Psychologists are frequently retained to assess adult plaintiffs seeking remedy for harms stemming from childhood abuse. Interpersonal traumas that occur during formative periods in childhood and adolescence can leave a complicated legacy. Biologically, childhood abuse can affect brain development and functioning across the lifespan and can lead to altered states of arousal during assessments. Psychologically, this abuse can lead to complex symptom presentations that do not always fit squarely into current diagnostic nosologies. Interpersonally, the legacy of childhood abuse can lead to distrust of people in positions of power that can extend toward forensic mental health professionals, requiring skillful navigation by the evaluator during assessments. This chapter discusses the biopsychosocial impacts of childhood abuse and the utility of using a trauma-informed approach to assessment. Recommendations are made with respect to procedural and interpersonal aspects of the assessment and considerations when formulating opinions on causality.