Emotion labor and Strain in a Child Psychiatry Unit: On the Interplay between Interpersonal Emotion Regulation towards Patients and Emotional Reflexivity

Purpose - Child psychiatry professionals are required to engage in the physical and affective containment of patients when they display negative or disruptive emotional responses. However, our understanding of the association between this specific type of emotion labor and strain is still limited. This study examined a multilevel moderated mediation model positing a) interpersonal response modulation (IRM; downregulating or suppressing patients’ emotions as required by the job) as a predictor of negative affect (NAS) and interpersonal strain (ISW; disengagement from interpersonal interactions at work) at the daily level, b) daily NAS as a mediating mechanism, and c) emotional reflexivity (REFL; capacity of reflecting upon and learning from emotions in a socio-relational context), modeled in terms of between-individual differences and within-days variations, as a moderating condition. Method - Data were collected on 42 workers of an Italian Child Psychiatry operating unit (79,8% response rate) who completed a baseline questionnaire and five daily assessments for a total of 210 shifts. Preliminary in-depth interviews were conducted to support the ecological validity of the study and measures. Multilevel modeling was employed. Findings - Results showed that, at the day level, IRM was positively associated with NAS which, in turn, was related to higher ISW. The association between daily IRM and ISW was fully mediated by NAS. Individual-level REFL did not significantly moderated these associations. In contrast, day-level REFL significantly moderated the direct and indirect effects of IRM, such that only when daily fluctuations in REFL were low, IRM increased NAS and, in turn, affected ISW. Theoretical and practical implications – Our study extends the emotion labor framework within an interpersonal perspective. This is the first study to explore the protective role of REFL, emphasizing the importance of training this personal resource. Limitations – Self-report measures. Retrospective assessment of affective experiences at the end of the shift.