Vatican treasurer Cardinal George Pell has promised to help lower suicide rates among people who were abused by Catholic priests as children.
Cardinal Pell met privately with a group of survivors who flew to Rome to watch him testify to an Australian Royal Commission into child abuse.
The cardinal gave his evidence from Rome via video link due to ill health.
A spokesman for the survivors, Gerard Ridsdale, said they had "an honest dialogue" at Thursday's meeting.
"There were no formalities... it was extremely personal in terms of what everyone was allowed to say and responded to," he said.
"This has been a very long, long process and this is just another step in that it doesn't change drastically the reality of institutional systemic abuse across the world that was covered up, it doesn't change that."
The group initially refused to see Pell, but said they met on a "level playing field" after some conditions surrounding the discussion were removed.
Cardinal Pell described the two-hour-long meeting as "hard", "honest" and "occasionally emotional".
He told reporters he was committed to working with the group to help stop suicides and end suffering.
"One suicide is too many. And there have been many such tragic suicides," he said.
On his fourth day of testimony on Thursday, Cardinal Pell admitted that a student told him a priest was "misbehaving with boys" in the 1970s.
He told the Royal Commission into Institutional Responses to Child Sex Abuse that he did not act because the student did not ask him to do anything about the complaint.
The cardinal also said it was a "disastrous coincidence" that five paedophiles came to be at the same school and parish in Ballarat in Victoria state the 1970s.
The Catholic Church in Australia has already accepted that there were hundreds of cases of abuse by paedophile priests over more than 80 years.
Cardinal Pell and the Royal Commission
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