Language Proficiency, Language Discrimination, Counselor Self- Efficacy, and Burnout Among International Counselors-in-Training

Language Proficiency, Language Discrimination, Counselor Self- Efficacy, and Burnout Among International Counselors-in-Training | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Language Proficiency, Language Discrimination, Counselor Self- Efficacy, and Burnout Among International Counselors-in-Training Rui Ding, Randall Boen This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-8991081/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 7 You are reading this latest preprint version Abstract The demand for culturally and linguistically responsive counselor education is rising in the United States; however, existing research on the challenges and mental health of international counselors-in-training is limited. Therefore, this exploratory study examined the relationships between language proficiency, language discrimination, counselor self-efficacy, and burnout among international counselors-in-training. Data were collected from 26 international counselors-in-training with diverse backgrounds. The participants completed a survey about their perceived English proficiency, perceived language discrimination, counselor self-efficacy, and burnout. A correlation analysis was conducted to determine the relationships between the variables. Results indicate that perceived English proficiency was positively associated with counselor self-efficacy, and perceived language discrimination was negatively associated with self-efficacy. Furthermore, perceived English proficiency and perceived language discrimination were negatively correlated. Burnout did not show a significant relationship with any of these variables. These findings highlight the intricate relationship between linguistic experiences and counselors’ confidence. Implications for counselor educators, supervisors, and the larger counseling community are discussed. language proficiency language discrimination counselor self-efficacy burnout counselor education supervision Introduction Within the past decade, student body diversity has become a focus within counselor education. This has significantly increased international student enrollment in counseling programs; in 2025, international students comprised 1.39% of all students enrolled in programs accredited by the Council for the Accreditation of Counseling and Related Educational [1], marking a more than 200% increase since 2015 [2]. These students have contributed to program diversity and improved access to mental health services for global and immigrant communities. However, they also face language barriers and cultural adjustment, as well as clinical and career development challenges [3–6]. Adapting therapy interventions to clients’ cultural worldviews contributes to better outcomes for diverse clients and requires counselors to understand culture and language as core elements of practice [7–10]. Despite these limitations, the cultural and linguistic backgrounds of mental health providers, especially international counselors-in-training (CITs), have received limited scholarly attention [11,12]. International counseling students face challenges such as language demands, adapting to new cultural environments and educational systems, reconciling non-Western values with prevailing counseling models, and encountering limited cultural sensitivity in training programs [13–16]. Thus, researching language barriers, counselor self-efficacy (CSE), and burnout among international CITs, especially their interrelationships and development, can improve understanding of these counselors’ professional growth. Language Barriers, Proficiency, and Discrimination International students face sociolinguistic challenges in expressing themselves and being understood in English, which can lead to concerns about being ridiculed for their language skills [14]. An early study involving foreign-born counselor education students found that language significantly influenced participants’ self-image and self-efficacy perceptions [17]. This issue is particularly evident among counseling trainees whose first language is not English; when doing clinical work in the United States, they are typically required to have advanced English proficiency [14,18]. The American Counseling Association’s Code of Ethics defines counseling as “a professional relationship that empowers diverse individuals, families, and groups to accomplish mental health, wellness, education, and career goals” [19, p. 3]. Language constitutes a fundamental aspect of both cultural and individual identity [20]; to provide culturally responsive services, counselors must integrate language considerations into their multicultural competence [21]. International counseling trainees whose first language is not English face significant challenges, such as foreign language anxiety and language proficiency [4]. Specifically, sociolinguistic experiences are conceptualized as perceived English proficiency (PEP) and perceived language discrimination (PLD) [22]. International clinicians often face language discrimination and are seen as less competent than native English-speaking therapists [16,18,23]. Peng et al. reported that international trainees face language discrimination in clinical environments, including low tolerance for therapists’ mistakes among clients, judgments about professionalism based on accents, and disappointment at being assigned to these therapists [23]. In educational environments, international counseling trainees encounter English proficiency–related discrimination from United States faculty, peers, and clients, which may contribute to a sense of inadequacy [23,24]. As a result, some trainees internalize the belief that their lack of English fluency equates clinical deficiency, even when they demonstrate clinical competence [24,25]. Finally, language discrimination during supervision can further lead trainees to feel disempowered and to experience reduced clinical self-efficacy [26]. The existing research highlights the importance of considering the connections between language, CSE, and negative consequences for trainees, such as burnout. Specifically, the sociolinguistic experiences of international CITs with English may affect their CSE. Counselor Self-Efficacy In counseling, when interactions involve multiple factions, individuals’ beliefs about their abilities can be shaped by their relationships with others. In this relational context, clients’ comments, nonverbal cues, and imagined reactions will likely affect how a counselor interprets their own efforts at performing counseling behaviors [23]. CSE specifically refers to counselors’ beliefs about their capability to provide practical services to clients [27]. Counselor education research indicates that self-efficacy includes career self-efficacy and counselor competence, and that supervision is important in helping counselors build self-efficacy [28–31]. Self-efficacy plays a crucial role in the ability of professional counselors to perform their roles successfully and confidently. Council for Accreditation of Counseling and Related Educational Programs (CACREP) standards emphasize that counseling programs should improve students’ self-efficacy by processing foundational coursework and clinical experiences to fill the gap between coursework and clinical practice [32]. Therefore, specific influences, such as CSE, among CITs from different cultures and even language backgrounds need to be understood [32]. Considering this process, using non-native language in counseling sessions could be challenging for international counseling students. Interpersonal and intrapersonal processes, such as racial identity development, are critical for improved self-efficacy outcomes of international counseling students [33]. Wade-Ball et al. found that racial identity development significantly predicts self-efficacy among CITs of color [34]. These authors advocated that the counselors could work with mentors or supervisors to support their ethnic-racial identity development further. Such mentoring could help students through reflective exercises, increasing awareness of their personal assumptions, values, and biases [34]. Okech and DeVoe observed that counselors’ reflective processes are significantly enhanced by working with individuals from different countries [35]; these interactions prompt them to reconsider aspects of life they may have been overlooked before leaving their home country. Burnout Burnout refers to the emotional and physical response to chronic workplace stressors, often resulting in significant negative outcomes [36]. Burnout in mental health professionals is influenced by various factors, including complex multidisciplinary collaboration, challenging relationships with clients and their families, client suicide, and legal frameworks [37–39]. Specific stressors related to clinic environments—such as overwhelming workload, inappropriate referrals, role conflicts, lack of supervision, or limited institutional support—can also contribute to burnout 40–42]. Cook et al. identified