Beyond Individualism Perspective of Trauma: Evidence for Adopting Collective Narratives for Empowering Long-Term Rehabilitation for Children of the Ethnic Qiang People Who Have Been Affected by Disaster

Wang Shuguang，Wang Y. Elaine，Wang M. Joshua＊

1.Background

The disastrous earthquake of May 12th, 2008 in the mountainous regions of Sichuan Province had its greatest impact on the Qiang people,a Chinese ethnic minority living in the earthquake’s 80-kilometer (50 mile) away from epicenter. Official data indicated that at the time the earthquake struck,the total surrounding population of this small ethnic community was approximately 300,000, and that a devastating number of over 80,000 Qiang people lost their lives (Sina, 2008). Especially hard hit by the disaster in the Qiang villages which were among the most socio-geographically disadvantaged remote rural mountainous areas of the Wen Chuan,Mao Xian, Li Xian and Bei Chuan Autonomous Prefecture, were women and children (Yang, 2009;EWC, 2008).

Data in earlier studies (Wang, Keats, Gao, Zhang& Yang, 2010) showed that many psychological aid professionals were western-trained and brought with them their own intervention methods and techniques.Very few had any knowledge about the ethnic Qiang people or awareness as to what would constitute a culturally appropriate approach (Chai, 2009). Most of the volunteers’ activities were hastily put together,with little coordination amongst them, which garnered many concerns about culturally appropriate and effective issues dealing with socio-psychological reconstruction in the Qiang community (Chai &Yang, 2010). According to indigenous perspectives(EBQCL, 1989; Cheng, 2009; Chai & Yang, 2010),over three thousand years of their history in this challenging geological area and mountainous region,the Qiang have developed a great deal of experience dealing with various natural disasters and illnesses.The community response to various disasters is therefore a core theme in their oral narrative cultural history, embedded in Qiang myth story-based narrative texts (Chai, 2009). Presented by the local cultural leaders, the Shi Bi, and key informants in the form of classic mythologies, or historical narratives, community members are exposed to social representations and cultural metaphors related to battling the consequences of natural disasters(Chai & Yang, 2010).

However, as documented by Yang & Zheng(2009), many psycho-behavior interventions of the volunteers in the aftermath of the earthquake introduced modern urban perspectives to the Qiang community. The outsiders’ emphasis on individuals rather than the community was treated with suspicion; children who were taken away from their context for individual counseling were often isolated afterwards and treated by their peers as having done something wrong or as if there was something wrong with them (Chai, 2009). Programs targeting Qiang children lacked understanding of this ethnic minority’s conceptualization of trauma,their vulnerability and ways of coping with it, as well as the underlying indigenous values, beliefs,faith, language, lifestyle, cultural practices, models of communication, and myths (Chai, 2009; Wang &Hainai, 2013; Wang, 2010; Wang, 2011). The failure of the western-based interventions necessitated a reappraisal of the public health response and a better understanding of the Qiang people (Chai, 2009;Chai & Yang, 2010; Wang, 2010). There was a clear need for the development of culturally appropriate intervention programs that could be demonstrated as a rising and potential conceptual framework of a cultural-focused agenda for effective responses for the traumatized ethnic community, specifically the children, in collectivism contexts.

2. Methods

2.1 Sample in the evaluation program

Initially, a sample for the study was designed with a cohort of 1200 ethnic Qiang village children from 800 intervention groups in Wen Chuan County and Miao Xian County and 400 in a comparison group in Li Xian County, a Qiang traditional residential area situated 80km-150 km away from the location of the intervention groups, across different villages and mountains. Locations selected for the comparison groups were identified through a study with a wide range of consultations as being reasonably comparable to the matching intervention groups in ethnic and cultural characteristics, sociodemographic and socio-geographic status (Chai &Yang, 2010; Wang & Yang, 2010). Careful measures were taken to ensure that those children selected as participants in the comparison group had never been involved in any intervention activities related to the project. A pre-test and post-test program were conducted to evaluate the effect of the intervention program from adoption of myth narrative-focused cultural practices.

