Intangible cultural heritage as school-based psychosocial support for left-behind adolescents in rural China: a...

Rural left-behind adolescents in China experience elevated risks of loneliness, negative affect, weakened belonging, and limited access to acceptable psychosocial support. Conventional school counselling models often depend on self-referral, verbal disclosure, and identification with a help-seeking role, conditions that may not fit the social and cultural context of many rural students. This manuscript develops and preliminarily evaluates a culturally grounded schoolbased psychosocial support programme using locally rooted intangible cultural heritage (ICH) activities, including paper cutting, embroidery, local song, and related symbolic practices. This study is a preliminary non-randomized waitlist-controlled pilot study with theoretical framework development and embedded qualitative process data. The programme was not art therapy in the formal clinical or professional sense: it was not delivered by credentialed art therapists, did not involve psychotherapeutic interpretation of artwork, and was not intended as treatment for diagnosable mental disorders. It is therefore conceptualized as an ICH-based arts-and-health psychosocial support programme for subclinical wellbeing needs in a rural school context. The proposed Motivation-Emotion-Language framework integrates self-determination theory, emotion regulation research, and Vygotskian cultural mediation. In a rural lower-secondary school in southwestern China, 28 left-behind students participated in a six-week ICH programme and 24 comparable students served as a waitlist comparison group. Compared with the waitlist group, the ICH group showed greater pre-post improvement in loneliness (d = 0.58, 95% CI [0.21, 0.95], p = .002), negative affect (d = 0.45, 95% CI [0.09, 0.81], p = .014), cultural identity (d = 0.53, 95% CI [0.17, 0.89], p = .004), and school belonging (d = 0.36, 95% CI [0.01, 0.71], p = .044). Because the study used a small non-randomized waitlist-controlled design, these findings should be interpreted as preliminary estimates rather than definitive evidence of efficacy. Illustrative qualitative process data suggested that students often engaged first through making rather than verbal disclosure, and that local motifs and songs elicited recognition of shared cultural belonging. Findings should be interpreted cautiously because of the small sample, nonrandomized allocation, short intervention duration, waitlist rather than active-control design, and adaptive introduction of singing activities in the final sessions. The study provides preliminary feasibility and outcome signals rather than definitive evidence of efficacy or mechanism. Future research should use randomized controlled trials, active comparison groups, longitudinal follow-up, repeated process measurement, mediation analyses, and implementation research.