symptoms of burnout using data from 246 novice counselors [43]. Common indicators included anxiety, depression, frequent crying, persistent fatigue, and job dissatisfaction; the participants also reported increased illness, weight changes, reduced confidence in their abilities, and difficulty concentrating. Burnout can impact different periods of counseling professional life, and CITs, starting their counseling path with clients, may be particularly vulnerable to burnout, as they struggle to balance academic, professional, and personal responsibilities [44,45]. Reysen et al. found that CITs experience burnout due to academic and personal stress, which may result in physical and mental health issues [46]. Additionally, Wardle and Mayorga reported that more than half of counseling students experienced moderate to severe burnout symptoms [47]. Effectively managing burnout among CITs has been shown to prevent counselor impairment and foster wellness, thereby supporting professional outcomes consistent with the general wellness orientation of the counseling profession [19,48, 49]. Previous research has primarily focused on external factors contributing to burnout among professional counselors, such as time allocated to non-counseling duties, inadequate support, and adverse work environments [50]. In contrast, internal factors, including counselors’ personal experiences of adversity, remain underexplored. Considering the specific environment international counseling students face when working with clients, exploring factors that help them build a counterforce against burnout is meaningful. Purpose of This Study The research addressed the following questions: (1) What is the relationship between PEP, PLD, and CSE among international CITs? (2) What is the relationship between PEP, PLD, and burnout among international CITs? Method Procedure and Participants Following approval from a university’s institutional review board, a four-stage participant recruitment procedure was implemented. First, students currently enrolled in counselor education programs at a large midwestern university were invited to participate through a survey distributed by the researcher. Second, emails were sent to CACREP-accredited programs to recruit international CITs. A total of 451 CACREP-accredited counseling programs were contacted. Third, recruitment materials were disseminated through professional organizations and listservs serving counselor education students nationwide, including the Association for Counselor Education and Supervision interest networks such as the Bilingual Counselor Education and Supervision and International Students and Faculty Interest Network. Follow-up requests were sent to enhance response rates. Finally, a recruitment flyer was posted in the ACA–Chinese Students Scholars Discussion Group on WeChat, a social media group for counseling students and scholars. CITs were eligible for the survey if they self-identified as an international student, were currently enrolled in a CACREP-accredited program, were actively engaged in clinical work during internship or practicum, or provided counseling within the past year. Participants completed a Qualtrics online survey, accessed via a link provided in the recruitment email. Informed consent was included on the Qualtrics online survey, to be completed before participants started the survey. Completion of the survey required approximately 15 minutes. Data collection was conducted during two intervals: April to June 2025 and August 2025 to January 2026. A total of 26 participants were included in the analysis. The sample included 3 participants aged 18 to 24 years, 17 participants aged 25 to 34 years, 3 participants aged 35 to 44 years, 2 participants aged 45 to 54 years, and 1 participant aged 55 to 64 years. The sample included 4 men and 22 women. Fifteen (57.69%) participants were doctoral students, and 11 (42.31%) were master-level students. Ten (38.5%) were in clinical mental health counseling, 1 (3.8%) in school counseling, and 15 (57.7%) in counselor education and supervision. The average supervision experience for the participants was 24.57 months. Instruments Perceived English Proficiency Scale The Perceived English Proficiency Scale consists of seven items rated on a 6-point scale from 1 (not at all competent) to 6 (extremely competent)[51]. This scale measures participants’ perceptions of their English proficiency in listening, speaking, reading, and writing, and their overall English ability. In a previous study involving Chinese international students, the scale demonstrated a Cronbach’s alpha coefficient of 0.79, and construct validity was supported by a positive correlation with self-esteem [52]. Perceived Language Discrimination The Perceived Language Discrimination Scale includes seven items rated on a 5-point scale from 1 (strongly disagree) to 5 (strongly agree), to assess participants’ perceptions of negative treatment due to their English [51]. Higher scores on this instrument reflect greater PLD. The Perceived Language Discrimination Scale demonstrates strong reliability, with Cronbach’s alphas ranging from 0.89 to 0.90 [51]. Counselor Activity Self-Efficacy Scales The Counselor Activity Self-Efficacy Scales consists of 41 items rated on a 10-point Likert scale from 0 (no confidence) to 9 (complete confidence)[53]. It measures counselors’ self-efficacy in performing activities related to their professional role, including their perceived ability, helping skills, and coping with advanced or challenging clinical situations. The scales include three subscales: Helping Skill Self-Efficacy, Session Management Self-Efficacy, and Counseling Challenges Self-Efficacy. The full Counselor Activity Self-Efficacy Scales demonstrated an internal consistency of 0.97; the internal consistency of the subscales ranged from 0.79 to 0.94 [53]. Counselor Burnout Inventory The Counselor Burnout Inventory is a 20-item measure rated on a 5-point Likert scale from 1 (never true) to 5 (always true)[54]. It assesses counselors’ burnout levels across five subscales, each with four items: Exhaustion, Incompetence, Negative Work Environment, Devaluing Clients, and Deterioration in Personal Life. Subscale scores range from 5 to 20, with higher scores indicating greater burnout. The factor structure was explored and confirmed using two independent samples of counselors from various U.S. settings [54]. Gnilka et al. found that Cronbach’s alpha for the total Counselor Burnout Inventory was 0.88, with subscale alphas between 0.73 and 0.85 in a sample of school counselors [55]. Demographic Questionnaire Participants were asked to complete a six-item demographic questionnaire developed for the purposes of this study. The information collected on this form includes if they are an international student or not, age, gender, degree, specialty area, and supervision experience. Data Analysis The data cleaning process excluded 37 samples with more than 25% missing data [56]. In accordance with previous studies, potential outliers—defined as values exceeding three standard deviations from the mean—were evaluated [57,58]. No outliers were identified in the present analysis. Descriptive statistics were then calculated to summarize the four variables, and Cronbach’s alpha was computed to assess the internal consistency of the scales. To explore the relationships between PEP, PLD, CES, and burnout and address the research questions, bivariate correlation analyses were conducted. The p-value of 0.05 was considered statistically significant in this study. All data analyses were performed using IBM SPSS Statistics (Version 30). Results Table 1 . Descriptive statistics and reliability estimates for key variables Variable Items M SD Min Max Cronbach’s α PEPS 7 4.69 0.91 2.71 6 0.96 PLDS 7 2.02 0.72 1.00 3.57 0.90 CASES 41 6.39 1.14 4.37 8.8 0.97 CBI 20 2.03 0.42 1.05 2.8 0.86 Note. Items = number of survey items; SD = standard deviation; Min =minimum; Max =maximum. PEPS = Perceived English Proficiency Scale; PLDS = Perceived Language Discrimination Scale; CASES = Counselor Activity Self-Efficacy Scales; CBI = Counselor Burnout Inventory. Some variables had missing data. Table 1 lists the descriptive statistics for the main variables. Internal consistency and reliability were assessed using Cronbach’s alpha for each scale. Reliability estimates were interpreted cautiously due to the small sample size. The Perceived English Proficiency Scale, the Perceived Language Discrimination Scale, and the Counselor Activity Self-Efficacy Scales showed excellent reliability (Cronbach’s α = 0.96, 0.90, and 0.97, respectively). The Counselor Burnout Inventory showed good reliability (Cronbach’s α = 0.86). Table 2 Bivariate correlations between key variables Variable (1) (2) (3) (4) (1) PEPS 1 (2) PLDS −0.78** 1 (3) CASES 0.50** −0.39* 1 (4) CBI −0.14 0.20 −0.01 1 Note. Spearman’s rho is reported. PEPS = Perceived English Proficiency Scale; PLDS = Perceived Language Discrimination Scale; CASES = Counselor Activity Self-Efficacy Scales; CBI = Counselor Burnout Inventory. *p < 0.05, **p < 0.01 Due to the study’s exploratory