2.2 Collective narratives as interventions

The participants in the intervention program were these Qiang children affected who were selected from three sites in the rehabilitation program: Luobu Zhai village, Yan Men Qiang School in Wen Chuan Township, and smaller sites in Miao Xian which draw on children from the town and many Qiang villages, Chi Bu Chu, Yong He,and Shui Lou. The children were recruited by the local authorities, including village leaders, teachers,and staff of the local Center for Disease Control and Prevention (CDCD). The Guidelines for Volunteer Leaders (VLs) involved in the program included guidance for baseline data collection, how to deal with children’s interviews, communication and engaging intervention activities using participatory approaches.

Based on a case study exploring traditional text to dealing with life difficulties and traumatic events, the Qiang’s oral mythological heroic story of Mujiezhu and Douanzhu (EBS, 1986; Chai, 2002,2006), was selected as the main classical myths on strategically responding to trauma from the Qiang’s perspective (Chai, 2009), and was used as the intervention strategy text for the program. This myth story was adopted by participatory approach to create a child-centered theatre of myth drama as a route of story-telling to communicate the Qiang’s traditional approach to combating and overcoming disaster trauma. The myth story-based childrencentered theatre as a key form of collective narration was particularly to focus on the general needs of the post-disaster psychosocial rehabilitation for these children, especially on developing awareness of the cultural beliefs and traditional response to the disaster (Gao, Keats & Wang, 2011).

To find out how the children responded to the adaptation of the myth-based story into dramatic form, some exploration work was carried out to evaluate its suitability and acceptability. This work helped to understand whether: 1) it was an acceptable form to convey the messages from a story-based drama; 2) the messages could be understood well enough and handled effectively to help the children have a positive experience and express their feelings; 3) the drama performance(including costumes, props, lines, language expression, songs, and dances) was acceptable for the local Qiang children’s mythological spirit, beliefs and aesthetics at different ages; and 4) exhibiting the messages could arouse the children’s willingness and desire to participate. Participatory communications as a child-centered approach were conducted in all activities in the development of the children’s myth story-based theatre, including an adaptable script,participatory rehearsals, exploratory previews,participatory in-group discussions, and the extended activities program from a broad activity types in the drama, story-telling, and writing; singing and music in Qiang style which were to ensure comparability across all age and category groups, a wide range of entertaining activities of therapeutic benefit in which all children could participate in diverse situations and contexts (Gao, Keats & Wang, 2011; Yang &Chai, 2010) were suggested.

2.3 Community engagement

The Shi Bi in Qiang society is a key figure who is at the same time a cultural and faith-based leader,indigenous representative, narrator of history and cultural classic stories, holder of the traditional knowledge and experience, and cultural practitioner and priest. The Shi Bi therefore undertakes the roles for engaging in traditional activities of mountain worship and advocacy of cultural heritage.Therefore, among the local Qiang people their own culture is also known as the Shi Bi culture.The traditional image of a Shi Bi grandpa can be reinforced by the children’s involvement in the myth story-based theatre and story-telling narration. The Shi Bi used their prestige and traditional power to advocate support and a positive response for the children’s shared activities, and support for the diffusion of health communication awareness from the mythological stories combating vulnerability in the disaster.

Community-based organization involvement was especially important for these children’s collective rehabilitation practice with a strong belief in the full involvement of environmental support.As data shown in Yang & Chai (2010), the children’s activities in this program were significantly facilitated by broad support of community-based organization involvement, which was given by the bureaus of school education, civil affairs and social security, public health and CDC, and community organizations at the village level, gradually identified the program as a pioneering practice in the innovative use of tradition to promote trauma coping for the effected Qiang children.

