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Vicarious traumatization is a transformation in the self of a trauma worker or helper that results from empathic engagement with traumatized clients and their reports of traumatic experiences. Its hallmark is disrupted spirituality, or a disruption in the trauma workers' perceived meaning and hope. McCann and Pearlman coined this term specifically with reference to the experience of psychotherapists working with trauma survivor clients. Others, including Saakvitne, Gamble, Pearlman, and Lev have expanded its application to a wide range of persons who assist trauma survivors, including clergy,front line social service workers, justice system professionals, health care providers, humanitarian workers, journalists, and first responders.