nature and small sample size, we used nonparametric correlational analyses with a Spearman’s rho (ρ) [59]. The Spearman’s rho (ρ) was calculated to get associations between the four variables, and effect sizes of correlations were interpreted as large (ρ = 0.50), medium (ρ = 0.30), and small (ρ = 0.10), based on established benchmarks [60]. A large negative association was found between PEP and PLD, ρ = −0.78, p < 0.01 (Table 2). The results also showed a large positive association between PEP and CSE, ρ = 0.50, p < 0.01, suggesting that greater PEP was associated with higher CSE. In addition, the results showed a medium negative association between PLD and CSE, ρ = −0.39, p < 0.05, suggesting that greater PLD was associated with lower CSE. Discussion This exploratory study investigated the relationships between PEP, PLD, CSE, and burnout among international CITs. The findings offer substantial insights into how these factors influence the clinical practice of international CITs. In particular, these results enhance the understanding of multilingual counselor training and present significant implications for graduate program educators, clinical supervisors, and scholars in the field. These preliminary findings are intended to guide larger-scale studies in the future. PEP exhibited a strong positive association with CSE, which is consistent with previous findings [58,61]. This may indicate a positive relationship: greater confidence in English proficiency aligns with higher confidence in performing counseling services and handling challenges in the sessions. This finding supports the conclusions of Leggett and Interiano-Shiverdecker et al. that the adaptation of international CITs to the host culture, including their use of English, influences their CSE [62,63]. Considering the communication requirement for counseling ability, including case conceptualization and therapeutic dialogue, international CITs may be more careful about their language usage in their clinical practice. Considering this, language proficiency may exert a particularly significant influence on self-efficacy beliefs, which are essential for skill development, persistence, and professional identity formation. In contrast, PLD demonstrated a moderate negative association with CSE. This finding indicates that language-based discrimination may serve as a barrier to the development of CSE. This aligns with past research stating that foreign language anxiety, defined as anxiety when learning or using a second language, can undermine confidence, weaken therapeutic rapport, and reduce CSE in international CITs [64–66]. This finding also aligns with the study by Kissil et al. that perceived prejudice against international counselors significantly predicted their self-efficacy [67]. Although language limitations did not hinder effective therapy with American clients, counselors were seen as less competent because of their accent, which reduced their confidence during sessions [68]. Perceived prejudice among international counselors has been identified as a significant predictor of their clinical self-efficacy, particularly in relation to basic helping skills [61]. Experiences of client rejection often led these counselors to question their professional competence, and such emotional responses and experiences subsequently influenced their counseling efficacy [67]. Future research should examine more nuanced factors of language-based discrimination that include variables such as cultural value conflict, bicultural stress, or clinical conflicts. The study also found that PEP was negatively associated with PLD; this is consistent with former studies [22,51,69]. This relationship indicates that international CITs who reported higher confidence in their English abilities tended to have lower occurrence of language-based discrimination. The magnitude of this effect suggests that language proficiency may play a central role in shaping trainees’ experiences within their training environments. This result aligns with previous conceptual work proposing that linguistic confidence can protect individuals from marginalization, whereas repeated experiences of discrimination may diminish perceptions of language competence. Although causality cannot be established, the strength of this association highlights the importance of language experiences in the counseling contexts of international trainees. For the second research question, the findings showed that the associations between burnout and PEP, PLD, and CSE were small and nonsignificant. These results may be due to the sample’s higher educational attainment (56% of participants pursuing doctoral degrees) and access to resources that can reduce burnout [70]. These resources include support from faculty and colleagues [71] and mentoring [72,73]. Given this result, future research could incorporate more diverse samples from various graduate levels and program branches to further investigate the relationship between burnout, language-related variables, and CSE. Limitations and Future Directions Several limitations of this study should be considered when interpreting the findings. First, reliance on self-report measures introduces the risk of response bias, particularly when language-related variables are assessed using a single item. Although self-reported language proficiency correlates with objective fluency measures [74], English proficiency includes speaking, listening, reading, and writing skills [75,76]. Only relying on self-report items may not capture these dimensions adequately or fully reflect participants’ language abilities [76]. Moreover, the sample size may also restrict generalizability. The study focused on international CITs currently engaged in clinical work, most of whom were doctoral students in counselor education and supervision or master’s students in clinical mental health counseling. Consequently, these findings may not represent all international CITs, especially those who have not begun clinical work or are in other specialties, such as school counseling, rehabilitation counseling, or couples and family counseling. The cross-sectional design further restricts the ability to draw causal conclusions about the relationships between PEP, PLD, CSE, and burnout. The study did not evaluate personal factors, such as duration of residence in the United States, individual challenges, or available support systems, all of which may influence English proficiency, self-efficacy, and coping strategies relevant to burnout. Additionally, the analysis did not consider geographic differences in participants’ origins or linguistic backgrounds, thereby limiting the comprehensiveness of the findings. Future research may incorporate objective English testing, such as the Test of English as a Foreign Language, International English Language Testing System, or Duolingo English Test, to objectively measure English proficiency. In addition, further expanding the surveys to include distinct indicators for speaking, listening, reading, and writing would enable a more comprehensive evaluation of participants’ language competence, particularly in clinical or educational contexts that emphasize mental health or counseling-related language, vocabulary, and knowledge application. Additionally, studies should include trainees from diverse cultural and linguistic backgrounds to better understand how PEP, PLD, self-efficacy, and burnout interact with demographic variables. With larger and more diverse samples, researchers could further examine the relationship between language-related factors and burnout. Longitudinal studies are recommended to track the development of CSE and coping strategies for preventing burnout over time. In addition, future studies could explore how language-related factors influence international CITs’ attitudes and emotions in response to client no-shows, dropouts, and transfers, which may affect their counseling efficacy [23]. Such research would provide insights into the broader impact on counselor training outcomes. Moreover, additional intervention research is necessary to evaluate on- and off-campus resources for international counseling students, such as English-speaking clubs, counseling-specific workshops, and mentoring, and their relationships with self-efficacy and language proficiency [77]. Implications This study has several key implications for counseling professionals when working with international CITs, such as counselor educators, supervisors, and the broader counseling community. First, the positive correlation between PEP and CSE suggests that CITs’ perceptions of their English abilities in listening, speaking, reading, and writing contribute to their self-efficacy. Counselor educators should develop training environments that foster language proficiency as a key contributor to CSE development. Counselor educators could offer additional mentorship and resources to increase the confidence of international CITs when interacting with clients (e.g., using role-play with peers or faculty to improve listening and speaking), and in case note management (e.g., offering an index of specialized