Professionals who work with trauma survivors in an open, engaged and empathic way and who feel responsible or committed to helping them are likely to experience indirect trauma. That means that they will be transformed by the work. The way helpers understand and experience the world and themselves is changed as they enter into the world of the survivor. While trauma work can be very meaningful and rewarding, it can also be very difficult and painful. The changes helpers experience in their identities, world views, and spirituality affect both the helpers' professional relationships with clients and colleagues and their personal relationships.