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Graduate School Theses and Dissertations Graduate School
The Relationships Between Individual Characteristics, Work Factors, and Emotional Labor Strategies in the Prediction of Burnout among Mental Health Service Providers
Jessica Belle Handelsman
University of South Florida, email@example.com
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Handelsman, Jessica Belle, "The Relationships Between Individual Characteristics, Work Factors, and Emotional Labor Strategies in the Prediction of Burnout among Mental Health Service Providers" (2012). Graduate School Theses and Dissertations. http://scholarcommons.usf.edu/etd/4064
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The Relationships Between Individual Characteristics, Work Factors, and Emotional Labor Strategies in the Prediction of Burnout among Mental Health Service Providers
Jessica B. Handelsman
A dissertation submitted in partial fulfillment of the requirements for the degree of Doctor of Philosophy Department of Psychology College of Arts and Sciences University of South Florida
Major Professor: Marc Karver, Ph.D. Vicky Phares, Ph.D. J. Kevin Thompson, Ph.D. Paul Spector, Ph.D. Jeffrey Kromrey, Ph.D. Committee Chairperson: Kathy Bradley-Klug, Ph.D. Date of Approval December 6, 2011
Keywords: Role Conflict, Role Ambiguity, Autonomy, Extraversion, Display Rules Copyright © 2012 Jessica B. Handelsman
Table of Contents List of Tables List of Figures Abstract Chapter One: Introduction Professional Burnout Predictors of Burnout Environmental/Work-related Factors Individual Factors Emotional Dissonance Emotions and Emotion Regulation Emotional Labor Chapter Two: Methods Participants Procedures Measures Background Information Personality Work-related Stressors Display Rules Emotional Labor Burnout Chapter Three: Results Descriptive Statistics Correlational Analyses Hypothesis Testing Supplemental Analyses Demographic Variables Professional Variables Caseload/Client Characteristics Perceived Emotional Display Rules Job-related Affective Well-being Adapted Emotional Abilities Scale i iii v vi 1 10 12 19 32 39 44 59 59 62 63 63 64 65 67 69 71 80 80 80 81 89 89 90 91 92 94 94
Chapter Four: Discussion Extraversion and Burnout Work Stressors and Burnout Extraversion as a Moderator of the Relationships between Work Stressors and Burnout Emotional Labor and Burnout Extraversion and Emotional Labor Extraversion as a Moderator of the Relationships between Work Stressors and Emotional Labor Emotional Labor Strategies as Mediators between Work Stressors and Burnout Supplemental Findings Demographic Variables and Burnout Professional Background Variables and Burnout Perceived Display Rules Perceived Importance of Emotion Management Job-related Affective Well-being Limitations Future Directions References Appendices Appendix A: Study Consent Page Appendix B: Background Questionnaire Appendix C: Challenging Client Behavior and Circumstances Questionnaire Appendix D: Eysenck Personality Questionnaire – Brief Version: Extraversion Subscale Appendix E : Role Conflict, Role Ambiguity, Job Autonomy Scales Appendix F: Job-Related Affective Well-Being Scale Appendix G: Perceived Display Rules Questionnaire Appendix H: Perceived Emotional Abilities Scale Appendix I: Emotional Labor Items Appendix J: Maslach Burnout Inventory – Human Services Survey
114 114 118 122 123 129 130 131 133 133 135 140 143 145 145 150 154 196 197 201 202 203 204 205 206 207 208
Moderate. and High Burnout MBI Subscale Correlation Matrix Descriptives for Measures of Independent and Dependent Variables 73 76 77 78 79 96 Pearson Correlation Coefficients among Primary and Secondary Variables 97 Extraversion Predicting Burnout Role Conflict Predicting Burnout 100 101 102 103 104 106 107 Table 10 Role Ambiguity Predicting Burnout Table 11 Autonomy Predicting Burnout Table 12 Burnout Predicted from Work Stressors and Extraversion: Moderation Model Table 13 Surface Acting Predicting Burnout Table 14 Surface Acting Predicted from Work Stressors and Extraversion: Moderation Model Table 15 Deep Acting Predicted from Work Stressors and Extraversion: Moderation Model 108 Table 16 Burnout Predicted from Role Conflict and Surface Acting Table 17 Burnout Predicted from Role Conflict and Faking: Mediation Test Table 18 Burnout Predicted from Role Ambiguity and Surface Acting iii 109 110 111 .List of Tables Table 1 Table 2 Table 3 Table 4 Table 5 Table 6 Table 7 Table 8 Table 9 MHP Demographic and Professional Characteristics MHP Client and Work Characteristics MBI Subscale Score Classifications Percentage of Sampled MHPs with Low.
Table 19 Burnout Predicted from Role Ambiguity and Faking Table 20 Response Frequencies for Perceived Emotional Display Rules Survey 112 113 iv .
List of Figures Figure I Conceptual Model 58 v .
e. surface acting and deep acting). role ambiguity.. role conflict. The present study aimed to fill a gap in the literature by evaluating the empirical links between work stressors (i. known as emotional labor (i.e. and surface acting were significantly associated with one or more dimensions of burnout. personality (i. extraversion). extraversion. autonomy.. The effects of emotional labor strategies as mediators of the relationships between work stressors and burnout were not statistically vi . Most notably. role conflict.e.e.Abstract Relatively few empirical studies in the professional burnout literature have examined mental health providers (MHPs). deep acting and surface acting). etc. The results of this study supported several of the hypothesized relationships between predictor variables and burnout. and burnout in a sample of MHPs. Support was not found for extraversion as a moderator of the relationships between work stressors and burnout or between work stressors and emotional labor strategies.e.) were also explored. Additional variables (i. Research on other professional groups has demonstrated that certain emotion regulation strategies. Data from an online survey of 188 MHPs working in Florida was analyzed using multivariate and univariate regressions. and are differentially associated with burnout... role ambiguity. emotional labor (i.e. professional guidelines for emotional expression). and lack of autonomy). client characteristics. perceived emotional display rules. are common responses to perceived display rules (i...
Implications and limitations of the findings. are discussed.significant. as well as suggestions for future research. vii .
refers to reduced feelings of fulfillment and satisfaction regarding one’s work or impact on clients. Schaufeli. The third dimension. Depersonalization (DP). developed by Maslach and her colleagues. Schaufeli & Enzman. & Leiter. 1998). diminished Personal Accomplishment (PA). 1986. as well as the development of more negative self-evaluations regarding one’s ability to perform his/her professional roles competently and with ease (Maslach & Jackson. conceptualizes professional burnout on a tri-dimensional continuum (Maslach and Jackson 1986). The first dimension. 1997. 1986. The most prominent and influential model of burnout. 1998). The second dimension. Although research indicates that burnout occurs across a variety of occupations. resulting in fatigue and/or distress (Maslach & Jackson. 1986. Emotional Exhaustion (EE). impersonal. 1974) over thirty years ago. refers to a depletion of emotional and psychological resources available to perform in one’s professional role.101) arising out of chronically elevated occupational stress (Maslach. and dehumanizing attributions about the recipients of one’s services (Maslach & Jackson. Schaufeli & Enzmann.Introduction Professional burnout – “a unique response syndrome” (Zohar. 1 . mental health service providers (MHPs) are thought to be at increased risk for burnout given the demanding and “intensely personal nature” of their work (Rupert & Morgan. 2001) – has gained international attention and been the focus of thousands of publications since it first appeared in the social sciences literature (Freudenberger. refers to a cognitive bias towards making negative. p. 1998). Schaufeli & Enzman.
In providing services to certain populations (e. Within the context of providing direct clinical services (e. Freudenberger. MHPs’ personal resources also are devoted to developing positive working relationships with their clients’ primary caregivers. Handelsman. 1986. Kim. Handelsman. and behaviors in clinical situations. However. Jackson. teachers. in part. Fields. court-mandated. feelings. case management). 1993. & Schuler.. Over the last half-century. An Action Plan for Behavioral Health Workforce 2 . the professional demands on MHPs extend beyond their therapeutic roles. particularly those that elicit cognitive dissonance. etc. see also Cherniss. program administrators. emotional dissonance. and physical resources. MHPs’ personal resources are directed toward not only identifying and accommodating their clients’ individual needs. and Bickman. facilitating clinical interventions during and between sessions.544. or other “countertransference” reactions. Yang.. referral sources. scheduling sessions. to socio-cultural and economic shifts. 1981). p.g. Schwab. Karver. Kim. developmentally disabled. and other individuals. elderly. incarcerated.. 2006).g. 1988.g. & Lee. who may be relied upon for the purposes of supplying information. the field of psychology has undergone dramatic changes related.2005. Today. MHPs in the United States are struggling to reconcile the conflicting interests of individual clients. cognitive.). youth. and other vested parties (Rupert & Morgan. insurance companies. Working in the mental health field can be both personally rewarding and demanding of one’s emotional. 2004. assessment. Leiter & Maslach. Lim. 1975. transporting clients to and from sessions. 2010. and monitoring clients’ safety and compliance with treatment recommendations (e. 2005. treatment. Maslach & Jackson. but also self-monitoring their own thoughts.
empirical studies of MHPs and/or other types of human service workers have shown burnout to be positively related to mental health problems (e. In addition. Rupert & Morgan. insomnia. 2004.. gastrointestinal disturbance. headaches. Rupert & Baird. Burnell. The importance of research in this area is underscored by evidence linking burnout to a variety of negative outcomes for individual workers. it reasons that MHPs would be at high risk for developing burnout. and reporting. The rise of managed healthcare has put greater financial pressure on MHPs to increase their caseloads and shorten the length of treatment. and consumers. 2004. as well as job dissatisfaction.. 2005). Rupert & Kent. SAMHSA. Specifically. physical health problems (e.g. Given the types of demands and pressures they face.g. 1988).g. & Kurdek. Rosenberg & Pace.Development. 2005. burnout was estimated to affect as many as one-third of practicing psychologists in the 1980s (Ackerley. while generating rapid and long-lasting clinical results (Rupert & Baird. absenteeism. 2005). anxiety. Rupert & Morgan. 2007).g.. and cognitive impairments (e. depression. 2004. An Action Plan for Behavioral Health Workforce Development. deficits related to nonverbal memory and both auditory and visual attention).. stress. Rupert & Morgan. decreased self-esteem). documentation. changes in professional and legal guidelines regarding assessment. and 3 . 2007). While contemporary prevalence rates have not been published. SAMHSA.. Bakker et al. poor work performance. coupled with downsizing within organizations due to financial constrictions. and a number of recent studies indicate that it continues to be a significant concern for psychologists and other service providers within mental health settings (e. 2007. prolonged illnesses). 2006. 2006. have increased the demands placed on MHPs (Rupert & Baird. Holder. organizations.
1997. & Schaufeli. Rupert & Morgan. 1986. Sixma. increased absenteeism. 2004. negatively influence their coworkers’ attitudes. 1989. Zhang. emotional distress. Maslach & Leiter. and innovation. For instance. & Bosveld. 2003). and turnover. 2006). & Schaufeli. That is.g. Studies have provided preliminary evidence to support this theory. Cherniss 1980. 2000. 2003). Olsson. 2006. Lee & Ashforth.turnover (e. diminished performance. 2005. Schaufeli. 2005. Related.g. 1992. 2005). 1989. Kahill. symptoms of burnout (e.) may be perceptible to others and. Rhodin Lunberg. a number of researchers have indicated that the behavioral manifestations of burnout may be transmitted to coworkers through a social contagion effect. Halbesleben & Buckley. 1993.. as agencies confront problems associated with diminished productivity. which may place remaining staff at greater risk for burnout (Evans et al. & Nyberg.. 1996.g. Elman & Dowd. As such... & Jiang.. etc. Bakker. lower organizational commitment and job satisfaction. Buunk & Schaufeli. Halbesleben & Buckley. feelings.. 2003. thus. reduced productivity. absenteeism. Xu. Furthermore. 2001. Sandstrom. 1998).. Bakker and Schaufeli 4 . 1997. among burned-out employees (Evans et al. cynical attitudes. Cherniss. it is not surprising that research has shown burnout to be a significant predictor of MHPs’ reported intentions to leave the mental health field altogether (e. & Enzmann.g. Rupert & Morgan. 2006). Bakker & Schaufeli. Edelwich & Brodsky 1980. and higher turnover may result in staff shortages and excessive workloads for remaining staff (Evans et al. Demerouti. 1988. Burke & Greenglass. creativity. Burke & Deszca. 2004. Shirom. Bakker. Raquepaw & Miller. and higher healthcare costs. Raquepaw & Miller. 1993. Bakker. Le Blanc. 2005. Schaufeli. 2006. The potential impact of burnout extends beyond the individual level. Shirom. and behavior patterns (e. Burnout also has implications at the organizational level.
and perceived social support. & Keith-Spiegel. these findings point to the importance of considering MHPs’ personal well-being in relation to their professional functioning. 2004. both directly and indirectly through its relationship with individual members’ job demands. It has been suggested that allowing MHPs with significant symptoms of burnout to continue practicing presents ethical concerns. 1987). as burnout at the team level was shown to be related to individual team members’ burnout scores. cognitively. 1989) found that 37% of distressed MHPs in their sample indicated that their distress had decreased the quality of care they had provided to their clients. job control. 2005). as the quality of services provided to their clients may decline (e. In one study of practicing psychologists (Pope. Bakker. an alarming 60% of the sample indicated that they had practiced therapy when they were “too distressed to be effective”. and Schaufeli (2003a) found evidence for burnout contagion within work teams. Tabachnick. Enochs & Etzbach. Poelstra. Demerouti. Although the definitions of “distress” used in these studies encompass more than symptoms of burnout. McCarthy & Frieze.g. Another study (Guy. and/or physically over-extended in trying to meet the many demands associated with their professional roles may have inadequate resources available for fostering therapeutic relationships and 5 . It reasons that therapists who become emotionally. Though more research is needed in order to determine whether burnout contagion occurs among MHPs. 1999.(2000) found that teachers who frequently talked with their burned out colleagues were more likely to demonstrate negative changes in their own work-related attitudes. & Stark. it reasons that exposure to coworkers with high levels of burnout may put individual MHPs’ at greater risk for developing symptoms of burnout.. Rupert & Morgan.
concern. compliance with recommendations. or ambivalent attitudes towards clients – could lead MHPs to demonstrate poor motivation.. 2000. reduction of symptoms. and/or negative emotionality with respect to clients. Shirk & Karver. Emotional distress also may interfere with MHPs’ abilities to self-monitor and attend to clients’ behavior during sessions. Martin. 2003) and adult clients (Lambert & Barley. 2000) underscores the importance of considering how burned-out MHPs’ behaviors during sessions may influence clients’ willingness to engage in the therapeutic process and follow through with treatment recommendations. inattention. etc. 6 . decreased investment and authenticity. 2002. and other interpersonal characteristics shown to promote collaboration.) and distal treatment outcomes (i. burned-out MHPs who lack positive professional attitudes may adopt less prosocial approaches to treatment and may be less able to elicit engagement and participation from clients. Cognitive manifestations of burnout – such as the development of negative. therapeutic abilities. More specifically. frustration. engagement. Fields. pessimism. 2003). etc. & Bickman. 2002). and actual performance may lead to increased anxiety. and a therapeutic bond with clients (Ackerman & Hilsenroth.. Graske.e. affective symptoms of burnout may undermine MHPs’ abilities to convey warmth. trustworthiness. callous. improved functioning. Handelsman. The fact that client perception of the therapeutic alliance is among the most robust predictors of both proximal treatment outcomes (i. Safran & Muran. In addition.). cynical. Burned-out MHPs’ negative self-perceptions and attitudes regarding their clinical competence.facilitating treatment with clients. 2006. consensus. which in turn have been shown to predict better treatment outcomes (Norcross.e. or hopelessness that is apparent to clients. for both youth clients (Karver. 2005. & Davis. attendance.
1980. few studies have empirically examined the relationship between burnout and treatment process or outcome variables. fundamental assumption (Cherniss. It reasons that having negative perceptions of and feelings toward clients may influence MHPs’ behaviors during sessions and interfere with development of positive therapeutic relationships with clients. & Simpson. Garner (2006) found a negative relationship between MHPrated burnout and client-rated rapport with MHPs. p. Consistent with this. Jackson. 1996). 5. Garner. Knight. Maslach. preliminary evidence suggests that MHP burnout and treatment process and outcome variables are probably linked. Barnes (1999) found burnout to be positively correlated with negative perceptions of clients and Homqvist and Jeanneau (2006) found burnout to be positively correlated with unhelpful and rejecting feelings towards clients. Handelsman (2006) found small-tomedium effects between MHP-rated burnout and perceptions of their therapeutic alliances with youth clients. and McCarthy and Frieze (1999) found that adult clients’ 7 . Todd and Watts (2005) found burnout among nurses and psychologists in the United Kingdom to be positively associated with self-reported negative emotional responses to clients’ behavior and negatively associated with self-reported willingness to help clients. as well as having an excellent working relationship with the participating organization. 2007. Maslach. and clients)” (Garner. 1996). Nonetheless. Maslach. Jackson.Although the detrimental impact of burnout on the quality of mental health services has been a longstanding. This gap in the empirical literature has been attributed to “the difficulty of gaining access to the necessary information (which typically requires collection of sensitive information from multiple sources. 2006. 1993. & Leiter. & Leiter. staff. Similarly.
Dennis and Leach (2007) found that the burnout dimension of depersonalization (i. the potential implications are enough to warrant concern in the mental health field. a cognitive bias towards making negative.. and that they would be less likely to refer a friend or family member to the burned-out therapists. This finding is concerning. & Landry.e. As such. Maslach & Jackson. is critical. 1998) was positively related to independent observer ratings of MHPs’ negative expressed emotion towards clients. Students indicated that they liked the burned-out therapists less. impersonal. Identifying factors that explain variance in levels of burnout among MHPs represents an important step in understanding how this condition develops.. as greater tendencies to express negative attitudes and feelings to clients may jeopardize the therapeutic alliance. Although more research is needed before firm conclusions can be made about the impact of MHP burnout on treatment processes and client outcomes. it is not surprising that college students (who were blind to condition) rated burned-out therapists more negatively than non-burned-out control therapists. research examining who develops symptoms. and dehumanizing attributions about the recipients of one’s services.e. Interestingly. Schaufeli & Enzman. and under which conditions. Given the prevalence and possible consequences of burnout. that the burned-out therapists were less attentive to the clients. 1986. Researchers have in fact identified a number of environmental/work-related and individual variables that reliably predict levels of burnout in various occupational 8 . particularly among MHPs. in an analog study (Renjilian.ratings of therapist burnout were positively related to therapists’ use of ineffective interpersonal approaches (i. 1998). social influence strategies) and negatively related to clients’ perceptions of the successfulness of therapy. Baum.
.. flight attendants. law enforcement. A small proportion of the literature. control. those two studies focused on a relatively narrow selection of antecedents (i. job stress. professional identity) and consequences (i.samples. educational level. etc. Furthermore. medical personnel. gender. store clerks. support. deep acting and surface acting). The literature on MHPs also has yet to clarify the underlying processes that account for the relationships between predictor variables and burnout.e. customer service representatives. job satisfaction and turnover intentions) of burnout. The primary objectives of the present study are to (a) determine whether these relationships generalize to a sample of MHPs. focuses on MHPs and only two meta-analytic studies of antecedent and consequences of burnout among MHPs have been published (Lee et al.. 2011.. Research on other types of human service professionals (e.. teachers.e.. work hours. work setting. are differentially associated with burnout. particularly among MHPs. Greater understanding of these processes may inform efforts to develop prevention and intervention strategies. work experience. age. and (b) evaluate the empirical links between work factors and individual factors in predicting MHPs’ emotional labor and levels of burnout.g. 2010). it is important to review what is known about the development and expression of burnout. Lim et al. Before discussing emotional labor. known as emotional labor strategies (i. over-involvement.e.) has demonstrated that certain types of emotion regulation. however. 9 .
. each emphasizing different aspects of the condition. Aronson. Extensive research – much of which has utilized the Maslach Burnout Inventory (MBI. Kestnbaum. however. Lewig. burnout is viewed not as a collection of individual symptoms. Subsequent research has challenged the accuracy of this framework and found limited support for the psychometric properties of the BM (e.g. Pines and Maslach. Maslach & Jackson. An examination of the subsequent literature reveals that multiple conceptualizations of burnout have been proposed. 2006. and diminished Personal Accomplishment (PA). Schaufeli. According to this model.. Corey & Corey. 1998. 1984. As aforementioned. Edelwich and Brodsky (1980) focused on loss of idealism. the most prominent and influential model of burnout was introduced by Maslach and her colleagues. a measure comprised of three 10 . 1981. Maslach and Jackson (1986) conceptualized professional burnout on a tri-dimensional continuum comprised of Emotional Exhaustion (EE). Maslach. while Freudenberger focused on failure to receive rewards. being worn out. the BM). 2001. For instance. 2006). who described it as a state of exhaustion. Perlman & Hartman. but as a transactional process that involves the interplay between internal and external factors (Bakker. 1982). Depersonalization (DP). 2006.e.g. & Dollard. 1978. and Kafry (1981) equated burnout with the concept of tedium and created a self-report instrument they named The Burnout Measure (i. Rosenberg & Pace.Professional Burnout The concept of professional burnout was first introduced by Freudenberger (1974).. 1996). Van Der Zee. 2003).. Shirom & Ezrachi. and many others have focused on motivational changes (e. Pines. Evans et al. & Leiter. and otherwise failing to manage an overload of work demands.
1996). & West. some researchers have questioned its threefactor structure (see Schaufeli & Enzmann. & Hays. 1985. p. Schaufeli & Enzmann. Lee & Ashforth. Brown. Belcastro. 2004). Bolton. Vanheule. it is not universally accepted and 11 . Jackson. and exhaustion continues. some researchers have suggested that the dimensions of burnout may not develop simultaneously (e. & Leiter. Rosseel. 1988). 1986). Brookings. Leiter.g. 549). Lee & Ashforth. emotional exhaustion has a central role in the development of burnout. 1998. it is suggested that “workers respond to exhaustion by depersonalizing clients. 1981. 2005. 1988. 1987.g. 1988). & Stuvenson. 1993. although they noted that the high association between emotional exhaustion and depersonalization made it difficult to determine the unique contributions of these dimensions. Barrera. Gold. Leiter & Maslach. they lose their sense of personal accomplishment and develop a full burnout syndrome” (Rupert & Morgan. 1981. 1989. For instance. Pierce & Molloy. several studies have shown that emotional exhaustion and depersonalization loaded on a single factor (e.. Munzenrider. Lee and Ashforth (1990) demonstrated support for the MBI’s three-factor structure.subscales that correspond with the three dimensions of burnout – has demonstrated support for this model (Maslach. & Vlerick. Dignam.. Accordingly. 1993. 2007). Many other studies have demonstrated support for the three-factor structure of the MBI (e. Green & Walkey.. 1989. Maslach & Jackson. and as commitment to clients diminishes. Iwanicki & Schwab. Golembiewski. 1986.g. Related. Leiter. Although the MBI is unequivocally the most utilized and cited measure of burnout (Halbesleben & Buckley. Fimian & Blanton. 1998). Rather. 1989. Although this theory has earned some research support (Lee & Ashforth. Leiter & Maslach. 1983. & McEvoy. 1990.
2000. including: work setting..g. Evidence on antecedents of burnout and the magnitudes of such relationships have been somewhat equivocal (Lee. 1989. 1988. Hellman & Morrison. 1999). Onyett. teaching. most agree that a combination of external (work-related) factors and individual differences accounts for the development of professional burnout. While not all researchers have adopted Maslach et al. doing administrative tasks (e. Vredenburgh. & Stein..’s model. supervision. total hours worked per week. income. & Muijen.. Farber. 2007. Raquepaw & Miller. Pillinger. Ackerley et al. 1995. caseload. Rupert & Morgan. Finnoy. research). type and severity of clients’ presenting problems. Dupree & Day. Radeke & Mahoney. 12 . 1983. Carlozzi. 1987..lack of longitudinal studies has not allowed for firm conclusions to be made about the progression of burnout symptoms. but separately. Boice & Myers. Thus. 1997. and performing other professional activities (e. 1987. paperwork). and aspects of the organizational climate (e. Studies of burnout in MHPs have examined a variety of such factors. time spent with clients. 2000.g. most researchers evaluate the three dimensions of burnout simultaneously. Allen. Predictors of Burnout Environmental/Work-related Factors. 1996. & Lee. 2011). 1999. position in the organizational hierarchy. 1983. 2004. Rupert & Baird. percentage of managed care versus self-pay clients served. Fortener. Lim. 2005. Yang. Lee & Ashforth. Much of the burnout literature has focused on how specific environmental conditions and other work-related variables may be implicated in the development of burnout.g. Rupert & Kent.
