560173

research-article2014
TCPXXX10.1177/0011000014560173The Counseling PsychologistWei et al.

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The Counseling Psychologist
2015, Vol. 43(1) 39­–63
Mindfulness, © The Author(s) 2014
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DOI: 10.1177/0011000014560173
and Counseling Self- tcp.sagepub.com

Efficacy: Hindering Self-

Focused Attention as a
Mediator

Meifen Wei1, Pei-Chun Tsai1, Daniel G. Lannin1,

Yi Du1, and Jeritt R. Tucker1

Abstract
The purpose of this study was to explore the mechanism by which counselor
trainees’ mindfulness and psychological flexibility are positively associated with
counseling self-efficacy. First, it was hypothesized that having fewer experiences
of hindering self-focused attention (i.e., counselor trainees’ awareness of
their own anxiety and distracting thoughts in sessions) would mediate the
association between mindfulness and counseling self-efficacy. Second, it was
hypothesized that having fewer experiences of hindering self-focused attention
would mediate the association between psychological flexibility and counseling
self-efficacy. Participants included 154 graduate counselor trainees. Results
supported our hypotheses that counselor trainees with greater mindfulness
reported having fewer experiences of hindering self-focused attention, which
in turn was positively associated with counseling self-efficacy. Similarly, those
with greater psychological flexibility also reported having fewer experiences of
hindering self-focused attention, which in turn was positively associated with
counseling self-efficacy. These findings were significant after controlling for age
and number of practicum courses.

1Iowa State University, Ames, IA, USA

Corresponding Author:
Meifen Wei, Department of Psychology, Iowa State University, W112 Lagomarcino Hall,
Ames, IA 50011-3180, USA.
Email: wei@iastate.edu

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40 The Counseling Psychologist 43(1)

Keywords
mindfulness, psychological flexibility, hindering self-focused attention,
counseling self-efficacy, counselor training

A critical aspect of counselor training is the development of perceptions of self-

efficacy in counseling-related activities (Larson & Daniels, 1998). Counselor
self-efficacy, which reflects counselors’ beliefs in their own capabilities to
effectively provide counseling to clients in the near future (Larson et al., 1992),
is an important outcome for assessing the development of counselor compe-
tence and counselor skills (Larson & Daniels, 1998). Empirically, counseling
self-efficacy is positively associated with variables relevant to counseling per-
formance such as counseling competence and the use of effective counseling
behaviors (Cashwell & Dooley, 2001; Daniels & Larson, 2001; Melchert,
Hays, Wiljanen, & Kolocek, 1996; Urbani et al., 2002). Therefore, cultivating
counseling self-efficacy is a critical component in counselor training.
Counseling practicum instructors and supervisors can teach trainees helping
skills, theoretical orientations, case conceptualizations, and case management
skills to increase their counseling self-efficacy. Larson (1998) indicated that
exclusively focusing on what counselors do during counseling sessions is not
sufficient for understanding how they build self-efficacy; other factors, such as
counselors’ qualities (e.g., mindfulness, psychological flexibility, insight, per-
sonality), could contribute to the building of counseling self-efficacy. This study
seeks to examine the mechanism by which counselors’ mindfulness and psycho-
logical flexibility are positively associated with counseling self-efficacy; we
proposed that having fewer experiences of hindering self-focused attention
(described below) is an important mediator of these associations.

Mindfulness and Counseling Self-Efficacy

Mindfulness has gradually become a mainstream psychotherapy construct
(Davis & Hayes, 2011), with some scholars even proposing that mindfulness
is a common factor in psychotherapy (Martin, 1997). Mindfulness is defined
as “paying attention in a particular way: on purpose, in the present moment”
(Kabat-Zinn, 1994, p. 4). It is thought to allow individuals to be “less reac-
tive” (Germer, 2005, p. 4) and to “respond to situations more reflectively [as
opposed to reflexively]” (Bishop et al., 2004, p. 235). Recently, Davis and
Hayes (2011) summarized several benefits of mindfulness such as improved
concentration and mental clarity (Young, 1997), objectivity (Brown, Ryan, &
Creswell, 2007), equanimity (Morgan & Morgan, 2005), affect tolerance

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Wei et al. 41

(i.e., the ability to tolerate difficult feelings in one’s self or in others; Fulton,
2005), self-control (Masicampo & Baumeister, 2007), and the ability to relate
to others and one’s self with kindness, acceptance, and compassion (Fulton,
2005; Wallace, 2001).
Mindfulness is likely to be important to counselors in building self-efficacy
relevant to managing counseling sessions. For example, mindfulness can help
counselor trainees focus on the present moment and increase affect tolerance
(Davis & Hayes, 2011). Due to these benefits, we reasoned that mindful train-
ees would be likely to focus on the “here and now,” stay calm, and have a clear
mind. As a result, such counselors would be fully aware of what happens dur-
ing counseling sessions and better able to concentrate their mental energy on
implementing appropriate interventions. Indeed, in one empirical study,
Greason and Cashwell (2009) found a positive association between mindful-
ness and counseling self-efficacy. They suggested that mindful counselor
trainees might be more present to fully hear their client’s story (Greason &
Cashwell, 2009). In addition, mindfulness has been linked to characteristics of
competent therapists such as empathy (Shapiro & Izett, 2008), self-awareness
and insights about professional identity (Birnbaum, 2008), self-compassion
(Kingsbury, 2009), and counseling skills (e.g., being more attentive to the
therapy process; Schure, Christopher, & Christopher, 2008). Given this theo-
retical and empirical support, we expected that mindfulness would be posi-
tively associated with counseling self-efficacy (see path a in Figure 1).

