One spring day last year, Baltimore Cardinal William H. Keeler and a dozen priests knelt before more than 100 people in a Maryland church. In an act of public atonement to victims of clerical sexual abuse, they recited the confiteor, the traditional Catholic confession of sin. For some in the audience, it was a long-awaited catharsis.

"You have no idea of the healing that came out of that for me," said Edwina Stewart of Frederick, who was sexually abused by a priest 40 years ago. She recalled breaking into tears during Keeler's prayer.

David Fortwengler never has had such a moment. The North Carolina contractor, abused in the late 1960s as an altar boy at Oxon Hill's St. Columba Catholic Church, appreciates that the Catholic Archdiocese of Washington is paying for his counseling and that an auxiliary bishop personally apologized to him. But all this has not quite closed his wound.

"It's not a matter of sitting down with a bishop for five minutes and him apologizing and [me] being able to move on -- it's more than that," Fortwengler, 48, said.

"I've never even received a phone call from Cardinal [Theodore E.] McCarrick" in his role as archbishop of Washington. "Not even a 15-minute phone call to say: 'Oh, I'm sorry. . . . I just want to make sure that we're fulfilling our obligations. . . . Are we doing okay?' I don't know. Just anything."

As those accounts make clear, U.S. Catholic bishops are responding in markedly different ways to their three-year-old pledge to promote healing and reconciliation with victims of clerical sexual abuse, a promise they made in a document issuing new policies to address the church's child abuse crisis.

The document, known as the Charter for the Protection of Children and Young People, states that dioceses are to reach out and "demonstrate a sincere commitment" to the "spiritual and emotional well-being" of "every person who has been the victim of sexual abuse as a minor." In addition, it says that each bishop or his representative "will offer to meet" with victims and their families "to listen with patience and compassion to their experiences and concerns."

In its second yearly audit of the charter's implementation, the U.S. Conference of Catholic Bishops found that all 195 dioceses were following the document's directions on healing and reconciliation, according to results released in February. The audit, however, looked mainly at whether dioceses had put specific mechanisms and structures in place to deal with abuse victims' complaints. It did not measure the more intangible but essential components of empathy and compassion that many say promote healing.

Interviews with diocesan officials, lay Catholic activists, abuse victims and their advocates reveal differing perceptions on how best to achieve that healing. What diocesan officials see as generous and genuine pastoral outreach -- including healing Masses, offers to pay for therapy and referrals to support groups -- is often viewed as inadequate by victims.

"What's most important is the human connection," said the Rev. Thomas Doyle, a canon lawyer who was among those first to alert the Church to predatory priests 20 years ago.

Doyle says bishops should meet personally with each victim. "Why is there not time to go to someone's home? It would heal so many wounds and begin to build credibility," he said. "The gap between the victims and the hierarchy is massive."

Susan Gibbs, spokeswoman for the Washington archdiocese, said: "We've done our best to try to reach out to any person who comes forward, to respond to his or her individual needs and also to respond to the parish. There will always be someone who feels we could have done something differently."

Mary A. Lentz, a Cleveland-based lawyer and author of parent guides on preventing child sexual abuse, has just completed a survey for U.S. Catholic bishops of victims' perceptions of the pastoral care they are being offered. Some dioceses are making an effort to reach out to victims and their families, she said, but others "have not been so progressive."

For victims to feel reconciled to the church, Lentz said, "at some point, the head of the diocese should meet with the victim" and that diocesan officials should "acknowledge the abuse and apologize without being asked to do so." If you are a bishop, she added, "you can't put your talking head out there. Someone is needed who truly understands, and empathizes" with what the victims have gone through.

Church officials sometimes fail to recognize that psychic wounds from childhood sexual abuse take years to heal and therefore require a long-term commitment to outreach by the church, she said.

Too often, this outreach is passive and "feels corporate . . . like simply meeting the written standard," said Mark Serrano, regional representative of Survivors Network of Those Abused by Priests (SNAP), a victims' advocacy group that most dioceses still see as an adversary rather than a partner.

Healing Masses might be good, Serrano added, but "how about including us in the planning for a Mass like that?"