Surprisingly. & Muijen. Farber. Rupert & Morgan.g. 1989. Accordingly. & Stein.. 2005). that numerous studies have examined levels of burnout in relation to MHPs’ workload and involvement in specific occupational activities (e. 2005. 1990. 13 . 2004. Carlozzi. 1997. research has investigated whether caseload or amount of direct client contact is associated with burnout. 1987. Vredenburgh. 1995. and spend more time doing administrative tasks/paperwork and providing supervision (Ackerley. 2007. Rupert & Morgan. Fortener. Hellman & Morrison. 1996). Explanations for this finding include that MHPs in agency settings tend to be less experienced. thereby making them more vulnerable to burnout. Dupree & Day. relative to MHPs in private practice. 1999. Sherman. 1987. Finnoy. Radeke & Mahoney. carry higher caseloads. work more hours per week. Raquepaw & Miller. agency-employed MHPs may face a higher number and wider range of demands. 1987. For instance. Boice & Myers.One relatively consistent finding across studies has been the relationship between burnout and work setting. 1999). 1983. 1988. & Stein. report more over-involvement with their clients. experience less autonomy and control in their professional roles. work with more severe clinical populations and a higher percentage of managed healthcare clients. Farber. 2000. Rupert & Kent.. It is not surprising. therefore. 1988. Although it has been suggested that the solitary nature of individual private practice can result in feelings of isolation and loneliness (Freudenberger. 1989. Onyett. with MHPs in the private sector reporting significantly less burnout than those who are agency-employed (Ackerley et al. Rupert & Baird. 1999). existing evidence suggests that working in an agency setting puts MHPs at greater risk for burnout. Raquepaw & Miller. 2000. Guy. Vredenburgh. Carlozzi. Pillinger. 1990a.
but was positively related to personal accomplishment. 2005). thereby increasing their susceptibility to symptoms of emotional exhaustion and depersonalization. Taken together. caseload was not associated with the first two dimensions of burnout. That is. It further is possible that individuals with higher levels of emotional exhaustion and depersonalization may experience diminished personal accomplishment over-time. a measure of personal accomplishment. Rupert & Kent. perceived over-involvement also was positively related to personal accomplishment. 2005). Rupert & Morgan. Interestingly. in accordance with the aforementioned progressive theory of burnout development (Rupert & Morgan. therapists who indicated that their caseloads were higher than their ideal caseloads reported more emotional exhaustion and depersonalization than did therapists who indicated being satisfied with their caseloads. Similarly. over-involvement with clients may over-tax MHPs’ personal resources. One possibility is that MHPs tend to perceive over-involvement with clients to be a necessary aspect of performing well in their clinical roles and. in their sample of MHPs. Nonetheless. 2007) found that perceived over-involvement with clients was positively related to emotional exhaustion and depersonalization. Related. thus. Rupert and colleagues (2005.. but is positively associated with personal accomplishment (e. it seems that environmental variables such as time spent with clients and caseload size may be less important for emotional exhaustion and depersonalization than how these factors interact with 14 . Raquepaw and Miller (1989) found that.g.studies have shown that time spent with clients is not related to emotional exhaustion or depersonalization. It is noteworthy however that MHPs’ satisfaction with their caseloads did demonstrate significant negative relationships with MHPs’ levels of emotional exhaustion and depersonalization. 2007.
and doing research. Most notably. Rupert & Morgan. Freeman.g. 2005). In addition.). Rupert & Kent. research has examined the relationships between MHP burnout and involvement in other professional activities. consulting. is associated with more favorable outcomes for MHPs in terms of burnout (e. and negatively related to levels of personal accomplishment. teaching. 2009. In addition to direct client contact. Rupert & Morgan. Jenkins. etc. 2005) found time spent doing administrative tasks and paperwork to be positively related to levels of emotional exhaustion and depersonalization. Rupert & Kent. Despite evidence that greater time spent providing direct care to clients. research suggests that working with certain types of clients may put MHPs at greater risk of burnout. several large-scale studies (Rupert & Baird. 2004. Numerous studies have shown that exposure to challenging client behavior is associated with stress (e.. It reasons that MHPs may find direct clinical work more rewarding and/or less draining than other professional activities. Rupert and Kent (2007) also found personal accomplishment to be negatively related to time spent supervising. in practicing psychologists. studies have shown working with clients who have severe mental illnesses and/or exhibit particularly challenging behavior to be positively associated with emotional exhaustion and 15 . the existing research on workload and work activities suggests that MHPs who spend more time doing tasks other than therapy/assessment tend to be at greater risk for burnout compared to MHPs who spend less time engaged in such tasks. relative to doing other tasks. & Lovell. Rose.individual factors (i. 1988. perceptions of and feelings about environmental factors may matter more than objective measures of such factors). 1997. Chung & Harding.. Ackerley.g. 2007. 2007. 1994.e. Taken together with the literature on direct client contact.
more need for consultation and collaboration with other service providers. 2005). the rise of managed healthcare has led to greater pressure on MHPs (particularly those in the public sector) to increase their caseloads. If those efforts do not yield positive therapeutic outcomes with such challenging clinical populations. 2000. Rupert & Baird. 2004. etc. cognitive.depersonalization in MHPs (Acker.. shorten the length of treatment. 2004. Based on Farber and Heifetz’s (1982) assumption that MHPs expect their work to be challenging but their clinical efforts to be rewarding. Rupert & Morgan. Research has shown that greater involvement with managed care clients is associated with a variety of factors that are linked to burnout. more critical incident reports. Lee et al. thereby overwhelming those resources and putting them at greater risk for burnout. and provide more extensive documentation for the purposes of financial reimbursement (Rupert & Baird. both during and between (e. It reasons that MHPs may find it difficult to reconcile these external demands with their perceptions of what is in their clients’ best interests clinically. positive changes in their clients) apparently produces burnout in psychotherapists” (1). & Comtois. This may evoke stress. Rupert & Morgan. 2005). including: more 16 . As aforementioned. and physical resources. (2011) suggest that “providing constant caring without the compensation of success (e. MHPs may be at even greater risk. 1999. Rupert & Kent. Mar. research has demonstrated a positive association between burnout and MHPs’ levels of involvement with clients covered by managed healthcare insurance. It reasons that working with individuals who demonstrate more significant and/or complicated presenting problems may require MHPs to utilize more emotional.g. which in turn may contribute to burnout. Related.) sessions. Linehan Cochran. 2007. Levensky.g..
As such. resources... Chen. Among the variables that have been studied are role stressors. see also Acker. 2005. Rupert & Kent. 2007. 1994. 2007) consistently found percentage of managed care clients comprising MHPs’ caseloads to be positively related to levels of emotional exhaustion and depersonalization. Astrachan. p. feelings. Chen. which is a state of emotional arousal when an individual experiences role-related stress events. 1994. have fewer opportunities to practice decision-making. and Lo (2007) state: “Role stress can arise from different patterns of mismatch in expectations. working longer hours. the unique characteristics and demands associated with providing services to managed care clients may put MHPs at greater risk for burnout. have less control over resources. 1990. 2003. Tsai. Drolen & Harrison. and negatively related to levels of personal accomplishment. 1995). Accordingly. Sederer & Mirin. 2005). role stress is external to role takers and results from social demands” (498). and desires (Acker. role stress plays a part in shaping professionals’ thoughts. receiving less supervision.frequent exposure to negative/challenging client behaviors. therefore. Tichler & Unutzer. The literature suggests that MHPs today. 2004. that Rupert and colleagues (2004. Wells. and behavior. professional expertise. Role conflict is a type of role stress 17 . Rupert & Morgan. and are more likely to “view their professional activities as inappropriate and incongruent with their training. especially those who work in agencysettings and/or are more involved with managed care. Accordingly. it is not surprising that studies have shown specific work stressors to be associated with symptoms of burnout..65. It is not surprising. and being less satisfied with one’s income (Rupert & Baird. doing more administrative tasks/paperwork. Minikoff. capability and values about the role. experiencing more stress.In contrast to role strain. 1999.
Acker (2003) found that role conflict and role ambiguity were positively correlated with both emotional exhaustion and depersonalization in a sample of MHPs. Knight. Another type of work stressor that has been examined in relation to burnout is lack of autonomy. a set of organizational climate variables that included role conflict and role ambiguity (as well as social support at work) added significantly to the total variance accounted for in all three dimensions of burnout. Furthermore. 2010. (2007) did find a significant relationship in their sample of drug abuse counselors. studies of MHPs have provided mixed evidence.66). given the limits of organizational rules. . Demerouti. 2009). Kim and Stone (2008) did not find a direct relationship between autonomy and burnout in their sample of social workers. which is conceptualized as the amount of control employees have over their decisions and work activities. 1981. and thus may be more vulnerable to symptoms of burnout. Bakker. For instance. Oktay. Schaufeli. & Bakker. & Van Rhenen. It reasons that MHPs who feel less able to exert control and independence within their work environments (that is..conceptualized as the result of “incompatible demands or expectations placed upon workers”.g. when controlling for demographic variables. Cherniss. while Garner et al. While multiple studies have found a significant negative association between autonomy and burnout (e. Pines & Kafry. 1992. lower autonomy) may experience more strain in trying to perform their professional roles. p. Garner. Mostert. while role ambiguity is another type of role stress conceptualized as the result of “uncertainty as to what to do and/or from questioning the impact of practice interventions in the lives of clients with mental illness” (Acker. More research is needed to clarify the relationship between these variables. Allen. 18 . 2007. 2003. and Simpson. 1992. 1983.
has differed across studies (Rupert & Jamie. for example. Rosenberg & Pace. Some of the factors studied in samples of MHPs include: demographic variables. theoretical treatment orientation. mixed finding have been reported in regards to the relationships between demographic variables and burnout. 1989.). inter-related environmental variables contribute to the prediction of burnout in MHPs. 19 ... 1985. 1996. The relationship between burnout and gender.g. the fact that not all people facing the same working conditions experience equivalent levels of burnout suggests that individual differences also are important (Buhler & Land.. numerous studies have examined individual factors to determine which variables may help to explain variance in burnout across employees. the roles of certain variables remain unclear. female MHPs have had lower levels of burnout than men.g. many studies have found no differences in levels of burnout by gender (e. 2003. Maslach. 1992).. Krogh. Individual Factors. 2003. Jacobs & Dodd. 1995.The empirical literature clearly indicates that multiple.. 2004). and personality traits. 1985. 2003. Maslach & Jackson. years experience. However. 1986. education. 1988. Acker. 1999) and. 2006. Vredenburgh et al. While it was initially suggested that women may be at greater risk for burnout compared to men (Freudenberger. Despite the large quantity of research. particularly in regards to depersonalization (e. Farber. Raquepaw & Miller. Dupree & Day. Thornton. Other studies have found significant differences by gender (e. In particular. 2007). in some cases..g.g. 2003). Mills & Huebner. professional background variables (e. Ackerley et al. 1998. etc. Acker. 1982a). Although researchers have tended to emphasize environmental and work-related factors that predict burnout (Halbesleben & Buckley.
1999). Rosenberg & Pace. there is not sufficient evidence to suggest that gender is a reliable and meaningful predictor of burnout. Given the relatively modest size of the samples used in most studies. 1985..Maslach & Jackson. Both Maslach and Jackson 20 . but average out when men and women are compared across settings. The relationship between race/ethnicity and burnout also remains unclear. as women tend to assume more childcare and other household duties than men (Rupert & Kent. It has been suggested that these findings may be the result of traditional gender-role socialization. These authors suggest that gender differences may in fact exist within work settings. Rupert and Morgan (2005) and then Rupert and Kent (2007) found that women in agency settings reported higher levels of emotional exhaustion than women in independent practice settings reported. Studies that include race/ethnicity as a variable have typically reported no significant differences in levels of burnout. Two studies. It is not clear why this interaction effect occurs. but one possible explanation is that the greater flexibility in work hours associated with independent practice may be more important for women than men. Additional studies need to be conducted by other researchers before conclusions can be made about the nature of the relationship between gender and burnout. at this point. however. This may be related to the fact that most studies have used samples in which Caucasian MHPs comprised the vast majority. it is possible that lack of statistical power may have prevented detection of small or medium effects. however. as females are traditionally taught to be emotionally invested (Rosenberg & Pace. while emotional exhaustion among men did not vary across work settings. 2007). have found significant differences by race/ethnicity. 2006. 2006). Vredenburgh et al. Interestingly.
African Americans tend to report less burden and strain as caregivers for people with a variety of illnesses. and Cohler (1993) found that racial groups did not significantly differ on perceived burden. mental retardation (Valentine. Further research is needed in order to determine whether these patterns generalize to burnout among MHPs. Haley. the Caucasian MHPs may have had higher levels of burnout due to lower levels of stress-tolerance. and lower levels of depression. Salyers and Bond (2001) also found racial congruence to be important for burnout. in a sample of parental caregivers of individuals with severe mental illness. 1996). Similarly. & Anderson. 1997.(1986) and Slayers and Bond (2001) found Caucasian MHPs reported higher levels of Emotional Exhaustion and Depersonalization than their African Americans counterparts reported. This finding is consistent with evidence from other studies. Cook. McDermott. In the latter study. (1996) found that African American caregivers of family members with Alzheimer’s disease appraised patient problems as less stressful than Caucasian caregivers did. Pickett. et al. Accordingly. but African Americans had significantly higher levels of coping mastery and selfesteem. Haley et al. For instance. including: dementia (Connell & Gibson. Vraniak. 1998). compared to Caucasians. and HIV/AIDS (Turner & Catania. Salyers and Bond suggest that “psychological thresholds for defining levels of stress or type of interactions that are considered stressful may differ as a function of cultural or ethnic background” (402). It reasons that understanding and responding to the needs of clients from different ethnic/cultural 21 . 1997).. Additional studies have shown that. these differences remained after controlling for geographic location and work environment. as clinicians who were racially incongruent with the majority of their clients reported higher levels of emotional exhaustion and depersonalization than did those who were racially congruent.
given the overall scarcity and mixed nature of findings from existing studies. 1989). the results may not generalize to other MHPs. alternatively. their risk of developing burnout. only the most resilient and adaptive MHPs remain in strenuous positions for many years.g. other studies have reported no relationship (e.. 2004. & Simpson.g. 1999). Rupert & Kent. Knight. Rupert & Kent. Rupert & Morgan. Despite initial theories that burnout develops over time as one is worn down by professional strain. 2007. While most studies have found burnout to be negatively correlated with age (e. there is not sufficient evidence to suggest that race/ethnicity is a reliable and meaningful predictor of burnout across samples of MHPS. Once again. Related to age is the amount of experience MHPs have had providing mental health services. Raquepaw & Miller. Findings on the relationship between age and burnout have been somewhat mixed. 2005. Mills & Huebner. 1998.. thus. It is noteworthy however that many of the findings reported in Raquepaw and Miller’s (1989) study are inconsistent with preceding and subsequent research. recent research shows a negative relationship between 22 . Accordingly. more research in this area is needed before sound conclusions can be made. 2007). Garland. Garner. Rupert & Morgan.backgrounds may require greater cognitive and emotional resources. 2007. thus. may contribute to MHPs’ occupational stress and.. as well.g. which. that more burned out MHPs tend to find positions in less demanding work-settings (private-practice) or to leave the field altogether (e. 2005. Carlozzi. & Stein. in turn. suggesting that their sample may have been distinct in some way and. It has been proposed that the negative relationship typically found between age and levels of burnout may reflect that older MHPs have learned how to cope with work pressures over time or. Presently. Vredenburgh.
including: education level (e. In addition.. Rupert & Kent. 1988. it follows that individuals with certain personality traits (as discussed in more detail below) may be inherently more able to manage work-related stress effectively. Explanations for this include that less experienced MHPs are less confident in their professional abilities and less practiced in managing work related demands (e.g. as novice MHPs tend to report greater difficulties in their roles than more seasoned MHPs do (e. greater exposure to various clinical situations may enhance MHPs’ abilities to anticipate and prepare for potential obstacles to treatment. and therefore only the more adaptive individuals continue to be MHPs. In turn. More seasoned MHPs have had more opportunities to build a repertoire of techniques for managing clinical and administrative demands. it is surprising that studies have neglected to examine the unique versus shared variance accounted for by these variables. Doctorate). Rupert & Kent. 2007. 2005). Ackerley et al. more experienced MHPs may be better able to prevent or at least mitigate the effects of these potential stressors. 1988. it has not been possible to tease apart the respective contributions of age and years of experience in predicting burnout. it also is possible that MHPs who are less able to cope effectively with occupational stress may discontinue working in the field. 2005). Masters. Based on this reasoning. As such. As aforementioned. Bachelors. 23 .. Many other professional training/background variables also have been examined in relation to burnout. Rupert & Morgan..burnout and years experience. thereby allowing them to avert burnout and remain in the field longer than individuals without these characteristics. and to improve on or develop new stress management strategies over time. 2007.. Given that age and years of professional experience are likely to be significantly intercorrelated. Rupert & Morgan.g.g. Ackerley et al..
it reasons that researchers may have suspected that certain types of training could help to protect against the stressors and cognitions that lead to professional burnout. empirical study). 2004. psychodynamic. it appears that over 100 additional studies examining the relationship between burnout and personality have been published in peer-reviewed journals since Schaufeli and Enzmann’s count. may directly contribute to burnout and also moderate the relationships between stressors and experienced stress. etc. social work. such as personality traits. other predictor variables.g. Borrowing from the stress and coping literature (e. it is not surprising that a large number of studies have empirically examined the relationships between personality traits. Based on a search of the PsycInfo database (using the keywords “burnout” and “personality” and the following limits: published 1998-2008. 2005. education. Ackerley et al. In fact.. Some of the personality variables studied include: locus 24 . 2005). psychiatry or other medical.). etc. Thus.. Raquepaw & Miller..).graduate program type (e. counseling. these variables typically have shown no relationship with burnout (e. 1993).. and burnout. 1989. Although not well explained in the research literature. researchers posit that differences in stable individual characteristics. Lazarus & Cohen-Charash.g. psychology. suggesting that MHPs’ levels and types of education may not matter as much as more ingrained individual characteristics in the context of burnout development. Rupert & Morgan. and treatment orientation (e. Hurrell. peer-reviewed journal. George & Brief. 1988.. 2002. cognitive-behavioral. as well as between experienced stress and stress responses (Brief & Weiss. Lazarus.g.g. Schaufeli and Enzmann (1998) counted over 100 studies that included measures of burnout and at least one personality variable. 2001). pharmacological. Regardless. both of which may contribute to burnout.
ability to love (Buhler & Land. Openness. 2006. Greenberg. One problem with the literature is that conceptualizations and measurement of personality. 2004. 2001a. 2006. 2003. exactness (Buhler & Land. 2003).. Buhler & Land. 1993. Lundström. Thoresen.. 2007. Browning et al. van der Zee. Eastburg. & Ridley. and the so-called Big Five traits (i. Buhler & Land. Janssen. & Hochwarter.. & Rolniak. Bakker. 2003). Shin. Piedmont. Perrewe. and Conscientiousness. Langelaan. 2000). De Vries. & Rutledge. Neuroticism.. Despite the large quantity of studies. Langelaan. & de Jonge. Kahn. 2006. 2006. Kim. Schneider. Louden. and to a lesser extent burnout. reactive aggression (Buhler & Land. van Doornen. & Åström 2007. & Schaufeli. Ghorpade. Kaplan. 2003). Barsky. Extraversion. & Dollard. Francis. & Jenkins-Henkelman. 2006. Kokkinos. Bakker. Lewig. Gorsuch. self-aggression (Buhler & Land.. have varied across studies. & Singh. e. Warren. 2003b. self-esteem (e. temperament/trait affect (e. personal satisfaction (Buhler & Land. Buhler & Land. 2003). Zellars. 2003a. Croon. appreciation need (Buhler & Land. van Doornen. 1974. & Van Heck. 2007. Houkes.. Agreeableness. & Umbreit. 2003). and Schaufeli (2006) argue that “the inclusion of certain personality variables in a research design seems to have been dependent more often on the arbitrary choice of the researcher than on a theory of 25 . 2003). Freudenberger. 2001b.g.g. Richter. 1999). 2007. Browning. Graneheim. 1994. Willemsen.e. Eisemann. 2003). 2006). 2007. Perrewé. Michielsen. Bakker. & Hochwarter. Bahner & Berkel.g. 2003). cognitive adaptation disposition (Browning et al. several issues make the findings on personality and burnout difficult to interpret. 2003). Ryan. & de Chermont. Zellars.g. Lackritz.. Williamson. 2003. 2004. existential frustration (Buhler & Land.of control (e.
e. studies examining the relationships between personality variables and the dimensions of burnout have not been sufficiently grounded in theory. Together. school.e. Unfortunately. Another challenge in interpreting the literature relates to the occupational diversity of samples used in studies of personality and burnout.e.personality” (34). agency... with the four personality traits contributing 12% above and beyond that accounted for by demographic and work 26 . and to take specific environmental conditions (e. Agreeableness. etc. Regarding depersonalization. workload. the set of predictors accounted for 41% of the variance in EE scores on the MBI. That is. Openness to experience. it is important for the relationships between burnout and personality traits to be assessed within the context of a given occupation (i. studies on MHPs comprise a relatively small proportion of the literature in this area. etc. Mills and Huebner (1998) found that four of the Big Five personality traits – Extraversion.. In a study of school psychologists. and Conscientiousness – explained 10% of the variance in emotional exhaustion.). Nonetheless. adaptive) manner.. for instance. Accordingly. private-practice. it reasons that the demands associated with specific occupational roles and environmental conditions may be more or less difficult for individuals with certain personality traits to manage in a positive (i. It reasons that people with certain traits may be more or less likely to pursue (and obtain employment within) particular occupational fields.e.g. above and beyond that accounted for by demographic and work variables (i. total environmental stressors). the complete set of predictors accounted for 22% of the variance in DP scores.) into consideration.. Furthermore. coworker/supervisor support. evidence from the existing research suggests that personality traits are related to levels of burnout in MHPs. mental health services) and setting (i.
2006. 2000). Thus. Willemsen. Bakker et al. Zellars et al. & Singh. 2007. Neither the set of demographic factors nor the set of work factors accounted for significant variance in personal accomplishment. 2004. Shin. Ghorpade. In addition. 2007. Lackritz. Lackritz. Michielsen. extraversion is associated with the use of effective coping strategies. Eastburg et al.. the complete set of predictor variables accounted for 30% of the total variance in PA scores. Shin.. it is not surprising that most research has shown extraversion to be negatively related to emotional exhaustion (Eastburg. & Van Heck. Watson & Clark. Ghorpade. 1992. It has been suggested that extraverts’ sanguine temperament lends itself to adaptive functioning (e. and to be more optimistic. dominant. 1992). 1994. Francis. 2007. & Singh. to experience and exhibit more positive emotions.. 1993) and depersonalization (Bakker et al.. Williamson. 1994. Francis et al. & Ridley.. Watson & Hubbard. Francis et al. such as rational problem-solving. 1996). 2006. with the additional variance explained by personality factors (24%). social support seeking.. 2007.. & Umbreit. and positively related to personal accomplishment (Bakker et al. 2004. 27 . & Umbreit. 2000).g. & Singh.g. Costa & McCrae.variables. and positive cognitive reappraisal of problems (e. active. 2004. & Umbreit. Zellars et al. Kim. De Vries.g. & Rutledge. self-confident. Louden. Ghorpade. 2006. Dorn & Matthews. This trait is characterized by tendencies to engage in a higher frequency and intensity of personal interactions. One Big Five personality trait that has earned attention in the general burnout literature and demonstrated a relatively consistent relationship with burnout in MHPs and other human service professionals is Extraversion (the polar opposite of introversion). Lackritz. 2004.. 2007.. Piedmont. Gorsuch. However. 2007. Shin. 1992). and excitement seeking (e. Kim.. Croon. Kim.
. Bakker et al. & Goodenow.’s study is not the first that failed to find a negative relationship. One explanation for this latter finding is that individuals with high extraversion may rely on interpersonal relationships to help mitigate or buffer against the impact of work stress. Ross. 2011). Though the finding of a non-significant association between emotional exhaustion and extraversion is inconsistent with most research. Piedmont (1993) found the excitement-seeking component of the extraversion scale of the Eysenck Personality Inventory to be positively correlated with emotional exhaustion. Related. 1997. but a negative predictor of depersonalization and a positive predictor of personal accomplishment. Delia & Patrick.g. while their tendencies to be optimistic and self-confident may foster feelings of personal accomplishment. Zellars et al. in Bakker et al.g. 1989). Extraversion was particularly related to personal accomplishment for volunteer counselors who reported many negative experiences with clients. Extraverts’ tendencies 28 . Studies have found mixed evidence regarding the association between social support and burnout (Lee et al. Lack of social support may be particularly detrimental for extraverts.. Specifically.’s study of volunteer counselors. extraversion was unrelated to emotional exhaustion. as some studies have found strong relationships (e. 1996. given their tendencies to seek social affiliation. Kruger. & Russell. The authors suggest that the tendency of extraverts to engage in intense personal interactions may counteract depersonalization. 1991). 2003).Interestingly. Elman & Dowd. Altmaier. (2000) found extraversion to be unrelated to emotional exhaustion in a sample of American nurses and Buhler and Land (2003) found that extraversion was positively related to emotional exhaustion in German nurses who reported low social support from coworkers (Buhler & Land. Botman.. while others have found very modest relationships (e.
thus. anxiety. alertness. and energy. and.to be sensation seeking and to engage in risky behaviors may be taxing of their internal resources and thus. Wiese. or depression) (Folkman & Moskowitz. but partially correlated. 2004). less sanguine temperaments). & Tellegen. Watson et al. and often require downregulation before a stressful situation can be addressed (Folkman & Moskowitz. to have difficulty regulating their experiences of and responses to these emotions and the situational stressors associated with them.. 1988. Watson. while 29 ... Such emotions can be stressful in and of themselves.. 2003. thus. to demonstrate higher levels of burnout. compared to employees with higher extraversion. Positive trait affect (PTA) is characterized by tendencies to be optimistic and experience feelings of enthusiasm. Vaidya. It follows that employees with low extraversion (i. they become more susceptible to emotional exhaustion. 1999). often elicit negative emotions (i. who work in environments characterized by high demands and low resources. Positive and negative affectivities are viewed as two distinct. may be particularly likely to experience negative emotions. without adequate external resources (such as social support at work) to facilitate coping. anger. 2004). many researchers (particularly in the industrial/organizational psychology literature) have examined trait affect in relation to the dimensions of burnout and occupational stress. Research indicates that environments characterized by high demands and low resources tend to be more taxing of individuals’ abilities to manage stress and. activeness. unipolar dimensions of personality (Thoresen et al. In addition to studying Big Five personality traits.e.e. see also. More research is needed in order to identify moderating and mediating factors that may help to clarify the relationships between extraversion and the dimensions of burnout in MHPs.
g. 2003.negative trait affect (NTA) is characterized by tendencies to be pessimistic and experience feelings of anger. 1985. Watson et al. 2004. Elliott. Support for this argument is provided by evidence of similar patterns of association with other factors.. Chartrand. & de Jonge. 2008. In fact. Watson. 1988. 1994. to retrieve more positive memories. For instance. Watson & Tellegen. Houkes. and vice versa (e. & Harkins. because it overlaps significantly with extraversion. 2003). & Albion. 2006. 1997.. Fogarty.. fear. 1993. Hoge. For instance. 30 . 1999). & Warren. implying that they are synonymous (e. Janssen. 2001b... Watson & Clark. numerous studies have empirically demonstrated the importance of PTA in the prediction of burnout (and occupational stress) across a variety of work samples (e. and to make more positive attributions about hypothetical events (e.g. nervousness.g. Burke. Hemenover. A review of the literature reveals that many authors have used the term extraversion interchangeably with PTA. 2004. some researchers have proposed that findings on extraversion are applicable to PTA. 2000. guilt. Barsky. Gohm. Watson et al.. Thoresen et al. Noguchi. it is not surprising that PTA has most often been empirically associated with extraversion (Thoresen et al. Rusting. 2001. 2003a. Conard & Matthews. Watson & Clark. Machin.g. both extraversion and PTA are associated with cognitive tendencies to focus more on positive information. Thoresen. Given their conceptual overlap. and perceived stress (Grandey.. Byrne.. & George. 1992. relevant research will be reviewed. & Dalsky. 1988). Evidence of the relationships between PTA and perceptions of work factors has been provided by a variety of research. Watson & Clark. & Bussing. 1984. 1997). 2001a. 1999. 1999). 2000. & Eysenck. 1988. Brief. Although PTA was not measured in the present study. 1992.
Zellars. Perrewé. in their meta-analysis of over 200 published and unpublished studies. Interestingly. individuals’ 31 . studies also have shown that PTA may moderate the relationships between other predictor variables and burnout (and other measures of occupational stress). PTA’s relationship with personal accomplishment is stronger than its relationships with emotional exhaustion and depersonalization). This review of the literature on environmental (work-related) and individual predictors of burnout reveals that theories tend to emphasize how cognitive and affective tendencies associated with particular traits are likely to influence individuals’ perceptions of and responses to working conditions (demands and resources) and. 2003. 2006). Jacobs & Dodd.. Thoresen et al.e. Ganster. Thoresen et al. 2003. (2003) found that PTA (as well as NTA) contributed unique variance to the prediction of burnout.. the literature indicates that the associations between PTA and the dimensions of burnout are complex and warrant further investigation. Perrewé. For instance.. & Hochwarter. Thoresen et al. 1993. & Perrewe. and turnover intentions. suggesting that PTA is more related to positive than negative outcomes. Page. 1992. & Fox. Most notably. job satisfaction. 1999. Jacobs & Dodd. & Jenkins-Henkelman. the associations generally were stronger when affect and outcome were matched in terms of hedonic tone (i. Zellars. & Hochwarter. Schaubroeck. 2003. Smith and Tziner (1998) found that PTA moderated the relationship between work satisfaction and burnout. In addition to demonstrating the direct relationships between PTA and burnout (e. Thompson. 2001. & Cooper. although PTA was at least moderately correlated with all of these dependent variables at the bivariate level. organizational commitment. thus. 2006. Kahn.2003b.g.. As with other personality characteristics. Schneider. Zellars. 2003).