terminology to improve reading and writing). Those areas warrant additional information and support to help international CITs grow. Second, the negative correlation between PLD and CSE suggests that CITs’ perceptions of language discrimination may undermine their counseling efficacy. Peng et al. found that, due to PLD based on their language and ethnic background, international CITs often experienced no-shows, transfers, and dropouts among their clients [23]. It is not unusual for international CITs to experience frustration with their language and self-doubt when they encounter clients’ evolving needs [23]. In this situation, the supervisor should take more responsibility to help international CITs cope with PLD. They could offer extra check-in time and track the progress of practicum/internship, especially regarding direct hours requirements. In addition, offering co-therapy sessions with peers or supervisors at the beginning of the practicum could be helpful, given that international students are often dealing with discrimination for the first time in their lives and may not recognize it, especially early in their programs [78]. Given that international CITs working with clients during their first year are likely to have less counseling experience than their American counterparts, supervisors should implement these interventions earlier [23]. Lastly, the counseling community (e.g., ACA, Association for Counselor Education and Supervision) should advocate for international trainees. The community can engage in community-level advocacy, including facilitating communication among interest groups, encouraging related topics at conferences or in publications, and offering more accessible resources through websites and other channels. Conclusion This exploratory study investigated the relationships between PEP, PLD, CSE, and burnout in international CITs. The results showed a positive association between PEP and self-efficacy, whereas PLD was negatively associated with self-efficacy. Additionally, PEP and PLD exhibited a negative correlation. These results highlight the importance of integrating linguistically and culturally adaptive pedagogy into counselor education training and supervision. Future research should employ longitudinal designs and include more diverse cultural and linguistic samples to clarify the interactions between PEP, PLD, CSE, and burnout. Declarations Funding This work did not receive any funding or support from funding agencies in the public, commercial, or not-for-profit sectors. Data Availability The datasets generated during and/or analyzed during the current study are not publicly available due to the need to protect and preserve respondents’ confidentiality. However, they are available from the corresponding author upon reasonable request. Ethical Approval The project was reviewed and approved by the University of Iowa. The procedures used in this study adhere to the tenets of the Declaration of Helsinki Informed Consent to Participate All participants were adults (≥18 years). Electronically informed consent was obtained from all participants prior to data collection. Participants were fully informed about the purpose of the study, the procedures involved, potential risks and benefits, and their right to withdraw at any stage without any penalty Consent for publication Not applicable. Conflicts of interest The authors declare that they have no competing interests. Acknowledgements Not applicable. References Council for Accreditation of Counseling and Related Educational Programs. 2024 Vital statistics report [Internet]. 2025. 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Psychol. 2024;43(5–6):620–50. https://doi.org/10.1177/0261927X241291258 McDowell T, Fang S-R, Kosutic I, Griggs J. Centering the voices of international students in family studies and family therapy graduate programs. J. Marital Fam. Ther. 2012;38(1):332–347. https://doi.org/10.1111/j.1752-0606.2012.00310.x Additional Declarations No competing interests reported. Cite Share Download PDF Status: Under Review Version 1 posted Reviews received at journal 03 Apr, 2026 Reviewers agreed at journal 26 Mar, 2026 Reviewers invited by journal 26 Mar, 2026 Editor invited by journal 09 Mar, 2026 Editor assigned by journal 09 Mar, 2026 Submission checks completed at journal 05 Mar, 2026 First submitted to journal 05 Mar, 2026 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. 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This has significantly increased international student enrollment in counseling programs; in 2025, international students comprised 1.39% of all students\u0026nbsp;enrolled in programs accredited by the Council for the Accreditation of Counseling and Related Educational [1], marking a more than 200% increase since 2015 [2]. These students have contributed to program diversity and improved access to mental health services for global and immigrant communities. However, they also face\u0026nbsp;language barriers and cultural adjustment, as well as clinical and career development challenges [3\u0026ndash;6]. Adapting therapy interventions to clients\u0026rsquo; cultural worldviews contributes to better outcomes for diverse clients and requires counselors to understand culture and language as core elements of practice [7\u0026ndash;10]. Despite these limitations, the cultural and linguistic backgrounds of mental health providers, especially international counselors-in-training (CITs), have received limited scholarly attention [11,12].\u0026nbsp;International counseling students face challenges such as language demands, adapting to new cultural environments and educational systems, reconciling non-Western values with prevailing counseling models, and encountering limited cultural sensitivity in training programs [13\u0026ndash;16]. Thus, researching language barriers, counselor self-efficacy (CSE), and burnout among international CITs, especially their interrelationships and development, can improve understanding of these counselors\u0026rsquo; professional growth.\u0026nbsp;\u003c/p\u003e\n\u003ch2\u003eLanguage Barriers, Proficiency, and Discrimination\u003c/h2\u003e\n\u003cp\u003eInternational students face sociolinguistic challenges in expressing themselves and being understood in English, which can lead to concerns about being ridiculed for their language skills [14].\u0026nbsp;An early study involving foreign-born counselor education students found that language significantly influenced participants\u0026rsquo; self-image and self-efficacy perceptions [17]. This issue is particularly evident among counseling trainees whose first language is not English; when doing clinical work in the United States, they are typically required to have advanced English proficiency [14,18]. The American Counseling Association\u0026rsquo;s Code of Ethics defines counseling as \u0026ldquo;a professional relationship that empowers diverse individuals, families, and groups to accomplish mental health, wellness, education, and career goals\u0026rdquo; [19, p. 3]. Language constitutes a fundamental aspect of both cultural and individual identity [20]; to provide culturally responsive services, counselors must integrate language considerations into their multicultural competence [21]. International counseling trainees whose first language is not English face significant challenges, such as foreign language anxiety and language proficiency [4].\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eSpecifically, sociolinguistic experiences are conceptualized as perceived English proficiency (PEP) and perceived language discrimination (PLD) [22]. International clinicians often face language discrimination and are seen as less competent than native English-speaking therapists [16,18,23]. Peng et al. reported that international trainees face language discrimination in clinical environments, including low tolerance for therapists\u0026rsquo; mistakes among clients, judgments about professionalism based on accents, and disappointment at being assigned to these therapists [23]. In educational environments, international counseling trainees encounter English proficiency\u0026ndash;related discrimination from United States faculty, peers, and clients, which may contribute to a sense of inadequacy [23,24]. As a result, some trainees internalize the belief that their lack of English fluency equates clinical deficiency, even when they demonstrate clinical competence [24,25]. Finally, language discrimination during supervision can further lead trainees to feel disempowered and to experience reduced clinical self-efficacy [26].\u003c/p\u003e\n\u003cp\u003eThe existing research highlights the importance of considering the connections between language, CSE, and negative consequences for trainees, such as burnout. Specifically, the sociolinguistic experiences of international CITs with English may affect their CSE.