It was precisely such cooperation that made the March 2004 atonement service that Keeler held at St. Joseph Catholic Community in Eldersburg, Md., unusual in the Washington region.

The event was organized by a group that included victims, clergy, concerned lay Catholics and Baltimore archdiocese employees. Their months-long planning for the service was part of the healing process, said Edwina Stewart, 66, a clinical social worker.

Keeler also published a list of all known priest abusers in his diocese, which helped break the silence surrounding sexual abuse -- a requisite for healing, Lentz said. As a result, more than 60 victims came forward, archdiocesan spokesman Sean Caine said.

Caine said that "any victim who requested a meeting directly with Keeler got one."

In the Arlington diocese, which covers Northern Virginia, Bishop Paul S. Loverde has celebrated six of the 10 healing Masses organized by the diocese in the past year, said its victim assistance coordinator, Patricia Mudd. The Masses drew a total of about 700 people, and trained counselors were available at receptions afterward, she said.

Mudd said that Loverde has met privately with at least three abuse victims and spoken with a handful of others after the Masses.

Bill Casey, co-leader of the Northern Virginia chapter of Voice of the Faithful -- an organization of lay Catholics that aims to support victims and create structural changes in the Church -- praised the Masses as a good step. But he said his group believes the events should be advertised in the secular press and at 12-step programs, where victims are most likely to see the notices. Up till now, they have been advertised in parish bulletins and the diocesan newspaper.

"We would argue for much more aggressive outreach . . . to find survivors," Casey said.

Washington's Cardinal McCarrick has met with some abuse victims, though spokeswoman Gibbs said she did not know how many. But in the past four years, Gibbs said, Auxiliary Bishop Kevin J. Farrell, whom McCarrick has appointed his point man for victim outreach, has met with about 80 abuse survivors. Many of them were molested in other dioceses but now live here, Gibbs said.

"He has a special e-mail they can reach him at," she said. "They can call him on his private line. It's not a one-time visit with the bishop -- it's whatever you need with the bishop."

Some abuse survivors praised Farrell's sincerity and demeanor but complained about lack of follow-up. Donna Kollars, who was molested by a priest in the late 1970s in Forestville, said that in her two-hour meeting with Farrell, "he was very sorry -- he seemed sincere in being angry about what this priest had done."

But when the priest pleaded guilty in December in Prince George's County Circuit Court, "there was nobody there from the church that I know of," Kollars said. "I think somebody should have been there to show support."

Gibbs said there has not been an archdiocesan-wide healing Mass because it is felt that such services are more meaningful when sponsored by individual parishes, several of which have held them.

The Richmond diocese has not sponsored any healing Masses, acting spokesman Steve Neill said. "Nobody asked for them," he said. "They're not required by the charter. And I haven't heard there has been any . . . criticism of us for not having them."

Neill said he did not think Richmond Bishop Francis Xavier DiLorenzo had met any victims since becoming head of the diocese last year, but he added that DiLorenzo's predecessor, Bishop Walter Sullivan, did.

Neither Richmond bishop has apologized to four men who say they were sexually abused as teenagers by the Rev. John E. Leonard, though Leonard was convicted last year of assault and battery of two of the men. "Never," replied one of the four, Thor Gormley, 52, of Virginia Beach, when asked whether he had received a conciliatory call from the diocese.

Asked about that, Neill said the diocese's vicar general made a public apology to all victims of clergy abuse during a Holy Week Mass in March. Any of the four who want counseling are "urged to come forward, and it will be made available," he said.

Asked whether the diocese should be the one to take the first step, Neill replied: "We don't want to invade their privacy."

"It's not a matter of sitting down with a bishop for five minutes and him apologizing and [me] being able to move on -- it's more than that," says David Fortwengler, 48, a North Carolina contractor who was abused as an altar boy at St. Columba Catholic Church in Oxon Hill."You have no idea of the healing that came out of" a public atonement, says victim Edwina Stewart of Frederick.David Fortwengler says he has not received "even a 15-minute phone call to say: 'I just want to make sure that we're fulfilling our obligations.' "