Evidence suggests that a combination of environmental and individual characteristics – such as personality traits and affective tendencies – make it more or less likely for emotional dissonance to occur (e. Renz. Morris & Feldman. & Richard. 1998. in ways that facilitate their positive functioning in the short-term and. perhaps more importantly. 1983. 2002. Tardino.g. 2007).g..e. This is consistent with the notion that burnout arises in individuals who are more inclined to experience work-related situations as stressful and/or less inclined to respond to work-related demands in an adaptive manner (i. & Watson. Brotheridge & Grandey. 2005). One factor that has earned increasing attention in the human services literature over the past few decades. 2003. & Munz.. in the long-term). Tang. Rafaeli & Sutton. 1998. Diefendorff. Abraham. 2000. personality.. and burnout.levels of occupational stress and burnout. 1987. 2005). Diefendorff. Rubin. Emotional Dissonance First introduced by Hochschild (1983). 1996.. emotional dissonance is defined as the state of strain that results when individuals’ true or felt emotions are inconsistent with their perceptions of what emotional expressions are appropriate or required in a given situation (Rubin et al.. Cheung. More specifically. & Richard. 2003. 32 . is emotional dissonance (e. and has been empirically linked to work demands.. Daus. 2005).g. Rubin et al. Arvey. & So-Kum. research indicates that experiences of and responses to emotional dissonance are conceptually and empirically associated with employees’ perceptions of and attitudes about emotional display rules (e. Fisher & Ashkanasy. Hochschild.
compassion)” 33 . 1996. p. These display rules can be formally transmitted through training manuals (Rafaeli & Sutton. 1993. they “spell out which emotions are appropriate in particular situations. & Richard. 1983.integrative. Research in this area has tended to focus on organizational (or site-specific) standards for employees’ emotional expressions during interactions with customers/clients and. For instance. Integrative display rules encourage expression of emotions that are hedonically positive and tend to “create good feelings in others and encourage harmony among people (e. The potential importance of occupation-specific standards/norms for emotional expressions has been largely ignored in the empirical literature. 1989).. 2003. but it reasons that they may operate in the same manner as organizational display rules. Wharton and Erickson (1993) describe three main types of emotional display rules . Rubin et al. Grandey.Emotional display rules represent formal and informal guidelines or standards for behavioral expression of emotions within a given context.. 2000. also see Ashforth & Humphrey. 2005). as well as how those emotions should be expressed to others” (Diefendorff. 1987) or informally transmitted through organizational culture (Van Maanen & Kunda. with coworkers. 1993.. even in the absence of explicit organizational standards (Rubin et al. individuals (such as MHPs) may learn and internalize display rules during their professional education and training. 2005). happiness. 284. These standards emphasize the publicly observable side of emotional expressions rather than the genuine feelings employees experience at work (Ashforth & Humphrey.. Morris & Feldman. and may perceive these guidelines as relevant in their current professional roles. and masking. love. In other words. differentiating. in some cases.g. 2005). Rubin et al. Hochschild.
masking. labor. with laborers being the lowest and human service workers being the highest.. involves suppression of felt emotions in order to express a different emotion or neutrality (Cropanzano. managerial/professional. 2004). but significant between-group differences for perceived demands to express positive emotions. 3). 1993).(Johnson. which classifies occupations into high and low interpersonal requirements (see Wharton. p. Brotheridge and Grandey (2002) compared display rule perceptions for five occupations (service/sales. regardless of their particular occupations. Using Hochschild’s (1983) dichotomous grouping approach. Weiss & Elias. differentiating display rules encourage expression of emotions that are hedonically negative and “tend to drive people apart (e. The third type of display rule. 2007. 2005). hate.g. It may be that individuals perceive similar demands to suppress negative emotions. Schaubroeck and Jones (2000) found that this occupational classification was positively related to perceived demands to express positive (integrative) emotions but was unrelated to perceived demands to suppress negative (differentiating) emotions. 2007. However. Research indicates that the most prevalent display rules in organizations promote expression of integrative emotions and masking of differentiating emotions (Diefendorff & Richard. clerical.. The results of these two studies provide support for a relationship between occupational differences and perceived demands to express positive emotions but not for perceived demands to suppress negative emotions. anger)” (Johnson. Conversely. 34 . 3). the particular emotional expressions considered to be appropriate and/or required in a given job vary by occupation and work setting (Rubin et al. human service) and found no between-group differences for perceived demands to suppress negative emotions. fear. p. 2003). Additionally.
Likewise. less clearly defined. frustration. but social exchanges between MHPs and clients are unique in that their ultimate purpose is to facilitate clinical improvement and reduced need for services in the long-term. It reasons that. MHPs’ expressions of differentiating emotions during sessions are likely to deter client engagement in most cases. the MHP’s emotional displays may be perceived by the client as highly invalidating and lead to a rupture of the therapeutic relationship. however. etc. The literature is silent on the matter of MHPs’ perceptions of and attitudes about display rules for emotional expressions with/toward clients. MHPs’ expressions of integrative emotions during sessions are likely to foster client engagement. it also is possible that previous operationalizations of occupational differences have not been sensitive enough to reveal important differences in interpersonal demands between jobs. if a MHP exhibits positive affect while a client is crying. as the goals of social exchanges between MHPs and clients are not clear-cut. For example.. the client’s clinical 35 .g. in many circumstances. disappointment.) toward a client in order to facilitate the therapeutic process. in the context of providing mental health services. Fostering engagement is a short-term objective of most types of service interactions. however. it is noteworthy that interactions between MHPs and clients do not always follow a traditional or normative social script and are likely to dramatically differ across MHPclient pairs based on the MHP’s professional background. and less explicit than in many other types of human service contexts. display rules may be more variable.However. certain clinical situations may prompt a MHP to exhibit negative affect (e. While a full discussion of the important distinctions between theoretical orientations/treatment approaches is beyond the scope of the current paper.
Because no measure of MHP display rules was found in the literature. without being directly observed by coworkers or supervisors). when an interaction partner’s reaction significantly deviates from that range.g. as the confidential nature of therapy and other mental health services typically requires that they be conducted “behind closed doors” (i. it is not surprising that the literature has yet to identify what emotional display rules MHPs perceive to apply in their interactions with clients. 2005). Yet. 1998). the MHP may experience emotions (e. 2007. it would be difficult to assess the extent to which MHPs in real-world settings demonstrate behavior consistent with these requirements. display rules also may act as a job stressor for employees. For instance.. the exchange may become socially awkward and stressful (Johnson. Nonetheless. Keltner & Kring. disdain.e. The general purpose of display rules is to promote positive and successful working environments and service experiences for customers/clients (Rubin et al. frustration) that conflict with his/her perception that conveying understanding and unconditional positive regard to clients is appropriate. Emotional displays usually are met with a prescribed range of responses. and So-Kum 36 . Tang. surprise. an important step toward understanding the importance of display rules within the context of mental health service delivery is to determine the range of emotional expressions that MHPs perceive to be acceptable or inappropriate.presentation and reason for referral. Given the complexity of these issues. However. As Cheung. if a MHP is attempting to express empathy and acceptance to a distressed therapy client and the client becomes angry. an exploratory measure was developed and piloted as part of the present study.. and setting characteristics.. Even if the content of professional or setting-specific display rules for MHPs were known.
regardless of its origin. This theory suggests that individuals with high PTA are more likely to experience emotional dissonance when display rules call for limited expression of positive emotions. while explicit display rules may reduce ambiguity at work by providing standards for appropriate emotional expression. few empirical studies have systematically investigated predictors of employees’ perceptions of and responses to display rules. and therefore become a source of job stress. Morris and Feldman (1996) contend that trait affect influences how frequently individuals experience emotional dissonance within a given environment. emotional dissonance is likely to occur more often. individuals with low PTA are more likely to experience emotional dissonance when display rules call for frequent expression of positive emotions. each respectively. individuals with high NTA are more likely to experience emotional dissonance when display rules call for limited expression of negative emotions. create emotional dissonance. they also may undermine employees’ autonomy in expressing their genuine emotions. when employees’ levels of NTA and/or PTA are incompatible with work demands (such as showing or not showing a particular emotion) . Researchers have proposed that.(2007) suggest. when emotional dissonance does occur. Although not specifically mentioned by Morris and Feldman (1996). Although display rules play a central role in emotion management at work. it reasons that similar patterns of association with emotional dissonance may be demonstrated with high and low levels of neuroticism and extraversion. Accordingly. employees with high levels of positive and/or negative affectivity are likely to have more difficulty regulating their emotional 37 . and individuals with low NTA are more likely to experience emotional dissonance when display rules call for frequent expression of negative emotions.
e. Rubin et al. 2003). & So-Kum. emotional dissonance).. For instance.. & Richard..g. Another study found that the importance supervisors place on interpersonal job demands of their workers (i. How individuals typically respond to emotional dissonance in their professional roles is more feasible to measure than levels of emotional dissonance and is a more proximal predictor of stress that may 38 . however. rather than the perceived requirement to express sanctioned emotions or suppress unsanctioned emotions (i. Tang. 2003. 2003.e. although Best.expressions (e..e.. to measure accurately. Further complicating this picture. Lewig & Dollard. much of which occurs without conscious awareness. display rules).e.. 1999. 2005). Zapf et al. 2007. Cheung. if not impossible.. studies of Chinese. It is noteworthy. evidence from research outside the United States (i. and Jones (1997) found the perceived requirement to avoid differentiating emotional expressions was positively associated with burnout. how explicit display rules were) was positively related to worker emotional exhaustion (Wilks & Moynihan. Brotheridge and Grandey (2002) found that the relationship between perceptions of this display rule and emotional exhaustion became nonsignificant when the effect of NTA was partialled out. Diefendorff. Brotheridge & Lee. and other employee samples) has shown that the mismatch between felt and expressed emotions (i. 2005). emotional dissonance. 2001).. is a stronger predictor of negative outcomes such as burnout (Abraham. as it is a complex and dynamic process. 1998. German. the same may be true of employees with high levels of neuroticism and/or low levels of extraversion. that emotional dissonance is challenging. and individual outcomes remain somewhat unclear (e. Downey. Again. 2005.g.. Rubin et al. Dutch. The relationships between display rules.
Gross. 1997. Emotions play critical roles in many aspects of human functioning. Brotheridge & Grandey. & So-Kum. such as by facilitating decision-making. providing information about the organism-environment match. Gross. 2000). Efforts to resolve emotional dissonance represent a subset of emotion regulation strategies known as emotional labor (e. Rubin et al. Keltner. In turn. 1998a. such as burnout (e.have greater implications than display rules for more distal outcomes. Tang. 2005). and preparing the individual for rapid motor responses (Frijda. as they “inform us about others’ behavioral intentions.. p. 2002. 1991). Brotheridge & Lee. Morris & Feldman.. 273.g.g. & Buswell. Grandey. Emotions also aid in social functioning. 1987.. Rubin et al. Emotions and Emotion Regulation. our own 39 . and script our social behavior” (Gross.. 1998b. 1998b. also see Fridlund. Grandey. Oatley & Johnson-Laird. the resulting emotional dissonance they experience is aversive and individuals are inherently motivated to reduce it (e.g. 1998b. 1994. 2005).g. Brotheridge & Grandey. When individuals’ genuine emotions conflict with their perceptions of display rules for a given situation. Grandey. 1998. 1998. Walden.. 1997. To better understand emotional labor it is important to first provide further context by briefly reviewing the broader literature on emotions and emotion regulation. Types of emotional labor have been differentially associated with burnout in a variety of occupational groups (e. 2000). 2000. Brotheridge & Lee. 2007. give us clues as to whether something is good or bad. 1983). Cheung. 1986. 2002. Schwarz & Clore.
1884. 2002. and enforcement of display rule compliance. 1990). also see Buck. 1998b. expression. 2006). although many studies have examined aspects of emotion regulation in human service professionals with and without burnout. display rule requirements (i. 2005.272. 1984.. very few have focused explicitly on MHPs. Goldberg & Grandey. sales representative.g.. Emotion regulation frameworks have been used to conceptualize the interactive processes underlying burnout development (e. Brotheridge. Early researchers viewed emotions as adaptive behavioral and physiological response tendencies that are directly activated by evolutionarily significant situations and can be modulated (James. 1983. Unfortunately. 2002. bill collector. 1894). Contemporary researchers typically view emotions as flexible response sequences that are activated whenever an individual assesses a situation (which may be real or imagined) as “offering important challenges or opportunities” (Gross. Brotheridge & Grandey. Tooby & Cosmides. 1979. Zapf & Holtz. MHPs’ training in helping clients deal with their emotions may influence how MHPs experience and respond to their own emotions. 1994. 2007. including: the average frequency and duration of interactions with clients. Zapf.g.e. 2003. The complex processes underlying the management of emotions are known collectively as emotion regulation. there are several limitations to the cumulative literature on this topic. 40 . First.emotional expressions convey important information to others about our own feelings and intentions.. Furthermore. Scherer. Hochschild. suppression. Grandey. and help to script others’ social behavior. This is problematic given that human service roles (e. mental health counselor) may significantly vary in terms of work demands. or masking of positive and negative emotions). Zammunier & Galli. 2001. p.
p. Weintraub. Before proceeding. 275. the literatures on emotion regulation and coping have developed somewhat independently. 1986). Gross’ framework therefore stresses that emotion regulation should be viewed as a 41 . Gross & Levenson. 1984. Rottenberg.” while emotion regulation pertains exclusively to the processes associated with modulating emotions (Gross. cognitive. when they have them. and behavioral processes (e. Following the work of Gross and colleagues as well as many other researchers who have published on burnout. 1998b. The most critical and commonly cited difference is that coping includes “nonemotional actions taken to achieve nonemotional goals as well as actions taken to regulate emotions. 275. and how they experience and express these emotions” (Gross.Another significant weakness of research in this area is that the term “emotion regulation” has not been defined in a consistent manner and has sometimes been used interchangeably with the term “coping”. 2003. 1997. it is therefore important to clarify the definition of emotion regulation that guided the present study. Zajonc. Gross & John. 2007). 1998a. 1999. Rusting.g. & Gross. Although emotion regulation researchers have borrowed from the coping literature. 2004. Gross. Richards & Gross.. 1999. Sandström et al. Scherer. Despite the fact that these constructs seem to overlap significantly (depending on the researcher’s framework of choice). they have distinguished emotion regulation in multiple ways. 1985). 2005. Extensive research has demonstrated the complex dependencies between affective. Gross. see also Folkman & Moskowitz. 1998b.. 1998b. p. the term emotion regulation will be defined as “the processes by which individuals influence which emotions they have. & Carver. see also Scheier.
multicomponential and dynamic process that serves to increase or decrease the experience and expression of both negative and positive emotions. 275).. and active at one or more points in the emotion generative process. An important underlying assumption in this model is that there are bidirectional links between limbic centers that generate emotions and cortical centers that regulate emotions. emotional cues) to be important. experiential. or “the latency. 272). and offset of responses in behavioral. and behavioral manifestations of emotion regulation may be automatic or controlled. duration. and neuroendocrine systems (p. rise time.e. These processes involve changes in what have been termed emotion dynamics. 1998b. 1998b. conscious or unconscious.. emotional response tendencies (ERTs) are activated. cognitive. they do not always correspond with the most appropriate or adaptive responses in all situations. This conceptualization of emotion regulation views the nervous system as “multiple. p. however. partially independent information processing subsystems… [that] monitor one another to varying degrees and are in continuous bidirectional excitatory or inhibitory interaction” (Gross. autonomic. genetic predispositions and experiences accumulated over one’s lifetime). cognitive. Accordingly. and may call for modification. ERTs develop out of the ongoing interaction between nature and nurture (i. Accordingly.e. Emotion regulation processes that modulate ERTs determine the “final shape of the emotional response” (273). magnitude. Gross’ view of emotion regulation – unlike many models of coping – makes no a priori assumptions about whether particular emotion regulation strategies are inherently 42 . 275). or physiological domains” (Gross. experiential. when an individual consciously or unconsciously evaluates internal or external stimuli (i. p. These are “relatively short lived” changes in behavioral. the physiological.
other antecedent-focused emotion regulation strategies (i.. The first type. thus. p. and. Folkman & Moskowitz.e. Gross.e. attentional deployment (i.. However. Terry & Hynes. 5). Wiebe.“good” or “bad”. Research suggests that problem-solving coping strategies (i. 1995. MHPs do not have control over whether their clients will present to treatment in a state of crisis. which conceptually overlap with the antecedent-focused emotion regulation strategies of situation selection and modification.e. selective attending and shifting focus). reappraisal of situational meaning) (e. 2007.e. antecedent-focused emotion regulation. efforts to reduce or prevent stress by altering circumstances that contribute to stress). Even if the use of situation selection or 43 . tend to be more adaptive in situations that are controllable. his model focuses on distinguishing between two types of strategies that differentially target components of the emotion regulation process “along the timeline of the unfolding emotional response” (Johnson.g. altering a situation to mitigate its emotional impact).. anticipatory situation selection or modification are not always possible. a MHP may avoid discussing topics that s/he believes are likely to elicit negative client reactions (e.. approach or avoidance). situation modification (i. noncompliance). 2004.. refers to individuals’ preemptive efforts to manage emotions before ERTs are fully activated. in order to prevent additional stress.g. MHPs may be able to regulate their emotional experiences and expressions using attentional deployment and cognitive reappraisal strategies while interacting with clients in crisis. 1998). These include situation selection (i. Benotsch. For instance.. For instance.e. & Lawton. Rather. In situations that are not controllable. attentional deployment and cognitive change) may be more helpful (Christensen...e. anger. and cognitive change (i. 1998b).
or resentment. rather than expressing these negative emotions. In the context of mental health services. faking.g. 2000. Hochschild. Gross. For instance. because response-focused emotion regulation occurs after ERTs have been fully activated. 1998b. disappointment. experiential. or is hostile in response to clinical feedback. response-focused. Rubin et al. a MHP might experience frustration. 1998b).and response-focused emotion regulation strategies used to regulate emotional experiences and expressions in order to abide by organizational (or professional) display rules and goals (e.. these strategies require continuous monitoring and modification of physiological. it may be counter-productive for the client and use of other antecedent-focused strategies may be more appropriate. This construct has gained a great deal of 44 .. or angry. makes excuses for not following through with recommendations. s/he might regulate his/her behavior in order to maintain a smile and courteous tone.modification is possible. According to emotion regulation theory. is conceptualized as attempts to curb emotional responses that already are fully activated – that is. but. and behavioral systems (Gross.e. to modify ERTs (Gross. 1983). when confronted by a hostile customer... 1998b).e. a sales clerk may feel anxious. but suppress these negative emotions and either remain silent or feign empathy for the client. masking) and simulation of emotions (i. Grandey. These strategies include suppression of emotions (i. The second type of emotion regulation strategies. 2005). emotional labor refers to the subset of antecedent. Emotional Labor As aforementioned. sad. when a therapy client expresses dissatisfaction with the treatment process.
. 2002. if an individual is not sufficiently motivated to comply with perceived organizational/professional display rules. Brotheridge & Grandey. According to their framework.g. & Tomiuk.g. Grandey. it has been difficult to interpret and consolidate findings across studies. s/he might respond to emotional dissonance by engaging in task withdrawal (e. 2000. 2003. 2005. Rubin et al. Pugliesi.. 2008. 1993). 1993. 2000. 1998) have defined emotional dissonance as a component of rather than the catalyst for emotional labor. they will not experience emotional dissonance or be motivated to engage in strategies that might be described as emotional labor. 2000.g.. their expressions will be genuine. Thus. et al. (2005) discuss how conceptual and semantic inconsistencies within this literature have contributed to “a current state of theoretical disorientation” regarding the nature of emotional labor (189). rather. 1998. because some researchers (e. Ashforth. Brotheridge & Lee. ask a coworker to step in and finish with 45 . as individuals may engage in other emotion regulation strategies. Wharton & Erickson. For instance. Rubin and colleagues (2005) also note that emotional labor is not the only response to emotional dissonance.scholarly interest in the organizational literature over the last two decades (e. 2000. such as emotional dissonance. Rubin. Schaubroeck & Jones. 2002. Kulik. For instance. emotional labor strategies are employed in order to reduce perceived emotional dissonance. (2005) therefore present an integrated and empirically driven model of emotional labor that helps to clarify the definition of this construct and its relationships with other variables. Fisher & Ashkanasy. Abraham. 1999.. Ashforth & Humphrey. Rubin et al. In one of the most comprehensive reviews to date. Kruml & Geddes. when employees’ felt emotions are consistent with their perceptions of emotional display rules.
For instance. which are sometimes referred to as acts of emotional deviance (Rubin et al. being passed over for promotions or raises. In contrast. The first. involves modifying felt emotions before ERTs are fully activated.. the aforementioned sales clerk might reduce emotional dissonance by selectively focusing on the customer’s needs. These strategies allow employees to bring their felt emotions into alignment with perceived display rules and thus to exhibit sanctioned behavioral responses in an authentic manner (Gross. therapeutic alliance “ruptures”. it is not clear how common they are or what impact they may have on individual and organizational outcomes. in order to limit interaction requirements).e. Alternatives to emotional labor.a customer). Rubin et al. there has been increasing interest in emotional labor responses to dissonance (Rubin et al. using the antecedent-focused emotion regulation strategies of attentional deployment (i... However. Two types of emotional labor strategies have been identified. 2005). as deviance from emotional display rules introduces the potential for negative consequences (e. 2005).. 2005).. and/or by evaluating the situation from the customer’s point of 46 .g.. unsanctioned behavior. 2005). task avoidance (e. 1998b.. and so forth. or genuine emotional expression (i.e.. As such. selective attending and shifting focus) and cognitive change (i. Rubin et al.. choose to work in the stock-room rather than behind the cash register. reappraisal of situational meaning). such as unpleasant client reactions. deep acting. termination of employment..g. 2003. Rubin et al.g. emotional labor is viewed as the more likely regulatory response to emotional dissonance in most cases. rather than the customer’s hostile tone of voice (attentional deployment). passive-aggressiveness (e. 2005). Gross & John. reprimands from supervisors. have received little attention in the empirical literature.e. not returning with the item a rude customer requested)..
in the second example. 1998a). the aforementioned sales clerk may respond to emotional dissonance by suppressing his/her negative emotions (masking) and maintaining a smile and courteous tone (faking) because s/he believes this is how the store manager expects him/her to respond in such situations. masking and faking). By genuinely empathizing with the client. as it involves suppressing genuine emotions and regulating observable expressions of emotions. Similarly. and acceptance. the MHP would avert full activation of negative ERTs and be more able to express authentic patience. in order to comply with perceived display rules (Gross. Gross & John . The second type of emotional labor.e. 2003.view (cognitive reappraisal). Although surface acting allows individuals to approximate expressions that are consistent with perceived display rules. Thus. 1998b. the sales clerk would be able to engage in courteous behavior without continued emotional dissonance. Rubin et al. deep acting strategies serve to decrease unsanctioned expressive behavior as well as subjective emotional experience (Gross. Similarly.. 2005). the MHP might engage in deep acting by selectively focusing on the client’s strengths (attentional deployment) and considering how aspects of the client’s personal situation represent real obstacles to treatment (cognitive reappraisal). it may not have a substantial or enduring impact 47 . understanding.. the aforementioned MHP may mask his/her true feelings and fake empathy because s/he believes professional norms dictate that therapists avoid negative reactions towards clients. after ERTs have been activated. In turn. rather than simply keeping silent or feigning empathy. For instance. is synonymous with responsefocused emotion regulation (i. surface acting.
or a control condition in which they were not instructed to do anything while watching the film (Gross.on emotional dissonance. Strack.e.e. Regardless. most likely because suppression of positive emotions is a less common requirement than suppression of negative emotions in the occupational context (Diefendorff & Richard. it seems that suppressing either negative or positive emotions is associated with undesirable individual outcomes (i. Martin. 2003). a reappraisal (i. 48 . Gross (1998a) conducted a study in which participants were assigned to one of three conditions: a suppression (i. Stepper & Strack. they reported experiencing as much negative emotion as participants in the control condition did. 1997.. When evaluating the relative benefits of emotional labor strategies. The reasons for this finding remain unclear. 1998a).. as masking and faking primarily serve to regulate expressive behavior rather than experienced emotions (Rubin et al. & Stepper. Interestingly. deep acting) condition in which they were told to think about the film so that they would not respond emotionally. it is important to consider how effective they are in reducing unsanctioned behavior and discordant emotions. surface acting) condition in which they were told to hide emotional reactions to a negative emotion-eliciting film so that an observer could not see what they were feeling.. 1993. and have received little attention. In contrast.e. 1988). experiencing continued negative emotions or reduced positive emotions). Although participants in the masking group exhibited significantly less expressive behavior. other studies have shown that suppressing positive emotions is associated with both expressing and experiencing less positive emotions (Gross & Levenson.. participants in the reappraisal condition not only exhibited significantly less expressive behavior but also reported experiencing less negative emotion. 2005).
For instance. Gross 49 . in order to match behavior with perceived display rules (e. which have already been fully activated. Wegner & Zanakos.. 2003.Another important consideration is that those emotional labor strategies that are helpful in the short-term may have drawbacks and/or not be as effective in the long-term (Preece & DeLongis. research has shown that attempts to suppress emotional thoughts are associated with increased accessibility and intrusive recurrences of these thoughts. Beal. 1990. Wegner. & Neale. particularly if cognitive load is high. as the former require continuous monitoring and modification of ERTs. Kennedy-Moore. Trougakos. Another possibility is that the resources required for surface acting may be more limited and/or less easily replenished than the resources tapped during deep acting.. which in turn are associated with heightened emotionality (Wegner. yet surface acting has been associated with negative individual outcomes. 1985). 2003). Gross & John. Regardless. 1998b. case by case) basis. 2005. and Weiss (2006) found that camp counselors who engaged in surface acting reported being able to regulate emotional expressions effectively on an episode-to-episode (i. 1995).g. Shortt. Gross. Stone. Totterdell & Holman. Grandey. Blake. It has been argued that surface acting strategies involve greater resource expenditure than deep acting strategies. 1994). 2003. resource expenditure may only be detrimental if it is more costly than it is beneficial. Studies outside the emotional labor literature have shown that the expression of positive emotions can trigger physiological changes that result in increased well-being for employees (Zajonc. & Page.e. but perceiving each episode to be more difficult to manage than individuals who engaged in deep acting reported. 1994. Wegner (1994) demonstrated that attempts to regulate negative emotions via thought suppression often yield paradoxical increases in negative mood.
efforts to suppress the feelings and thoughts associated with undesirable ERTs may have the opposite effect (i. In other words. suggesting psychological resources had been depleted.g.. 1995). It may even be that suppression promotes a dishabituation or relative elevation of emotional response to that thought” (617). 1999.. Related. 1998.” when cognitive resources are limited (277-278). 1997. it is not surprising that numerous studies have linked masking and/or faking with perceived stress (e. Pugliesi. which are indicators of increased stress 50 . Furthermore.e. 2007). Gross (1998a) found that masking and faking were associated with impaired performance on subsequent cognitive tasks. Richards and Gross (1999) found that suppression of emotions impaired female participants’ incidental memory for information presented during suppression. increased sensitivity (i. Wegner and Zanakos (1994) suggest. Brotheridge. It follows that the emotion regulation processes underlying masking may interfere with human service providers’ abilities to receive and store critical information during interactions with clients (Johnson. Abraham.(1998b) suggests. increase these feelings and thoughts) when an individual’s cognitive resources already are allocated to other mental tasks.e. Furthermore. Research also has linked suppression of negative emotions to sympathetic activation of the cardiovascular system and impaired immune functioning (Gross & Levenson. 1999).. Erickson & Wharton. 1997). “suppression of emotional thoughts prevents the person from habituating to the thoughts and thus lessening their emotional impact. psychophysiological responding) to previously suppressed emotional thoughts has been shown to persist after suppression is discontinued (Wegner & Gold. “the conscious operating system that seeks out desired mental contents is out-performed by a less cognitively costly monitoring system that flags undesirable mental contents. With depleted resources.
stress) in surface actors’ interaction partners (Butler. It reasons that if MHPs’ surface acting causes their clients to experience increased stress. 2002. if clients react 51 . 22. 1989. The associations between surface acting and stress-related outcomes often are attributed to “internal tension and the physiological effort” associated with both masking genuine emotions and faking alternative emotions (Brotheridge & Grandey. such as distraction and reduced responsiveness. Freudenberg. p. Aside from the personal costs associated with surface acting. therapeutic relationships may be jeopardized. Smith. Burke & Greenglass. & Hollander.g. Pugliesi. 2003). and cancer (Gross. 1997.. It reasons that surface acting may allow individuals to comply with perceived display rules and reduce emotional dissonance (if only slightly) in the moment. 1985).. 1998. & Jiang. including: asthma (Florin. but may not help reduce overall stress or deter emotional dissonance from occurring in the future. Greer & Watson. with elevated stress representing both an antecedent and consequence of surface acting. Morris & Feldman.and are associated with a variety of stress-related health problems. Xu. 1999). Erickson & Gross. Egloff. 2006). Wilhelm. 1996. 1985). More research is needed in order to clarify the association between stress indicators and surface acting. Zhang. It is also possible that the positive relationship between surface acting and stress is reciprocal. 1997). elicit increased physiological responding (i. Furthermore. research has shown that the cognitive costs associated with this type of emotional labor. cardiovascular disease (Guyton & Hall.e. see also Gross & Levenson. This is noteworthy given that burnout is similarly associated with ineffective coping and health problems (e.