\u003c/p\u003e\n\u003ch2\u003eCounselor Self-Efficacy\u003c/h2\u003e\n\u003cp\u003eIn counseling, when interactions involve multiple factions, individuals\u0026rsquo; beliefs about their abilities can be shaped by their relationships with others. In this relational context, clients\u0026rsquo; comments, nonverbal cues, and imagined reactions will likely affect how a counselor interprets their own efforts at performing counseling behaviors [23]. CSE specifically refers to counselors\u0026rsquo; beliefs about their capability to provide practical services to clients [27]. Counselor education research indicates that self-efficacy includes career self-efficacy and counselor competence, and that supervision is important in helping counselors build self-efficacy [28\u0026ndash;31]. Self-efficacy plays a crucial role in the ability of professional counselors to perform their roles successfully and confidently.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eCouncil for Accreditation of Counseling and Related Educational Programs (CACREP) standards emphasize that counseling programs should improve students\u0026rsquo; self-efficacy by processing foundational coursework and clinical experiences to fill the gap between coursework and clinical practice [32]. Therefore, specific influences, such as CSE, among CITs from different cultures and even language backgrounds need to be understood [32]. Considering this process, using non-native language in counseling sessions could be challenging for international counseling students.\u003c/p\u003e\n\u003cp\u003eInterpersonal and intrapersonal processes, such as racial identity development, are critical for improved self-efficacy outcomes of international counseling students [33]. Wade-Ball et al. found that racial identity development significantly predicts self-efficacy among CITs of color [34]. These authors advocated that the counselors could work with mentors or supervisors to support their ethnic-racial identity development further. Such mentoring could help students through reflective exercises, increasing awareness of their personal assumptions, values, and biases [34]. Okech and DeVoe observed that counselors\u0026rsquo; reflective processes are significantly enhanced by working with individuals from different countries [35]; these interactions prompt them to reconsider aspects of life they may have been overlooked before leaving their home country.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eBurnout\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eBurnout refers to the emotional and physical response to chronic workplace stressors, often resulting in significant negative outcomes [36].\u0026nbsp;Burnout in mental health professionals is influenced by various factors, including complex multidisciplinary collaboration, challenging relationships with clients and their families, client suicide, and legal frameworks [37\u0026ndash;39]. Specific stressors related to clinic environments\u0026mdash;such as overwhelming workload, inappropriate referrals, role conflicts, lack of supervision, or limited institutional support\u0026mdash;can also contribute to burnout 40\u0026ndash;42].\u0026nbsp;Cook et al. identified symptoms of burnout using data from 246 novice counselors [43]. Common indicators included anxiety, depression, frequent crying, persistent fatigue, and job dissatisfaction; the participants also reported increased illness, weight changes, reduced confidence in their abilities, and difficulty concentrating.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eBurnout can impact different periods of counseling professional life, and CITs, starting their counseling path with clients, may be particularly vulnerable to burnout, as they struggle to balance academic, professional, and personal responsibilities [44,45]. Reysen et al. found that CITs experience burnout due to academic and personal stress, which may result in physical and mental health issues [46]. Additionally, Wardle and Mayorga reported that more than half of counseling students experienced moderate to severe burnout symptoms [47]. Effectively managing burnout among CITs has been shown to prevent counselor impairment and foster wellness, thereby supporting professional outcomes consistent with the general wellness orientation of the counseling profession [19,48, 49].\u003c/p\u003e\n\u003cp\u003ePrevious research has primarily focused on external factors contributing to burnout among professional counselors, such as time allocated to non-counseling duties, inadequate support, and adverse work environments [50]. In contrast, internal factors, including counselors\u0026rsquo; personal experiences of adversity, remain underexplored. Considering the specific environment international counseling students face when working with clients, exploring factors that help them build a counterforce against burnout is meaningful.\u003c/p\u003e\n\u003ch2\u003ePurpose of This Study\u003c/h2\u003e\n\u003cp\u003eThe research addressed the following questions: (1) What is the relationship between PEP, PLD, and CSE among international CITs? (2) What is the relationship between PEP, PLD, and burnout among international CITs?\u003c/p\u003e"},{"header":"Method","content":"\u003ch2\u003eProcedure and Participants\u003c/h2\u003e\n\u003cp\u003eFollowing approval from a university\u0026rsquo;s institutional review board, a four-stage participant recruitment procedure was implemented. First, students currently enrolled in counselor education programs at a large midwestern university were invited to participate through a survey distributed by the researcher. Second, emails were sent to CACREP-accredited programs to recruit international CITs. A total of 451 CACREP-accredited counseling programs were contacted. Third, recruitment materials were disseminated through professional organizations and listservs serving counselor education students nationwide, including the Association for Counselor Education and Supervision interest networks such as the Bilingual Counselor Education and Supervision and International Students and Faculty Interest Network. Follow-up requests were sent to enhance response rates. Finally, a recruitment flyer was posted in the ACA\u0026ndash;Chinese Students Scholars Discussion Group on WeChat, a social media group for counseling students and scholars. CITs were eligible for the survey if they self-identified as an international student, were currently enrolled in a CACREP-accredited program, were actively engaged in clinical work during internship or practicum, or provided counseling within the past year. Participants completed a Qualtrics online survey, accessed via a link provided in the recruitment email. Informed consent was included on the Qualtrics online survey, to be completed before participants started the survey. Completion of the survey required approximately 15 minutes. Data collection was conducted during two intervals: April to June 2025 and August 2025 to January 2026.\u003c/p\u003e\n\u003cp\u003eA total of 26 participants were included in the analysis. The sample included 3 participants aged 18 to 24 years, 17 participants aged 25 to 34 years, 3 participants aged 35 to 44 years, 2 participants aged 45 to 54 years, and 1 participant aged 55 to 64 years. The sample included 4 men and 22 women. Fifteen (57.69%) participants were doctoral students, and 11 (42.31%) were master-level students. Ten (38.5%) were in clinical mental health counseling, 1 (3.8%) in school counseling, and 15 (57.7%) in counselor education and supervision. The average supervision experience for the participants was 24.57 months.\u003c/p\u003e\n\u003ch2\u003eInstruments\u003c/h2\u003e\n\u003ch3\u003ePerceived English Proficiency Scale\u0026nbsp;\u003c/h3\u003e\n\u003cp\u003eThe Perceived English Proficiency Scale consists of seven items rated on a 6-point scale from 1 (not at all competent) to 6 (extremely competent)[51]. This scale measures participants\u0026rsquo; perceptions of their English proficiency in listening, speaking, reading, and writing, and their overall English ability. In a previous study involving Chinese international students, the scale demonstrated a Cronbach\u0026rsquo;s alpha coefficient of 0.79, and construct validity was supported by a positive correlation with self-esteem [52].\u003c/p\u003e\n\u003ch3\u003ePerceived Language Discrimination\u0026nbsp;\u003c/h3\u003e\n\u003cp\u003eThe Perceived Language Discrimination Scale includes seven items rated on a 5-point scale from 1 (strongly disagree) to 5 (strongly agree), to assess participants\u0026rsquo; perceptions of negative treatment due to their English [51]. Higher scores on this instrument reflect greater PLD. The Perceived Language Discrimination Scale demonstrates strong reliability, with Cronbach\u0026rsquo;s alphas ranging from 0.89 to 0.90 [51].\u0026nbsp;\u003c/p\u003e\n\u003ch3\u003eCounselor Activity Self-Efficacy Scales\u003c/h3\u003e\n\u003cp\u003eThe Counselor Activity Self-Efficacy Scales consists of 41 items rated on a 10-point Likert scale from 0 (no confidence) to 9 (complete confidence)[53]. It measures counselors\u0026rsquo; self-efficacy in performing activities related to their professional role, including their perceived ability, helping skills, and coping with advanced or challenging clinical situations. The scales include three subscales: Helping Skill Self-Efficacy, Session Management Self-Efficacy, and Counseling Challenges Self-Efficacy. The full Counselor Activity Self-Efficacy Scales demonstrated an internal consistency of 0.97; the internal consistency of the subscales ranged from 0.79 to 0.94 [53].