2.4 The Behaviour Checklist for impact evaluation

The Behavior Checklist was developed as an instrument of observation to collect baseline data on children’s behavior prior to the intervention and to evaluate its impact after the intervention. The checklist was designed in a simple form for use by parents/caregivers and the volunteer helpers. Focus group discussions and individual conversations were conducted with 46 participants, parents/caregivers,teachers, and other diverse villagers (key informants,stakeholders, community leaders and cultural leaders). They were asked, “What kind of positive behavior characteristics revealing recovery and coping have you observed in the children around you in the village who were affected by the earthquake?”The items listed in Table 1 represent the responses most frequently expressed in reply to the questions that were selected to comprise the behavior checklist(Wang, 2011; Keats & Wang, 2014). The behavior checklist was used to record observations of the children’s behavior during each activity session. It was completed by the Activity Volunteers (AVs).The AVs were the people immediately involved with the children in the conduct of an activity. They could be a teacher in the elementary school, kindergarten director, parent or caregiver, volunteer activity coach or trainer in a village.

2.5 Measurements and analysis

Using the Behavior Checklist to evaluate the children’s resilient behaviors throughout the intervention, observations were conducted in September 2009 (baseline, 16 months after the earthquake) and in January 2010 (follow-up, 19 months after the earthquake). Data for the evaluation of the intervention program’s effectiveness was collected in June 2010 (five months after the project intervention). Follow-ups were conducted in June 2011 and June 2013. Analysis of the differences between those exposed and those unexposed to the program was used to assess the impact of the program. The level of change in behaviors signifying resilience was scored with a Likert-type scale with four levels of response: “Always (5)”, “Sometimes(3)”, “Seldom (1)”, “Hardly ever (0)”. High scores on the scale indicated high levels of positive progress.Scores on this scale ranged 0 - 55 on the 11 items of the Behavior Checklist. The Cronbach’s alpha reliability for this scale was 0.71 at baseline.

3. Findings

3.1 Children’s resilience at baseline

As shown in earlier data analysis (Keats &Wang, 2014; Wang & Dong, 2015) presented a slow and tiny tendency in resilient coping. The total score on the Behavioral Checklist was only 14.18 with an average score of 1.28 at baseline. The very small, insignificant positive tendency shown by the slightly increased scores from base-line to follow-up (averaging 1.82), indicates that 18 months after the earthquake, the Activity Volunteers (AVs)evaluating the level of resilient behaviors in these ethnic Qiang children living in the epicenter of the disaster area, recorded meaningful difficulties and limited coping. This finding indicates there was little natural recovery during the period before the implementation of the intervention program.

No significant positive change was observed in these children’s resilience behaviour. A total score of 5.89, with an average score of 0.54 for change within the 11 items (See Table 1) from baseline to followup pre-test showed only a very limited tendency for children’s natural recovery during the four months before the implementation of the intervention program. This result further implies that the process of natural recovery for most characteristics of these children’s resilience will need to take a long-term healing period. It should be expected that these, and in particular “enjoyment and happiness,” are difficult to recover and require a long-term healing period.

There was only a slight positive change forchildren’s natural resilience behavior, limited to two items, aspects of participation and cooperation. As mentioned by many local villagers, they believed that the features of “cooperation” and “attention to Activity Volunteers” were necessary components of local ethnic Qiang children’s resilience. However, it was also widely considered as the Qiang traditional trait advocating collectivism as the ethnic value of Qiang culture. It seems this traditional trait in the children’s resilience which is culturally stressed had had little impact from the natural disaster. As data in Wang & Dong (2015) showed, most of the children were able to maintain full cooperation and attention to activity volunteers and activity organizers. It is likely that the aspects of Qiang children’s resilience depicted in the items “cooperation” and “attention to Activity Volunteers and activity organizers,” are actually the cultural characteristics of the Qiang personality. Except for extreme cases of cultural and social collapse, “cooperation” and “attention to Activity Volunteers” capture the psychological resilience and cultural norms of the Qiang people that were geared towards dealing with the impact of disasters in a sustainable and reliable manner.