Psychological Flexibility and Counseling Self-

Efficacy
According to Hayes, Luoma, Bond, Masuda, and Lillis (2006), psychological
flexibility is defined as the ability to contact the present moment and to change
or persist in behavior that benefits one’s personal values. Being psychologi-
cally flexible involves behaving consistently with one’s chosen values even in
the presence of unwanted internal experiences (Hayes, Strosahl, & Wilson,
1999). Thus, psychological flexibility can be important for counselor trainees.
To elaborate, Harris’s (2008) metaphor of a radio can be used to demonstrate
how psychological flexibility relates to trainees’ counseling self-efficacy.
Similar to a radio, the mind transmits a variety of messages—some may be
positive and helpful whereas others may be negative and distracting. When a
radio program is negative, a listener may choose to continue to listen to it, turn
it off, or turn to another program. Similarly, counselors with greater psycho-
logical flexibility may feel the freedom to accept an unwanted thought, turn it
off, or focus their attention on another behavior consistent with their values—
such as effectively helping their clients (Ruiz, 2010).

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42 The Counseling Psychologist 43(1)

Fewer Experiences of
Hindering Self-Focused
d Attention c

Mindfulness a

Counseling
Self-Efficacy
b
Psychological
Flexibility

Covariates: Age and

Number of Practicum g
Courses Taken

Figure 1.  The conceptual mediation model.

Moreover, just as a radio-listener does not have to believe what the radio
says, counselors who do not take their anxiety-provoking thoughts literally
may experience less unwanted distress, which may otherwise divert their
attention away from immediate counseling tasks. A recent empirical study
found that after receiving training in acceptance and action interventions,
counselor trainees increased their counseling self-efficacy, reduced profes-
sional self-doubt, and fostered self-compassion (Stafford-Brown & Pakenham,
2012). Thus, we hypothesized that psychological flexibility would be posi-
tively associated with counseling self-efficacy (see path b in Figure 1).
Moreover, though mindfulness and psychological flexibility share similar
aspects (e.g., being in the present moment), they also differ. For example,
both mindfulness and psychological flexibility are beneficial to counseling
self-efficacy, but committing to values-guided action is only relevant to psy-
chological flexibility. Empirically, Stafford-Brown and Pakenham (2012)
found that acceptance and action (i.e., behaving in a manner that is congruent
with valued goals while being willing to accept undesirable thoughts and
feelings), along with mindfulness, significantly and uniquely predicted gains
in counseling helping skills self-efficacy.

Having Fewer Experiences of Hindering Self-

Focused Attention as a Mediator
Even though there is theoretical and empirical support for the positive associa-
tions of mindfulness and psychological flexibility with counseling self-efficacy,

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Wei et al. 43

little is known about which factors mediate these positive associations (Buser,
Buser, Peterson, & Seraydarian, 2012). To date, only one published study has
explored this line of research. Greason and Cashwell (2009) found that attention
mediated the relationship between mindfulness and counseling self-efficacy.
This finding suggests that mindfulness relates to enhanced attention, which in
turn helps the development of counselor trainees’ counseling self-efficacy.
However, more studies are needed to examine the mechanisms responsible for
the beneficial effects of mindfulness. In the current study, we proposed that hav-
ing fewer experiences of hindering self-focused attention explains the positive
associations between mindfulness and psychological flexibility with counseling
self-efficacy.
Hindering self-focused attention refers to experiences of being troubled by
an awareness of one’s own anxiety and other internal distractions that occur
when providing counseling (Williams, Hurley, O’Brien, & De Gregorio, 2003).
Conceptually, if counselor trainees are overwhelmed by self-doubt or perfor-
mance anxiety, this may distract them during counseling and in turn reduce their
counseling self-efficacy (Williams, 2003). Indeed, empirical evidence suggests
that when counselor trainees’ anxiety decreases, counseling self-efficacy
increases (Hill, Sullivan, Knox, & Schlosser, 2007). One reason for this rela-
tions may be that counselors who are not overwhelmed by self-doubt or perfor-
mance anxiety are likely to facilitate effective interventions, and thus are likely
to gain confidence in their counseling abilities. Thus, we expected to find a posi-
tive association between having fewer experiences of hindering self-focused
attention and counseling self-efficacy (path c in Figure 1).
In the present study, we first proposed that having fewer experiences of
hindering self-focused attention might mediate the relationship between mind-
fulness and counseling self-efficacy. Counselor trainees who are mindful might
remain focused on the present moment and actively listen to clients. Empirically,
counselors who practiced mindfulness reported better attention and concentra-
tion (Valentine & Sweet, 1999), greater presence with clients (Christopher,
Christopher, Dunnagan, & Schure, 2006; Schure et al., 2008), and increased
focus on the therapeutic process (Schure et al., 2008). Therefore, mindful train-
ees may be more likely to be present with clients’ suffering, communicate a
more accurate felt sense of clients’ inner experience, and be able to focus on
their immediate counseling tasks. Such counselor trainees are expected to have
fewer experiences of hindering self-focused attention in counseling sessions
(path d in Figure 1). In addition, there is theoretical support and empirical evi-
dence to show a positive association between fewer experiences of hindering
self-focused attention and counseling self-efficacy (path c in Figure 1). Taken
together, because mindfulness allows trainees to be present with clients and
focus on the counseling process, trainees who are more mindful might report

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44 The Counseling Psychologist 43(1)

fewer experiences of hindering self-focused attention in counseling sessions,

which would enhance their counseling self-efficacy.
Second, we proposed that having fewer experiences of hindering self-
focused attention may also serve as a mediator for the relationship between
psychological flexibility and counseling self-efficacy. Theoretically, trainees
with more psychological flexibility are more willing to accept unpleasant
internal experiences, such as anxiety and other distractions, rather than
attempting to suppress them (Hayes et al., 2006). As described previously in
our radio metaphor, trainees who are psychologically flexible are more likely
to accept the fact that their anxiety-provoking voices (e.g., the background
noise from radio music) are always there. Rather than directing energy toward
suppressing or denying unpleasant internal experiences, trainees who are
psychologically flexible may be able to choose to pay attention to their val-
ues—attending to what their client has said (e.g., listening to the radio music).
For these theoretical reasons, it can be expected that counselors who are psy-
chologically flexible are likely to have fewer experiences of hindering self-
focused attention (path e in Figure 1). Furthermore, as addressed earlier,
having fewer experiences of hindering self-focused attention was expected to
be positively associated with counseling self-efficacy (path c in Figure 1).
Therefore, because psychological flexibility allows trainees to choose actions
based on their values (e.g., helping their clients), those who are psychologi-
cally flexible are less likely to experience hindering self-focused attention,
which in turn would enhance their counseling self-efficacy.

