Year after year, the clock ticked by and the calendar marched forward, carrying the three women further from the real world and pulling them deeper into an isolated nightmare.

Now, for the women freed from captivity inside a Cleveland house, the ordeal is not over. Next comes recovery - from sexual abuse and their sudden, jarring reentry into a world much different from the one they were grabbed from a decade ago.

Related stories

Therapists say that with extensive treatment and support, healing is likely for the women, who were 14, 16, and 21 when they were abducted. But it is often a long and difficult process.

"It's sort of like coming out of a coma," says Barbara Greenberg, a psychologist who specializes in treating abused teens. "It's a very isolating and bewildering experience."

Emerging into the future is difficult enough. The two younger Cleveland women are doing it without the benefit of crucial formative years.

"By taking away their adolescence, they weren't able to develop emotional and psychological and social skills," says Duane Bowers, who counsels traumatized families through the National Center for Missing and Exploited Children. "They're 10 years behind in these skills. Those need to be caught up before they can work on reintegrating into society," he says.

That society can be terrifying. As freed captive Georgina DeJesus arrived home from the hospital, watched by a media horde, she hid herself beneath a hooded sweatshirt. The freed Amanda Berry slipped into her home without being seen.

In the house owned by Ariel Castro, who is charged with kidnapping and raping the women, claustrophobic control ruled. Police say Castro kept them chained in a basement and locked in upstairs rooms, that he fathered a child with one of them, and that he starved and beat his captives into multiple miscarriages.

In all those years, they set foot outside of the house only twice - and then only as far as the garage.

"Something as simple as walking into a Target is going to be a major problem for them," Bowers says.

Jessica Donohue-Dioh, who works with survivors of human trafficking as a social-work instructor at Xavier University in Cincinnati, says the freedom to make decisions can be one of the hardest parts of recovery. That has been a challenge for Jaycee Dugard, who is now an advocate for trauma victims after surviving 18 years in captivity - "learning how to speak up, how to say what I want instead of finding out what everybody else wants," Dugard told ABC News.

Another step toward normalcy for the three women will be accepting something that seems obvious to the rest of the world: They have no reason to feel guilty.

"I'd make sure these young women know that nothing that happened to them is their fault," Elizabeth Smart, who was kidnapped at 14 and held in sexual captivity for nine months, told People magazine.

Family support will be crucial, the therapists say. But what does family mean when one member has spent a decade trapped with strangers?

"The family has to be ready to include a stranger into its sphere," Bowers says. "Because if they try to reintegrate the 14-year-old girl who went missing, that's not going to work. . . .They have to accept this stranger as someone they don't know."