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This paper explores some of the complex difficulties facing clinicians trying to assess whether a patient's report of incest is fantasy or reality. The role of sexualized family interactions, the age of the child, the nature of the act, and the quality of the reports are discussed as relevant variables. Cases are used to illustrate various points. In conclusion, we provide 8 questions the clinician should review before making any judgments about a report of incest being reality, especially when legal procedures are involved.
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