Current Study
In sum, the current study is in response to researchers’ recommendations in
the areas of mindfulness, psychological flexibility, self-focused attention,
and counseling self-efficacy. With respect to psychological flexibility and
mindfulness, Williams, Hayes, and Fauth (2008) proposed, “ . . . two con-
structs that deserve special attention in future research on therapist self-
focused attention [e.g., hindering self-awareness] are mindfulness and
attentional flexibility” (p. 313). They noted, “ . . . mindfulness [is] a potential
strategy for increasing a therapist’s ability to stay present . . . while at the
same time reducing reactivity that could become distracting or hindering”
(Williams et al., 2008, p. 314). Thus, we first hypothesized that having fewer
experiences of hindering self-focused attention would mediate the associa-
tion between mindfulness and counseling self-efficacy. Second, we hypoth-
esized that having fewer experiences of hindering self-focused attention
would mediate the association between psychological flexibility and counsel-
ing self-efficacy (see Figure 1 for conceptual model).

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Wei et al. 45

Finally, Larson and Daniels’s (1998) review of counseling self-efficacy

indicated that counseling self-efficacy does not seem to differ across trainees’
demographic variables such as sex, race, theoretical orientation, or degree;
however, two factors positively associated with counseling self-efficacy are
trainees’ age (Larson, Cardwell, & Majors, 1996) and number of clinical
experiences (Melchert et al., 1996). Therefore, age and the number of practi-
cum courses taken were specified as covariates in this study (see paths g and
f in Figure 1).

Method
Participants and Procedure
Participants were 154 graduate students, 134 of whom were female (87%).
The sample included non-Latino White Americans (n = 124; 82%), African
Americans (n = 10; 7%), Multiracial Americans (n = 6; 4%), Asian Americans
(n = 4; 3%), Latino/a Americans (n = 3; 2%), international students (n = 2;
1%), and Native Americans (n = 1; 1%). The age of participants ranged from
21 to 62. Regarding their sexual orientation, 128 (83%) identified as hetero-
sexual, 11 (7%) as bisexual, 6 (4%) as lesbian, 4 (3%) as gay, and 4 (3%)
reported other. Approximately two thirds of participants (n = 104; 68%) were
in Master’s programs and the remainder (n = 49; 32%) were in doctoral pro-
grams. Forty-seven (31%) of participants were from community and mental
health programs, 35 (23%) from school counseling programs, 26 (17%) from
counseling psychology programs, 25 (16%) from clinical psychology pro-
grams, 15 (10%) from counselor education programs, 2 (1%) from rehabilita-
tion counseling, and 3 (2%) from other counseling-related programs such as
clinical mental health counseling, professional counseling, and marriage and
family therapy. Sixty-one participants (40%) were from the Midwest, 33
(21%) from the Northwest, 26 (17%) from the South-Atlantic, 23 (15%) from
the West Coast, and 10 (7%) from the South-Central area of the United States.
More than two-thirds of participants reported a humanistic or person-centered
(39%) theoretical orientation or cognitive behavioral therapy (34%) as their
theoretical orientation.
We used a snowball method of data collection, sending an invitation email
to counselor trainees after receiving permission from relevant email listserv
owners. These listservs were from divisions of the American Psychological
Association (APA) and the American Counseling Association. We also sent
email invitations to training directors from APA-accredited counseling and
clinical psychology programs and Council for Accreditation of Counseling
and Related Educational Programs–accredited counseling-related programs.

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46 The Counseling Psychologist 43(1)

Participants were required to be graduate students in either a counseling psy-

chology or counseling-related program, and were also in a practicum course
at the time of data collection. Participants were told that the purpose of this
study was to identify helpful factors for counselor training and that it would
take approximately 10 to 15 min to complete the questionnaire. Counselor
trainees could provide their contact information to enter into a drawing for a
US$20 gift certificate.

Measures
Mindfulness.  Mindfulness was assessed using the Mindful Attention Aware-
ness Scale (MAAS; Brown & Ryan, 2003). The MAAS (15 items) assesses
dispositional mindfulness, which refers to awareness of, and attention to,
what is taking place in the present moment. A sample item is “I find it diffi-
cult to stay focused on what’s happening in the present.” Participants were
asked to rate items on a 6-point scale ranging from 1 (almost always) to 6
(almost never). Higher scores indicate greater awareness and attention at the
present moment. Coefficient alphas ranged from .80 to .87 in previous
research (Brown & Ryan, 2003); the alpha coefficient in the present study
was .88. Evidence of construct validity has been shown through positive
associations of mindfulness with subjective well-being, self-esteem, opti-
mism, and self-actualization (Brown & Ryan, 2003).

Psychological flexibility. Psychological flexibility was assessed using the

Acceptance and Action Questionnaire–II (AAQ-II; Bond et al., 2011). The
AAQ-II, which is comprised of seven items, measures willingness to accept
undesirable thoughts and feelings while behaving in a manner that is con-
gruent with constructed values and goals. A sample reverse-scored item is
“My painful experiences and memories make it difficult for me to live a life
that I would value.” Items on the AAQ-II are rated on a 7-point scale from 1
(never true) to 7 (always true). In the original scale, a higher score indicated
a greater level of psychological inflexibility. However, in the present study,
scores for each item were reversed, so that higher scores indicate greater
levels of psychological flexibility. Coefficient alphas ranged from .78 to .87
in Bond et al.’s (2011) study. In the present study, the alpha was .87. Evi-
dence of concurrent validity was supported by negative associations of psy-
chological flexibility with depression, anxiety, and greater overall
psychological ill-health (Bond et al., 2011). Evidence of discriminant valid-
ity was supported by a weak correlation between psychological flexibility
and social desirability (Bond et al., 2011).