In contrast. It reasons that if deep acting is less taxing (relative to surface acting) of one’s internal resources. such that emotional dissonance is less likely to reoccur.. Hochschild (1983) initially hypothesized that. 2003).g. to experience lower stress in managing work demands. and is positively associated with service quality (i. 2003. and ultimately to exhibit lower levels of burnout. Research on the relationship between emotional labor and burnout is relatively limited compared to the literature on other predictors of burnout. Totterdell & Holman. it may allow employees to devote more attention and energy to their occupational tasks. 2003. Butler et al. evidence has shown that deep acting is not associated with increased physiological responding (a stress indicator) in employees or their interaction partners.g. relative to surface acting. For instance. or is at least as beneficial as it is costly.. deep acting would be more associated with burnout. Johnson. as he presumed that aligning one’s felt emotions with display rules requires an individual to 52 . overall. Grandey. more adaptive ERTs. skeptical. their MHPs may be more likely to experience further emotional dissonance and higher overall stress. Deep acting may not only reduce emotional dissonance but also lead to internalization of new cognitions and.negatively (e. existing research has yielded some interesting findings. and no published studies have empirically examined this relationship in a sample of MHPs. affective delivery and task performance) and job satisfaction (e.. 2007. become disengaged. ultimately. or hostile).e.. Nonetheless. research has associated the deep acting strategies of attentional deployment and cognitive reappraisal with positive outcomes. It is possible that individuals who are more likely to engage in deep acting are also more likely to have the characteristics that promote successful stress management and positive performance.
while deep acting was unrelated to EE and DP and positively related to PA. over time. The authors suggest that the greater stress associated with surface acting may help to explain its association with EE. MartínezIñigo. However. be enthusiastic and hide frustration) reported more post-simulation emotional exhaustion (EE) and made more errors on the order form. 2007. Goldberg & Grandey. if surface 53 .g.become emotionally involved with coworkers or customers/clients. & So-Kum. & Holman. most evidence suggests that surface acting is a better predictor of burnout than is deep acting (e. surface acting rather than deep acting accounted for the energy depletion effect of display rules. Brotheridge & Grandey. Tang. Furthermore. Yet. and thus is more taxing than simply faking. For instance. In another study. Rubin et al. 2002. 2007. Alcover. Totterdell. Alcover.g. Brotheridge and Grandey (2002) found that surface acting was positively related to EE and depersonalization (DP) and negatively related to personal accomplishment (PA). Brotheridge & Lee. while deep acting was unrelated to EE. 1998.. 2007. The authors found that participants who had been given positive display rules (e. 2005). Morris & Feldman. Cheung.. Totterdell. 1997. the lack of authenticity associated with surface acting may lead employees to experience feelings of detachment from one’s true feelings and those of others. & Holman (2007) found that surface acting had a positive association with EE. thereby leading to higher DP.. Goldberg and Grandey (2007) conducted an analog study (using a call center simulation) to examine whether efforts to comply with display rules lead to depletion of energy and attentional resources during service encounters. They also argue that. compared to participants who had not been given display rules to follow during the simulated interaction. Martínez-Iñigo.
and lack of autonomy) increases the likelihood that MHPs will engage in emotional labor. goals. and/or lack of autonomy (i. 2007). Accordingly.. While some studies have found evidence that such work stressors may moderate the relationship between emotional labor and burnout (e. Evidence suggests that occupational demands and role stressors are positively associated with emotional dissonance (see review by Bono & Vey. control over decisions and activities) may feel unable or unmotivated to engage in deep acting strategies. Johnson & Spector.e.e. it is possible that greater work stressors (e. individuals experiencing high levels of work-related strain may be more inclined to engage in surface acting..g. 2005). role ambiguity. role conflict. no studies were found that examine emotional labor as a mediating variable between work stressors and burnout. uncertainty about expectations.g. overall. Regardless of whether MHPs engage in surface or deep acting. as they may “presume” (not necessarily on a fully-conscious level) that it is less taxing. they may experience diminished PA. which in turn may increase their risk for burnout..actors view their own emotional displays as disingenuous or unsuccessful. 54 . incompatible demands/expectations)..e. role ambiguity (i. it follows that higher levels of work-related stress also may contribute to higher rates of emotional labor. Related. work stressors may have a direct and indirect effect through emotional labor on burnout.. MHPs who experience more role conflict (i. In turn. Few studies have examined specific work factors (other than emotional display requirements) as predictors of employees’ emotional labor strategies. or impact of role). Despite research indicating that surface acting may be more costly than deep acting is of employees’ internal resources.
Woolf. 2009). & Ilardi. p. & Hurst. Austin. Judge. Rubin et al. and O’Donovan (2008). Sheldon. and Weiss (2006) found that experiencing positive emotions was negatively related to surface acting. 58).In addition to studies examining the relationships between work characteristics and emotional labor strategies. 2005.. Beal. research has examined individual characteristics. Gross & John. and Gosserand and Diefendorff (2005) all found positive relationships between extraversion and deep acting. Woolf. Similarly. Ryan. Dore. Diefendorff. & Gosserand. 2005. it has also been suggested that surface actors experience a diminished sense of well-being due to the inauthenticity of their interactions (Brotheridge & Lee.. It is possible that these results reflect the influence of trait affect. Croyle. 2008. Rawsthorne. 2003. Findings on the relationship between personality and deep acting have not been as clear. Johnson (2007) found that individuals with high PTA were more likely to engage in deep 55 .g. Dore. Gross & John. Johnson (2004). It reasons that the strain associated with use of surface acting strategies may be greater in individuals with lower extraversion. & O’Donovan. as “emotional labor should be more effortful and provide fewer payoffs” (Judge. 1997). Trougakos. however. most have found a negative relationship (e. individuals with lower extraversion should experience greater strain because they have to work harder to engage in surface acting and experience less fulfillment from such exchanges. assuming that the emotions they fake are positive and the emotions they mask are negative. It is possible that whether employees tend to engage in surface or deep acting may largely depend on individual characteristics such as personality. That is. 2002. 2003. & Hurst. Although relatively few studies have evaluated the relationship between surface acting and extraversion. Austin. 2009.
acting than surface acting. In addition, if one considers evidence that associations tend to be stronger when variables are matched in terms of hedonic tone (Thoresen et al., 2003), it reasons that deep acting, which typically involves refocusing and/or reframing information in ways that foster positive emotions, cognitions, and behaviors, would be more strongly related to PTA than NTA. In summary, research has demonstrated that a variety of situational factors and individual characteristics are implicated in human service employees’ use of particular emotional labor strategies and experiences of burnout. The theoretical and empirical evidence reviewed in this paper was used to develop a model illustrating the hypothetical relationships between these variables among MHPs (Figure 1). The present study aimed to evaluate some of the associations depicted in this model by testing the following primary hypotheses. 1) Extraversion will be negatively related to EE and DP, and positively related to PA. 2) (a) Role conflict and role ambiguity will be positively related to EE and DP, and negatively related to PA, while autonomy will be negatively related to EE and DP, and positively related to PA, but (b) these relationships will be moderated by extraversion, such that the associations between the three work demand/stressor variables and the three burnout dimensions will be stronger for individuals with lower extraversion. 3) Emotional labor strategies will account for significant variance in the three dimensions of burnout, with (a) surface acting (faking and masking) being positively related to EE and DP, but negatively related to PA, and (b) deep acting strategies (attentional deployment and reappraisal) being negatively related to EE and DP, but positively related to PA..
4) Extraversion will be (a) negatively related to surface acting, and (b) positively related to deep acting. 5) Extraversion will moderate the relationships between work demands/stressors and emotional labor, such that: (a) Role conflict and role ambiguity will be more strongly positively associated with surface acting in individuals with lower extraversion, and autonomy will be more strongly negatively associated with surface acting in individuals with lower extraversion. (b) Role conflict and role ambiguity will be more strongly negatively related to deep acting in individuals with lower extraversion, and autonomy will be more strongly positively related to deep acting in individuals with lower extraversion. 6) (a) Surface acting and (b) deep acting will partially mediate the relationships role conflict, role ambiguity, and autonomy have with levels of burnout. Several exploratory hypotheses were tested as well in an effort to provide preliminary evidence regarding variables that have yet to be addressed in the literature. 7) Caseload characteristics (i.e., client severity and proportion of caseload with medical assistance insurance) will be positively associated with surface acting and burnout. 8) MHPs will perceive display rules to dictate that integrative and neutral emotional expressions are acceptable, while differentiating emotional expressions are not acceptable, within the therapeutic context. 9) The stringency of perceived display rules will be (a) positively associated with EE and DP, and negatively associated with PA; and (b) positively associated with both types of emotional labor, but more strongly associated with surface acting strategies than deep acting strategies.
10) Perceived importance of controlling emotional displays at work will be (a) positively associated with surface acting and deep acting; and (b) positively associated with EE and DP, and negatively associated with PA. 11) MHPs’ job-related affective well-being will be (a) negatively associated with EE and DP, and positively associated with PA and (b) negatively associated with role conflict and role ambiguity, and positively associated with autonomy. Figure 1
= not tested
Methods Participants The final sample consisted of 188 MHPs working in Florida. This number exceeds the estimated minimum N needed to provide adequate power (1-β ≥ 0.80) for detecting medium effects at an alpha level of 0.05. Demographic and professional characteristics of the final sample are shown in Table 1. Participants ranged in age from 24 to 74 (X=45, SD=13) and were predominately female (72%), White/Caucasian American (94%), non-Hispanic/non-Latino (85%), currently married (69%), and parents (63%). These demographic characteristics are relatively consistent with reported norms for the mental health workforce, (Duffy et al., 2004; Manderscheid & Henderson, 2004; SAMHSA, 2002; An Action Plan for Behavioral Health Workforce Development, SAMHSA, 2007). MHPs’ highest education levels included high school/general education diploma, specialty certifications, Master’s degrees, and Doctorates, though most participants’ (91%) had one or more advanced degrees. While not all participants provided further information about their disciplines, the vast majority of those who did reported degrees in psychology, counseling, social work, or marriage/family therapy. Participants’ amounts of professional experience ranged from under one year to 41-50 years. About 18% had five or fewer years, while over 40% had more than 15 years of experience. Accordingly, this sample represents MHPs with disproportionately high levels of education and experience relative to the national workforce, which consists increasingly of individuals without graduate level training and less time working in the 59
Manderscheid & Henderson. as estimates for the mental health workforce in Florida at the time of this study were not found. only 52% of MHPs reported being satisfied with the size of their current caseloads. A wide variety of work settings in Florida is represented by this sample (Table 1). It is not clear whether the demographic and professional characteristics of this sample are consistent with state norms. Active caseloads ranged from one to “hundreds” of clients/patients. 2007). Participants were asked to identify their theoretical orientations by selecting one or more categories. As shown in Table 1. than their current caseloads. Participants worked in as many as four types of settings. Because an open-ended response format was used to collect this information. though most (79%) reported providing services in one type of setting. For instance. while a striking minority endorsed having a psychoanalytic theoretical orientation.. 2002 An Action Plan for Behavioral Health Workforce Development. some participants indicated the number of groups they run per week. 60 . while other participants reported the average number of evaluations they conduct per day. SAMHSA. responses widely varied and it was not possible to consolidate the data in a valid and reliable way. Over half of the sample reported working in private practice and 25% of those MHPs worked in at least one additional setting. 2004. Most participants (72%) indicated having more than one theoretical orientation and some indicated having as many as six theoretical orientations. while 25% and 21% reported that their ideal caseload would be larger and smaller. SAMHSA. Perhaps more importantly. the vast majority of participants endorsed having a cognitive theoretical orientation. respectively.field (Duffy et al. 2004.
five hours per week doing clinical support tasks. At least 50% of MHPs in this sample reported spending at least ≥18 hours per week providing direct care (treatment plus assessment).2% of MHPs in this sample reported working exclusively with child/adolescent clients (0-17 years old) and only 34% reported working exclusively with adult clients (at least 18 years old). 61 .5%) reported that they would prefer to work with clients who were younger or older. respectively. Only 13. Participants’ involvement in various professional activities also is summarized in Table 2. as less than one third of the sample reported working exclusively with clients having a particular type of coverage (e.g. Most MHPs in this study had clients with various types of coverage. Over two-thirds of participants had at least some private pay clients. A small minority (8.. The majority of the sample spent one or less hours per week providing and receiving supervision. and one hour per week on consultation. five hours per week on administrative tasks. About 45% of the sample reported having no clients with private managed care insurance and over half the sample reported seeing no clients with Medicaid or Medicare insurance. Participants were asked to indicate the percentage of their clients in different age groups (see Table 2). MHPs also were asked to indicate whether they would prefer to provide services to a different age group than they currently serve. suggesting that over 90% were satisfied with the age groups comprising their current caseloads. though these clients comprised a small proportion of total cases for most MHPs. only private pay or only medical assistance).Participants were asked to indicate the percentage of clients they serve who are covered by different types of insurance or are private pay.
or employers. Individuals contacted by phone who agreed to provide valid email addresses were sent a follow-up recruitment email with information about participating in the study. coworkers. They were informed that no personally identifying information (i. including it in newsletters. administrators at numerous mental health care facilities and professional organizations were contacted and asked to disseminate recruitment information to potential participants by forwarding it in an email. Public listings of MHPs in Florida were used to contact potential participants by email and phone. Data collection occurred between April 2009 and March 2010. Participation in this study was solicited via emails. Participants could be working in any setting and with clients/patients of 62 . and telephone. In addition to contacting potential participants directly. professional listservs.. etc. and/or posting flyers (provided by the researcher). contact information.) would be collected and no identifying information would be collected about individual clients/patients. attitudes. mentioning it during staff meetings. Upon accessing the website. Potential participants were asked to visit a secure website to take a completely voluntary and anonymous online survey about their professional activities. posting it on electronic listservs. names.Procedures MHPs were recruited from the public and private sectors within the state of Florida. fluent in the English language. and experiences. wordof-mouth. individuals were required to provide informed consent to participate in the study prior to beginning the survey (Appendix A). Individuals were eligible to participate in this study if they were at least 18 years old. IP addresses. and providing direct mental health care within the state of Florida.e.
Participants who did not meet all inclusion criteria (e. It was developed based on two of the six items from Ackerley et al. average number of concurrent clients.e. Participants were asked to indicate their sex. voluntary. work setting. a 16-item questionnaire created for this study (see Appendix C). parent status. Respondents are asked to estimate the percentage (0-100%) of their 63 . client age range. this measure included items that assess MHPs’ years of mental health service experience.e.’s (1988) Psychologist’s Burnout Inventory. No specific level of education.. MHPs’ demographic and professional characteristics were assessed using a questionnaire created for the present study (Appendix B). time spent providing treatment/assessment.g. involvement with managed care cases. were not currently providing direct care to clients/patients) or did not respond to more than one measure were excluded from the sample and their data were not used in any analyses. amount of experience. as well as anecdotal and empirical research on clinical characteristics that contribute to client severity and difficulties providing effective mental health services. Information about MHPs’ exposure to various challenging client behaviors and circumstances was evaluated using the Challenging Client Behaviors and Circumstances Questionnaire (CCBCQ). etc.). and education (see Table 1). and uncompensated.any age. Measures Background Information.. doing paperwork. involvement in different professional tasks (i. race/ethnicity. and caseload characteristics (i. In addition. marital status.). or professional title was required to be eligible for this study. age. etc.. Participation was completely anonymous.
what percent of your clients refused to participate in session/were noncompliant with treatment recommendations?” Total scores were computed by summing the percentages across items. adapted from the Eysenck Personality Questionnaire Revised-Short (EPQR-S..g.. The EPQ-BV also includes twelve neuroticism items (e. the coefficient alpha for the Extraversion scale of the EPQ–BV (α = 0. “Do you like plenty of action and excitement around you?”). Appendix D). in Sato’s (2005) study.9) was higher than that of the original EPQR–S. both of which have been criticized for having poor reliability. skin cutting or burning)?” and “Within the last 30 days. This measure has demonstrated superior psychometric properties to the EPQR-S and another abbreviated version of the EPQR-S (EPQR-A. This value also was higher than the values reported for the EPQR–S and the EPQR-A in the past (Eysenck & 64 .. which are rated on a Likert-type scale ranging from 0 (“not at all”) to 4 (“extremely”). More specifically. was considered a score of 202.. what percent of your clients made suicidal statements or gestures. suggesting the measure had acceptable internal consistency.Brief Version (EPQ-BV. This measure is comprised of twelve extraversion items (e. Examples of items include “Within the last 30 days. 1992).clients/patients within the past 30 days who demonstrated the behaviors or characteristics described.g. 2005. High scores on this measure represent greater exposure to challenging client behaviors and circumstances. MHPs’ levels of extraversion were evaluated using the extraversion items of The Eysenck Personality Questionnaire. for instance. Eysenck & Eysenck. or engaged in self-harm behaviors (e. Personality. such that a total percentage of 202% across items. Sato. Francis et al. “Are you an irritable person?”) that were not included in the present study. 1992).79 was found in the present study. A Cronbach’s alpha of 0.g.
MHPs’ perceived role conflict and role ambiguity were assessed with Rizzo. House.. internal consistency was evaluated to be α =0. and a relatively robust factor structure (Sato.92. 1990)].g. and Lirtzman’s (1970) widely used questionnaire (Appendix E). which is comparable to those reported for other measures of extraversion (Sato.. 2005). a lower alpha of 0.904. Numerous studies have examined the validity of Rizzo et al. The six-item role ambiguity subscale taps into perceived lack of role predictability and clarity of behavioral requirements (e. In the present study.. Acceptable internal consistency has been reported for this scale [α = 0. internal consistency. Kelloway and Barling (1990) and Gonzalez-Roma and Lloret (1998) used various factor analytic techniques to demonstrate the construct validity of the role conflict and ambiguity scales. test–retest reliability.82 (Kelloway & Barling. “I feel certain about how much authority I have.68 was found (which will be addressed in the Discussion section). using a Likert-type scale ranging from 1 (“very false”) to 7 (“very true”). α = 0.’s measure. This measure asks respondents to indicate how accurately each statement reflects their experiences at work. 2005). Work-related Stressors. “I receive an assignment without adequate resources and materials to execute it. 1992. For instance. Acceptable 65 .88) with the corresponding measures in the original EPQR–S.g. In the present study. 2007). The eight-item role conflict subscale taps into perceptions of incompatible or incongruous performance or role requirements (e.”). The test–retest reliability values of the EPQ–BV subscale are r = 0. the EPQ-BV seems to have acceptable construct validity. & Kisamore.Eysenck. The construct validity of the EPQ-BV was demonstrated as the extraversion subscale was highly correlated (r = 0. Stone. 1992). Francis et al.”). In sum.86 (Jawahar.
83). Spector. Accordingly.. using a five-point Likert response format ranging from never to always.e.g. α = 0. 1990). 1975) Idaszak and Drasgow’s (1987) version were used because the minor changes made to the wording of the original JDS items resulted in stronger internal validity. Kelloway & Barling. The present study found the autonomy scale to have an alpha of 0.g. Total scores were computed such that higher scores represent higher levels of perceived autonomy at work. Van Katwyk..927. 1974. which are rated on a Likert-type scale ranging from 1 (“very inaccurate”) to 7 (“very accurate”). 1999. MHPs’ perceived autonomy was assessed using Idaszak and Drasgow’s (1987) modified version of the Autonomy subscale from the Job Diagnostic Survey (JDS. 1975. The negative affect items were reverse scored to allow a total score to be calculated by summing the positive and negative emotion scores. Johnson & Spector. The present study also found this subscale to have acceptable internal consistency (α = 0. This measure is comprised of three items (e. which is comparable to the high internal consistency reliability previously reported (e. “I decide on my own how to go about doing the work”). high scores on this measure indicate high levels of affective well-being (i. MHPs’ emotional reactions to their work were measured with the Job-related Affective Well-being Scale (JAWS. Fox.91. 2007).g..internal consistency has been reported in prior studies (e. Hackman & Oldham.. The 2066 . α = 0. Appendix E). experiencing positive emotions frequently and negative emotions infrequently). Appendix F). This questionnaire asks respondents to indicate how often their jobs made them feel 20 emotions in the prior 30 days. Extensive support for the external criterion validity of the JDS has been reported (see Hackman & Oldham. & Kelloway.80.
Disgust. Frustration. Sometimes. Admiration. reported to have an acceptable alpha of 0. Calmness. and Bruursema (2003). and Disappointment.81 was found for the JAWS. Display Rules. sometimes.93. Ratings on 67 . Respondents are given the option of selecting Not Applicable if they do not believe that a professional standard exists for displays of a given emotion. Patience. Goh. Total subscale scores were calculated for integrative. always) it is acceptable. although it is a negative emotion. Respondents are asked to rate how often (never. Responses of Never. Fear/Anxiety. Responses of Not Applicable were excluded from these calculations. differentiating. Spector. Sympathy. Anger. according to formal or informal professional standards. In the present study. a questionnaire created for this study. Appendix G). Items were developed in order to tap into perceived display rules regarding expressions of integrative. Empathy. Items included in the Integrative Emotional Displays score included Enthusiasm.item version of the JAWS used in the present study was adapted from the original 30item version by Fox. and neutral emotions. Items were generated by the author and pilot tested using a sample of clinical psychology graduate students. Happiness/Joy. respectively. it is not necessarily differentiating. an alpha of 0. Items included in the Differentiating Emotional Displays score included Boredom. and Always were recoded as 0. and 2. 1.729 (when excluding responses of Not Applicable). The internal consistency reliability for this measure was found to be 0. Dislike/Contempt. for mental health service providers to display (outwardly express) 18 emotions during interactions with clients/patients. differentiating. Sadness was not included in these calculations because. Perceived display rules were evaluated using the Perceived Display Rules Survey (PDRS. and Excitement. and neutral emotional displays by summing across items of similar hedonic tone.
emotional labor).the No Emotions and Neutral Emotions items were included in the Neutral Emotional Displays score. Possible total scores range from eight to 32.. how important is it for mental health service providers to not show their true feelings in emotional situations?”. indicating that these two items may be addressing different types of display rules and should not be analyzed together.706. The Pearson correlation for the Integrative and Differentiating scores was 0.. Items do not make distinctions between the importance of regulating specific types of emotions (i. suggesting that the association between these subscales is minimal.e.815 and 0.094. While items do not refer explicitly to surface and deep acting. with higher scores indicating that the respondent perceives controlling emotional displays at work to be of high importance. An example of an item from this scale is “Based on professional standards for working with clients/patients. respectively. the alpha for Neutral Emotional Displays was 0. Cronbach’s alphas for the Integrative and Differentiating Emotional Displays total scores were 0.156. the perceived importance of using emotional labor strategies to regulate emotional displays is reflected in many of the items. Respondents are asked to rate items on a four-point scale ranging from 1 (Not Important) to 4 (“Very Important”). On the other hand.e. suggesting that both had acceptable internal consistency. Items tap into respondents’ perceptions of how important it is to regulate their emotional expressions in general and using specific regulation strategies (i. integrative and differentiating). 68 . The perceived importance of controlling one’s emotional displays at work was evaluated using eight items (Appendix H) adapted from the Emotional Abilities Scale developed by Miller (2004).
” A sample item from the surface acting subscale (which taps into the masking dimension) is “Hide my true feelings about a situation. MHP’s surface acting was assessed using four items from the ERQ and two items from the ELS. In the present study. which tap into the masking component. The only modifications to items were to change the word “customers” to “clients”.89. Deep acting was measured using three items from Brotheridge and Lee’s (2003) Emotional Labour Scale (ELS). which tap into the cognitive reappraisal component. A sample item from the deep acting subscale (which taps into the attentional deployment dimension) is “Make an effort to actually feel the emotions that I need to display to others. α = 0. which tap into the attentional deployment component. These measures were used to broadly cover the emotional labor strategies of deep acting and surface acting.and response-focused emotion regulation measure. internal consistency alphas were 0.80 for 69 . Higher average scores on each of the subscales represent higher levels of the dimension being assessed. which tap into the faking component. Emotional Labor. and six items from Gross and John’s (2003) Emotion Regulation Questionnaire (ERQ).774. The revised ELS items ask respondents “On an average day at work. how often do you do each of the following when interacting with clients?” Statements are rated on a Likert-type scale ranging from 0 (“never”) to 4 (“always”).86).” Brotheridge and Lee (2003) reported acceptable coefficient alphas for the deep acting and surface acting subscales (α = 0. as well as five items from Grandey’s (2003) antecedent.94 and 0.The internal consistency of the adapted Emotional Abilities Scale (AEAS) used in this study was 0. Modified versions of three established scales were used in order to evaluate MHP’s emotional labor strategies (Appendix I). suggesting it has acceptable reliability.
