Five days after the devastating southwest China earthquake, psychological counselors are still unable to tell 12-year-old Liu Xiaohua that she's an orphan.
Playing in the welfare center in Mianyang, Sichuan Province, the girl has been waiting for her parents to collect her and take her home.
But Zhao Guoqiu, a Health Ministry psychological intervention expert, says her mental state is still too fragile for her to receive the news that her parents died in the quake.
Liu, of the Qiang ethnic minority, has been "resistant" to discussing her horrific experiences immediately after the disaster, says Zhao.
The sixth grader was in class at the Qushan Primary School, in Beichuan County, one of the worst-hit areas, when the quake struck.
The building collapsed, but a teacher helped her escape from the debris and she returned home to find her grandmother and her younger brother dead.
Her parents had died rushing to her school.
"This is the most difficult case I have dealt with in 30 years. To see the death of her relatives is extremely cruel for someone so young," says Zhao.
Counselors are still trying to win her trust in order to help her express the grief of that day, but she curls up weeping and refuses to discuss those events whenever the subject is raised.
"Her therapy has progressed very slowly as she has avoided facing reality," says Zhao.
"The disaster has cast a huge shadow in her mind and she can't expel the shadow, it could develop into a serious psychological problem, which could ruin her future or even drive her to suicide."
The eight children in the welfare center are among tens of thousands of people thought to be seriously traumatized by the disaster.
The quake, which was felt in many parts of the country, has caused 28,881 deaths nationwide. In Sichuan alone, the death toll exceeded 28,300, while more than 10,000 are still buried.
In Mianyang's Jiuzhou Stadium, where Premier Wen Jiabao met Liu Xiaohua during a visit on Tuesday, Lu Jianguo, a psychologist from the Chengdu Medical College has found many severely traumatized people.
"Almost everybody is suffering depression, anxiety, guilt, self-doubt or anger, and suffer insomnia or nightmare," says Huang Guoping, director with the Psychological Intervention Center of the Mianyang No. 3 hospital.
About 60 percent of the people would probably recover within a year, but the rest could suffer trauma symptom for life, says Huang.
The work of a psychological consultant, according to Wu Huiqiong, research fellow with the psychological research center of the Guangzhou-based Sun-Yet Sen University, was to "encourage the patients open their hearts, cry, and let out their grief".
"We first accompany them to gain trust, let them tell their stories, and help them restore their normal psychological status," she says.
Zhao Guoqiu says the best time for psychological intervention is 24 to 72 hours after the disaster. "The later, the harder," he says.
After the earthquake, the Health Ministry dispatched a team of more than 20 experts to help with psychological intervention.
But Zhao believes their capabilities are limited. "Not just children need psychological treatment, adults need it as well."
Some other experts suggested that rescuers may need such treatment too.
Post-disaster psychological intervention in China is a recent phenomenon. After the devastating typhoon Saomai that killed at least 460 in 2006, a team of 32 doctors and volunteers was sent to the worst hit area in Zhejiang.
But a lack of specialists has hindered the development of psychological intervention, as China, with a population of 1.3 billion, has fewer than 15,000 psychological doctors.
(Xinhua News Agency May 18, 2008)