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Wei et al. 47

Experiences of hindering self-focused attention.  Experiences of hindering self-

focused attention was measured by the Hindering Self-Awareness scale
(HAS; Williams et al., 2003). The HSA (10 items) measures therapists’ expe-
riences with hindering self-focused attention during a therapy session. It
includes two subscales—Anxious Awareness and Distracting Awareness. A
sample item is “How often do you experience awareness of negative self-talk
(e.g., self-critical thoughts, distracting thoughts) during a session?” Items are
rated on a 5-point scale from 1 (never) to 5 (always). In the original scale, a
higher score indicated more experiences of hindering self-focused attention.
However, in the present study, scores for each item were reversed so that
higher scores indicated fewer experiences of hindering self-focused atten-
tion. The coefficient alpha was .76 in Williams et al.’s (2003) study, and was
.83 in the present study. Williams and colleagues also reported evidence of
construct validity by a significant positive association between hindering
self-focused attention and private self-consciousness, and evidence of dis-
criminant validity by a nonsignificant association between hindering self-
focused attention and self-monitoring among therapists.

Counseling self-efficacy.  Counseling self-efficacy was assessed by the Session

Management Self-Efficacy scale (SMSE; Lent, Hill, & Hoffman, 2003). The
SMSE (10 items) reflects perceived capability to facilitate the process of
counseling sessions. Participants are asked to indicate how confident they are
in their ability to do a number of session management tasks effectively, with
a sample item being, “Help your client to understand his or her thoughts, feel-
ings, and actions.” Items are rated on a 9-point scale from 0 (no confidence at
all) to 9 (complete confidence). Higher scores indicate greater SMSE. Lent
and colleagues (2003) reported coefficient alphas of .96 and .97, respectively,
on their two-time point study among counselors in a prepracticum course.
The coefficient alpha was .93 in the present study. Evidence of validity has
been supported through a positive association with counseling outcome
expectations among counselor trainees (Lent et al., 2003).

Results
Preliminary Analyses
Missing data, which were examined first, ranged from 0.2% for mindfulness
to 0.4% for counseling self-efficacy. The result from Little’s missing com-
pletely at random test was nonsignificant, χ2(35, N = 154) = 40.22, p = .25,
suggesting that the missing cases were not significantly different from the

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48 The Counseling Psychologist 43(1)

nonmissing cases (Schlomer, Bauman, & Card, 2010). In line with sugges-
tions of Schlomer et al., full information maximum-likelihood estimation
method was used for the analyses in Mplus.
Next, a multivariate normality test was conducted to examine whether the
data met the normality assumption. The result of the multivariate normality
test indicated that the data were not multivariate normal, χ2(2, N = 154) =
111.07, p < .001. Therefore, the scaled chi-square statistic (Satorra & Bentler,
1988) was used to adjust for the impact of non-normality on the results, and
the Satorra–Bentler (SB) scaled chi-square difference test (Satorra & Bentler,
2001) was used to compare nested models.
Finally, a chi-square test was used to see whether our sample was repre-
sentative of the national population in terms of race and sex. Only students
from counseling and clinical programs (n = 51) in our sample were used to
compare with national data. In APA accredited counseling and clinical psy-
chology programs, 71% of trainees are non-Latino White and the remainder
are racial and ethnic minorities (http://www.apa.org/ed/accreditation/about/
research/gender-ethnicity-table.pdf). In our sample, 76% of trainees were
non-Latino White and 24% were of racial minority status. The nonsignificant
chi-square result, χ2(1, N = 51) = 0.20, p = .66, implied that the proportion of
races in our sample is comparable with the proportion of races in the national
data. Furthermore, in the national data, as well as in our sample, 77% of train-
ees are female. That is, the proportion of sex in our sample was identical to
the proportion of sex in the national data.
Means, standard deviations, and zero-order correlations for all variables
are provided in Table 1. All four main variables were significantly correlated
with each other. Regarding covariates, age was significantly and positively
associated with mindfulness, psychological flexibility, and fewer experiences
of hindering self-focused attention. The number of practicum courses was
significantly and positively associated with counseling self-efficacy.

Measurement Model
Before examining the measurement model, we created three parcels for each
of the latent variables of mindfulness, psychological flexibility, and counsel-
ing self-efficacy (Russell, Kahn, Spoth, & Altmaier, 1998). To create these
parcels, we first conducted exploratory factor analyses on each scale, extract-
ing a single factor via the maximum-likelihood method. We then rank-ordered
the items on the basis of the absolute magnitude of their factor loadings, and
successively assigned triads of items to each of the three parcels to equalize
the average loadings of each parcel on the respective factor. Reversed scores
for the two subscales of Anxiety Awareness and Distract Awareness were

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Wei et al. 49

Table 1.  Means, Standard Deviations, and Correlations Among Measured

Variables (N = 154).

1 2 3 4 5 6
1. Mindfulness —  
2.  Psychological flexibility .34*** —  
3. Fewer experiences of .41*** .52*** —  
hindering self-focused
attention
4.  Counseling self-efficacy .33*** .35*** .46*** —  
5. Age .29*** .19* .22** .15 —  
6. Number of practicum −.10 −.04 .15 .28** .01 —
courses
M 4.10 5.53 3.44 6.31 29.39 2.16
SD 0.74 0.92 0.48 1.29 8.53 1.64

Note. Means are based on item-level means. Higher scores indicate greater degrees of
mindfulness, psychological flexibility, and counseling self-efficacy, but fewer experiences of
hindering self-focused attention.
*p < .05. **p < .01. ***p < .001.