. ranging from 1 (“strongly disagree”) to 7 (“strongly agree”). 2003).81 for the reappraisal and suppression subscales. For instance..e. Gross and John (2003) showed that Suppression was significantly related to Inauthenticity. A Likert-type scale ranging from 0 70 .the deep acting (i. and behaviors.’s (1997) Emotional Work Requirements Scale (Brotheridge & Lee.. Best et al.”). as the surface acting and deep acting subscales are correlated with another commonly used measure. while Suppression was shown to have a negative association with coping through venting. “I control my emotions by not expressing them.g. gestures. The reappraisal subscale is comprised of six items (e. and emotional expressions.73). Gross and John’s (2003) Emotion Regulation Questionnaire (ERQ) assesses individual differences in expressive suppression and cognitive reappraisal with a Likerttype scale.. respectively. masking) subscale consists of four items (e. masking) subscales. α = 0.g. Gross and John (2003) reported acceptable alphas for the reappraisal and suppression subscales (α = 0. The suppression (i. respectively.84 and 0. Response-focused emotion regulation items from Grandey’s (2003) measure ask respondents to indicate how often they engage in faking behaviors in their jobs (e. or feelings. The convergent validity of the ELS has been demonstrated.”). Reappraisal was shown to have a positive association with coping through reinterpretation. Items measure emotional experience..g. In addition. The convergent validity of the ERQ has been demonstrated in multiple ways..e. attentional deployment) and surface acting (i. I change what I’m thinking about.e.79.”). The present study found acceptable internal consistency alphas of 0. “When I want to feel more positive emotion (such as joy/amusement). while Reappraisal was not. “I put on an act in order to deal with customers. in the form of speech.
using a 7-point Likert-type scale (0 = never. scores for each subscale are considered to be independent. Although the measure also includes three antecedent-focused emotion regulation items. 6 = everyday). they were not included in this study. 2003). The most recent MBI manual (Maslach. Levels of professional burnout were measured with the Maslach Burnout Inventory – Human Services Survey (MBI.(“never”) to 4 (“always”) is used to rate items. and Personal Accomplishment (PA). This 22-item. as they are redundant with the items from Brotheridge and Lee’s (2003) deep acting subscale that was used in this study. Ratings are used to calculate subscale scores representing the three dimensions of burnout: Emotional Exhaustion (EE). multivariate analyses with the three 71 . α = 0. The present study found an alpha of 0. The present study found a higher Cronbach’s alpha for the composite masking score (α = 0.80). While some items are associated with more than one dimension. Jackson. DP.88). 1996) discourages researchers from computing a composite burnout score based on all 22 items. see Appendix J). & Leiter. Maslach & Jackson. The validity of Grandey’s measure was demonstrated by correlating the subscales with observer rating of affective delivery and self-reported stress (Grandey. given research suggesting that EE. 1981. Depersonalization (DP). Burnout. paper-and-pencil questionnaire asks respondents to indicate how frequently they experience specific job-related feelings.86. As such.69). Johnson (2007) found that the composite score for the masking dimension (which includes items from both the ELQ and ERQ) demonstrated acceptable internal consistency reliability (masking. and PA have differential patterns of association with predictor and outcome variables. Grandey (2003) reported an acceptable coefficient alpha for this subscale (α = 0.
and high burnout based on these guidelines are presented in Table 4. A sample item is “I feel I’m positively influencing other people’s lives through my work.” A higher degree of burnout is represented by higher scores on the EE and DP subscales.90 for EE. Jackson & Leiter. The EE subscale is comprised of 9 items and yields a potential score range of 0 to 54. The MBI manual (3rd edition) reports Cronbach’s alphas of 0. 1996). A sample item is “I feel emotionally drained from my work. reliability coefficients were 092 for EE. A sample item is “I feel I treat some recipients as if they were impersonal objects. 72 . In the present study.79 for DP. 0. 0. but lower scores on the PA subscale.71 for PA. The MBI has been widely used and has earned extensive empirical support.74 for DP. moderate.” The PA subscale is comprised of 14 items and yields a potential score range of 0 to 48.71 for PA (Maslach. Qualitative score classification guidelines are presented in Table 3 and the percentages of sampled MHPs with low. and 0.” The DP subscale is comprised of 5 items and yields a potential score range of 0 to 30. and 0. Evidence of the convergent validity of the MBI has been demonstrated in several ways.subscales examined as a criterion set and separate univariate analyses were run for each of the MBI subscales in the present study. including through correlations with behavioral ratings of burnout made by coworkers and spouses (Maslach. The correlations between the three MBI subscales for the present sample and the normative sample are relatively consistent (see Table 5). 1996). Jackson & Leiter.
7% 26 14 % 53 135 28 % 72 % 8 30 40 43 37 30 <5 % 16 % 21 % 23 % 20 % 16 % N % 73 .Table 1. MHP Demographic and Professional Characteristics (N=188) Variable Age (In Years) Missing <30 30-39 40-49 50-59 60+ Sex Male Female Ethnicity Latino/Hispanic Race (Multiple Responses Possible) Missing White/Caucasian Black/African American Asian Native American/Alaskan Native Native Hawaiian/Pacific Islander Other Multiracial Marital Status Missing Currently Married Divorced/Separated/Widowed Never Married Parent? Missing Yes No 1 118 69 <1 % 63 % 37 % 1 129 28 30 <1 % 69 % 15 % 16 % 1 175 12 2 5 0 6 6 <1 % 93 % 6% 1% 3% 0% 3% 7.
2 % 39.Table 1.1 % 15 % 70.4 % 4.4 % <1 % 0 5 1 1 11 101 69 <3% <1 % <1 % 6% 54 % 37 % N % 74 .2 % 57 % 25 % 20. Associate’s Bachelor’s Master’s Doctorate’s Years Experience Less Than 1 1-5 6-10 11-15 16-20 21-30 31-40 41-50 Over 50 Theoretical Orientations (Multiple Responses Permitted) Missing Don’t Know Biological/Pharmacological Cognitive Behavioral Psychodynamic Humanistic Family Systems Psychoanalytic Other >2 Theoretical Orientations 1 2 28 132 107 47 38 74 9 43 136 <1% 1.E.8 % 23 % 72% 1 32 36 30 25 37 14 1 0 <1 % 17 % 19 % 16 % 13.3 % 19. (continued) MHP Demographic and Professional Characteristics (N=188) Variable Highest Education Missing High School Diploma/G.D.7 % 7.
1 % 12.3 % 9. 75 .3 % 3.Table 1. and child care facilities.5% 79. Counseling Center University-Based Outpatient Clinic Other Outpatient Clinic Emergency Room Inpatient Facility Residential Treatment Facility VA Inpatient/Outpatient Jail/Detention Center Other 1 N 4 98 47 39 1 97 18 11 21 38 4 23 8 6 2 33 73 2% % 52 % 25 % 21 % <1 % 51.2 % 2.6 % 38.9% 4.9 % 11.2% 20.8% Private Practice Only # Treatment Settings Missing 1 2 3 4 1 1 149 28 9 1 .2 % 1. (continued) MHP Demographic and Professional Characteristics (N=188) Variable Ideal Caseload Size Missing Same Larger Smaller Services Settings Missing Private Practice Primary School College/Univ.2 % 4.3% 14.5% Examples of responses coded as “Other” include (but are not limited to) home-based services.8% .6 % 5. domestic violence/homeless shelters.1 % 17. Department of Children and Families.
8 16.0 33.9 0 0 0 0 0 0 0 100 90 100 95 100 100 100 2 186 186 186 186 29.1 5.82 1.4 .89 36.0 1.8 67.7 29.4 13.5 10.8 37.26 10.8 .3 18.2 23.3 33.4 1.9 45.0 0 0 0 0 100 100 100 100 Mean SD Min Max 76 .0 13.1 27.1 37.4 15.9 13.4 3.6 21.1 4.0 24.4 19.1 18.3 15.Table 2 MHP Client and Work Characteristics N Percent of Clients by Pay Categories Missing % Private pay % Private managed care % Medicare/Medicaid % Other Percent of Clients of Different Ages Missing % 0-3 years % 4-10 years % 11-17 years %18-24 years % 25-64 years % 65+ years % Adult Hours/Week on Professional Activities/Tasks Treatment Assessment/Testing Direct Care (Treatment + Assessment) Clinical Support/Administrative Tasks Providing Supervision Receiving Supervision Providing Consultation Total Hours # Treatment Settings 186 184 183 177 163 158 168 187 187 15.3 2.5 6.57 1 0 1 1 0 0 0 4 1 40 22 45 60 40 8 20 100 4 1 188 188 188 188 188 188 188 3.9 11.2 38.4 9.6 5.
& Leiter.Table 3 MBI Subscale Score Classifications* EE Low Moderate High 0-16 17-26 27-78 DP 0-6 7-12 13-102 PA 39-84 32-38 0-31 *Maslach. Jackson. 1996 77 .
4% 8.7% 5.3% PA 77.5% DP 83% 11. and High Burnout EE Low Moderate High 59% 32.1% 14.4% 8.Table 4 Percentage of Sampled MHPs with Low.5% 78 . Moderate.
Jackson & Leiter.520** -0.Table 5 MBI Subscale Correlation Matrix DP EE Study sample Normative sample1 DP Study sample Normative sample1 -0.260* 0.05.267** -0. one-tailed. one-tailed 1 Reported in the most recent MBI manual (Maslach. 1996) 79 .220* PA Note: *p ≤ .286** -0.377** 0. ** p ≤ .01.
Relationships between each of the MBI subscales and the other variables measured range from negligible to large in size. The work demand/stressor variables – role conflict (RC). It is noteworthy. None of the measures were significantly skewed or kurtotic. and autonomy 80 . Range restriction was most severe on the DP subscale. Floor and ceiling effects were also found for the role ambiguity and autonomy scales. while most of the PA scores fell at the high end of the scale. An examination of the data revealed that scores on all measures were normally distributed (neither skewed nor kurtotic). role ambiguity (RA). respectively. suggesting floor and ceiling effects. The intercorrelations among the three dimensions of burnout range from moderate to strong and are all statistically significant.Results Descriptive Statistics Table 6 presents descriptive statistics for each of the independent and dependent variables measured. Most of the EE and DP scores fell at the low end of the scale. respectively. Correlational Analyses Pearson product-moment correlation coefficients were calculated to evaluate the strength of the linear relationships among the independent and dependent variables. however. that there was restriction of range on the three MBI subscales. Relationships between primary and secondary measures are displayed in Table 7.
This approach allows for predictors to be tested across equation models and is appropriate when: “(a) one set of variables is a priori designated as the predictor set and the other as the criterion set.2 software in order to test the relationships between predictor and criterion variables simultaneously. With 81 . p=. The correlation between the surface acting variables of masking and faking was significant (r=. and (c) no reasons exist for estimating mutually uncorrelated dimensions or structure among observed predictor variables” (Lambert. (b) the underlying conceptual framework treats the criterion variables separately. 1996). Wildt.10). Associations among each of the variables measured will be discussed further within the context of each hypothesis. given that researchers are discouraged from creating a composite burnout score from the three MBI subscales (Maslach. and hence independent regression equations are appropriate for each criterion variable. Hypothesis Testing Multivariate multiple regression analyses were conducted using SAS 9. while the deep acting variables of attentional deployment and reappraisal were not significantly related (r=. & Durand. p=. although the present study was cross-sectional and non-experimental in design.00). p. and thus control for possible intercorrelations between these variables and avoid the risk of inflated Type I error associated with performing numerous tests on the same variables.123. an a priori theoretically-based distinction was made between predictor and criterion variables included in this study.(AU) were strongly intercorrelated with one another. In regards to the first of these guidelines. Jackson & Leiter. The second criterion also is met. 282). but the associations were not so large as to suggest redundancy.434. 1988.
respect to the third specification, the predictor variables were hypothesized to be intercorrelated. Assumptions of multivariate regression are 1) multivariate normality of the residuals, 2) homogenous variances of residuals conditional on predictors, 3) common covariance structure across observations, and 4) independent observations (UCLA Academic Technology Services, 2011). Because there is no a standard way to evaluate these assumptions and neither SAS nor other common statistical packages include tests of multivariate normality, alternative methods were used to evaluate these assumptions. White’s test of homoscedasticity was run for each of the dependent variables and univariate normality of residuals was evaluated using the Shapiro-Wilk test. No violations were detected based on these indicators of normality. Follow-up univariate regression analyses were then performed to examine the relative contributions of particular predictor variables to particular criterion variables (e.g., MBI subscales). Hypothesis 1 stated that extraversion would be negatively related to EE and DP, and positively related to PA. Extraversion demonstrated significant but small correlations in the expected directions with EE and PA, but was not significantly correlated with DP. The coefficient for extraversion and PA (which are matched in terms of hedonic tone) was strongest, but still modest. To examine these relationships further, a multivariate regression was conducted with extraversion predicting the three burnout scales. The overall regression equation was significant [Wilks λ=.935, F(3, 184)=4.23, p≤.01]. Follow-up univariate regressions (Table 8) indicated that extraversion was a significant predictor of EE [adjusted R2=.016, F(1, 186)=4.03, p≤.05, β=-0.15] and PA [adjusted R2=.038, F(1, 186)=8.45, p≤.01; β=0.21], but not DP [adjusted R2=-.005, F(1, 186)=.09, ns; β=0.02]. Accordingly, Hypothesis 1 was partially supported. 82
Hypothesis 2a stated that role conflict and role ambiguity would be positively related to EE and DP, and negatively related to PA, while autonomy would be negatively related to EE and DP, and positively related to PA. Role conflict (RC) demonstrated significant correlations in the expected directions with the three MBI subscales. Medium positive associations were found with EE and DP, and a small negative association was found with PA. Role ambiguity demonstrated similar relationships with the three dimensions of burnout, although the positive association with DP was smaller and the negative association with PA was larger. A moderate negative correlation was found between autonomy and EE, but autonomy’s association with DP and PA were modest and failed to reach statistical significance. The overall multivariate regression equation with role conflict (RC) predicting the three burnout dimensions simultaneously was significant [Wilks λ=.871, F(3, 173)=8.5, p≤.01]. Follow-up univariate regressions (Table 9) indicated that RC was a significant predictor of EE [adjusted R2=.085, F(1, 175)=17.38, p≤.01; β=.30], DP [adjusted R2=.063, F(1, 175)=12.82, p≤.01; β=.26], and PA [adjusted R2=.04, F(1, 175)=8.35, p≤.01; β=-.21]. The overall multivariate regression equation with role ambiguity (RA) predicting the three burnout dimensions simultaneously was significant [Wilks λ=.826, F(3, 174)=12.24, p≤.01]. Follow-up univariate regressions (Table 10) indicated that RA was a significant predictor of EE [adjusted R2=.107, F(1, 176)=22.24 p≤.01; β=.33], DP [adjusted R2=.043, F(1, 176)=8.92, p≤.01; β=.22], and PA [adjusted R2=.101, F(1, 176)=20.83, p≤.01; β=-.33]. The overall multivariate regression equation with autonomy (AU) simultaneously predicting the three burnout dimensions was significant [Wilks λ=.889, F(3, 173)=7.19, p≤.01]. Follow-up univariate regressions (Table 11) indicated that AU was a significant predictor of EE [adjusted R2=.102, F(1, 83
175)=21.03, p≤.01; β=-.33], but not DP [adjusted R2=.004, F(1, 175)=1.79, ns; β=-.10] or PA [adjusted R2=.015, F(1, 175)=3.63, ns; β=.14]. Accordingly, Hypothesis 2a was partially supported. Hypothesis 2b stated that extraversion would moderate the associations between the three work demand/stressor variables and the three burnout dimensions. To test this hypothesis, centered variables were created from each of the independent variables (extraversion, role conflict, role ambiguity, and autonomy) by subtracting the group mean of each variable from the individual scores within those variables. Interaction terms were then created based on these centered variables. Multiple regressions were conducted for the dimensions of burnout, using the centered variables and the interaction terms predicting the three dimensions of burnout (EE, DP, PA). The overall regression equation [Wilks λ=.677, F(21, 471.47)=3.27, p≤.01] was significant, however follow-up univariate regressions demonstrated that none of the interaction terms were significant in the prediction of EE [adjusted R2=.16; F(7, 166)=5.76, p≤.01], DP [adjusted R2=.07; F(7, 166)=2.96, p≤.01], or PA [adjusted R2=.10; F(7, 166)=3.81, p≤.01] (Table 12). This indicates that extraversion did not significantly moderate the relationships between the work demand/stressor variables (RC, RA, and AU) and EE, DP, or PA and thus Hypothesis 2b was not supported. Hypothesis 3a stated that surface acting would be positively related to EE and DP, but negatively related to PA. As expected, both types of surface acting were significantly positively correlated with EE and DP. While faking was significantly negatively correlated with PA, masking was not significantly correlated with PA. A multivariate multiple regression was conducted with the surface acting variables (masking and faking) 84
predicting the three burnout subscales. The overall multivariate regression equation was significant [Wilks λ=.80, F(6, 352)=7.01, p≤.0001]. Follow-up univariate regressions (Table 13) indicated that both faking (β=.16) and masking (β=.21) were significant predictors of EE [adjusted R2=.094, F(2, 178)=10.33, p≤.0001], while faking (β=.29) but not masking (β=.14) was a significant predictor of DP [adjusted R2=.13; F(2, 178)=14.56, p≤.0001]. Similarly, faking (β=-.25) but not masking (β=-.04) was a significant predictor of PA [adjusted R2=.061; F(2, 178)=6.82, p≤.01]. Accordingly, Hypothesis 3a was partially supported. Hypothesis 3b stated that deep acting would be negatively related to EE and DP, but positively related to PA. Deep acting strategies were not significantly correlated with any of the MBI subscales and were not significant predictors in the regression equations. Hypothesis 3b was not supported, therefore. Hypotheses 4a and 4b stated that extraversion would be negatively associated with surface acting and positively associated with deep acting, respectively. These hypotheses were not supported, as extraversion was not significantly correlated with any of the emotional labor strategies (faking: r=-.04, p=.57; masking: r=-.05, p=.45; attentional deployment: r=0, p=.99; reappraisal: r=.035, p=.63). Small to moderate correlations were found between role conflict and the surface acting subscales (faking: r=.18, p≤.05) masking: r=.25, p≤.01), and between role ambiguity and the surface acting subscales (faking: r=.21, p≤.01; masking: r=.17, p≤.05). In contrast, autonomy was not significantly related to faking or masking. To test whether extraversion moderated the relationships between work demands/stressors and surface acting (Hypothesis 5a), a multivariate multiple regression with moderation was 85
Accordingly.027. p=. nor follow-up univariate regressions. a multivariate multiple regression with moderation was performed with the centered variables and their interaction terms (Table 15) predicting the two deep acting strategies [Wilks λ=. and AU) and deep acting strategies.884. Hypothesis 5b was not supported. and AU) and the dimensions of burnout.160)=1. indicating that extraversion did not significantly moderate the relationships between the work stressor variables (RC. RA.82]. Thus.64. Neither the overall multivariate model [Wilks λ=. F(14. p=. Reappraisal: adjusted R2=0. extraversion was not significantly related to any of the work stressor or emotional labor variables.02.159)=0.02.64. were significant [Refocus: adjusted R2=-.74].12] or masking [adjusted R2=.945. p=.45. and AU) and surface acting. F(7.159)=0. Baron and Kenny’s (1986) statistical approach with Sobel’s method (1982) was 86 .160)=1.performed with the centered variables and their interaction terms (Table 14) predicting the two surface acting strategies [Wilks λ=.67.07].82]. Hypothesis 5b stated that extraversion would moderate the relationships between work demands/stressors and deep acting. given that moderation effects can occur in the absence of significant bivariate relationships.13]. p=. p=. F(7. The work stressor variables and deep acting strategies were not significantly associated and.81.038. F(7. F(7.945. 316)=. Hypothesis 6a stated that surface acting would partially mediate the relationships between the work demand/stressor variables (RC.53. F(14. p=. p=. Follow-up univariate regressions demonstrated that none of the interaction terms were significant in the prediction of faking [adjusted R2=. F(14.93. 318)=1. Hypothesis 5a was not supported.62. as aforementioned. 316)=. RA. RA. extraversion did not significantly moderate the relationships between the work stressor variables (RC. Nonetheless.
As determined in testing Hypothesis 3a. DP. 2) the independent predictor variable is significantly associated with the dependent variable. To evaluate the first condition. both types of surface acting were significantly positively correlated with EE and DP. the correlations between the predictor variables (RC. RA. and 4) the association between the independent predictor and the dependent variable significantly decreases. According to Baron and Kenny (1986). Associations between the two types of surface acting (faking and masking) and the dimensions of burnout were examined to determine if condition three was met. autonomy was not significantly correlated with faking or masking scores. masking) were examined. 3) the proposed mediator is significantly associated with the dependent variable. but remains significant. the associations between the remaining predictor variables (RC and RA) and the dependent variables (EE. role ambiguity. As aforementioned. a variable may be considered a partial mediator if four conditions are met: 1) the independent predictor variable is significantly associated with the proposed mediator variable. AU) and the proposed mediators (faking. after accounting for the proposed mediator. Sobel’s test is then used to determine the significance of the indirect effect of the mediator. significant relationships between the three dimensions of burnout and both RC and RA were found. and autonomy had with the dimensions of burnout. and PA) were examined. Therefore. 87 . While small to moderate positive correlations were found between both RC and RA and both types of surface acting. mediation of autonomy’s relationship with the burnout subscales was not tested.used to evaluate surface acting scores as partial mediators of the relationships role conflict. To determine whether Baron and Kenny’s second condition was met. but only faking (not masking) was significantly correlated with PA scores.
p≤. F(9. F(188.8.131.52. but not masking (Table 16). and PA [adjustedR2=.0001]. DP [F(3. p≤.005 for the follow-up univariate analyses. Separate univariate regressions with faking and role ambiguity predicting each of the three burnout dimensions were then performed 88 . masking does not mediate the relationships between work demands/stressors (RC and RA) and PA.91.0001]. Follow-up univariate analyses for EE [F(3. p≤. 166)=11. 166)=5. 166)=10. p≤.0007]. 171)=14. DP [F(3.157. p≤. p≤. p≤. p≤. For EE [adjustedR2=.132.091 F(2.Accordingly. a series of multivariate multiple regressions predicting each burnout dimension and follow-up univariate analyses were conducted.0001]. 171)=17. results were found for RA. 167)=13. F(9. but not masking (Table 18).0001].01]. The multivariate regression equation was significant for RA [Wilks λ=.62. and PA [F(3.04. 171)=9.72)=7. 167)=8. 399. and PA [F(3.0001]the indirect effect of RC through faking were not statistically significant (using the adjusted p-value). Similar.16.693.04. Follow-up univariate analyses for EE [F(3. Separate univariate regressions with faking and role conflict predicting each of the three burnout dimensions were then performed and the slopes and standard errors generated were used to perform subsequent Sobel tests (Table 17).733. The multivariate regression equation was significant for RC and the surface acting strategies predicting the three burnout subscales [Wilks λ=. p≤.0001].28)=6.0001].84.0001]. To determine whether Baron and Kenny’s fourth condition was met. DP [adjustedR2= . showed significant effects of RC and faking. a Bonferroni adjustment was used to correct for familywise Type I error and the critical value of p was adjusted to . 401. F(2. showed significant effects of RA and faking. Due to the large number of tests being conducted.20. 167)=10.01] predicting the three burnout subscales]. p≤. p≤.32.
426.65. Demographic Variables. F(2. 172)=16. No significant differences by sex were found for EE or PA. female MHPs had significantly lower DP scores [F(1.0001]. For EE [adjustedR2=.144. DP: F(1. p=. Because deep acting was not significantly correlated with any of the other variables.. 185)=2. role ambiguity. Compared to male MHPs. DP [adjustedR2= .654. Hypothesis 6b stated that deep acting would partially mediate the relationships role conflict. p≤. Supplemental Analyses Relationships between burnout and several secondary variables (i. F(2.128.76. and exploratory measures) were also examined.0001] the indirect effect of RA through faking were not statistically significant (using the adjusted p-value).e. 172)=13. p=. 172)=15. and autonomy had with levels of burnout. F(2. No meaningful differences between MHPs with and without children were found with respect to burnout [EE: F(1.and the slopes and standard errors generated were used to perform subsequent Sobel tests (Table 19).837.017].88. PA: F(1.255.121] although parents reported significantly lower EE. demographic and professional characteristics of MHPs. 185)=5.186)= 5. MHP age demonstrated a small negative correlation with EE but was not significantly correlated with DP or PA. p=. Accordingly. 89 . this hypothesis was not supported. p≤. p≤.154. and PA [adjustedR2=. client characteristics.018. p=.0001].61. No significant differences in burnout were found when Caucasian and non-Caucasian MHPs were compared. Hypothesis 6a was not supported. 185)=.
185)=21. and 41-50 years.002].000].49].185)=5. p=.Professional Variables.214. Given that prior research has shown MHPs with less experience to report higher levels of burnout. p=. 39)=1. and higher autonomy [F(1. lower role ambiguity [F(1.37]. p=.223. p=. 180)=5. 185)=9. p=. MHPs working in at least part time in private practice had significantly lower EE [F(1.176. 31-40 years. No significant differences were found for EE [F(4. or PA [F(4. but not DP (r=. was found to be correlated with the number of treatment settings in which MHPs were currently providing services.003).767. p=. MHPs working exclusively in private practice reported significantly more hours spent providing direct care [F(1.733. or PA [F(4. no significant differences across groups were found for EE [F(4. one year. p=. Again.33.175. p=.00] and DP [F(1. MHPs’ years of experience was examined in several ways. p=. two years. Individuals working exclusively in private practice had lower levels of burnout compared to those working at least part-time in other settings [EE: F(1. three years.22]. p=. 185)=380. and significantly higher PA [F(1. 174)=24. First responses were group into the following categories: 10 or less years.234. 21-30 years.015].013.448. p=. p=.008. DP [F(4. DP: F(1. 180)=5.000].37].92].015]. four years.185)=7.99. with those working in more settings reporting more emotional exhaustion. p=. scores on the MBI were compared across MHPs with less than one year. PA: F(1. Emotional exhaustion (r=.34. 39)=. 182)=1.116.00] compared to those who were not working in private practice.825. p=. compared to MHPs working at least part time in other settings. 182)=.084. p=. p=.88. p=. 11-20 years.216.00.11) or PA (r=. and five years of experience.99.022].92]. less hours spent on administrative and clinical support tasks [F(1. p=.86). 175)=13. No difference between these groups were found for exposure to 90 . DP [F(4. 39)=. p=.61. 182)=1. 185)=24.
assessment plus treatment hours) was moderately positively correlated with PA (r=.007).472.001).007) and DP (r=.154] or role conflict [F(1. p=. Average hours per week spent providing direct care services (i. No significant associations were found between proportions of other insurance types (e. When examining the total sample of MHPs.005). while percent child clients was negatively correlated (r=-. The proportion of MHPs’ caseloads that were children versus adults was examined in relation to burnout. but no relationship with EE or DP. p≤.challenging client behavior and circumstances [F(1.009). 174)=3..e.001). p=. percent of private pay clients in MHPs’ caseloads demonstrated small negative associations with EE (r=-.003).19.064]. Caseload/Client Characteristics. p=. and significantly negatively associated with PA (r=-. but was unrelated to PA. p=.21. p=. In contrast.g. Percent of clients with medical assistance demonstrated a small negative association with PA (r=-. p=.006) and DP (r=. 185)=9.259. p=. No significant differences were found for DP or PA on this variable.109.256.30.20. private managed care) and burnout.20. p≤. These variables were unrelated to DP and PA.20. Percent adult clients was moderately positively correlated with EE (r=. Client insurance type was also examined in relation to burnout. 178)=2.. p<.047. 91 . p=.25. but unrelated to EE and DP.001). MHPs who reported a preference for working with a different age group than that with which they were currently working had significantly higher EE than MHPs who reported being satisfied with the age group with which they were working (F(1. average hours per week spent on administrative and clinical support tasks was significantly positively associated with EE (r=. p=.001).
