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This study examined the reciprocal association between counseling trainees' trait and state anxiety and their clients' symptom distress and the mediating effects of working alliance. Data set included 6,888 sessions conducted by 211 master's level beginning therapists with their 1,216 clients in China. Trainees completed a measure of trait anxiety at the beginning of practicum. Before each session, trainees completed the state anxiety measure and clients reported their symptom distress; and after every session, both the trainees and clients rated their perceived working alliance. Multilevel modeling showed that (a) Therapist trainees' level of trait anxiety did not predict overall client outcome in terms of symptom reduction. (b) At the session-to-session level, higher therapist state anxiety before one session significantly predicted higher client distress before the next session, and higher client distress before one session significantly predicted higher therapist state anxiety before the subsequent session. (c) Therapist and client perceptions of working alliance were both significant mediators of the reciprocal relationship between therapist state anxiety and client distress. Findings suggested that it was trainees' state anxiety, instead of trait anxiety, that reciprocally related to client symptom outcome at the session-to-session level. Implications for clinical training were discussed. PRACTICAL IMPLICATIONS A generally more anxious therapist trainee does not seem to have worse overall clinical effectiveness compared with a generally less anxious trainee. From session to session, trainees who experience less state anxiety tend to establish a stronger working alliance with their clients, which leads to more client symptom relief. Evidence suggests against selecting trainees based on their trait anxiety level; but it is recommended that supervisors help trainees manage their state anxiety before a session. [ABSTRACT FROM AUTHOR]