used as observed indicators for the latent variable of having fewer experi-
ences of hindering self-focused attention.
In line with recommendations by Anderson and Gerbing (1988), we first
conducted a confirmatory factor analysis to examine whether the measure-
ment model showed an acceptable fit to the data before examining our struc-
tural model. All models were estimated using the maximum-likelihood
method in the Mplus 6 program (Muthén & Muthén, 2007). Criteria for
acceptable fit have ranged from comparative fit index (CFI) ≥ .90, standard-
ized root mean square residual (SRMR) and root mean square error approxi-
mation (RMSEA) ≤ .10 to more conservative criteria of CFI ≥ .95, SRMR ≤
.08, and RMSEA ≤ .06 (Hu & Bentler, 1999).
The result of the measurement model indicated a good fit to the data, χ2(52,
N = 154) = 69.25, p = .06, scaled χ2(52, N = 154) = 68.63, p = .06, CFI = .98,
RMSEA = .05, 90% confidence interval (CI) = [.00, .07], SRMR = .04. The
loadings of the measured variables on each latent variable were statistically
significant (ps < .001, see Table 2), which implies that each latent variable
appears to have been adequately measured by its respective indicators.
Furthermore, correlations among the two independent variables (mindfulness
and psychological flexibility), the mediator variable (having fewer experi-
ences of hindering self-focused attention), and the dependent variable (coun-
seling self-efficacy) were all statistically significant (ps < .001, see Table 3).

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50 The Counseling Psychologist 43(1)

Table 2.  Factor Loadings for the Measurement Model (N = 154).

Unstandardized Standardized
Measure and variable factor loading SE Z factor loading
Mindfulness
  Mindfulness Parcel 1 0.69 .03 12.61 0.85***
  Mindfulness Parcel 2 0.69 .03 12.90 0.86***
  Mindfulness Parcel 3 0.70 .03 12.64 0.85***
Psychological flexibility
  Psychological Flexibility Parcel 1 0.84 .03 12.79 0.86***
  Psychological Flexibility Parcel 2 0.92 .03 12.89 0.87***
  Psychological Flexibility Parcel 3 0.83 .04 11.58 0.81***
Fewer experiences of hindering self-focused attention
  Fewer experiences of anxious 0.43 .06 9.43 0.77***
awareness
  Fewer experiences of 0.39 .06 9.25 0.76***
distracting awareness
Counseling self-efficacy
  Counseling Self-Efficacy Parcel 1 1.23 .02 15.32 0.95***
  Counseling Self-Efficacy Parcel 2 1.22 .02 13.35 0.87***
  Counseling Self-Efficacy Parcel 3 1.25 .03 13.11 0.86***
Age 1.00a  
Number of practicum courses 1.00a  

Note. The alpha statistic based on Mindfulness Parcels 1, 2, and 3 was .88; the alpha statistic
based on Psychological Flexibility Parcels 1, 2, and 3 was .88; the alpha statistic based on
Counseling Self-Efficacy Parcels 1, 2, and 3 was .92.
aThese loadings were fixed to 1.00 because there was only one indicator. Therefore, no

significance test is reported for these loadings.

*p < .05. **p < .01. ***p < .001.

Structural Model
Before examining mediation effects, we first computed the direct effects from
mindfulness and psychological flexibility to counseling self-efficacy after con-
trolling for age and number of practicum courses taken. The results indicated a
good fit of the model to the data, χ2(36, N = 154) = 46.83, p = .11, scaled χ2(36,
N = 154) = 45.54, p = .16, CFI = .99, RMSEA = .04, 90% CI = [.00, .08],
SRMR = .04. The direct effect from mindfulness to counseling self-efficacy
was significant, β = .27, p = .002. The direct effect from psychological flexibil-
ity to counseling self-efficacy was also significant, β = .30, p < .001. These
results supported the direct effects of mindfulness and psychological flexibility
on counseling self-efficacy.

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Wei et al. 51

Table 3.  Correlations Among Latent Variables (N = 154).

1 2 3 4 5 6
1. Mindfulness —  
2.  Psychological flexibility .39*** —  
3. Fewer experiences of .53*** .64*** —  
hindering self-focused
attention
4.  Counseling self-efficacy .36*** .39*** .55*** —  
5. Age .33*** .25** .33*** .15 —  
6. Number of practicum −.09 −.03 .09 .28*** .02 —
courses

Note. Age and number of practicum courses are manifest variables. Higher scores indicate
greater degrees of mindfulness, psychological flexibility, and counseling self-efficacy, but fewer
experiences of hindering self-focused attention.
**p < .01. ***p < .001.

Next, we examined the hypothesized partially mediated structural model.

The results indicated a good fit of the model to the data, χ2(52, N = 154) =
69.25, p = .06, scaled χ2(52, N = 154) = 68.63, p = .06, CFI = .98, RMSEA =
.05, 90% CI = [.00, .07], SRMR = .04. All the hypothesized structural paths
(paths c, d, and e) were significant, except for the direct path from mindfulness
to counseling self-efficacy (β = .14, p = .15) and the direct path from psycho-
logical flexibility to counseling self-efficacy (β = .10, p = .39; see Figure 2).
Therefore, we constrained these two direct paths to zero to see whether doing
so worsened the fit of the model to the data. The results for this fully mediated
model also showed a very good fit to the data, χ2(54, N = 154) = 71.65, p = .05,
scaled χ2(54, N = 154) = 71.31, p = .06, CFI = .98, RMSEA = .05, 90% CI =
[.00, .07], SRMR = .04. A chi-square difference test was used to compare the
partially mediated model with the fully mediated model, and the results indi-
cated no significant difference in the fit for the two models, χ2(2, N = 154) =
2.69, p = .26. This indicated that the direct paths from mindfulness and psycho-
logical flexibility did not make a significant contribution to the model. All the
paths related to the mediation hypotheses (i.e., paths c, d, and e) in this fully
mediated model were significant, and this fully mediated model (see Figure 3)
was therefore used to examine the significance levels of the indirect effects.

Bootstrap Procedure for Testing the Significance Level of

Indirect Effects
In line with Shrout and Bolger’s (2002) recommendation to utilize a boot-
strap procedure for testing the significance level of indirect effects, we

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52 The Counseling Psychologist 43(1)

Fewer Experiences
of Hindering Self-
Focused Attention
.31**
.41**

Mindfulness
.14

.39*** .50***
Counseling
.33*** Self-Efficacy
.10
Psychological
Flexibility
-.05

-.08 .25** .10

.26**

Age

-.03 .02
.13

Number of Practicum
Courses

Figure 2.  The partial mediation model.