16. The only items that over 50% of MHPs rated as never being acceptable were Boredom. No Emotions. Sadness. Client severity also demonstrated small but significant positive correlations with role conflict (r=. Frequency data for this measure are shown in Table 20. and Calmness.Client severity (i.11.16. although the response of Never for Fear/Anxiety had the largest relative percentage. p≤. A small minority of MHPs rated negative emotional displays as being always acceptable and a large majority of MHPs rated neutral and positive emotional displays as being sometimes or always acceptable. p≤. and proportion of clients with medical assistance (r=. Frustration. Patience. 92 . The only items that over 50% of MHPs rated as being always acceptable were Empathy.. For each of the 18 items. For all but four items. p=. but a large positive correlation with DP. Perceived Emotional Display Rules. responses ranged from Never to Always.05). Sympathy.05). at least some MHPs indicated that no display rules exist. p≤. No MHPs rated Enthusiasm. p≤.e. although ratings of Not Applicable were rare.24. Neutral Emotions.03). Responses on the display rules measure created for this study revealed that MHPs’ perceptions of the acceptability of displaying different emotions while interacting with clients are variable. Happiness/Joy. Dislike/Contempt.01).002). Anger. Neutral Emotions. and Disgust. masking (r=. and a moderate negative correlation with JAWS scores (r=-.18.003). Empathy. cumulative proportion of caseload with particularly challenging pathology and circumstances) demonstrated small positive and negative correlations with EE and PA. respectively. faking (r=. Admiration. p=.24. average hours per week spent on administrative and support tasks ( r=. and Patience as never being acceptable. The majority of MHPs rated displays of the remaining 11 emotions (Enthusiasm.
49. the sum of integrative emotion items and reverse coded differentiating emotion items).179.05. Average ratings for neutral emotional displays (No Emotions.004).04). Sympathy. Associations with MHPs’ perceptions of professional display rules were examined using a composite score (X=20. and Disappointment) were 0. A significant positive association was found between integrative display rules and attentional deployment (r=.Disappointment. percent of caseload with medical assistance insurance (r=. and Excitement) as being sometimes acceptable.259. Happiness/Joy. Patience. and AEAS total scores (r=. and Excitement) were 1. Fear/Anxiety. Empathy. while differentiating display rules demonstrated a significant positive association with masking (r=. No associations with other primary or secondary variables reached statistical significance. and MHP age (r=-. For the sake of brevity. Average ratings for integrative emotional displays (Enthusiasm.011).189.e. p=. with a standard deviation of 0.018) .214. with a standard deviation of 0. Dislike/Contempt. with a standard deviation of 0. p=. p=000). Significant correlations were found with EE (r=.53.02). Neutral Emotions) were 1. Average ratings for differentiating emotional displays (Boredom. perceived importance of emotional abilities (AEAS total scores). Disgust.32. Admiration. Display rules for integrative and differentiating emotions also were examined separately in relation to the other variables. 93 . p=. SD=3.001).06) representing display rules that promote integrative and censure differentiating emotional expressions in the context of treatment (i.171.151.04.. Frustration. attentional deployment (r=. Anger. p=.38. p=.256. Calmness. p=. this combination of display rules will be referred to here as simply “positive display rules”.29.
JAWS scores demonstrated a moderate negative association with role conflict (r=-. A small but significant negative correlation was found between JAWS scores and Client Severity scores (r=-. JAWS scores were significantly positively correlated with extraversion (r=.210.281. p=.318.445. p=00). p=00). which measured individuals’ perceptions of how important it is for MHPs to control their emotions at work.00). faking. and/or lower autonomy tended to report lower job-related affective well-being. p=. above and beyond that accounted for by the primary predictor variables a multivariate hierarchical regression was performed. Role conflict. p=00). was examined in relation to MBI subscale scores.225. In order to evaluate whether the supplemental variables explained additional variance in burnout. The AEAS was moderately positively correlated with faking (r=. masking. p=.36.005). Accordingly. MHPs who reported higher role conflict. Scores on the JAWS were significantly correlated with the three MBI subscales in the expected directions.27. direct care hours per week. role ambiguity. p=. clinical 94 .415. a moderate negative relationship with DP (r=-.009). as expected.Job-related Affective Well-being. Scores on the AEAS.365.00). p=00). extraversion. Thus.48. p=00).002). and a large positive correlation with autonomy (r=. Adapted Emotional Abilities Scale. individuals who reported lower job-related affective wellbeing tended to report higher burnout. p=. p=. though this effect was small. a large negative association with role ambiguity (r=-. but was unrelated to the deep acting scales. JAWS scores demonstrated a strong negative relationship with EE (r=-. and a strong positive relationship with PA (r=.191. The AEAS demonstrated a small positive correlation with DP (r=. autonomy.00) and masking (r=. higher role ambiguity. but no relationship with EE or PA.
The overall multivariate regression equation was significant [Wilks λ=.15). the increase in variance accounted for in PA by adding the supplemental variables to the original set of predictors was not statistically significant [Fchange=(7.001] revealed that role conflict (β=.001]. MHP age (β=. p<. clinical support/administrative hours (β=. adding the six supplemental variables to the six primary predictors resulted in significant increases in variance accounted for in DP [Fchange=(7. However.23). 134)=3.19) and direct care hours (β=. ns] 95 . F(13.63)=3. The follow-up univariate multiple regression for DP [adjusted R2=. p≤.16.17). and client severity (β=.05].001] revealed that autonomy (β=-. MHP age. percent medical assistance clients. direct care hours (β=.24) accounted for significant variance [adjusted R2=. 134)=6.68. The univariate regression for PA revealed that extraversion (β=. The increase in variance accounted for by adding the six supplemental variables to the primary predictor variables was statistically significant [Fchange=(7. F(39.16) accounted for significant variance. p≤.19. 134)=3. Again.20).09. and client severity were examined as predictors of the three burnout dimensions. 391.86.31. p<. 134)=1.21).75. extraversion (β=-.21). p≤. F(13. percent private pay clients.25.30).892.support/administrative hours per week. 134)= 3.001].16). F(13. accounted for significant variance. p≤.05]. 134)=4. faking (β=.89. The follow-up univariate multiple regression for EE [adjusted R2=. and the percent of MHPs’ caseloads comprised of adult clients (β=-.38.
97 96 .16 5.23 14.95 6.51 3.38 3.88 20.41 8.30 5.11 48.42 41.19 7.17 7.32 124.26 5.82 Mean SD 96 6-42 0-12 0-15 4-32 0-743 26-68 17-33 9-32 30.91 3.50 7.45 6.05 14.58 134.28 3.34 25.12 18.23 25. Descriptives for Measures of Independent and Dependent Variables N Missing Possible Score Range MBI-Emotional Exhaustion (EE) MBI-Depersonalization (DP) MBI-Personal Accomplishment (PA) Extraversion (EXT) Role Conflict (RC) Role Ambiguity (RA) Autonomy (AU) Deep Acting-Reappraisal Deep Acting-Attentional Deployment Surface Acting-Faking Surface Acting-Masking Total Client Severity Job-related Affective Wellbeing (JAWS) Perceived Positive Display Rules AEAS 188 188 188 187 177 178 177 185 184 185 184 181 188 179 177 0 0 0 1 11 10 11 3 4 3 4 7 0 9 11 0-54 0-30 0-48 0-48 8-56 6-42 3-21 6-42 0-12 0-20 4-36 0-1600 0-80 0-30 8-32 Observed Score Range 0-44 0-20 22-48 5-43 8-46 6-40 3-21 15.37 2.17 6.04 4.Table 6.
301** .166* -.055 .055 1 .022 .022 .014 .213** -.564** 1 -.335** .220** -.137 -.Table 7.267** .123 .063 .564** -. ** p≤.123 1 .104 1 .035 -. Pearson Correlation Coefficients among Primary and Secondary Variables 1 2 3 4 5 6 7 8 9 10 11 1 MBI-Emotional Exhaustion 2 MBI-Depersonalization 3 MBI-Personal Accomplishment 4 Extraversion 5 Role Conflict 6 Role Ambiguity 1 .034 -.666** 1 -.003 -.220** -.435** -.325** .048 .062 -.018 .009 -.366** -.037 .328** .286** -.143 -.143 .286** -.101 .137 -.021 -.251** .213** -.181* .166* -.328** -.335** -.018 .014 -.208** -.434** 1 97 7 Autonomy 8 Deep Acting Attentional Deployment 9 Deep Acting – Reappraisal 10 Surface Acting – Faking 11 Surface Acting – Masking * p≤.301** .034 1 .004 .124 .285** .325** -.088 .124 -.143 .035 .275** -.05.213** .103 -.261** -.048 .000 -.052 .363** .273** -.213** -.021 .363** -.273** -.01 97 .255** .255** .275** -.103 .435** -.104 .063 -.176* .024 .251** .052 .434** .055 .003 -.146* .267** 1 .062 .042 -.146* .181* .666** -.024 .004 .107 .176* .366** 1 -.101 .055 -.009 .042 .285** .107 .143 .088 -.261** .208** 1 -.037 .000 .
028 .191** -.281** -.102 -.365** .002 .161* -.107 -.137 .344** -.148* -.030 .037 -.224** .009 -.146 .158* . & Support Activities 15 AEAS Total 16 Positive Display Rules 17 JAWS 2 3 4 5 6 7 8 9 10 11 .110 -.028 -.259** .143 .056 .063 .078 .093 .018 -.065 .072 -.036 -.119 .247** .012 . Pearson Correlation Coefficients among Primary and Secondary Variables 1 12 Client Severity Total 13 Hrs/Wk Direct Care Activities 14 Hrs/Wk Admin.070 .075 -.141 .Table 7 (continued).033 .087 .080 -.074 -.101 .095 -.191** .149 .131 .099 -.091 .131 .141 .070 -.078 -.481** -.105 .206** .106 -.111 .160* .200** .108 98 18 MHP Age 19 % Adult Clients 20 % Child Clients 21 % Private Pay 22 % Medical Assistance Insurance 98 .174* .080 -.123 .025 .164* .012 .066 -.018 -.150* -.445** -.125 -.020 .184* -.166* -.049 .012 .187* -.133 .266** -.180* -.073 .079 .034 .207** .259** -.096 .360** .201** .151* -.063 .144 -.028 .032 .301** -.131 -.087 -.018 .027 -.018 .119 .029 .097 .077 -.318** .166* .023 -.065 -.204** .256** -.038 .042 -.162* -.210** .012 .005 .001 .006 -.133 -.110 .415** .107 .067 .175* .
095 .060 -.060 -.006 -.140 -.121 .110 .144 -.249** 1 .018 -.112 .016 .073 .059 -.055 -.059 -.207** .018 .050 .080 .249** .192** .055 .110 .016 -.139 .187* .155* .093 1 .115 .037 -.210** -.158* .321** -.017 .016 -.017 -.050 -.207** .139 -.121 -.981** .187* -.185* -.040 -.160* -.040 .121 -.040 .321** 1 -.115 -.Table 7 (continued).354** . & Support Activities 15 AEAS Total 16 Positive Display Rules 17 JAWS 13 14 15 16 17 18 19 20 21 22 1 -.158* .041 -.048 -.191** -.191** .073 1 -.006 -.192** -.014 -.200** .210** .080 -.005 -.195** -.237** -.981** 1 -.035 -.050 -.095 .140 .050 -.155* 1 .079 .065 .014 -.079 -.304** -.192** 1 -.014 -.354** 1 99 18 MHP Age 19 % Adult Clients 20 % Child Clients 21 % Private Pay 22 % Medical Assistance Insurance 99 .217** .093 -.217** 1 .035 -.005 -.037 -.048 .014 .192** -.121 -.139 .041 .304** .016 -.200** -.040 .195** -.065 1 .139 -.225** -.014 .144 .160* -.112 .237** . Pearson Correlation Coefficients among Primary and Secondary Variables 12 12 Client Severity Total 13 Hrs/Wk Direct Care Activities 14 Hrs/Wk Admin.014 -.225** -.185* .
22 -0.08 0.04 0.56 <.15 -0.02 0.0001 0.01 0.32 0.15 0.0004 0.16 -0.09 0.15 -0.04 0.06 -0.16 0.14 100 .0001 0.Table 8.05 -2.21 0.58 -2.06 4.01 0.004 -0.34 1.76 0.08 0.19 0.17 3.91 0.28 0.33 0.33 0.42 0.10 0.59 -1. Extraversion Predicting Burnout B Extraversion EE DP PA Role Conflict EE DP PA Role Ambiguity EE DP PA Autonomy EE DP PA -0.0001 0.003 <.0001 0.89 <.33 -0.05 0.91 <.89 -0.14 -4.72 2.11 0.99 -4.15 0.26 0.30 2.15 Standard Error t p β 0.21 0.05 0.06 4.004 0.30 0.19 0.26 -0.
32 0.15 -0.0001 0.89 <.004 0.Table 9.58 -2.06 4.26 -0.04 0.17 3.21 101 .0004 0.08 0.30 0.16 Standard Error t p β 0. Role Conflict Predicting Burnout B Role Conflict EE DP PA 0.
0001 0.09 0. Role Ambiguity Predicting Burnout B Role Ambiguity EE DP PA 0.56 <.0001 0.22 -0.33 0.15 -0.33 102 .06 4.05 0.28 Standard Error t p β 0.003 <.72 2.99 -4.42 0.Table 10.
15 0.Table 11.89 -0.11 0.26 Standard Error t p β 0.19 0.06 -0.0001 0.34 1.14 -4.10 0. Autonomy Predicting Burnout B Autonomy EE DP PA -0.91 <.33 -0.59 -1.19 0.14 103 .
65 .23 0 .027 -.05 .69 .22 .065 .109 .012 .16 .21 .169 -.142 -.36 1.114 3.037 Standard Error t p β 6.161 .077 .031 3.00 .226 -.101 .2 1.08 .076 .09 .021 25.06 .16 .157 -.50 1.17 .016 .84 -2.43 2.05 .15 .07 .23 .33 .28 .91 .009 .62 .016 .005 .37 -1.88 1.05 .152 .2 .12 104 .152 -.09 .007 .148 .11 .61 -.134 .74 1.22 0 .617 -.052 . Burnout Predicted From Work Stressors and Extraversion: Moderation Model B EE Intercept Role Ambiguity (RA) Role Conflict (RC) Autonomy (AU) Extraversion (EXT) EXTxRA EXTxRC EXTxAU DP Intercept Role Ambiguity (RA) Role Conflict (RC) Autonomy (AU) Extraversion (EXT) EXTxRA EXTxRC EXTxAU -4.043 .Table 12.02 .92 .260 .02 .49 1.022 .018 -1.98 1.98 -.123 .54 .62 .011 .05 -.
40 .012 .276 -.31 -2.49 .084 .022 9.33 .21 .06 -.57 .005 .00 .84 .104 -.85 2.09 .048 105 .566 .36 .011 .1 -2.92 -.081 -. Burnout Predicted From Work Stressors and Extraversion: Moderation Model B PA Intercept Role Ambiguity (RA) Role Conflict (RC) Autonomy (AU) Extraversion (EXT) EXTxRA EXTxRC EXTxAU 45.97 -.Table 12 (continued).064 .626 0 -.93 .155 .011 -.005 .55 -.152 .01 Standard Error t p Β 4.048 .4 -.008 .054 .18 .
21 Standard Error t p β 106 .10 0.06 3.06 0.Table 13.034 0.06 -0.41 0.04 0.36 0.74 1.008 0.19 0.13 0.12 2.69 0.25 -0. Surface Acting Predicting Burnout B EE Faking Masking DP Faking Masking PA Faking Masking -0.17 0.59 -0.0002 0.29 0.32 0.40 -0.003 0.04 0.15 0.11 0.13 2.88 0.53 0.08 -3.
03 .06 .04 .38 .01 .27 -.0 .01 .01 .06 .Table 14.01 .01 -.01 .06 .69 .22 .03 -.005 -.02 .02 .08 .08 -.08 .014 .06 .11 .62 .09 -.18 .02 .93 .42 .10 .15 -.89 .31 .022 .01 .68 2.01 .10 .10 .08 .04 . Surface Acting Predicted From Work Stressors and Extraversion: Moderation Model B Standard Error t P β Faking Role Ambiguity (RA) Role Conflict (RC) Autonomy (AU) Extraversion (EXT) EXTxRA EXTxRC EXTxAU Masking Role Ambiguity (RA) Role Conflict (RC) Autonomy (AU) Extraversion (EXT) EXTxRA EXTxRC EXTxAU .63 .07 .88 .78 .46 .53 .81 -.01 1.07 .43 .40 .09 .02 -.74 .79 .02 -.19 .75 .01 .16 .05 .50 .00 .3 .06 107 .54 .
06 .01 -.02 .60 .17 .88 .08 -.67 .04 .07 .19 .01 -.04 .74 -1.66 1.09 .00 -.06 .07 .04 -.01 .53 -.06 .51 .10 .01 . Refocus) Role Ambiguity (RA) Role Conflict (RC) Autonomy (AU) Extraversion (EXT) EXTxRA EXTxRC EXTxAU Reappraisal Role Ambiguity (RA) Role Conflict (RC) Autonomy (AU) Extraversion (EXT) EXTxRA EXTxRC EXTxAU .94 .42 .37 .03 ..55 .09 .01 -.42 .06 .36 .01 .88 -.13 .02 .01 .12 .01 .73 .00 .08 -.12 .03 .03 .07 .72 . Deep Acting Predicted From Work Stressors and Extraversion: Moderation Model B Attentional Deployment (i.01 -.09 .15 .08 .79 .34 .e.24 .38 .70 .43 .Table 15.72 .04 108 .02 .46 .63 .01 Standard Error t P β .09 -.49 .02 .
Masking DP Role Conflict (RC) Surface Acting -Faking Surface Acting.Table 16.00 .01 .87 -.37 1.26 .25 .001 .75 3.09 .11 .08 -2.04 .20 .00 .10 .08 .27 .03 .24 .17 .44 1.34 .01 .12 . Burnout Predicted from Role Conflict and Surface Acting B Standard Error t P β EE Role Conflict (RC) Surface Acting -Faking Surface Acting.06 2.02 .56 .40 .19 .45 .19 .93 .19 .12 109 .12 3.27 .33 2.12 .14 .13 -.07 .17 -.06 .Masking PA Role Conflict (RC) Surface Acting -Faking Surface Acting -Masking -.25 -2.01 .
023 .265 .Table 17.12 -.29 -3.123 -2.004 .65 3.04 . Burnout Predicted from Role Conflict and Faking : Mediation Test Standard B Error EE Role Conflict (RC) Surface Acting -Faking .402 .241 1.008 DP Role Conflict (RC) Surface Acting -Faking .88 .09 2.95 4.000 2.16 .12 .39 .28 .554 .175 3.227 t P β Sobel P Test 2.05 .45 .000 .03 .169 -.08 .001 -.002 .416 .46 PA Role Conflict (RC) Surface Acting -Faking -.263 .007 110 .
12 .97 -.08 -3.22 .06 2.Masking DP Role Ambiguity (RA) Surface Acting -Faking Surface Acting.48 .09 .Table 18.19 .10 .04 .14 .26 .21 .09 .01 .05 .44 -2.32 .00 .10 .22 -.12 4.61 .13 .32 1.Masking PA Role Ambiguity (RA) Surface Acting -Faking Surface Acting-Masking -.05 .06 .9 .04 .04 3.40 .00 .35 .06 .25 -.98 1.15 .37 .003 .00 .33 . Burnout Predicted from Role Ambiguity and Surface Acting Standard B EE Role Ambiguity (RA) Surface Acting -Faking Surface Acting.00 .14 Error t P β 111 .45 1.15 .
05 .395 .44 .12 .208 2.39 .008 t P β Test Sobel P DP Role Ambiguity (RA) Surface Acting -Faking .96 .261 -.171 .Table 19.09 PA Role Ambiguity (RA) Surface Acting -Faking -.60 -2.004 -.000 .10 2.02 112 .319 2.29 .214 2.000 .36 .42 .004 .09 .40 . Burnout Predicted from Role Ambiguity and Faking Standard B Error EE Role Ambiguity (RA) Surface Acting -Faking .17 4.23 -.29 2.06 .01 .019 .38 4.9 .51 .12 -3.000 .
9 3.2 30.1 0 .5 .8 48.5 4.2 16.7 3.2 54.6 .8 3.1 .5 .9 60.9 66 38.5 Never N 56 0 2 0 1 9 0 2 12 0 124 11 12 73 118 92 32 32 % 29.7 24.3 75.8 66.7 59 20.1 1.5 2.7 2.5 .7 3.3 5.1 76.1 71.8 62.3 3.1 .5 9 .5 Always N 8 66 135 148 56 55 77 53 57 142 1 17 53 4 2 1 5 2 % 4. Response Frequencies for Perceived Emotional Display Rules Survey Missing N No Emotions Neutral Emotions Calmness Patience Happiness/Joy Admiration Enthusiasm Excitement Sympathy Empathy Boredom Sadness Dislike/Contempt Anger Disgust Fear/Anxiety Frustration Disappointment 2 1 3 2 3 1 2 1 1 1 2 1 1 1 1 1 1 1 % 1.5 .2 3.3 113 .8 0 1.3 5.8 4.4 0 66 5.1 .3 44.7 4.5 .5 1.5 .7 3.5 80.9 17 17 Sometimes N 101 111 38 31 122 114 103 125 111 39 46 152 4 102 57 83 143 14 % 53.Table 20.1 6.8 29.5 .1 1.5 2.3 5.2 4.1 .3 30.5 1.9 28.7 4.7 N 21 10 10 7 6 9 6 7 7 6 15 7 1 8 10 11 7 58 N/A % 11.3 35.6 1.3 41 28.1 75.8 78.6 54.5 .2 5.5 59 20.5 .5 65.7 29.2 8 3.5 1.8 0 1.
. and ideas for future research in this area. Kim et al. Prior studies have demonstrated relationships between combinations of these variables in other professional samples. Francis et al. 2006. emotional labor strategies.. The following sections provide a summary of the current study’s findings. 114 . extraversion. No prior studies were found that examined these variables in this professional group. 2004. and burnout in a sample of MHPs..Discussion The present study aimed to fill a gap in the literature by evaluating the empirical links between work stressors (i.g. Eastburg et al. Extraversion and Burnout Extraversion is one personality trait that has been negatively associated with burnout in prior empirical studies (e. 2007. and lack of autonomy). 2009.. 1994. The relationships between these variables and emotional labor and burnout among MHPs were also of interest. Chung & Harding. and (b) evaluate the empirical links between work factors and individual factors in predicting MHPs’ emotional labor and levels of burnout. 2007.e. The primary objectives of the present study were to (a) determine whether these relationships would generalize to a sample of MHPs. role ambiguity. role conflict.. Bakker et al. Ghorpade et al. The current study also aimed to provide preliminary information about MHPs’ perceptions of professional display rules and the importance of controlling emotional displays at work... a discussion of their implications and limitations.
. Costa & McCrae. however. 1992) and to use more effective coping strategies (e. respectively. Bakker et al. 1996) – may act as protective factors that mitigate the emotional strain of working in the mental health field.Michielsen et al. It reasons that the qualities that characterize extraversion – such as tendencies to experience and express more positive emotions (e. as extraversion accounted for 1. The strength of these relationships is somewhat smaller than that reported in prior studies. Zellars et al.g. Costa & McCrae. the present study found that extraversion was a significant negative and positive predictor of emotional exhaustion and personal accomplishment. Although the present findings are correlational and causality therefore cannot be assumed... It is possible that the present findings are underestimates due to lack of variability on the MBI subscales. Bakker et al. 2004..6% and 3. 2006.. 1992. 2006. Consistent with previous research and Hypothesis 1. In turn. 2000). Piedmont. most of which used professional groups other than MHPs. Tendencies to be more optimistic and self-confident (e.8% of the variance in EE and PA. Watson & Hubbard.g. the relationships between extraversion and burnout highlight the potential importance of intrinsic personality characteristics for MHPs’ interpretations of and reactions to professional experiences. such MHPs may report higher personal accomplishment. 1993. respectively. If MHPs with lower levels of extraversion could be provided with additional supports or resources and taught strategies for 115 . in the MHPs sampled. Dorn & Matthews. These effects were relatively small. 1992) may lead extraverted MHPs to make more positive self-evaluations regarding their abilities to perform their professional roles competently and to experience more feelings of fulfillment and satisfaction regarding work and their impact on clients.g.
Related. 2002). & Singh. 2004. 1998). Gelso. or at least decrease the likelihood that MHPs will report depersonalizing their clients. Beneficence and non-maleficence are two central ethical standards in the mental health field (Koocher & Keith-Spiegel. It is important to note that range restriction on the MBI was most severe on the DP subscale. In contrast to its significant relationships with emotional exhaustion and personal accomplishment. which might diminish the effectiveness of treatment (Hayes. 2007. 2007. & Hummel. Kim. it may be possible to mitigate the impact of stressors that can lead to burnout. Accreditation institutions.. indicating that these variables were not significantly associated. Shin. not to allow their personal attitudes and values to color their views and treatment of clients. now require training programs to incorporate cultural diversity training into curricula and the literature emphasizes the importance of 116 . and indirectly through exposure to professional mores. emphasis on the importance of tailoring therapeutic approaches to accommodate individual differences among clients has increased over the last several decades (see Norcross... Therapists are often trained directly. 2000). Lackritz. MHPs are encouraged to be wary of so-called “countertransference” reactions toward clients. & Umbreit.improving their adaptive functioning and increasing their use of effective coping strategies. Francis et al. Ghorpade. This finding is inconsistent with previous evidence of a negative association between extraversion and DP (Bakker et al. One possible explanation for this range restriction is that clinical training might decrease MHPs’ risk of developing negative and dehumanizing attributions about their clients. 2006. 2011). with the highest score being 20 out of a possible 30. such as the American Psychological Association. extraversion’s correlation with depersonalization was close to zero in the present sample. Zellars et al.
my client is not trying hard to get better in treatment).integrating culture into evidence-based practice (Alegria. & Stelk. practitioners may be trained to view respect. MHPs’ tendencies to de-individualize clients and view them in a negative manner may occur regardless of MHPs’ levels of extraversion. As such. 2008). particularly given that these variables are not matched in terms of hedonic tone and are therefore likely to demonstrate lower correlations (Thoresen et al.. acceptance. 2010.. Slaton. I am not the best match for this client. particularly if they viewed the task of completing the online survey as an additional stressor. extraversion may be less implicated in the development of depersonalization than the other dimensions of burnout.g. however.g. and/or unconditional positive regard for clients as critical and abide by these standards or feel reluctant to admit otherwise. It is also possible. Farmer. Atkins. lack of variability in DP scores may have precluded detection of an association with extraversion. why higher rates of depersonalization have been found in other samples. empathy. while other extraverts respond by making other types of attributions (e. that these results are an accurate representation of the relationship between extraversion and depersonalization. 117 . This does not explain. however. Yamada & Brekke. 2003).. such that MHPs with higher levels of burnout were less likely to participate in this study. It is possible that a self-selection bias occurred. Regardless. Accordingly. Perhaps some extraverts respond to work-related strain by making negative external attributions about their clients (e. but I am successful with other clients and this client might be successful under other circumstances).
. and/or who perceive their roles to be more poorly delineated (i.e. In addition.. role conflict and role ambiguity were positively related to EE and DP. It reasons that those individuals who experience more incompatible work demands and expectations (i. role ambiguity... 118 .Work Stressors and Burnout This study examined the associations between several work stressors (i.e. It is important to note that these results should be interpreted with caution. as the role conflict measure had lower reliability than has been previously report and is typically considered acceptable. and lack of autonomy) and the dimensions of burnout (Note: secondary work stressor variables. Nonetheless. role ambiguity). and negatively related to PA. are at greater risk for experiencing strain in their roles and thus at greater risk for burnout. such as exposure to challenging client pathology and circumstances.e. role conflict). will be discussed later in the Supplemental Findings section). role conflict. the finding of significant relationships between the two role stressors and burnout is consistent with Acker’s (2003) study of MHPs. it is possible that role conflict items were interpreted differently by the MHPs in this sample than they have been by previously studied occupational groups. While it is unclear why a lower alpha was found in the present study. As hypothesized (2a). Lack of clarity with respect to one’s role and the impact of one’s role in the lives of clients may create a sense of professional disorientation that is distressing in itself. which is the emotional response to specific stressful events (Chen et al. This role stress may also predispose MHPs to role strain. the relationships between role ambiguity and the burnout dimensions may be underestimated due to range restriction on these measures.