Table 1 Changes in the Children’s Resilience Behavior from Baseline to Post-test Recorded in Ethnic Qiang Communities

Children’s resilience beha vior Post-Activity test June 2013 Mean n=957 b Observed Change Mean(95% CI) c p 9. Language usage Inter. 2.51 4.95 2.44 ( 1.06, 3.82) ???Comp. 2.53 3.42 0.89 ( 0.45, 1.33) ?10. Attempting new tasks Inter. 1.17 3.11 1.95 ( 1.06, 2.83) ??Comp. 1.14 1.65 0.51 (-0.48, 1.49) n.s 11. Attention to activity volunteers Inter. 3.93 4.91 0.98 ( 0.48, 1.47) ?Comp. 3.96 4.67 0.71 ( 0.20, 1.22) ?Average： Inter. 2.08 4.12 2.04 ( 0.97, 3.11) ???Comp. 2.01 2.75 0.74 (-0.75, 2.23) n.s Baseline(Follow-up pre-test)June 2010 Mean n=1100 a Data in the analysis was obta ined from a follow-up pre-test before the intervention began in June 2010, it did not c over baseline information from Ju ne 2009. n=1100 is respectively from 7 34 in the intervention gro up and 366 in the non-intervention group at follow-up baseline who were actually selecte d. 100 children in the init ial sample of 1200 left for varying reasons, such as inco nvenience to take more time to involv e in linking activities; unw illing to take time to b e involved in the program, illn ess, and wit hdrawal without explanati on (more details see Wang, 2010).b n= 957 involved in the evalu ation is resp ectively from 663 in the in tervention group and 297 in the non-interventio n group at post-activity. The rate of sampl e attrition was 14.9% durin g the 3 years from pretest to post-test in this res earch.c Observation for effect was c onducted ten times per year from VLs and AVs, and data were su mmarized from record s of twenty observations during and after the intervention activities.Inter. is Intervention; Comp. is Compari son;? = p ＜ .05;?? = p ＜ .001; ??? = p ＜ .0 00; n.s: not significant.a

3.2 Change in accessing to counseling

Before the intervention program was conducted for this study, a survey of parents/caregivers was conducted to examine whether there was any change in the wellbeing of Qiang children who were able to access counseling, compared to those who had no access. Unlike several estimates regarding children’s recovery from natural disaster (New, 2008), as data presented in Wang (2010), Wang & Yang (2010), and Keats & Wang (2014) findings from three return visits indicated that the effect of counselling was very limited, both short and long-term, and for the varying degrees of trauma exposure (Wang, 2010;Keats & Wang, 2014).

3.3 Observed changes in the intervention group

As the data in Table 1 indicates, the intervention program was successful in promoting children’s resilience behavior over a 3-year period on all the behavior items except “enjoyment” and “attention to Activity Volunteers,” where only a small change was observed. The reasons for this were clearly different;the lack of change on attention to activity volunteers was probably due to the high level of alertness and attention that they had demonstrated all along (typical of all Chinese children). However, the lack of change in enjoyment seems to be due to the long process required for healing the ability for enjoyment in these children.

Obviously, for most of the behaviors observed,children’s resilience behaviors have been greatly improved by the intervention activities, as indicated by the change from very low average scores at baseline to the very high average scores at post-test,with significant positive effect. Highly significant changes were observed in communication, alertness,cooperation, achievement, concentration and language usage. Significant improvements also occurred in children’s participation and sociability,eye contact, and attempt at new tasks. Moreover,the positive impact was sustainable over time, as indicated by data collected in 2010 and 2013 (Keats& Wang, 2014; Wang & Dong, 2015).

However, there was only a slight improvement in the total scores reflecting enjoyment and happiness even following participation in the intervention activities. The average scores in Table 1 show that the very low levels of enjoyment and happiness recorded at baseline went through a significant change following the intervention, and yet remained very low. This finding indicates that even four years after the earthquake the rehabilitation of inner enjoyment and happiness was more difficult and gradual for these children even with the 6-month activity program. This result also has implications for program planners, suggesting that true rehabilitation following such large magnitude disasters necessitates longer-term action or more indepth and sustained promotion for population-based psychological health.