\u0026nbsp;\u003c/p\u003e\n\u003ch3\u003eCounselor Burnout Inventory\u003c/h3\u003e\n\u003cp\u003eThe Counselor Burnout Inventory is a 20-item measure rated on a 5-point Likert scale from 1 (never true) to 5 (always true)[54]. It assesses counselors\u0026rsquo; burnout levels across five subscales, each with four items: Exhaustion, Incompetence, Negative Work Environment, Devaluing Clients, and Deterioration in Personal Life. Subscale scores range from 5 to 20, with higher scores indicating greater burnout. The factor structure was explored and confirmed using two independent samples of counselors from various U.S. settings [54]. Gnilka et al. found that Cronbach\u0026rsquo;s alpha for the total Counselor Burnout Inventory was 0.88, with subscale alphas between 0.73 and 0.85 in a sample of school counselors [55].\u0026nbsp;\u003c/p\u003e\n\u003ch3\u003eDemographic Questionnaire\u003c/h3\u003e\n\u003cp\u003eParticipants were asked to complete a six-item demographic questionnaire developed for the purposes of this study. The information collected on this form includes if they are an international student or not, age, gender, degree, specialty area, and supervision experience.\u003c/p\u003e\n\u003ch2\u003eData Analysis\u0026nbsp;\u003c/h2\u003e\n\u003cp\u003eThe data cleaning process excluded 37 samples with more than 25% missing data [56]. In accordance with previous studies, potential outliers\u0026mdash;defined as values exceeding three standard deviations from the mean\u0026mdash;were evaluated [57,58]. No outliers were identified in the present analysis. Descriptive statistics were then calculated to summarize the four variables, and Cronbach\u0026rsquo;s alpha was computed to assess the internal consistency of the scales. To explore the relationships between PEP, PLD, CES, and burnout and address the research questions, bivariate correlation analyses were conducted. The p-value of 0.05 was considered statistically significant in this study. All data analyses were performed using IBM SPSS Statistics (Version 30).\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003e\u003cstrong\u003eTable 1\u003c/strong\u003e\u003cstrong\u003e. Descriptive statistics and reliability estimates for key variables\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"521\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 72px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eVariable\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 54px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eItems\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 48px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eM\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 53px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSD\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 76px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMin\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 106px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMax\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 113px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eCronbach\u0026rsquo;s \u0026alpha;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 72px;\"\u003e\n \u003cp\u003ePEPS\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 54px;\"\u003e\n \u003cp\u003e7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 48px;\"\u003e\n \u003cp\u003e4.69\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 53px;\"\u003e\n \u003cp\u003e0.91\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 76px;\"\u003e\n \u003cp\u003e2.71\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 106px;\"\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 113px;\"\u003e\n \u003cp\u003e0.96\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 72px;\"\u003e\n \u003cp\u003ePLDS\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 54px;\"\u003e\n \u003cp\u003e7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 48px;\"\u003e\n \u003cp\u003e2.02\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 53px;\"\u003e\n \u003cp\u003e0.72\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 76px;\"\u003e\n \u003cp\u003e1.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 106px;\"\u003e\n \u003cp\u003e3.57\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 113px;\"\u003e\n \u003cp\u003e0.90\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 72px;\"\u003e\n \u003cp\u003eCASES\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 54px;\"\u003e\n \u003cp\u003e41\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 48px;\"\u003e\n \u003cp\u003e6.39\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 53px;\"\u003e\n \u003cp\u003e1.14\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 76px;\"\u003e\n \u003cp\u003e4.37\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 106px;\"\u003e\n \u003cp\u003e8.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 113px;\"\u003e\n \u003cp\u003e0.97\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 72px;\"\u003e\n \u003cp\u003eCBI\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 54px;\"\u003e\n \u003cp\u003e20\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 48px;\"\u003e\n \u003cp\u003e2.03\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 53px;\"\u003e\n \u003cp\u003e0.42\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 76px;\"\u003e\n \u003cp\u003e1.05\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 106px;\"\u003e\n \u003cp\u003e2.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 113px;\"\u003e\n \u003cp\u003e0.86\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cem\u003eNote.\u003c/em\u003e Items = number of survey items; SD = standard deviation; Min =minimum; Max =maximum. PEPS = Perceived English Proficiency Scale; PLDS = Perceived Language Discrimination Scale; CASES = Counselor Activity Self-Efficacy Scales; CBI = Counselor Burnout Inventory. Some variables had missing data.\u003c/p\u003e\n\u003cp\u003eTable 1 lists the descriptive statistics for the main variables. Internal consistency and reliability were assessed using Cronbach\u0026rsquo;s alpha for each scale. Reliability estimates were interpreted cautiously due to the small sample size. The Perceived English Proficiency Scale, the Perceived Language Discrimination Scale, and the Counselor Activity Self-Efficacy Scales showed excellent reliability (Cronbach\u0026rsquo;s \u0026alpha; = 0.96, 0.90, and 0.97, respectively). The Counselor Burnout Inventory showed good reliability (Cronbach\u0026rsquo;s \u0026alpha; = 0.86).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003e2 Bivariate correlations between key variables\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"512\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 94px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eVariable\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 107px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e(1)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 95px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e(2)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 107px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e(3)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 109px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e(4)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 94px;\"\u003e\n \u003cp\u003e(1) PEPS\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 107px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 95px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 107px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 109px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 94px;\"\u003e\n \u003cp\u003e(2) PLDS\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 107px;\"\u003e\n \u003cp\u003e\u0026minus;0.78**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 95px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 107px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 109px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 94px;\"\u003e\n \u003cp\u003e(3) CASES\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 107px;\"\u003e\n \u003cp\u003e0.50**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 95px;\"\u003e\n \u003cp\u003e\u0026minus;0.39*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 107px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 109px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 94px;\"\u003e\n \u003cp\u003e(4) CBI\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 107px;\"\u003e\n \u003cp\u003e\u0026minus;0.14\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 95px;\"\u003e\n \u003cp\u003e0.20\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 107px;\"\u003e\n \u003cp\u003e\u0026minus;0.01\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 109px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cem\u003eNote.