022). Moreover, most participants reported they had received formal training in these areas and had high levels of confidence in their ability to recognize signs of grooming and luring, 95 and 94 percent, respectively (Lindenbach et al., 2022). By contrast, a study of multidisciplinary professionals in the UK found that only 31 percent had received formal training in assisting children affected by online exploitation; not surprisingly, only 34 percent of that same population were confident in their ability to assess whether a child was at risk for online exploitation (Bond & Dogaru, 2019). It would seem that if we want frontline professionals to be able to respond to the changing nature of child sex abuse, we need to provide them with the relevant training to enable them to do so with confidence.

Frontline professionals in the USA have similarly reported a need for heightened levels of support due to the unique nature of combatting child abuse online. Specifically, law enforcement and prosecutors in that country indicated that investigating and prosecuting CSAM were having a negative impact on their mental health and well-being (Cullen et al., 2020). Part of the secondary trauma was attributable to the brutal nature of the content, but law enforcement also reported feelings of frustration and ineffectiveness due to their inability to keep up with rapidly changing technology and a lack of cooperation from many technology companies (Cullen et al., 2020). Seeing more and more perpetrators move to the Dark Web is especially discouraging to law enforcement because the security and encryption provided protects the offenders’ anonymity and makes it difficult for law enforcement to identify perpetrators and feel successful in their work (Cullen et al., 2020).

In addition to frustration with their inability to keep up with changing technologies and a lack of cooperation from technology companies, law enforcement, as well as prosecutors in the US study, cited a frustration with outdated laws, many written in the 1970s and 1980s before the Internet was widely available (Cullen et al., 2020). Another contributor to their feelings of frustration was a lack of resources with one participant reporting that even when they have all of the images and all of the disclosures, the investigations cannot move forward because of a lack of resources, especially on the technological side of investigations (Cullen et al., 2020).

What works? Two areas that US law enforcement and prosecutors identified as contributing to their success in this field are multi-disciplinary teams and—similar to the frontline professionals in other countries—more training (Cullen et al., 2020). Thus, they ask for more of both in addition to more therapeutic support for frontline professionals, cooperation from technology companies, more resources (personnel, funds, and technological), and updated laws (Cullen et al., 2020).


The rapidity of technological change in recent decades has created a monumental knowledge gap that prevents many frontline providers from meeting the needs of the victims and survivors of modern forms of child sex abuse. While frontline providers continue to possess a relatively high level of confidence in their ability to address contact child sex abuse, many have not received training in technology-facilitated abuse. This lacuna is especially problematic as many—if not most—instances of child sex abuse today contain at least one technology component. However, due to a lack of training, policies, and protocol, these aspects of the abuse might pass unidentified and, thus, are never prosecuted, contained, or therapeutically treated as part of the survivor’s complex trauma. Even worse, some of the research suggests that a lack of understanding of the nature of technology-facilitated child sex abuse may lead to blaming the victim for their abuse. Thus, all frontline professionals should be provided with robust training to better prepare them for responding to the unique nature of modern child sex abuse.

But training alone is not enough. This growing body of research makes clear that much more needs to be done if we expect our frontline professionals to be successful in combatting child abuse in digital spaces. This includes conducting research to identify evidence-based therapeutic interventions that can address the unique needs of a generation whose abuse might last a lifetime; the modernization of laws to prevent perpetrators from accessing and exploiting children as well as to facilitate the investigation and just prosecution (including victim remedies) of criminals who gain access to the world’s children; and, of course, robust mental health and wellness supports for our frontline professionals who, despite overwhelming challenges, continue to show up for work every day and do the best they can with the little they have been given as they strive to care for and protect the world’s children in a new age of abuse and exploitation.

As the Kempe Center for the Prevention and Treatment of Child Abuse and Neglect celebrates its 50th anniversary, it is, of course, appropriate to reflect on the past 50 years and to take pride in the leadership that Kempe has consistently and courageously provided to ensure that child abuse is a publicly known and addressed phenomenon through clinical services, research, advocacy, and education. However, the Kempe Center’s historical success in helping lead society in addressing these issues will not ensure its future success. If Kempe wants to remain a leader in this field over the next half century, it will have to pivot to the unique challenges children, families, and communities face in the twenty-first century and the new and robust tools that are now available both to perpetrate and to combat child maltreatment in all forms and in a variety of modern contexts.