Comparatively, no significant differences in resilient behavior have been observed in the comparison groups. As part of the process of natural recovery, average scores that showed significant improvements were only in a few of the Behavior Checklist items, mainly in children’s cooperation behavior, and slight changes in their participation and gregariousness, alertness, achievement and language usage. In the comparison groups as well, the slowest to show change were the items referring to enjoyment and happiness, followed by eye contact, communication, concentration, and attempting new tasks, which were also the items for which significant changes occurred less in the intervention groups.

Overall, the findings for the comparison groups show that some aspects of resilience in children can recover slowly, through a natural process and over time. However, there was no evidence, as observed by this study in this period at least, that many of the major characteristics of children’s resilience behavior can be rehabilitated effectively without psychocultural health promotion activities.

3.4 Distal factors

Data analysis in this study further suggested that psycho-cultural mediators in promoting children’s resilience behavior in the ethnic Qiang community was moderated by many distal factors characterizing the socio-demographic background,the milieu and vulnerable factors in which children were context engaged. Regarding the multiple regression model’s analysis in Table 2, firstly, the younger children involved in the activity program who were living in villages far away from the town seemed more involved and responsive during the myth-based and story-telling activities than older

children. Based on local perspectives (Chai & Yang,2010), not surprisingly, these ethnic children who were living in remote Qiang villages were more involved in tradition as they had more access to their community members who helped them encode collective memory of cultural representations of modes of coping with life events. Second, the milieu valuables show a stronger impact of the intervention than demographic variables on children’s resilience behavior. The children who were involved in school-based myth-based program activities were generally more likely to significantly improve resilient behavior than those children who were involved in the activities in rural villages, where communication is more problematic. Promotion of psychological recovery among the school students benefited greatly from an effective development of the cultural perspective of the intervention and the orderly organization of students’ involvement in the myth-based story-telling theatre activities. This was undoubtedly related to the better organization of the schools, compared to the rural villages, in ensuring that all students had the opportunity to join the various intervention activities (Shui, Chai, & Hu,2010). Third, vulnerable categories in this analysis are another important factor. Positive behavior changes at varying levels had occurred in all children in the intervention group, across all categories of vulnerability. Particularly, the children from the three most vulnerable categories, A (CLFM: children who have lost father, mother, or both parents), B(CFDS: children who have a family member but one who cannot or has difficulty in giving support to the child) and C (CPDE: children who have been physically disabled by the earthquake) showed more significant change in their resilience. The different levels of children’s involvement in the activities was one major explanation for this (Shui, Chai, &Hu, 2010), indicating that the traumatized children who were strongly affected by the impact of the earthquake displayed a strong desire to promote their rehabilitation, possibly due to the underlying collective meaning for the community. These children as survivors paid attention to the meaning of spiritual growth in the myth metaphor (Chai &Yang, 2010).

Table 2 Multiple Regression Models: The Relationship Between Multiple Factors to Enhance the Children’s Resilience in 2013

Apparently, evidence from the data in Table 2 indicated that the children’s participation in myth story-based narrative activities had the greatest influence for their psycho-cultural rehabilitation.The highest regression coefficient in effective evaluation in 2013 suggested that involvement in this intervention’s activities made the largest contribution to the positive change in their resilient behavior (44.8% F(6,957) = 27.8, p ＜ .000). The highest standardized regression coefficient (β= .492, p ＜ .000) in the category of the variable of participation for myth story-based narrative activities indicated that children’s sharing and discussing their experiences while participating in the activities, resulting in collective desensitization about the disaster response, was very important in promoting the effect of the intervention. In addition,children’s participation in the myth story-based narrative drama either by watching, role-play or singing and dancing, also had a significant impact on promoting behavioral improvement (β = .444, p＜ .000). The themes stressing resilience that were included in the myth-based role play, conversations and body-centered activities, can be viewed as utilizing comprehensive elements that are also present in art therapy, psycho-drama therapy, group psychotherapy, cognitive-behavior therapy, and problem-solving therapy (Shui, Chai, & Hu, 2010;Gao, Keats, & Wang, 2010). Lastly, communitybased advocate activities played a significant positive role in the recovery of children’s psychological resilience (R2 = 33.6% F(6,957) = 25.8, p ＜ .000).Several factors inherent to the community-based advocacy activity appeared to be very important for the change in the children’s resilient behavior including the Shi Bi masters’ cultural engagement;Story-based advocacy practices that helped transfer lessons learned from the myth story to current life experiences contributed further to the significant effect on children’s positive resilient behaviors; local governmental engagement, involvement in schoolbased social activities, and media engagement, were also important contributors for the promotion of change in children’s resilient behavior.

