The symptoms of child sexual abuse and posttraumatic stress disorder (PTSD) affect a child's self-efficacy. A child's self-efficacy beliefs impact the course and treatment of PTSD, because perceived self-efficacy plays a mediating role in children's ability to cope with trauma. Self-efficacy research indicates that emotional competence can be learned and may provide treatment for PTSD that provides symptom reduction as well as a means of substituting problem-solving coping skills for emotion-focused coping skills.