.g.g. 1983). 1983.) also can lead to strained relationships and thus negative feedback from people around them (e. in addition to role stress. Individuals’ depressive symptoms (e.2007). Accordingly. Beck.g. However. For instance. 1976. MHPs with higher depersonalization or lower personal accomplishment may report higher role ambiguity due to the development of cynical attitudes about their clients and their own abilities to have a 119 .g. harsh judgments of others. causality cannot be inferred from this study’s findings and alternative explanations must be considered.. Symptoms of depression are then reinforced by individuals’ negatively biased and sometimes accurate interpretations of their environments (e. By definition. Coyne. 1983). Coyne.. individuals with higher burnout may be more likely to perceive aspects of their work environments in a negative manner. which in turn may reinforce their symptoms of burnout. and to filter out information that is incompatible with their internal experiences (e. Coyne. Coyne & Gotlib. The literature on depression has provided evidence for the development and exacerbation of negativistic thinking among individuals with depressive disorders (e. individuals with depression tend to focus on aspects of their environments that are consistent with their negative feelings and thoughts. irritability. 1976. burnout involves the experience of negative emotions and thinking. Beck. Coyne & Gotlib. 1983).. A similar process may occur among individuals with burnout. and thus begin to perceive themselves as facing more role conflict. MHPs with high levels of emotional exhaustion may be more easily distressed when they receive inconsistent feedback from two different supervisors about how to manage particular clinical situations.. Beck. may contribute to burnout. 1976). social withdrawal. Similarly. 1976. Beck.g. etc. Therefore. 1976. Repeated experiences of role strain.
That is. If such work stressors precede burnout. however. In sum..g. the relationships observed between these role stressors and the dimensions of burnout may be reciprocal. less social support. It would be interesting. Environments 120 . to examine whether ratings of work stressors such as role conflict and role autonomy are mediated or moderated by other setting characteristics and change over time in conjunction with levels of burnout. mental health settings in which MHPs experience high role conflict and ambiguity may have other characteristics (e. Another possibility is that the relationship between EE and autonomy is spurious. as the limitations and restrictions they experience in working with clients are likely to elicit feeling of frustration and despair. more administrative demands) that contribute to burnout. for instance. Supervisors who view MHPs to be experiencing distress in their professional roles may respond by providing increased structure and oversight. The present study found autonomy to be a significant negative predictor of EE as hypothesized. It reasons that MHPs with less control and independence in their work environments are at greater risk for the emotional symptoms of burnout. the ambiguity MHPs perceive about their roles may in fact be an extension of their disconnectedness with clients and skepticism about their own abilities to help clients. Future studies with a longitudinal design are needed to help determine the progression of burnout. that MHPs are given less autonomy when they evidence emotional exhaustion at work. prevention and intervention efforts can be directed toward identifying ways to decrease MHPs’ exposure to these stressors. That is.meaningful impact on them. It is also possible. but not associated with DP or PA (Hypothesis 2a). It is also possible that one or more other variables accounts for the association between the two role stressors and burnout.
This is an empirical question that should be examined in future studies. Kim & Stone. In addition. the present study failed to support the hypotheses that autonomy would be a negative predictor of depersonalization and a positive predictor of personal accomplishment. If inadequate autonomy is found to precede the development of burnout symptoms. that increase risk for emotional exhaustion. or employ more MHPs with particular characteristics. As with the aforementioned work stressors.that allow for limited autonomy may have other characteristics.g. Furthermore.e. some MHPs who feel that they have substantial 121 . It is possible that increased external controls are helpful to some MHPs who face difficult clinical situations and therefore mitigate stress that leads to depersonalization of clients. by seeing fewer clients with insurance and more who self-pay). Independent practitioners also may be able to make changes in their professional lives to afford themselves greater autonomy (e. MHPs may be able to separate their perceptions of their clients and their own work from their perceptions of autonomy. it may be beneficial for administrators and supervisors to increase MHPs’ independence and control in ways that mitigate stress that contributes to the development and maintenance of emotional exhaustion. As aforementioned.g. 2008) and suggest that the amount of control MHPs perceive themselves to have in their professional roles is unrelated to their attitudes about clients and their own abilities to have a positive impact on their clients. longitudinal research on autonomy and burnout is needed. These findings are consistent with some prior studies (e... or autonomy may not be experienced as a stressor in all cases.. who perceive lower levels of autonomy) may still take ownership of the positive impact they have on clients (PA). some MHPs who view their supervisors as dictating how treatment must be conducted (i.
and autonomy) and the three burnout dimensions (Hypothesis 2b). 2004. Personality factors are thought to influence the extent to which individuals are affected by potential stressors as they are implicated in the processes of appraisal and coping (Brief & Weiss. role ambiguity. That is. Chen et al. 2001). It had been hypothesized that the relationships between these stressors and burnout would be stronger in individuals with lower extraversion because extraversion is associated with use of effective coping strategies.autonomy at work may nonetheless view their own abilities to conduct therapy as inadequate. 2007. role ambiguity. Accordingly. extraversion was theorized to act as a buffer against the strain resulting from stressors such as role conflict. 2002. The results of this study indicate that extraversion did not have this mitigating role among the MHPs sampled. Lazarus & Cohen-Charash. While substantial research has examined the moderating role of neuroticism in stressor-burnout relationships. Extraversion as a Moderator of the Relationships between Work Stressors and Burnout The findings of this study did not support the hypothesis that extraversion would moderate the relationships between the three primary work stressor variables (role conflict. George & Brief. The strength of 122 .. levels of extraversion do not explain the extent to which these work stressors are associated with burnout. few studies have looked at the moderating role of extraversion. and lack of autonomy. It is also important to consider that the present findings may be underestimates due to significant range restriction on the burnout and autonomy measures. and no studies were found that examined whether extraversion moderated burnout’s relationships with the three work stressors examined here.
It is possible that range restriction on each of the measures precluded detection of a moderation effect. Given that faking and masking are thought to involve continuous monitoring and modification of emotional response tendencies (ERTs) after they have been fully 123 . etc. as moderators of burnout.). due to prior research indicating that this type of emotional labor is associated with negative outcomes in other occupational groups.g.. neuroticism and agreeableness). 2007.. Emotional Labor and Burnout It was hypothesized that the surface acting strategies of faking and masking would be positively associated with burnout (Hypothesis 3a). low extraversion and high neuroticism). It would also be interesting if future studies examined other personality traits (e. Goldberg & Grandey. However. it is also possible that these results are an accurate depiction of the relationships. 2007. as expected.g. and autonomy had with the dimensions of burnout did not vary significantly based on MHPs’ levels of extraversion. role ambiguity.. indicating that the two forms of surface acting may have different implications for burnout. masking was only a significant predictor of EE. Further research should attempt to use a sample of MHPs that represents a wider distribution of experiences with respect to these work stressors. and combinations of personality traits (e. 2002. While faking was a significant positive predictor of EE and DP and negative predictor of PA.g. The positive relationship between both surface acting strategies and emotional exhaustion is consistent with prior studies of other types of professionals (e. Brotheridge & Grandey.. Martinez-Inigo et al.the relationships role conflict.
Surface acting also may require resources that are limited and/or difficult to replenish.g. 2006. Gross. which in turn is associated with indicators of increased stress such as sympathetic activation of the cardiovascular system and impaired immune functioning (e. research has shown that suppression of emotional thoughts is associated with greater accessibility and intrusive recurrences of these thoughts. Totterdell & Holman. Accordingly. which is associated with increased emotionality (Wegner. & Page. 1994). Gross & John. Beal et al. 2003. 1994. Furthermore. Wegner & Zanakos. Surface acting may allow MHPs to comply with perceived display rules and to some extent reduce emotional dissonance when it occurs. but may not help MHPs to reduce their overall stress or prevent emotional dissonance from occurring in the future. 1994). the use of surface acting strategies may result in emotional exhaustion.g.g. Wegner. 2003. Blake. Gross. Gross & Levenson. Grandey. masking may in fact lead to paradoxical increases in negative mood (e. Grandey.. 1990.. 2003. 2003). it does not alter their felt emotions (e. 1998b. Over time. 1998b. it reasons that using these strategies may be more costly than beneficial for MHPs. 1997). It is also possible that Butler et al.. Wegner.g. Shortt.. Gross & John. such that faking and masking among MHPs leads to increased stress in clients. 2003).. which in turn may lead to greater susceptibility to daily stress and thus increased use of surface acting in the future. if MHPs are not practiced in other emotional labor strategies or “believe” (perhaps not on a fully conscious level) that surface acting is an appropriate response to emotional dissonance. thereby interfering with 124 . 2003.’s (2003) findings of increased physiological responding in surface actors’ interaction partners generalize to MHPs. Studies have shown that although surface acting allows individuals to regulate their observable emotions. Totterdell & Holman.activated (e.
if clients perceive MHPs’ emotional displays to be inauthentic. Mattila.. Another possibility is that the relationships between surface acting strategies and emotional exhaustion are explained by other unknown factors. By extension. Fisk. and ultimately have more negative exchanges that result in greater strain for both clients and MHPs. use of faking. experience less satisfaction in their interactions with MHPs.the therapeutic alliance. this may result in less stressful exchanges between customers and employees. Jansen. & Sideman. the therapeutic alliance is likely to be negatively affected. Again. When customers perceive employees’ positive emotional displays to be more authentic. 2002). which may then increase MHPs’ rate of emotional dissonance. research on employee-customer interactions has found surface acting to elicit more negative reactions from customers. and ultimately creating more strain and susceptibility to emotional exhaustion for MHPs. Brotheridge & Grandey. Further research is needed to determine whether it is possible to train MHPs to use alternatives to surface acting. and burnout symptoms.g. Cote (2005) suggests that this leads to more strain for employees. they tend to have more positive perceptions of such employees and to report greater satisfaction with their encounters with those employees (Grandey. It reasons that the inauthenticity of faking may lead MHPs to experience feelings of detachment from their clients and thus higher DP. In turn. Related. they may have more negative perceptions of the MHPs. MHPs with higher levels of DP also may be less motivated to engage in other emotion regulation strategies and instead resort to faking in 125 . The finding that faking was positively associated with depersonalization is also consistent with prior studies of other professionals (e. 2005). if clients are able to sense that MHPs are faking and/or depersonalizing them.
It reasons that individuals who express emotions that are inauthentic may experience less fulfillment and confidence in regards to their work.28.e.01). research has associated surface acting with increased physiological responding (i.0518) when entered into the multivariate multiple regression with faking. It is also possible that range restriction on the DP scale prevented a stronger link with masking from being detected. the higher levels of EE and DP associated with faking may result in diminished PA. It is also possible that depersonalization and faking may be associated due to other unidentified variables. some MHPs with elevated levels of DP may justify the unorthodox expression of particular emotions (presumably negative emotions) by reasoning that clients’ behavior warrants such displays. It is possible that rates of masking are variable among individuals with higher DP. p≤.. faking emerged as a significant negative predictor of PA.. the predictive relationship fell just below levels of statistical significant (p=. Mixed support was found for the hypothesized relationship between surface acting and personal accomplishment. As aforementioned. In addition. This is consistent with prior studies with other professional groups (e. Although masking demonstrated a significant positive correlation with depersonalization (r=. as some MHPs may be less inclined to suppress feelings that are inconsistent with display rules if they perceive clients in a more negative manner. as low levels of perceived personal accomplishment may foster an attitude of disillusionment that leads MHPs to participate in clinical interactions without committing to the therapeutic process with any real interest or authenticity.g. That is.order to adhere to perceived display rules. As expected. Brotheridge & Grandey). It is also possible that the relationship between faking and PA is reciprocal. stress) in 126 .
display rules) and thus a personal accomplishment to mask such emotions. That is.e. if clients’ reactions are negative. Support was not found for this hypothesis. while other MHPs view masking as a reflection of their own professional inadequacy. 2003. while other MHPs may view their experience of unsanctioned emotions (and thus their masking of such emotions) to be an indication that they failed to maintain objectivity and personal boundaries with respect to their clients. Gross. 1998a) and to involve less resource expenditure (e. Personal accomplishment and masking were not significantly related on the univariate or multivariate levels. or vice versa.surface actors’ interaction partners (Butler et al. 2003). Gross & John. 2003. and. This in turn may lead to further diminishment of perceived personal accomplishment. some MHPs may consider it the proper response to hide emotions that are inconsistent with professionally sanctioned emotional expressions (i. MHPs may experience further emotional dissonance and higher overall stress. may cancel out. 2003). Totterdell & Holman. These results are consistent 127 . the effects of masking on PA.. Grandey. as attentional deployment and reappraisal are thought to allow individuals to decrease subjective emotional experiences in addition to unsanctioned expressive behavior (Gross. 1998b. diminished personal accomplishment may lead some but not all MHPs to experience strain that results in the use of masking. Accordingly. Similarly. it may have a negative impact on therapeutic relationships. It was anticipated that burnout would be lower among individuals who reported higher rates of deep acting (Hypothesis 3b). If surface acting causes MHPs’ clients to experience increased stress.g.. It is possible that some MHPs view masking as appropriate and therefore do not experience diminished PA.
The present findings must be interpreted with caution. This is in contrast to surface acting. It is also possible.with some studies of other types of professionals that found surface acting to be a better predictor than deep acting of burnout (e. Rubin et al. Tang.30 p≤. suggesting that they may not tap into the same construct. 2007. Cheung. Totterdell. 1997. that self-reports are not a valid or reliable method of measuring individuals’ use of deep acting strategies. 2007. In addition. MHPs therefore may not be aware of the extent to which they employ deep acting strategies. deep acting involves modifying felt emotions before ERTs are fully activated and thus is unlikely to occur on an entirely conscious level. Deep acting may require more resources and create more strain for some MHPs than others. however. It is also possible. which is characterized by emotion regulation efforts that occur after emotional response tendencies have been fully activated and thus are likely to occur on a more conscious level. 2005). Goldberg & Grandey.g. given that the deep acting subscales were not significantly correlated with one another. however. 2002. that deep acting strategies simply are not reliably associated with burnout in MHPs. MHPs may be more able to recognize when they are faking and masking.. & Holman. By definition. Alcover. even if there are instances in which they use these strategies automatically.. Morris & Feldman. Martínez-Iñigo. 1998. the relationships found between deep acting strategies and burnout (as well as the other variables) in this study may not be an accurate depiction of the true associations between these variables. 2007. & So-Kum. Brotheridge & Lee. Brotheridge & Grandey. deep acting may not mitigate the 128 .01). however. r=. suggesting that the measure performed differently in the present sample. In sum. This finding is not consistent with that reported by Johnson (2007.
2007). In fact. researchers may be able to refine the emotional labor construct and determine whether it is possible to measure specific strategies adequately using a self-report questionnaire method. also see Goldberg & Grandey. 59-60. Woolf. 2000). is needed. Perhaps neurological or physiological measures could be used in analogue studies to determine whether individuals’ perceptions of emotional labor are consistent with their internal responses to emotional stimuli. It would also be interesting to compare neurological and physiological indicators of emotion regulation in MHPs with and without burnout who use different EL strategies. Extraversion and Emotional Labor Support was not found for the hypotheses (4a and 4b) that extraversion would be significantly associated with both types of emotional labor. Another theory is that “the draining influence of deep acting might be counteracted by the uplift from changing underlying feelings to be consistent with expected displays of positive emotion” (Judge. and deep acting strategies were conceptualized as 129 . the benefits and costs of deep acting may equal out. That is. 2009. Strategies such as attentional deployment and reappraisal may change individuals’ perceptions of felt emotions but not their levels of physiological arousal (Grandey.impact of overall stress. and particularly deep acting. It had been theorized that extraversion would be negatively associated with surface acting and positively associated with deep acting as this personality trait has been empirically linked to the use of effective coping strategies. extraversion’s relationships with surface acting and deep acting strategies were close to zero. p. Based on the evidence from such studies. & Hurst. Further work developing valid and reliable measures of emotional labor.
g. & Hurst. It is possible that these relationships do not generalize to MHPs because such individuals are different from other professionals or emotional labor is different in the context of mental health work. Extraversion as a Moderator of the Relationships Between Work Stressors and Emotional Labor This study did not find support for extraversion as a moderator of the relationships between work stressors and emotional labor (Hypothesis 5b). It was theorized that MHPs with lower levels of extraversion would be more inclined to engage in surface acting and less inclined to engage in deep acting when they experienced greater 130 . & O’Donovan. It remains unknown whether the same display rules apply in the mental health field. 2009) and a positive relationship between extraversion and deep acting (e. Johnson. Austin. 2008. more work in this area is needed before conclusions can be made.. Gross & John. The vast majority of research examining emotional labor focuses on occupations that promote expressions of positive emotion and discourage expressions of negative emotion. Croyle. 2005. 2003. Dore. Judge. & O’Donovan. Woolf. 2005). While the present study piloted a measure of MHPs’ perceived display rules (which is further discussed below). Dore. 2008. Austin. Diefendorff.. several studies of other professional groups have found a negative relationship between extraversion and surface acting (e.g. Extraversion is presumed to be beneficial in such jobs given that the emotions employees are expected to display are congruent with their tendencies to experience more positive emotions. In addition. Gosserand & Diefendorff.a more adaptive forms of emotion regulation than surface acting strategies. 2004. & Gosserand.
these results should be considered with caution. because introverts tend to engage in less effective coping strategies. and none of the work stressors were significantly associated with the deep acting strategies of attentional deployment and cognitive reappraisal. If this study’s findings are accurate. role ambiguity. MHPs with low levels of extraversion are no more or less likely to engage in surface acting or deep acting.work stressors. it is possible that extraversion simply is not reliably associated with MHPs’ perceptions of work stressors or their use of particular emotional labor strategies. Emotional Labor Strategies as Mediators between Work Stressors and Burnout This study did not support the hypotheses that emotional labor strategies would partially mediate the relationships between the primary work stressor variables (role conflict. MHPs with low levels of extraversion report comparable levels of autonomy and rates of emotional labor . Accordingly. In regards to surface acting. Extraversion was not significantly correlated with any of the work stressor or emotional labor variables. suggest that extraversion is not implicated in the strength of the relationships between work stressors and emotional labor strategies. While lack of power may have played a role. Given the above described limitations of the deep acting scales and lack of variability on the work stressor measures. but their indirect relationships through the surface acting 131 . when faced with work stressors. however. While role conflict and role ambiguity demonstrated small to moderate positive associations with both faking and masking. autonomy was not significantly associated with either surface acting strategy. lack of autonomy) and burnout (Hypothesis 6a and 6b). The results of this study. role conflict and role ambiguity (but not autonomy) were directly related to burnout.
Nonetheless. The present results. Another possibility. however. further research is needed to see if these findings are replicated Support was not found for the hypothesis that deep acting strategies would partially mediate the relationships between work variables and burnout (Hypothesis 6b). It had been hypothesized that MHPs experiencing higher levels of those work stressors may experience greater emotional dissonance (Bono & Vey. Again.strategies failed to reach statistical significance. Therefore. in combination with range restriction on the other measures. While it is likely that inadequate power prevented mediation from being detected. Additional research is needed to determine if this finding is replicated. Neither faking nor masking was significantly related to autonomy. It is possible that range restriction on the autonomy scale and burnout subscales did not allow for the complex relationships between these variables to be realized. as neither attentional deployment nor cognitive reappraisal were associated with any of the other variables. it is 132 . the present findings may be accurate in reflecting that the indirect effects of work stressors through surface acting are minimal. is that autonomy simply does not play a reliable role in the use of particular emotional labor strategies and development of burnout. however. Autonomy also was not related to DP or PA. showed that the indirect effects of role conflict and role ambiguity through surface acting were not significant. 2005) and thus be more likely to engage in surface acting to reduce that strain. which in turn was hypothesized to contribute to burnout. The previously mentioned psychometric issues with the deep acting measure. surface acting strategies were not examined as mediators between autonomy and burnout. may have prevented relationships between these variables from being detected.
also possible that work stressors are not reliable predictors of deep acting. MHPs may engage in cognitive reappraisal and attentional deployment to regulate their emotions regardless of the role conflict, role ambiguity, and autonomy they experience at work.
Supplemental Findings A variety of secondary variables were included in this study to provide further information about the sample (and thus assist with interpretation of findings), and to begin evaluating relationships that are not addressed in the empirical literature on MHPs. While some of the variables have been previously studied (e.g., MHP demographic characteristics), other variables have received minimal or no attention (e.g., display rules). The following section summarizes these findings and presents ideas for future research. Demographic Variables and Burnout. Demographic characteristics were examined in relation to the other variables in order to ascertain whether prior findings would be upheld with this MHP sample. No significant differences by sex were found for EE or PA. This is consistent with some prior studies (e.g., Ackerley et al., 1988; Farber, 1985; Mills & Huebner, 1998; Raquepaw & Miller, 1989; Thornton, 1992). Compared to male MHPs, female MHPs in this study reported significantly lower DP scores. Gender differences in depersonalization have been reported in a number of other studies (e.g., Acker, 2003; Maslach & Jackson, 1985; Rosenberg & Pace, 2006; Vredenburgh et al., 1999). It is possible that sex differences in depersonalization are associated with differences in gender socialization. Traditional gender-norms dictate that males value and strive for personal achievement, power, status, goal-attainment, self133
reliance, competition, and restriction of emotionality (Freudenberger, 1990b; Heppner & Gonzales, 1987; Wester & Vogel, 2002), while females value and strive for closeness, supportiveness, caring, interpersonal warmth, and understanding (Romans, 1996). Accordingly, female MHPs’ gender socialization may, to some extent, protect them from developing depersonalization because the ideals of empathy and intimacy have been more reinforced and internalized over time. No significant differences in burnout were found when Caucasian and nonCaucasian MHPs were compared. This was expected given that most previous research has found burnout levels to be similar across racial/ethnic groups. MHP age demonstrated a moderate negative correlation with EE but was not significantly correlated with DP or PA. An inverse relationship between age and burnout, particularly EE, has been reported in numerous studies of MHPs (e.g., Garland, 2004; Garner, Knight, & Simpson, 2007; Rupert & Morgan, 2005; Rupert & Kent, 2007; Vredenburgh, Carlozzi, & Stein, 1999). It is possible that emotional exhaustion is lower among older MHPs because they have learned how to cope with work stressors over time and/or that MHPs with higher emotional exhaustion have left the field, leaving only the most resilient and adaptive older MHPs (e.g., Rupert & Morgan, 2005; Rupert & Kent, 2007). Although MHPs who were parents reported slightly lower EE, no meaningful differences between MHPs with and without children were found with respect to burnout. No studies examining differences in burnout between MHPs who are parents and nonparents were found in the literature.
Professional Background Variables and Burnout. A variety of professional background variables was examined in relation to burnout. As with MHP age, years of experience providing mental health services was negatively associated with EE, but was unrelated to the other burnout dimensions. Some prior studies have found less experienced MHPs to report higher burnout, relative to more seasoned MHPs (e.g., Ackerley et al., 1988; Rupert & Kent, 2007; Rupert & Morgan, 2005). As aforementioned in regards to MHP age, it is possible that time in the field has provided more experienced MHPs with greater confidence and more opportunities to refine their coping skills for better managing work related demands. It is also possible that burnedout MHPs tend to change careers, leaving only the most resilient MHPs to continue working in the field. In the present study, average hours per week spent on administrative and clinical support tasks was significantly positively associated with EE and DP, and significantly negatively associated with PA; while average hours per week spent providing direct care services (i.e., assessment plus treatment hours) was moderately positively correlated with PA, but unrelated to EE and DP. These findings are consistent with prior research (Rupert & Baird, 2004; Rupert & Kent, 2007; Rupert & Morgan, 2005). It reasons that time spent providing direct care to clients may be more rewarding than time spent on other tasks. Administrative and clinical support tasks may not only yield fewer rewards, but also elicit more feelings of frustration regarding bureaucratic requirements and drain MHPs internal resources. MHPs who were working in a greater number of treatment settings tended to report significantly higher emotional exhaustion. No other studies were found that 135
examined number of treatment settings in relation to burnout. It reasons that splitting time across multiple sites may add extra strain and/or drain more personal resources, leaving MHPs at greater risk for emotional exhaustion. Further research is needed to determine whether working in more settings in fact puts MHPs at greater risk for emotional exhaustion and, if so, what it is about working in more settings that explains this effect. Compared to MHPs working exclusively in the public sector, MHPs who were working at least part-time in private practice reported significantly lower burnout scores on all three MBI subscales. Lower levels of burnout among MHPs in the private sector have been reported in numerous studies (e.g., Ackerley et al., 1988; Farber, 1983; Fortener, 1999; Hellman & Morrison, 1987; Raquepaw & Miller, 1989; Rupert & Kent, 2007; Rupert & Morgan, 2005; Vredenburgh, Carlozzi, & Stein, 1999). One possible explanation for these findings is that MHPs in private practice have less exposure to colleagues’ burnout symptoms and, therefore, are less susceptible to a social contagion effect. Prior research has provided some evidence that symptoms of burnout may be transmitted to coworkers (e.g., Bakker & Schaufeli, 2000; Bakker, Demerouti,& Schaufeli, 2003a). Further research in this area is needed to determine the prevalence and relative importance of a contagion effect in the development of burnout among MHPs. Another possible explanation for lower levels of burnout among MHPs in private practice is that they tend to face fewer demands compared to those in other settings (Ackerley, 1988; Rupert & Baird, 2004; Rupert & Morgan, 2005). To test this theory, MHPs working exclusively in the private sector and those working at least part-time in the public sector were compared on several variables. The former group reported 136
For instance. it reasons that the association between burnout and predictor variables such as direct care hours and autonomy among MHPs in private practice may be more variable when client characteristics. An Action Plan for Behavioral Health Workforce Development. SAMHSA. and higher autonomy. 2007). Although these are only correlational data. and clinical experience (to name only a few) are considered The present study found that MHPs across settings reported equivalent levels of challenging client behavior and circumstances. one explanation for lower levels of burnout occurring among MHPs working exclusively in private practice is that they may experience relatively less strain secondary to having relatively fewer administrative and clinical support demands and relatively less role ambiguity. perhaps it is not surprising that MHPs in private practice and other settings experience comparable levels of role conflict. less time spent on administrative and clinical support tasks. but this group also reported levels of role conflict and exposure to challenging client behavior and circumstances that were comparable to those reported by MHPs working at least parttime in the public sector. it would be interesting for more research to examine interactions between predictors of burnout among MHPs working in different settings. referral sources. As aforementioned. This may lead to clinical situations in which MHPs experience conflict in their professional roles. 2005. they may experience relatively more fulfillment as a result of doing relatively more direct care and having relatively more autonomy. MHPs must try to reconcile the interests of individual clients. insurance companies.significantly more time spent providing direct care. but the analyses did not control 137 . Furthermore. caseload size. While outside the scope of the present study. Given the current financial and political climate. lower role ambiguity. and other vested parties (Rupert & Morgan.