4. Discussion

4.1 Individualism perspective on trauma therapy

Individualism as a philosophic methodology emphasizes that the individual in interactions is an essential nature of the society (Forster, 1950:26), and an analysis in Bellah et al. (1996) indicated that the individual perspective of psychology and trauma healing is embedded in the Western philosophy of individualism, viewed as an essential dimension in humanity’s ultimate values. The individualismoriented perspective is a fundamental dimension of epistemological methodology that has influenced theories and practices in traditional fields such as the literary arts, medicine, epidemiology, public health, psychology, and social study (Mauss, 1985;Dargush, 2008). The increasing demand for the evidenced-based, individual-oriented Western psychotherapies (Ma, 2009; Bellah et al., 1996), the widely accepted strategy in individualism- oriented therapeutic strategy in western society is to stress the cultivating independent context, which could be separated from their real life by involving therapist’s communications to reconstruct enjoyed experience through effective self-expression for enhancing selfassertion in an individual inner world. The actual nature of the effective psychotherapy is commitment by self-authenticity for problem-focused and problem-solving, rather than particularly focusing relationships from family, relatives, religion, and communities in the context which is embedded in socio-cultural dynamics.

In the ethnic Qiang community with a postdisaster reconstruction setting, as argued by Ma(2009) and Wang (2010, 2011), the post-traumatic stress disorder (PTSD) as a key concept was widely,even inappropriately, used in dealing with traumarelated identify and psychological healing and rehabilitation. The first was to identify individuals with obvious stress symptoms and treat those who met the diagnostic criteria for PTSD to carry out timely intervention and treatment, and then included establishing sites for training programs for local health staff engaging in long-term psychological counseling and psychological health services at the village level. That approach, as well as the training itself, reflected the concept and perspective of PTSD, including screening scales, analytical methods, intervention techniques and practices,embodying the Western individualistic philosophy(Wang, 2010; Farr, 1998; Farr & Marková, 1995).Consequently, the PTSD perspective was widely utilized with the ethnic Qiang community to identify individual survivors with the symptoms specified on the mental health scales (Yang, 2009; Wang,2010). However, the failure to engage traumatized community members in psychological counseling and psychiatric therapies led to a public-health dilemma, especially in view of the large numbers of affected and vulnerable children (Chai & Yang,2010). The PTSD perspective not only did not help, there were concerns raised that the presence of counselors and physicians further stigmatized those affected by the massive trauma (Ma, 2009;Sykes, 2004; Myers, 2005), in ways not dissimilar to the reluctance of people living with HIV/AIDS,STIs and other epidemics to see a doctor in their village (Chai & Yang, 2010; Wang, 2011; Wang &Hainai, 2013). The fear of being labeled “mentally ill” increased (Wang & Keats, 2005; Good, 2010).The populace demand was for the traditional ways of dealing with disasters, as practiced over the many centuries of Qiang culture.