Note. Dashed lines indicate nonsignificant paths.
**p < .01. ***p < .001.

Fewer Experiences
of Hindering Self-
.35** Focused Attention
.58**

Mindfulness

.39*** .50***
Counseling
.33*** Self-Efficacy

Psychological
Flexibility
-.04

-.08 .25** .09

.23**

Age

-.03 .02
.13

Number of Practicum
Courses

Figure 3.  The full mediation model.

Note. Dashed lines indicate nonsignificant paths.
**p < .01. ***p < .001.

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Wei et al. 53

calculated indirect effects utilizing a total of 10,000 bootstrap samples

(Mallinckrodt, Abraham, Wei, & Russell, 2006). According to Shout and
Bolger’s suggestion, if the 95% CI for the average estimates of these 10,000
indirect effect estimates does not include zero, it can be concluded that the
indirect effect is statistically significant at the .05 level. Results shown in
Figure 2 indicate a significant indirect effect from mindfulness—through
having fewer experiences of hindering self-focused attention—to counseling
self-efficacy, 95% CI = [.15, .61], b = 0.36, β = .35 × .58 = .20. Similarly,
results indicate a significant indirect effect from psychological flexibility—
through having fewer experiences of hindering self-focused attention—to
counseling self-efficacy, 95% CI = [.24, .65], b = 0.43, β = .50 × .58 = .29.
Thus, results support our hypotheses that having fewer experiences of hinder-
ing self-focused attention mediates both the association between mindfulness
and counseling self-efficacy as well as the association between psychological
flexibility and counseling self-efficacy (see Figure 3). These findings were
significant after controlling for age and number of practicum courses.1
Finally, approximately 40% of the variance in counseling self-efficacy was
explained by having fewer experiences of hindering self-focused attention
and number of practicum courses; 57% of the variance in having fewer expe-
riences of hindering self-focused attention was explained by mindfulness and
psychological flexibility.

Post Hoc Analyses

Although there is good theoretical and empirical support for the direction
of our hypothesized effects, it is possible that having fewer experiences of
hindering self-focused attention might allow trainees to be mindful and
psychologically flexible, which in turn might benefit their counseling self-
efficacy. For this reason, we examined an alternative model wherein hav-
ing fewer experiences of hindering self-focused attention (predictor)
predicted mindfulness and psychological flexibility (mediators), which in
turn predicted counseling self-efficacy (outcome). Because this alternative
model and our hypothetical partially mediated model were both saturated
models, the fit indices were identical. However, the 95% CIs included zero
for both indirect effects. Specifically, there was a nonsignificant indirect
effect from having fewer experiences of hindering self-focused atten-
tion—through mindfulness—to counseling self-efficacy, 95% CI = [−.04,
.23], b = 0.09, β = .48 × .14 = .07, and a nonsignificant indirect effect from
having fewer experiences of hindering self-focused attention—through
psychological flexibility—to counseling self-efficacy, 95% CI = [−.18,
.31], b = 0.08, β = .63 × .10 = .06. Therefore, the indirect effects were not
supported by the alternative model.

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54 The Counseling Psychologist 43(1)

Discussion
The current study adds two important contributions to the literature. First, the
results of the present study indicate that having fewer experiences of hinder-
ing self-focused attention mediate the associations between mindfulness and
counseling self-efficacy, even after controlling for age and total number of
practicum courses taken (see Figure 3). This provides evidence that the ben-
efits of mindfulness may apply to counselor trainees, and is consistent with
previous research findings (e.g., Davis & Hayes, 2011). Namely, mindfulness
might help counselor trainees to slow down, attend to the present feelings of
their clients, and communicate a “felt sense” of clients’ inner experiences
(Dreifuss, 1990; Shapiro, Carlson, Astin, & Freedman, 2006). Perhaps train-
ees who are mindful may be likely to stay present with their clients, fully
listen to their clients’ stories, and closely observe their clients’ nonverbal
behaviors (Greason & Cashwell, 2009). All of these abilities can help trainees
pay better attention to their clients and to the counseling tasks at hand rather
than focusing on their own anxiety and other distractions in counseling ses-
sions. Such positive tendencies in counselor trainees would, in turn, be asso-
ciated with higher counseling self-efficacy.
Furthermore, it deserves attention that mindfulness did not add explanatory
power to the prediction of counseling self-efficacy, as the direct relationship
between mindfulness and counseling self-efficacy was not statistically signifi-
cant (see Figure 3). That is, the link between mindfulness and counseling self-
efficacy can be described exclusively in terms of the indirect (i.e., mediation)
effect of having fewer experiences of hindering self-focused attention. Given
that, to date, only one empirical study has examined this mediating effect
(Greason & Cashwell, 2009), the results of the present study advance the lit-
erature by further exploring the underlying mechanisms through which mind-
fulness is beneficial to counseling self-efficacy. Based on the current results,
one plausible reason for the observed positive relationship between mindful-
ness and counseling self-efficacy is that counselor trainees who are mindful
report that they have fewer experiences of hindering self-focused attention
which, in turn, is positively linked to counseling self-efficacy.
Second, the current results indicate that having fewer experiences of hin-
dering self-focused attention mediates the association between psychological
flexibility and counseling self-efficacy (see Figure 3). Again, this result was
significant even after controlling for age and total number of practicum
courses taken. As we addressed previously, the goals of psychological flexi-
bility are (a) to change the relationship one has with undesirable thoughts and
feelings, and (b) to promote behavior that is consistent with one’s valued
goals, such as providing effective counseling to clients, rather than focusing

