This article reports the outcome of a four-year follow-up of a pilot study using a combination of art therapy, cognitive behavioral therapy, and group process to address the therapeutic issues related to childhood sexual abuse. All group participants were evaluated using the Trauma Symptom Checklist for Children (Briere, 1995), commonly used in trauma centers, before and after their participation in an 8-week group cycle. The results of this extended study support the combined use of art therapy (AT) and cognitive behavioral therapy (CBT) as an effective intervention to reduce symptoms most often associated with childhood sexual abuse. (Contains 3 tables.)