4.2 Collective representation

The concept of collective and social representation (Durkheim, 1898/1974) has been used extensively in sociology and social psychology in conjunction with the understanding that social and cultural communications are linked to values,ideas, beliefs, and practices when dealing with issues related to gender, health, social knowledge, social change and community development (Farr, 1998;Farr & Marková, 1995; Farr & Moscovici, 1984;Campbell & Jovchelovitch, 2000). In the field of social representations of health and illness, activities are focused on developing collective responses to emerging epidemics, negative life events and disasters (Farr, 1998). From the social representation perspective, beliefs about health, illness and methods of trauma healing may not be learned from direct individual experiences, but are drawn largely from processes of collective communications,interventions and practices embedded in various cultural dimensions (Wang, 2007; Wang & Hainai,2013). This study argues that individual behavior changes are always mediated and structured by cultural backgrounds and in turn traversed by important differences of culturally relevant elements such as Qiang Shi Bi and community engagement.Children’s individual behavior, in trauma healing and promotion, is always contextual, always culturally embedded.

In traditional cultures, beliefs, explanations and interpretations about health and illness are rooted in routine, daily social-psychological processes, and may represent a system of meaning that differs from that underlying the scientific medical knowledge.The traditional cultural discourse, values and beliefs delivered within oral story-telling narratives, people’s theatre, religion and cultural leaders’ initiatives represent traditional communication models. These are used for interpreting and delivering the scientific knowledge that is needed in order, for example, to effectively respond to emerging infectious diseases in ethnic minorities and tribal populations, while advocating and engaging the community in health promotion and health psychology (Wang & Keats,2005; Wang, 2008; Zhang, Wang, & Zhuo, 2008).For ethnic societies of China, culture-focused strategical texts for collective representations has a sound practice for enhancing the effective identification and response to emerging infectious diseases among ethnic minorities and tribal populations (Wang, 2007; Wang & Keats, 2005). As documented by Chiu & Hong (2006: 104-106), in traditional high context societies, members are more likely to collectively adopt habitual behaviors. People who are living in traditional high context societies are more likely than those living in lower contexts to adopt habitual tendencies in using contextual meanings for communication. In China, culture was shown to be a vehicle for health-related knowledge,beliefs and practices in adopting and adapting scientific knowledge pertinent to battling emerging infectious diseases (Wang & Hainai, 2013), but only when the massages were sanctioned collectively.

As documented by Cheng (2009) and Chai &Yang (2010), ethnic Qiang live in a collectivist culture where particularly emphasis is on interdependent relationships in extended family groups, within which traditional ways of dealing with natural disasters, illness and grief were developed. The mythological representations of trauma provide the tools for a culturally-relevant understanding of the children’s needs, beliefs, and attitudes regarding healing from trauma. Thus, more suitable indigenous strategies for psychological rehabilitation for affected children can be developed in the context of collective social representation (Ma, 2009; Chai & Yang, 2010;Wang, 2011; Wang, Keats, & Gao, et. al., 2010). As suggested in this study, culture in collective settings is a highly meaningful resource that can consistently support the development of indigenous survival strategies and ways of dealing with various life problems, including coping with and healing from trauma. Unfortunately, perspectives drawn from the fields of anthropology and social psychology have not been adopted often enough in the practice of psychotherapy and counseling with disadvantaged ethnic minorities. Initial national efforts to assist the ethnic Qiang community affected by the massive earthquake employed individual, clinic-based approaches that drew from clinical, counseling and psychiatric models, without recognition of the collectivist, indigenous character of the community and the need for a psycho-culturally focused strategy(Yang, 2009).

4.3 Collective narrative response to trauma

Collective narration plays a role in reconstructing the life history of individuals. Bellah et al. (1996) revealed that individuals have the indivisibility of our history and identity so collective narratives will return an independent self to a meaningful society. Findings in this study suggest that success in implementing myth story-based collective narrative behavior changes to promote rehabilitation for these ethnic Qiang children were due to the adoption of a cultural agenda for collectively oriented responses to their common challenges and resilience issues. The narratives of the master cultural leader Shi Bi describe Qiang’s strategies for living in the world, providing lessons learned based on faith, emotions, norms, identity,cooperation, tolerance, negotiation, acceptance,communication, character, and perseverance, other than simple massages about the logic and nature of things. Qiang’s myths such as the tales of Mujiezhu and Douanzhu are part of the Shi Bi master’s“toolbox,” and provide socio-historically, readymade discourse on strategies and coordination in the face of crises, providing metaphors, clues, strategies and an index about life experiences and build collectively shared and openly discussed practices for dealing with life issues (Wang & Dong, 2015).