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Wei et al. 55

on one’s own anxiety (Hayes et al., 1999). This mediation result implies that
counselor trainees with psychological flexibility may be more likely to accept
their anxious or distracting thoughts, thereby allowing them to behave in
accordance with their values of helping clients. That is to say, the positive
qualities associated with being psychologically flexible seem to be beneficial
for counselor trainees, affording them fewer experiences of hindering self-
focused attention, which in turn enhances their counseling self-efficacy.
Similarly, the direct association between psychological flexibility and
counseling self-efficacy changed from significant to nonsignificant after the
mediator of having fewer experiences of hindering self-focused attention was
added to the model (see Figure 3). Specifically, the link between psychologi-
cal flexibility and counseling self-efficacy can also be explained exclusively
from the indirect (i.e., mediation) effect of having fewer experiences of hin-
dering self-focused attention. Again, this finding underscores the role of hav-
ing fewer experiences of hindering self-focused attention in perceptions of
counseling self-efficacy. Although previous research has found that psycho-
logical flexibility is positively associated with counseling self-efficacy
(Stafford-Brown & Pakenham, 2012), the reasons this process occurs were
less certain. Therefore, the results of the present study advance the literature
by identifying a possible factor—having fewer experiences of hindering self-
focused attention—as an important mechanism that underlies the association
between psychological flexibility and counseling self-efficacy.
It is important to note that a sizable portion of the variance in counseling
self-efficacy was explained by having fewer experiences of hindering self-
focused attention (β = .58, see path c in Figure 3). This highlights the need of
training programs to consider counselor trainees’ experiences of hindering
self-focused attention—such as anxiety and distraction—that often erode
counseling self-efficacy. Moreover, the present findings also suggest a need
to encourage supervisors or instructors to address trainees’ anxiety in super-
vision, counseling theory courses, and practicum experiences (e.g., Hill &
Lent, 2006; Williams et al., 2003; Williams, Judge, Hill, & Hoffman, 1997).
Cultivating counseling self-efficacy is a critical component in counselor
training; however, counselor training should not be limited to helping skills,
theoretical orientations, and case conceptualizations. The current study sug-
gests that counselor training should also consider internal counselor factors
such as experiences of being hindered by anxiety and other internal distrac-
tions during counseling sessions.
Our study also provides evidence that a sizable portion of the variance in
having fewer experiences of hindering self-focused attention was explained
by mindfulness (β = .35, see path d in Figure 3) and psychological flexibility
(β = .50, see path e in Figure 3). These results further emphasize the benefit

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56 The Counseling Psychologist 43(1)

of encouraging mindfulness for counselor trainees as a means to have fewer

experiences of hindering self-focused attention. In two qualitative studies
(Christopher et al., 2006; Schure et al., 2008), counselor trainees reported
that, as a result of practicing mindfulness, they were able to focus more
intently on clients and the therapeutic process during sessions. It is possible
that greater mindfulness may help counselor trainees attend to clients’ current
needs rather than to their own anxious or distracting thoughts. Moreover,
greater psychological flexibility may help counselor trainees flexibly direct
their attention away from their anxious or distracting thoughts and toward
specific efforts to help clients in session. The contributions of this study are
in line with recommendations made by Williams and colleagues (2008) to
examine the constructs related to mindfulness and attentional flexibility on
therapists’ experiences of hindering self-focused attention.

Limitations and Future Directions

Despite numerous strengths, this study also had several limitations. First, the
current study only collected data at one time point. Even though we attempted
to rule out one alternative model, our final model cannot provide evidence for
causal relationships among variables. One way to advance the current find-
ings would be to conduct a longitudinal study to examine whether practicing
more mindfulness predicts having fewer experiences of hindering self-
focused attention, which in turn enhances counseling self-efficacy over time.
Moreover, this study failed to consider some potential covariates, such as trait
anxiety. For example, a person with high trait anxiety may also report lower
mindfulness and psychological flexibility, more experiences of hindering
self-focused attention, and lower counseling self-efficacy.
Second, a snowball method of data collection is a limitation because of the
potential for self-selection bias (e.g., only trainees who are interested in this
topic participated in this study). The current study was also limited to the use
of self-report measures for mindfulness and psychological flexibility. Future
study designs might assess how the actual practice of mindfulness and psy-
chological flexibility influences relevant outcome variables such as trainees’
effectiveness in therapy. In one qualitative study, therapists who regularly
practiced mindfulness meditation reported that mindfulness helped them be
more aware of clients’ suffering and experience a “felt sense” of clients’ inner
experiences (Aiken, 2006). Therefore, future studies might examine whether
the frequency of practicing mindfulness and psychological flexibility exer-
cises might predict counselors’ empathy and compassion.
Third, the current study only explored counselor-related factors on counsel-
ing self-efficacy. Many scholars have proposed that practicing mindfulness

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Wei et al. 57

meditation strengthens the therapeutic relationship (e.g., Shapiro & Carlson,

2009) and helps therapists gain personal benefits such as self-care (Rothaupt &
Morgan, 2007). Future research could therefore address how trainees’ mindful-
ness and psychological flexibility contribute to relationship factors (e.g., thera-
peutic working alliance), client factors (e.g., client satisfaction about
counseling), and other counselor factors (e.g., self-compassion, counselor skills
self-efficacy, or counselor self-care). Thus far, to our knowledge, only one
study has explored the influence of mindfulness practice on the development of
trainees’ counseling skills (Buser et al., 2012). Thus, future studies can investi-
gate the contribution of mindfulness practice on improvements in attention dur-
ing sessions, which in turn may lead to an improved therapeutic alliance,
greater client satisfaction, and higher therapist counseling self-efficacy.
Fourth, the current study was limited in that it assessed mindfulness and
psychological flexibility as general traits; therefore, future studies can
assess these two variables in the context of the counseling process. Recently,
Aggs and Bambling (2010) developed the Mindful Therapy Scale to assess
therapist mindfulness in session. With this scale available, researchers can
conduct process studies to examine how a therapist’s mindfulness in ses-
sion can benefit counseling self-efficacy or other counselor outcomes (e.g.,
reducing professional self-doubt, promoting empathy). Similarly, the cur-
rent study examined counselor trainees’ general experiences of hindering
self-focused attention. As we know, counselors’ experiences of their hin-
dering self-focused attention in general may vary significantly with differ-
ent clients. However, thus far, few studies have assessed therapists’ actual
experience of their in-session self-focused attention (Williams & Fauth,
2005). As a result, future studies can continue to advance the current model
by examining whether counselors’ mindfulness or psychological flexibility
in-session allows them to have fewer specific experiences of hindering self-
focused attention, which in turn increases their counseling self-efficacy
with specific clients.
Besides the research directions already presented, it is important to note
that little is still known about the processes by which mindfulness and psy-
chological flexibility are beneficial to the development of counseling self-
efficacy and other relevant counselor outcomes. Future studies might continue
to investigate theoretically relevant mediators to uncover these processes. For
example, mindfulness practice contributes to a decrease in anxiety (Lee et al.,
2007); in turn, anxiety is negatively associated with both empathy (Shapiro,
Schwartz, & Bonner, 1998) and counseling self-efficacy (Larson et al., 1992).
Therefore, taken together, it is possible that mindfulness practice helps coun-
selor trainees reduce their anxiety, which in turn may indirectly foster the
development of empathy and counseling self-efficacy (Buser et al., 2012).

