**Dorit Segal-Engelchin \*, Netta Achdut, Efrat Huss and Orly Sarid**

Spitzer Department of Social Work, Ben-Gurion University of the Negev, POB 653, Beer-Sheva 84105, Israel; nettaach@bgu.ac.il (N.A.); ehuss@bgu.ac.il (E.H.); orlysa@bgu.ac.il (O.S.)

**\*** Correspondence: dorsegal@bgu.ac.il; Tel.: +972-50-558-3764

Received: 1 March 2020; Accepted: 24 March 2020; Published: 28 March 2020

**Abstract:** Research on mental health professionals (MHPs) exposed to a shared war reality indicates that they are subject to emotional distress, symptoms of posttraumatic stress disorder, and vicarious trauma. This article focuses on a CB-ART (cognitive behavioral and art-based) intervention implemented during the 2014 Gaza conflict with 51 MHPs who shared war-related experiences with their clients. The intervention included drawing pictures related to three topics: (1) war-related stressors, (2) coping resources, and (3) integration of the stressful image and the resources drawing. The major aims of the study were (1) to examine whether significant changes occurred in MHP distress levels after the intervention; (2) to explore the narratives of the three drawing and their compositional characteristics; and (3) to determine which of selected formats of the integrated drawing and compositional transformations of the stressful image are associated with greater distress reduction. Results indicate that MHP distress levels significantly decreased after the intervention. This stress-reducing effect was also reflected in differences between the compositional elements of the 'stress drawing' and the 'integrated drawing,' which includes elements of resources. Reduced distress accompanied compositional transformations of the stressful image. MHPs can further use the easily implemented intervention described here as a coping tool in other stressful situations.

**Keywords:** mental health professionals; shared war realty; distress; art-based intervention; warrelated stressors; coping resources
