About one in three women has been sexually abused by age 18 (Russell, 1986). Many survivors of childhood sexual abuse (CSA) experience negative psychological symptoms (Browne & Finkelhor, 1986; Kendall-Tackett, Williams, L.M., & Finkelhor, 1993). These women may later in life engage in relationships. The negative impact of sexual abuse may result in challenges faced by the relationship due to shame and difficulty trusting (Kochka & Carolan, 2002; MacIntosh & Johnson, 2008). CSA can also pose sexual challenges for the couple (Kochka & Carolan, 2002). Research has found that couples therapy can be important to the CSA survivor's recovery as well as relationship functioning and growth (Kochka & Carolan, 2002; Hunt-Amos, Bischoff, & Pretorius, 2004; MacIntosh & Johnson , 2008). . The purpose of this literature review is to examine the problems that arise in heterosexual couples as a result of childhood sexual abuse experienced by their partner, and the challenges and opportunities available to them through couples counseling. It is important for therapists to be aware of issues related to past sexual abuse for couples seeking therapy (Feinauer, 1989). This was achieved by reviewing previous research-based literature on sexual abuse and the effects it has on survivors and their relationships. From quantitative and qualitative studies, the findings and relationship to previous research are discussed in this review. A study published in 1989 by Leslie L. Feinauer explored the sexual functioning of female CSA survivors who thought they had adapted to the sexual trauma and compared it to survivors who did not identify themselves as having adapted to it. Fifty-seven nonclinicians with… half of the article… Hor, D. (1986). Impact of sexual abuse on children: A review of the research. Psychological Bulletin, 99(1), 66-77. doi:10.1037/0033-2909.99.1.66Feinauer, L.L. (1989). Sexual dysfunction in women sexually abused as children. Contemporary family therapy: An International Journal, 11(4), 299-309. Kochka, P., & Carolan, M. (2002). Alliance protection: The influence of memories of childhood sexual abuse on couple dynamics. Journal of Couple and Relationship Therapy, 1(4), 59-71. MacIntosh, H. B., & Johnson, S. (2008). Emotionally focused therapy for couples and survivors of childhood sexual abuse. Journal of Marital & Family Therapy, 34(3), 298-315. Hunt-Amos, S., Bischoff, R. J., & Pretorius, R. (2004). Husband's experience of wife's childhood sexual abuse: An exploratory study and implications for couples therapy. Journal of couple and relationship therapy, 3(4), 1-21.