\u003c/em\u003e Spearman\u0026rsquo;s rho is reported. PEPS = Perceived English Proficiency Scale; PLDS = Perceived Language Discrimination Scale; CASES = Counselor Activity Self-Efficacy Scales; CBI = Counselor Burnout Inventory. *p \u0026lt; 0.05, **p \u0026lt; 0.01\u003c/p\u003e\n\u003cp\u003eDue to the study\u0026rsquo;s exploratory nature and small sample size, we used nonparametric correlational analyses with a Spearman\u0026rsquo;s rho (\u0026rho;) [59]. The Spearman\u0026rsquo;s rho (\u0026rho;) was calculated to get associations between the four variables, and effect sizes of correlations were interpreted as large (\u0026rho; = 0.50), medium (\u0026rho; = 0.30), and small (\u0026rho; = 0.10), based on established benchmarks [60]. A large negative association was found between PEP and PLD, \u0026rho; = \u0026minus;0.78, p \u0026lt; 0.01 (Table 2). The results also showed a large positive association between PEP and CSE, \u0026rho; = 0.50, p \u0026lt; 0.01, suggesting that greater PEP was associated with higher CSE. In addition, the results showed a medium negative association between PLD and CSE, \u0026rho; = \u0026minus;0.39, p \u0026lt; 0.05, suggesting that greater PLD was associated with lower CSE.\u0026nbsp;\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eThis exploratory study investigated the relationships between PEP, PLD, CSE, and burnout among international CITs. The findings offer substantial insights into how these factors influence the clinical practice of international CITs. In particular, these results enhance the understanding of multilingual counselor training and present significant implications for graduate program educators, clinical supervisors, and scholars in the field. These preliminary findings are intended to guide larger-scale studies in the future.\u003c/p\u003e\n\u003cp\u003ePEP exhibited a strong positive association with CSE, which is consistent with previous findings [58,61]. This may indicate a positive relationship: greater confidence in English proficiency aligns with higher confidence in performing counseling services and handling challenges in the sessions. This finding supports the conclusions of Leggett and Interiano-Shiverdecker et al. that the adaptation of international CITs to the host culture, including their use of English, influences their CSE [62,63]. Considering the communication requirement for counseling ability, including case conceptualization and therapeutic dialogue, international CITs may be more careful about their language usage in their clinical practice. Considering this, language proficiency may exert a particularly significant influence on self-efficacy beliefs, which are essential for skill development, persistence, and professional identity formation.\u003c/p\u003e\n\u003cp\u003eIn contrast, PLD demonstrated a moderate\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003enegative association with CSE. This finding indicates that language-based discrimination may serve as a barrier to the development of CSE. This aligns with past research stating that foreign language anxiety, defined as anxiety when learning or using a second language, can undermine confidence, weaken therapeutic rapport, and reduce CSE in international CITs [64\u0026ndash;66]. This finding also aligns with the study by Kissil et al. that perceived prejudice against international counselors significantly predicted their self-efficacy [67]. Although language limitations did not hinder effective therapy with American clients, counselors were seen as less competent because of their accent, which reduced their confidence during sessions [68]. Perceived prejudice among international counselors has been identified as a significant predictor of their clinical self-efficacy, particularly in relation to basic helping skills [61]. Experiences of client rejection often led these counselors to question their professional competence, and such emotional responses and experiences subsequently influenced their counseling efficacy [67]. Future research should examine more nuanced factors of language-based discrimination that include variables such as cultural value conflict, bicultural stress, or clinical conflicts.\u003c/p\u003e\n\u003cp\u003eThe study also found that PEP was negatively associated with PLD; this is consistent with former studies [22,51,69]. This relationship indicates that international CITs who reported higher confidence in their English abilities tended to have lower occurrence of language-based discrimination. The magnitude of this effect suggests that language proficiency may play a central role in shaping trainees\u0026rsquo; experiences within their training environments. This result aligns with previous conceptual work proposing that linguistic confidence can protect individuals from marginalization, whereas repeated experiences of discrimination may diminish perceptions of language competence. Although causality cannot be established, the strength of this association highlights the importance of language experiences in the counseling contexts of international trainees.\u003c/p\u003e\n\u003cp\u003eFor the second research question, the findings showed that the associations between burnout and PEP, PLD, and CSE were small and nonsignificant. These results may be due to the sample\u0026rsquo;s higher educational attainment (56% of participants pursuing doctoral degrees) and access to resources that can reduce burnout [70]. These resources include support from faculty and colleagues [71] and mentoring [72,73]. Given this result, future research could incorporate more diverse samples from various graduate levels and program branches to further investigate the relationship between burnout, language-related variables, and CSE.\u003c/p\u003e\n\u003ch2\u003eLimitations and Future Directions\u003c/h2\u003e\n\u003cp\u003eSeveral limitations of this study should be considered when interpreting the findings.\u003c/p\u003e\n\u003cp\u003eFirst, reliance on self-report measures introduces the risk of response bias, particularly when language-related variables are assessed using a single item. Although self-reported language proficiency correlates with objective fluency measures [74], English proficiency includes speaking, listening, reading, and writing skills [75,76]. Only relying on self-report items may not capture these dimensions adequately or fully reflect participants\u0026rsquo; language abilities [76]. Moreover, the sample size may also restrict generalizability. The study focused on international CITs currently engaged in clinical work, most of whom were doctoral students in counselor education and supervision or master\u0026rsquo;s students in clinical mental health counseling. Consequently, these findings may not represent all international CITs, especially those who have not begun clinical work or are in other specialties, such as school counseling, rehabilitation counseling, or couples and family counseling. The cross-sectional design further restricts the ability to draw causal conclusions about the relationships between PEP, PLD, CSE, and burnout. The study did not evaluate personal factors, such as duration of residence in the United States, individual challenges, or available support systems, all of which may influence English proficiency, self-efficacy, and coping strategies relevant to burnout. Additionally, the analysis did not consider geographic differences in participants\u0026rsquo; origins or linguistic backgrounds, thereby limiting the comprehensiveness of the findings.\u003c/p\u003e\n\u003cp\u003eFuture research may incorporate objective English testing, such as the Test of English as a Foreign Language, International English Language Testing System, or Duolingo English Test, to objectively measure English proficiency. In addition, further expanding the surveys to include distinct indicators for speaking, listening, reading, and writing would enable a more comprehensive evaluation of participants\u0026rsquo; language competence, particularly in clinical or educational contexts that emphasize mental health or counseling-related language, vocabulary, and knowledge application. Additionally, studies should include trainees from diverse cultural and linguistic backgrounds to better understand how PEP, PLD, self-efficacy, and burnout interact with demographic variables. With larger and more diverse samples, researchers could further examine the relationship between language-related factors and burnout. Longitudinal studies are recommended to track the development of CSE and coping strategies for preventing burnout over time. In addition, future studies could explore how language-related factors influence international CITs\u0026rsquo; attitudes and emotions in response to client no-shows, dropouts, and transfers, which may affect their counseling efficacy [23]. Such research would provide insights into the broader impact on counselor training outcomes. Moreover, additional intervention research is necessary to evaluate on- and off-campus resources for international counseling students, such as English-speaking clubs, counseling-specific workshops, and mentoring, and their relationships with self-efficacy and language proficiency [77].