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58 The Counseling Psychologist 43(1)

Implications for Counselor Training

The results from this study have several potential implications for coun-
selor training. This study demonstrated that having fewer experiences of
hindering self-focused attention may help counselor trainees build counsel-
ing self-efficacy. However, in reality, many counselor trainees may experi-
ence hindering self-focused attention such as anxiety, self-critical voices,
and other distractions while in counseling sessions, which can erode their
confidence in their ability to help clients. The present study suggests the
utility of two potential tools for reducing the frequency of experiencing
hindering self-focused attention. The first tool to reduce hindering self-
focused attention is mindfulness; being mindful appears to help counselor
trainees remain present with their clients and attend to the counseling pro-
cess rather than focusing on distractions that impede therapeutic work.
Results of the present study provide empirical support for the emerging
trend of integrating a mindfulness-based curriculum into counselor training
(e.g., McCown, Reibel, & Micozzi, 2010). The second tool the present
study offers to reduce hindering self-focused attention is encouraging psy-
chological flexibility. On one hand, psychological flexibility seems to allow
counselor trainees to change the relations they have with unwanted thoughts
and feelings through accepting or observing them without reacting to them.
On the other hand, psychological flexibility also seems to allow trainees to
freely choose actions, such as paying attention on their clients rather than
focusing on their own unwanted thoughts and feelings (e.g., anxiety or self-
critical voice).
In addition to the two tools already mentioned, during supervision,
supervisors can help their supervisees to process experiences of hindering
self-focused attention. Supervisors can normalize the negative internal
experiences that supervisees face, and help them identify elements of their
counselor role that elicits hindering self-focused attention. To do this,
supervisors may not only utilize interventions that promote mindfulness or
psychological flexibility, but may also consider helping supervisees pro-
cess their personal concerns and underlying reasons for their anxiety.
Similarly, trainees might be encouraged to initiate discussions in supervi-
sion sessions or in practicum classes, so they can learn ways to reduce the
negative influence of hindering self-focused attention on their counseling
work and self-efficacy.

Declaration of Conflicting Interests

The author(s) declared no potential conflicts of interest with respect to the research,
authorship, and/or publication of this article.

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Wei et al. 59

Funding
The author(s) received no financial support for the research, authorship, and/or publi-
cation of this article.

Note
1. The indirect effects were also significant without controlling for age and number
of practicum course. Specifically, the results indicated a significant indirect effect
from mindfulness through having fewer experiences of hindering self-focused
attention to counseling self-efficacy, 95% CI = [.17, .62], b = 0.36, β = .35 × .58 =
.20. Similarly, the results indicated a significant indirect effect from psychological
flexibility through having fewer experiences of hindering self-focused attention
to counseling self-efficacy, 95% CI = [.26, .65], b = 0.43, β = .51 × .58 = .30.
Moreover, being in different training programs (e.g., counseling, clinical), holding
different theoretical orientations and pursuing different educational degrees (i.e.,
master’s vs. doctorate) may also be potential confounding variables. Therefore,
these three variables, age, and number of practicum courses were added into the
model as five covariates. The significant pattern for the indirect effects remained
the same. That is, there was a significant indirect effect from mindfulness through
having fewer experiences of hindering self-focused attention to counseling self-
efficacy, 95% CI = [.02, .47], b = 0.21, β = .29 × .40 = .12. Similarly, there was
a significant indirect effect from psychological flexibility through having fewer
experiences of hindering self-focused attention to counseling self-efficacy, 95%
CI = [.07, .67], b = 0.31, β = .51 × .40 = .20.

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Author Biographies
Meifen Wei is a professor of psychology in the Counseling Psychology program at
Iowa State University. She received her doctorate from the University of Missouri in
2000. Her research focuses on risk and protective factors of coping with minority
stress, attachment and affect regulation, and psychotherapy process and training.
Pei-Chun Tsai is a doctoral candidate in the Counseling Psychology program at Iowa
State University and a current pre-doctoral intern at Georgia Tech University
Counseling Center. Her research interests are (a) the influence of training and supervi-
sion on trainees’ counseling self-efficacy and multicultural counseling competence,
and (b) the intersection of ethnicity, gender, and culture on coping with minority stress.
Daniel G. Lannin is a doctoral candidate in the Department of Psychology at Iowa
State University. His research interests are focused on understanding and mitigating
barriers to seeking psychological help.
Yi Du is a doctoral candidate in counseling psychology at Iowa State University. Her
research interests include psychosocial adjustment of international students, body
image and disordered eating, and clinical anxiety experienced by trainees in counsel-
ing psychology.
Jeritt R. Tucker is a doctoral candidate in counseling psychology at Iowa State
University. His research objectives include (a) better understanding how stigma inter-
feres with seeking psychological help, and (b) identifying counselor characteristics
and interventions that facilitate positive client outcomes.

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