Background: Children and adolescents who have been sexually abused are at a greater risk for physical, emotional, and behavioral problems throughout their life. However, the literature on outcomes of child sexual abuse contains many underexplored domains, especially those relating to children’s families. This is a critical element when considering the dependency that children innately have on their families, only increased while recovering from a trauma. The present study examined the impact of caregiver belief and support on child outcomes, as well as the relationship between caregiver belief and support, in substantiated sexual abuse cases. Methods: Data from 94 extended forensic interview cases was retrospectively analyzed. The analysis evaluated the influence of child factors, abuse factors, and family factors on child trauma symptom scores (as measured by the Trauma Symptom Checklist for Children [TSCC] and Trauma Symptom Checklist for Young Children [TSCYC]) and child behavior problem scores (as measured by the Child Behavior Checklists [CBCL] for ages 1.5-5 and 6-18). Results: Caregiver belief was predictive of lower trauma symptom scores measured by the TSCC (p=0.02). Girls had lower trauma symptom scores than boys, as measured by the TSCYC (p=0.02), and lower problem behavior scores measured by the CBCL 6-18 (p=0.05). In a post-hoc analysis of independent t-tests, TSCC trauma symptom scores were lower in children whose caregiver believed their allegation (p=0.02) and supported them in the aftermath (p=0.04). However, TSCYC trauma symptom scores were reported as higher in children whose caregiver supported them (p=0.05). Overall, caregiver belief and support appeared to have a significant correlation (p<0.001). Conclusions: Future research in the risk and resilience of child sexual abuse survivors should consider caregiver belief and support as distinct yet related concepts. Caregivers who believe and support the child may be more aware of potential trauma symptoms and child behavior problems. Different perspectives (i.e. child-report, caregiver-report) should be used to assess trauma symptoms and child behavior problems in research and practice.