Chinese Counseling Trainees' Trait and State Mindfulness and Client Symptom Outcome: A Longitudinal Examination With Multilevel and Random-Intercept Cross-Lagged Panel Models

This study aimed to explore how Chinese counseling trainees' trait and state mindfulness predicted their clients' symptom level over the course of therapy. A data set consisting of 6,888 sessions from 1,216 clients and their 211 master's level beginning therapist trainees in China was used, which included a measure of trainees' trait mindfulness at the beginning of their practicum and their state mindfulness and client-rated symptom distress level at the beginning of each of their therapy sessions. Multilevel modeling and random-intercept cross-lagged panel model results suggested that (a) at the trainee level, a trainee's trait mindfulness did not predict their average client symptom improvement over practicum; (b) at the session-to-session level, higher trainee state mindfulness before one session significantly predicted lower client distress before the next session, and higher client distress before one session did not predict trainee state mindfulness before the subsequent session. Findings suggested that it was the trainees' session-to-session state mindfulness, instead of their general trait mindfulness, that temporally led to greater client symptom reduction. Implications for clinical training were discussed.