Apparently, the myth story-based narratives in this program not only demonstrated the Qiang’s philosophical views about the universe, the world, and life which provide cognitive education by alternative positive experiences, but more importantly, the myth-based narrative practice in this intervention was a collective and social representation of coping with various threatening events and situations such as natural disasters.Involving children in myth story-based narratives provides children with a great chance to establish a beginning of communication, dialogue, and negotiation with their traditions of ethnic groups,with further building the senses of community,ethnic group, and identity for their cultural values through get-togethers for sharing traditional texts,acquiring shared life skills, and knowledge on facing difficulties. Arts presentations from myth story-based children’s theatre have played a crucial role in collective art-narrative therapy through understanding group-based self-definition and development of diverse strategies from ethnic arts to collectively responding to trauma. Given its non-clinical approach, the collective narratives of mythological stories do not require individual disclosures or a public outpouring of psychological drama. The children’s myth story provides a collective alternative to the multiple individual demands, aspirations and wishes. By praising heroes and figures of major events in the history of their own people, children can develop ideas and feelings related to their collective identity and ancient history.Myth-story communication is therefore a vehicle for children to become involved in a cultural event that collectively shares ideas and values about the suggested response to traumatic issues. The mythstory narrative provides the opportunities for children to express their thoughts about the disaster theme, as well as their opinions, attitudes, and strategies of response, in a collective debate and discussion.

Additionally, as expressed in the interviews,the Shi Bi master is the unquestioned cultural leader of the local Qiang villages, the person most revered by the children and to whom they went for help.The community’s engagement in the rehabilitation program for the affected children was an essential extension of the myth narrative tradition. Through education and participation in community-based services in the post-disaster reconstruction, the children’s psychological growth and self-efficacy are promoted and enhanced (Wang, 2011).

5. Conclusion

The mainstream approach in western society to trauma healing emphasizes the impact on individual communications. However, the evidence presented in this study suggests that in the context of traditional collectivist societies, western clinical, counseling and psychiatric approaches may be ineffective and unacceptable. Evidence from this study on rehabilitation for traumatized populations in ethnic minority communities in poster-disaster settings of the May 12th Wen Chuan Earthquake in 2008 shows that the individual-oriented perspective of clinical counseling and psychiatric approaches is not universal and should not be considered a standard intervention strategy across cultures, especially in the different ethnic and tribal communities, as high contextual collectivist societies. Accordingly,collective narratives for population-based trauma in ethnic cultures is a very meaningful resources which can provide, through cultural leader and community engagement, consistent support for the understanding, management, development and strengthening of health practices that deal with psychological difficulties, including healing from trauma and coping with various life problems.

The study highlighted the ethnic Qiang’s psycho-cultural practices, such as adopting myth story-based collective narratives that were successful in facilitating health communications and community engagement, and in improving children’s resilience in coping with the aftermath of a natural disaster of great magnitude. Further efforts should focus on translating this new finding to gain new knowledge on trauma healing in ethnic and indigenous communities, by exploring new ideas on an evidence-based conceptual framework to public health education of ethnic minority communities,and stressing indigenous methods should not be devalued or diminished where globalization and rapid social marketing impact on the valuable traditional health practices. As Yan Ma, a Qiang young woman who suffered in May 12th Wen Chuan Earthquake in 2008 said, “The best way to express and remember our experience of the collective growth from survival in terrible natural disaster,is to narrate our own story, which can be guided,inspired, encouraged, informed, reconstructed, and shared by Qiang’s myth.”

(Editor: Yan Yuting)

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