\u003c/p\u003e\n\u003ch2\u003eImplications\u003c/h2\u003e\n\u003cp\u003eThis study has several key implications for counseling professionals when working with international CITs, such as counselor educators, supervisors, and the broader counseling community. First, the positive correlation between PEP and CSE suggests that CITs\u0026rsquo; perceptions of their English abilities in listening, speaking, reading, and writing contribute to their self-efficacy. Counselor educators should develop training environments that foster language proficiency as a key contributor to CSE development. Counselor educators could offer additional mentorship and resources to increase the confidence of international CITs when interacting with clients (e.g., using role-play with peers or faculty to improve listening and speaking), and in case note management (e.g., offering an index of specialized terminology to improve reading and writing). Those areas warrant additional information and support to help international CITs grow. Second, the negative correlation between PLD and CSE suggests that CITs\u0026rsquo; perceptions of language discrimination may undermine their counseling efficacy. Peng et al. found that, due to PLD based on their language and ethnic background, international CITs often experienced no-shows, transfers, and dropouts among their clients [23]. It is not unusual for international CITs to experience frustration with their language and self-doubt when they encounter clients\u0026rsquo; evolving needs [23]. In this situation, the supervisor should take more responsibility to help international CITs cope with PLD. They could offer extra check-in time and track the progress of practicum/internship, especially regarding direct hours requirements. In addition, offering co-therapy sessions with peers or supervisors at the beginning of the practicum could be helpful, given that international students are often dealing with discrimination for the first time in their lives and may not recognize it, especially early in their programs [78]. Given that international CITs working with clients during their first year are likely to have less counseling experience than their American counterparts, supervisors should implement these interventions earlier [23]. Lastly, the counseling community (e.g., ACA, Association for Counselor Education and Supervision) should advocate for international trainees. The community can engage in community-level advocacy, including facilitating communication among interest groups, encouraging related topics at conferences or in publications, and offering more accessible resources through websites and other channels.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eThis exploratory study investigated the relationships between PEP, PLD, CSE, and burnout in international CITs. The results showed a positive association between PEP and self-efficacy, whereas PLD was negatively associated with self-efficacy. Additionally, PEP and PLD exhibited a negative correlation. These results highlight the importance of integrating linguistically and culturally adaptive pedagogy into counselor education training and supervision. Future research should employ longitudinal designs and include more diverse cultural and linguistic samples to clarify the interactions between PEP, PLD, CSE, and burnout.\u003c/p\u003e\n\u003cp\u003e\u003cbr\u003e\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eFunding\u003cbr\u003e\u003c/strong\u003eThis work did not receive any funding or support from funding agencies in the public, commercial, or not-for-profit sectors.\u003cstrong\u003e\u003cbr\u003e\u0026nbsp;Data Availability\u003cbr\u003e\u003c/strong\u003eThe datasets generated during and/or analyzed during the current study are not publicly available due to the need to protect and preserve respondents\u0026rsquo; confidentiality. However, they are available from the corresponding author upon reasonable request.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthical Approval\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe project was reviewed and approved by the University of Iowa. The procedures used in this study adhere to the tenets of the Declaration of Helsinki\u003cbr\u003e\u003cstrong\u003eInformed Consent to Participate\u003cbr\u003e\u0026nbsp;\u003c/strong\u003eAll participants were adults (\u0026ge;18 years). Electronically informed consent was obtained from all participants prior to data collection. Participants were fully informed about the purpose of the study, the procedures involved, potential risks and benefits, and their right to withdraw at any stage without any penalty\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConflicts of interest\u003cbr\u003e\u003c/strong\u003eThe authors declare that they have no competing interests.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgements\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eCouncil for Accreditation of Counseling and Related Educational Programs. 2024 Vital statistics report [Internet]. 2025. 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Ther. 2012;38(1):332\u0026ndash;347. https://doi.org/10.1111/j.1752-0606.2012.00310.x\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"discover-education","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"diedu","sideBox":"Learn more about [Discover Education](https://www.springer.com/journal/44217)","snPcode":"44217","submissionUrl":"https://submission.nature.com/new-submission/44217/3","title":"Discover Education","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"Discover Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"language proficiency, language discrimination, counselor self-efficacy, burnout, counselor education, supervision","lastPublishedDoi":"10.21203/rs.3.rs-8991081/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-8991081/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003eThe demand for culturally and linguistically responsive counselor education is rising in the United States; however, existing research on the challenges and mental health of international counselors-in-training is limited. Therefore, this exploratory study examined the relationships between language proficiency, language discrimination, counselor self-efficacy, and burnout among international counselors-in-training. Data were collected from 26 international counselors-in-training with diverse backgrounds. The participants completed a survey about their perceived English proficiency, perceived language discrimination, counselor self-efficacy, and burnout. A correlation analysis was conducted to determine the relationships between the variables. Results indicate that perceived English proficiency was positively associated with counselor self-efficacy, and perceived language discrimination was negatively associated with self-efficacy. Furthermore, perceived English proficiency and perceived language discrimination were negatively correlated. Burnout did not show a significant relationship with any of these variables. These findings highlight the intricate relationship between linguistic experiences and counselors\u0026rsquo; confidence. Implications for counselor educators, supervisors, and the larger counseling community are discussed.\u003c/p\u003e","manuscriptTitle":"Language Proficiency, Language Discrimination, Counselor Self- Efficacy, and Burnout Among International Counselors-in-Training","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-03-27 16:18:17","doi":"10.21203/rs.3.rs-8991081/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"editorInvitedReview","content":"","date":"2026-04-03T07:46:50+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"106773412318515705509540163139207533820","date":"2026-03-26T06:56:05+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2026-03-26T06:16:53+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2026-03-09T14:53:06+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2026-03-09T07:12:39+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2026-03-05T20:39:49+00:00","index":"","fulltext":""},{"type":"submitted","content":"Discover Education","date":"2026-03-05T14:02:26+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"discover-education","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"diedu","sideBox":"Learn more about [Discover Education](https://www.springer.com/journal/44217)","snPcode":"44217","submissionUrl":"https://submission.nature.com/new-submission/44217/3","title":"Discover Education","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"Discover Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"fd97e507-9cdd-4a65-8ebe-7b371f662651","owner":[],"postedDate":"March 27th, 2026","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2026-03-27T16:18:17+00:00","versionOfRecord":[],"versionCreatedAt":"2026-03-27 16:18:17","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-8991081","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-8991081","identity":"rs-8991081","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}