1999. Preliminary evidence suggests that prior experiences with clients do play a role in the development of burnout.for caseload size. are likely to vary across sites. respectively.g. as well as environmental conditions. For instance. Rupert & Morgan. The present study’s finding that MHPs with relatively more exposure to challenging client pathology and circumstances tended to have higher levels of burnout is consistent with prior research (Acker. A 138 . Cochran. 2005). (2006) found that high neuroticism and low extraversion predicted higher levels of depersonalization for volunteer counselors who reported many negative experiences with clients.). Truchot. etc. Rupert & Kent. high neuroticism and low extraversion. In addition. direct care hours. & Comtois. Linehan. university-based medical setting. but not for those who reported few negative experiences with clients. Bakker et al. Mar. 2004. but not for those who reported few negative experiences with clients. those working exclusively in private practice were compared to a combined group of MHPs who were working either exclusively in public practice or in both the public and private sectors. Related.A. 2007. and Meyer (2000) found that therapists who sense inequity or a lack of reciprocity with their clients experienced a decrease in perceived levels of personal accomplishment.. or any other factors that may or may not differ across settings. Rupert & Baird. It is possible that a different pattern of associations with burnout would emerge if MHPs working exclusively in private practice were compared to those working exclusively in the public sector or in particular treatment settings (e. hospital. 2000. community mental health clinic. Levensky. predicted lower levels of personal accomplishment for volunteer counselors who reported many negative experiences with clients. Similarly. Keirsebilck. V. as client and MHP characteristics.
It is possible that MHPs who work with relatively more adults may face more stressors due to challenges of working with older clients or to environmental characteristics specific to settings in which adults are served. For instance. interact over time to produce symptoms of burnout may allow researchers to identify risk and protective factors that could be targeted in prevention or intervention efforts. For instance. while age composition was unrelated to DP and PA. Future research is needed to test this and other differences between settings that serve clients of different age groups. perhaps MHPs who provide treatment to adults tend to be more formal and focused on impression management with their clients. In addition. It is also possible that MHPs who work with relatively more adults tend to have characteristics that put them at greater risk for emotional exhaustion. which may then result in greater strain. rather than prospective methods and multiple informant ratings. The age composition of MHPs’ caseloads was examined in relation to burnout. No prior studies were found that reported on the relationship between client age and MHP burnout. 139 . however. was the use of retrospective self-reports to measure therapists’ prior experiences with clients. Percent adult clients was moderately positively correlated with EE. such as exposure to more severe clinical populations or negative client experiences. and high-risk behaviors that may result in more strain for MHPs.limitation of that study. the atmosphere within treatment settings for children may be more warm and nurturing in an effort to cater to the younger population. Increased understanding about how internal variables and external variables. personality disorders. older clients are more likely to present with long-standing mental illness.
This suggests that MHPs with stronger views about integrative emotional displays being acceptable and differentiating emotional displays being 140 . and both integrative and neutral emotional displays were considered more acceptable than differentiating emotional displays.g. no prior studies were found that examined the relationship between MHP satisfaction with the age group with which they work and MHP burnout. and more specifically their caseload composition. These variables could also be associated through one or more other variables (e. It reasons that MHPs’ dissatisfaction with the age composition of their caseloads may create strain that contributes to the development of emotional exhaustion. Again. The distribution of composite positive display rules scores suggests that the vast majority of MHPs viewed the expressions of integrative emotions to be acceptable and differentiating emotions to be unacceptable.. it is also possible that emotional exhaustion leads MHPs to experience less satisfaction with their work in general.MHPs who reported a preference for working with a different age group than that with which they were currently working had significantly higher EE than MHPs who reported being satisfied with the age group with which they were working. treatment type. caseload size. Integrative emotional displays were considered more acceptable than neutral emotional displays. composite positive display rules scores were positively correlated with EE. MHP experience.). overall. While neither integrative nor differentiating display rules were significantly related to any burnout dimension. but similar levels of DP and PA. The exploratory measure of perceived display rules that was created for and piloted in this study revealed some interesting associations. etc. However. Perceived Display Rules.
e. It is also possible that older MHPs have less stringent perceptions of display rules because. they also may have had more opportunities to be exposed to supervisors and coworkers who model or otherwise promote adherence to varying display rules. Alternatively.g. It is also possible that age influenced how MHPs made their ratings. it may be due not only to having more professional experience but also to tendencies to become more self-directed with age. less experienced MHPs. 141 . and personalized approaches to. Future studies should examine whether the relationship between perceived display rules and emotional exhaustion is mediated or moderated by the use of particular emotional labor strategies. MHPs who face these rules in their work environments may be more likely to experience other stressors (e. Given that age is highly correlated with experience..unacceptable tended to experience higher rates of emotional exhaustion.. with older MHPs tending towards less extreme responding (i. Another interesting finding is that MHP age was negatively correlated with perceptions of positive display rules. working with clients. more administrative demands or paperwork requirements) that put them at risk for emotional exhaustion. more ratings of “sometimes”). If older MHPs have had more time in the field. Further research is needed to identify individual and setting characteristics that contribute to MHP’s display rule perceptions. If such a trend occurs. It is possible that MHPs who perceive more stringent positive display rules may become drained in trying to abide by these standards and therefore experience more emotional symptoms of burnout. over time. it is possible that MHPs who are older have been in the field longer and therefore had different and/or more training than younger. they have developed more independent attitudes about.
Given that the PDRS was created for the present study to provide preliminary information about MHPs’ perceptions of display rules, its psychometric properties (particularly its content validity and external reliability, but also its factor structure) have yet to be examined. Furthermore, there was inadequate power to run comprehensive analyses of the measure itself or further analyses of its relationships with the other variables. Future research should attempt to explore the quality and utility of this measure further. The questions that remain unasked and unanswered about the consistency and importance of display rules in the context of providing mental health services are too numerous to delineate in this paper. However, the preliminary evidence provided by this study of an association between perceived display rules and burnout suggests that further work in this area is warranted. Next steps in this area may include investigating the consistency of perceived display rules within and across settings, as well as variations in perceived display rules across clinical contexts. Rules may be different depending on clients’ ages/developmental levels, socio-cultural backgrounds, genders, and presenting problems. For instance, in dialectical behavior therapy (DBT) for clients with borderline personality disorder, MHPs are encouraged to share feelings of frustration with clients in certain situations (Linehan, 1993), which is directly in contrast with the notion that MHPs’ negative emotions should not be expressed toward clients. It also will be important to examine the relationships between perceived display rules and MHPs’ actual behavior. Aside from the impact perceived display rules may have on individual MHPs (i.e., burnout), they may also influence clients’ experiences in treatment. For instance, some clients may view MHPs as more genuine and relatable if they show some negative 142
emotions and/or less positive emotions. The empirical research in this area is limited, but some empirical support has been found for therapist self-disclosure in general. Hill and colleagues (1988) found therapist self-disclosure was associated with clients’ positive evaluations of therapist helpfulness. Knox and colleagues (1997) found therapist selfdisclosure to be associated with clients’ insight and perceptions of the therapist as more real and human, which in turn were associated with the therapeutic relationship. Barrett and Berman (2001) found that clients liked their therapists more and had less distress associated with symptoms following treatment, when their therapists engaged in selfdisclosure in response to similar client self-disclosure. Despite the positive findings reported in some studies, other studies have reported negative or neutral relationships between therapist self-disclosure and therapeutic outcomes (Hill & Knox, 2002). Further research on perceived display rules is needed to determine their implications for both MHPs and clients. Perceived Importance of Emotion Management. When MHPs’ attitudes regarding the importance of emotion management at work (as measured by the AEAS) were evaluated in relation to the other variables, several significant associations emerged. Depersonalization demonstrated a small positive relationship with AEAS scores. One explanation for this finding is that MHPs who perceive emotion management at work to be of greater importance are more likely to experience strain that contributes to burnout. Depersonalizing clients may be a way for MHPs to cope with the (perceived) demand to control their emotions, as it may allow MHPs to maintain emotional distance. It is noteworthy, however, that the relationship between these variables was modest. The perceived stringency of display rules was significantly positively correlated with MHPs 143
perceptions about the importance of emotion management in their work. It reasons that MHPs who view display rules to be stricter would also view emotional management skills to be more essential. AEAS scores demonstrated moderate and large correlations with masking and faking, respectively. It is possible that MHPs who perceive emotion management at work to be more important engage in more surface acting as a means of adhering to these demands. It is important to note, however, that there are several limitations of this measure. The AEAS includes items that tap into both the perceived importance of regulating one’s emotional displays (irrespective of type of emotion) and the perceived importance of using emotional labor strategies, making the total score difficult to interpret. In addition, this measure uses terminology (i.e., “masking”) that may result in misleading findings. For instance, MHPs may have endorsed items about the importance of masking negative emotions when they actually meant that it is important not to show those emotions. Such responses are different in that masking refers to suppression while other strategies (deep acting) could be used to avoid showing negative emotions. Given that most people are not familiar with emotional labor terminology, it may appear that MHPs were endorsing surface acting, when in fact their ratings reflect their perceptions of display rules that sanction expressions of negative emotions, or vice versa. Future research in this area is needed to develop a measure or measures that discriminate between the perceived importance of controlling one’s emotions and of using specific strategies to do so. No published studies were found that examined MHPs’ perceptions about the importance of emotion management in the context of providing direct care. Further empirical research is needed to determine whether MHPs who perceive emotion management to be more important are actually 144
more likely to monitor and modify their own emotional displays. Related, it would be interesting if a measure was created to examine rates of emotional dissonance, which theoretically follows experiences of emotions that are inconsistent with perceived display rules and precedes the use of emotional labor strategies (Rubin et al. 2005). Although emotional dissonance may not occur on a fully conscious level, MHPs self-reports may yield interesting associations with burnout and related variables. Job-related Affective Well-being. The JAWS demonstrated moderate to large associations with the three burnout dimensions, as well as role conflict, role ambiguity, and autonomy, as expected. While causality cannot be inferred from these results, it reasons that the stress associated with experiencing more work stressors leads to a diminished sense of well-being, and that that in turn puts MHPs at greater risk for burnout. Future studies with large samples and, ideally, longitudinal designs, should examine whether job-related affective well-being mediates or moderates the relationships between work stressors and burnout in MHPs.
Limitations Besides its correlational design and the other limitations of this study that were discussed earlier, several additional limitations should be noted. The present sample was relatively small given the number of analyses conducted. This effected power levels and precluded the use of more sophisticated statistical methods (e.g., factor analysis, modeling techniques) for evaluating the data. In addition, the sample was geographically limited to MHPs providing direct care services in Florida and so these results may not generalize to MHPs in other regions. Moreover, it is not clear whether the demographic 145
Data from the combined 146 . which consists increasingly of individuals without graduate level training and with less time working in the field (Duffy et al. lack of power prevented the author from performing comparisons of MHPs working in different settings. It is possible that there is a point after which the benefits of having more experience level off. 2004. Although the vast majority of MHPs (70%) reported working in one type of setting. 2002 An Action Plan for Behavioral Health Workforce Development. It would be interesting for future research to examine whether experience has a non-linear relationship with burnout. 2007). SAMHSA. 2004. Another potential limitation to the generalizability of this study’s findings is that the MHPs’ sampled had disproportionally high levels of education and experience. as estimates for the mental health workforce in Florida around the time of this study were not found. Manderscheid & Henderson. Again. A larger and more diverse sample of MHPs is needed to investigate the relative importance of education and experience. others worked in as many as four types of settings. over 90% of the present sample had one or more advanced degrees and over 40% had greater than 15 years of clinical experience. SAMHSA.and professional characteristics of this sample are consistent with state norms. In contrast to the national workforce. Lack of power prevented further analysis of differences across MHPs with different degrees and amounts of experience. It is therefore difficult to assess whether the sample is representative of MHPs in Florida.. It is possible that the relationships examined in this study would differ in a sample of MHPs with less training and time in the field. MHPs from a wide variety of work settings in Florida are represented in this sample.
state affect) at the time they are making ratings (Kazdin.e. Response bias is the most notable difficulty associated with such measures (Kazdin. Although participation in this study was completely anonymous. feel.sample were used to evaluate the hypotheses and therefore it is unclear whether the associations of interest vary across settings. flyer. The use of self-report measures to evaluate the variables of interest represents another limitation of this study. MHPs may have been unconsciously influenced to respond in particular ways in order to appear more favorably or to be consistent with their core beliefs about how they ought to think. Those who chose to participate may represent a select group of MHPs that differ in important but unknown ways from those who declined to participate. In addition. there are important disadvantages to using self-report questionnaires. While it is often the only feasible method of data collection. 1998). It is also possible that efforts to solicit participation from a diverse and representative sample of MHPs were not successful. Another limitation of self-report measures is that respondents do not always consider important information when deciding how to answer questions and are likely to be influenced by whatever is most salient to them (often information obtained from their most recent or impactful experiences) and their moods (i. Another limitation of this study is that the sample is comprised of MHPs who volunteered to participate after learning about the project via email. given that the present survey was administered electronically. phone. or word-of-mouth. results from the current sample may not generalize to other MHPs. people often have varying interpretations of items and. MHPs were 147 . 1998).. In either case. and act given their perceptions of what is prototypical of professionals in the mental health field.
148 . Multiple informant studies are nearly absent in the burnout literature at this time. It is therefore possible that the relationships between variables are influenced by the order in which MHPs completed the individual questionnaires comprising the survey. The present study used a single version of the survey instead of randomizing the order of measures for each participant. coworkers. 1998). Related.. 1998). Future research should obtain ratings from multiple informants. it is possible that exposure to questions early in a survey can influence respondents ratings on later questions (Kazdin. responses widely varied and it was not possible to consolidate the data in a valid and reliable way. It reasons that MHPs with larger caseloads are greater risk for burnout due to increased demands and exposure to potential stressors. it is unclear whether their ratings of work stressors and other variables (e. Future studies should use a forced choice format to obtain information about caseload size. Having only one informant can inflate relationships between variables due to lack of method variance (Kazdin. and clients.unable to ask for clarification. it is possible that MHPs with particular characteristics are more likely to respond to questionnaires in important ways. Another limitation of this study is the single informant design. For the 30% of MHPs in the present sample who reported working in multiple settings. Another limitation of this study is that an open-ended response format was used to collect information about MHPs’ caseload size. As such. such as supervisors.g. While biased responding should be evenly distributed across a sample. This would allow for comparison across informants to assess whether there are differences between MHPs’ self-perceptions and others’ perceptions of them.
several. it is impossible to determine whether symptoms of burnout among these MHPs occurred secondary to their experiences in one or several settings. etc. Future studies can try to counteract these limitations by asking MHPs to provide separate ratings for each of the settings in which they work. as well as the role ambiguity scale. and the phrasing of individual items. MHPs in the present study were provided with very general directions on the work stressor scales to rate how accurately each statement reflected their “experiences working as a mental health service provider”. Those varieties of medical assistance insurance do not necessarily represent the same client demographic group. These instructions. As aforementioned. although the effects of working in one setting may influence ratings about other settings. in completing administrative requirements.involvement in particular professional activities. It may be helpful to consider revising the role conflict scale. or all of the settings in which they were employed. caseload characteristics. did not provide respondents with a means to distinguish between professional contexts when providing ratings of the stressors. suggesting it may not be an appropriate measure of this construct for MHPs. rather than allowing respondents to provide separate estimates of each. Another limitation of this study is that percentage of Medicaid and Medicare patients comprising MHPs’ caseloads was inadvertently combined into a single response option. to include items that tap into specific professional contexts in which MHPs may experience these stressors (e. in receiving or providing supervision). the internal reliability of the role conflict scale was lower in this study than in prior research. Similarly.. in providing treatment. It is not known whether the items comprising the role conflict 149 .g.) reflect their experiences in one.
1975) does not adequately or accurately capture MHPs’ perceptions of this variable. to be less compliant with perceived 150 . Related. Knowing more about how MHPs with moderate to high levels of burnout actually behave in relation to clients will help promote better understanding of how burnout impacts the therapeutic process.. It is possible that Idaszak and Drasgow’s (1987) modified version of the Job Diagnostic Survey’s autonomy subscale (Hackman & Oldham.and role ambiguity scales used in the present study adequately capture the experiences of MHPs. it is possible that burnout leads MHPs to spend less time preparing for sessions. This section will discuss remaining questions and areas for further study. administrative tasks. a number of other areas warrant mention.g. For instance. It reasons that there are some observable differences between MHPs with different levels of burnout. It may be beneficial to collect qualitative data through interviews and focus groups with MHPs in order to develop new items and/or revise the original items. It is possible that the implications of autonomy for providing direct care services to clients versus doing less clinically-oriented tasks (e. An important next step for researcher is to examine the relationships between the dimensions of burnout and MHPs’ in-session and between-session behavior. the autonomy measure used in the present study is very brief (three items) and was not designed specifically for use with MHPs. making decisions about one’s own work schedule) are different. Future Directions In addition to the future research directions already noted.
By comparing the behavior of MHPs with various levels of burnout. some authors encourage MHPs to set boundaries on their therapeutic responsibility and resist tendencies to take ownership of their clients’ problems (Friedman. Such knowledge could then be used to inform burnout prevention and intervention efforts.display rules. and to be more pessimistic about client prognosis. For instance. Lee et al (2011) argue that “the responsibility fundamentally rests with the psychotherapist himself or herself to devise 151 . treatment efficacy. another area that warrants further exploration is the effectiveness of burnout prevention and intervention strategies. Patterson. Williams. Piercy & Wetchler. to be less patient with client resistance. 1998). The literature includes suggestions for ways that individual therapists can reduce their symptoms of burnout or their risks of developing burnout in the future (Norcross. 1976). 1987). Grauf-Grounds. 1989). and the mental health system in general. Related. For MHPs working in the private sector who may not have peer or supervisor supports readily available. 1974). Kaslow & Shulman. Kaslow & Shulman. 1987) have all been recommended as potential ways to manage work-related stress that can lead to burnout. 1985. developing strong networks of social support (Maslach. and participating in personal psychotherapy (Fleischer & Wissler. 2000). noncompliance. or lack of insight. Other authors have suggested that MHPs work to establish balance between their professional involvement and their personal lives. 1985. it may be possible to identify reliable indicators that this condition is developing or worsening. For example. to be less compliant with paperwork/administrative duties. to be less invested in client outcomes. 1978. 1987. ambivalence. taking regular vacations (Maslach. & Chamow. maintaining healthy eating habits (Raquepaw & Miller. engaging in exercise (Freudenberger.
is also needed. Finding support through consulting with peers or joining supervision groups are suggested as an alternative to support from colleagues or supervisors within an organization or institution. may be less likely to rely on social support and may benefit from learning more internally focused strategies. For instance. These recommendations. Future studies are needed to examine the relative efficacy of individual prevention and intervention strategies. however. Martin and Schinke (1998) recommend that orientation programs and in-service training workshops be used to address issues of professional burnout. for instance. Perhaps more practical are Selvini and Selvini-Palazzoli’s (1991) suggestions that employers encourage collaboration. 1989). or Lee et al. The authors also suggest that supervisors and administrators promote an atmosphere of open communication and exchange of constructive feedback. Suggestions for prevention and intervention strategies at the organizational level have also been presented in the burnout literature. team consultation.and implement self-care strategies that accommodate the specific demands and challenges of the private practice… It is imperative for independent practitioners working without regular supervision or guidance to make self-monitoring a top priority” (6).’s (2011) 152 . Other suggestions for organizational prevention and intervention include limiting the time therapists are required to spend on administrative tasks (Raquepaw & Miller. Research to determine which strategies are most successful among MHPs with particular characteristics. It reasons that MHPs with low extraversion. and otherwise decreasing workload (Pines & Maslach. and emotional connection within the workplace. such as low extraversion. may be unrealistic given the current financial and political pressures organizations face. 1978).
What is learned from such research may then be used to inform efforts to develop and disseminate effective prevention and intervention strategies. In conclusion. role ambiguity. role conflict. Despite the large number of suggestions for preventing and ameliorating burnout at the organizational level. and perceived display rules were significantly associated with one or more dimension of burnout. emotional labor. The findings of this study underscore the importance of continued work examining the complex relationships between internal and external factors in the development and maintenance of burnout among MHPs. as well as perceived display rules and several other exploratory variables. the present study attempted to fill a gap in the empirical literature by examining the relationships between extraversion. work stressors. and offering opportunities for professional development” as examples of resources that may decrease MHPs’ burnout risk (6). 153 . Future studies are needed to examine which strategies are more effective and in which settings. and increase resources and supports for therapists. several interesting associations were found. providing formal and informal peer consultation. autonomy. surface acting. extraversion. help therapists to maintain appropriate boundaries with clients. Despite the aforementioned limitations of this study.suggestions that training directors and supervisors simplify case management processes. and burnout. Most notably. in a sample of MHPs. no studies have been published about the relative efficacy of these strategies. (2011) suggest “inviting psychotherapists into decision-making processes. Lee et al.
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PRIMARY INVESTIGATOR: Jessica Handelsman. Eligible participants may be working in private practice or the public sector. MA. IP address. or other mental health service providers. within Florida. University of South Florida FACULTY ADVISOR: Marc Karver.A. mental health technicians. If you have questions about your rights as a person taking part in a research study. Your involvement would be completely anonymous and voluntary. ___ Dissertation 196 . case-managers. A unique identification number will be used to keep track of your survey responses. counselors. etc. such as your name. Marc Karver. University of South Florida STUDY DESCRIPTION: If you choose to participate in this study.D. you may contact the Division of Research Integrity and Compliance of the University of South Florida at (813) 974-9343. POTENTIAL RISKS & BENEFITS: No known risks are associated with participation in this study. nurses. Clinical Psychology Doctoral Candidate. psychiatrists. However. you may find answering the survey questions interesting and enjoyable. there will be no way to trace any responses back to you. and (c) currently provide direct mental health services (in a professional context) to clients/patients of any age. CONFIDENTIALITY: You will not be asked to provide any personally identifying information about yourself. Jessica Handelsman. the data obtained from you will be combined with data from others and published results will not include information that would personally identify you in any way. and may be psychologists. I understand the above information and volunteer to participate in this anonymous study. as long as the above criteria are met. You will not be paid for your participation. Nonetheless. M. (b) fluent in English. you are free to discontinue at any time without penalty of any kind. ELIGIBILITY: Individuals are eligible to participate in this study if they are: (a) at least 18 years old. ANONYMOUS study about mental health service providers' experiences. Dept. Please read this section carefully and then select the box if you are willing to participate in this study. Because participation in this study is completely anonymous. The primary objective of this study is to examine various factors that may be associated with the professional experiences of mental health service providers. at 813-974-6595 or the faculty supervisor.. social workers. If you choose to participate and then change your mind while completing the survey. phone number. Ph. Furthermore. social security number. of Psychology. QUESTIONS??? If you have questions about this study. The results of this evaluation may be published. you will be asked to complete an online survey.Appendix A Study Consent Page The following information is provided to help you decide whether you are willing to take part in this VOLUNTARY. all anonymous data will be stored in secure electronic files and/or locked file cabinets at the University of South Florida (USF). Ph. at 813974-7443.D.. the information gained by this evaluation may contribute to quality improvement efforts within the mental health field. however. please contact the primary investigator.
Master of Sciences Master of Arts Other (please specify) 197 .g. case management. or high school) College/university-based counseling center (open to students and/or employees) University-based outpatient clinic (open to public) Other outpatient facility (e..)? Under one year 1 year 2 years 3 years 4 years 5 years 6-10 years 11-15 years 16-20 years 21-30 years 31-40 years 41-50 years Over 50 years (please specify) What is the highest educational degree you have earned to date? High School Diploma/G.g. assessment.. Associate’s Degree Bachelor’s Degree Master’s Degree Doctorate’s Degree Other (please specify) Please further describe your highest degree(s) and the discipline(s) in which you earned it/them. hospital. etc. treatment. middle. community clinic) Hospital emergency room Inpatient facility (e.D.g.. crisis stabilization unit) Partial inpatient facility Residential treatment facility Other (please specify) Approximately how many years of experience do you have providing mental health related services (e.Appendix B Background Questionnaire In which of the following treatment settings do you currently provide mental health services? (Select all that apply) Private practice (independent or group) Primary school (elementary.E.
mental health technician. case manager. evaluator. psychotherapy..g.)? Approximately how many HOURS PER WEEK do you typically spend on the following tasks: Providing treatment (e.. consulting psychiatrist. writing clinical reports and client contact/progress notes..g. approximately what percentage of your clients/patients fit into the following age categories (total must equal 100%): 198 . etc. case conceptualization. doing financial paperwork. attending staff meetings..) Providing supervision Receiving supervision Providing consultation Which of the following describe(s) your theoretical orientation? (select all that apply) Don't Know Biological/Pharmacological Cognitive Behavioral Psychodynamic Humanistic Family Systems Psychoanalytic Other (please specify) On average. skills training.g. scoring and interpreting assessment measures.. PhD PsyD MD Other (please specify) What is/are your current job titles/professional roles (e. how many active cases (i. social worker. medication administration.Please further describe your doctorate degree(s) and the discipline(s) in which you earned it/them. current clients/patients) do you have on your caseload at a given time? What is your ideal caseload size? Smaller than it is now (I would prefer to work with fewer clients/patients) The same size it is now (I would not change the number of clients/patients on my caseload) Larger than it is now (I would prefer to work with more clients/patients) On average. counseling. etc.) Doing administrative tasks (e.g. etc. behavior management/monitoring. therapist/counselor.e. etc. nurse.) Doing assessment/testing Doing clinical support activities (e.
POS) Medicaid or Medicare Other What is your age (in years)? What is your sex? Male Female Are you Latino or Hispanic (A person of Cuban. Mexican. or other Pacific Islands) White or Caucasian (origins in any of the original peoples of Europe. HMO. Puerto Rican. Japan. including Central America. 0-3 years old 4-10 years old 11-17 years old 18-24 years old 25-64 years old 65+ years old Would you prefer to work with a different age group of clients/patients than you currently work with? No Yes Approximately what percentages of your clients/patients are covered by: Private pay Private managed-care insurance (e. and who maintains tribal affiliation or community attachment) Native Hawaiian or other Pacific Islander (origins in any of the original peoples of Hawaii. Southeast Asia. India. Korea. or other Spanish culture or origin. Guam. South or Central American. regardless of race)? No Yes Don't know Which of the following racial categories most accurately describe you (please select all that apply)? Don’t know Black or African American (origins in any of the black racial groups of Africa) Asian (origins in any of the original peoples of the Far East.. PPO. or the Indian subcontinent including. China. the Middle East. and Vietnam) Native American or Alaska Native (origins in any of the original peoples of North and South America. the Philippine Islands. Thailand. or North Africa) Other (please specify) 199 .g. for example. Pakistan. Samoa. Malaysia. Cambodia.
What is your current relationship status? (Note that the term “married” is used here to describe civil unions and domestic partnerships. in addition to legal marriages) Never married Separated/divorced/widowed Currently married Are you a parent? No Yes 200 .
g. what percent of your clients. sociopathic) statements? lacked remorse when their actions were harmful to others? were highly oppositional or defiant toward you or others? were verbally aggressive toward you or others? were physically aggressive toward you or others? had delusions. or engaged in self-harm behaviors (e.g.Appendix C Challenging Client Behavior And Circumstances Questionnaire Please estimate the percentage (0-100%) of your clients/patients within the past 30 days who demonstrated the behaviors or characteristics described.. 1) made suicidal statements or gestures.. anorexia. etc. Within the last 30 days..)? had borderline personality disorder? canceled or did not show up for scheduled sessions? refused to participate in session/were noncompliant with treatment recommendations? expressed negative attitudes about mental health treatment? 201 . hallucinations.. antisocial. skin cutting 2) 3) 4) 5) 6) 7) 8) 9) 10) 11) 12) 13) 14) 15) 16) or burning)? had been court-ordered to treatment? were sexual offenders? had engaged in neglect or abuse of their children? made psychopathic (i. or other psychotic symptoms? had substance use disorders? had eating disorders (e. bulimia..e.
Slightly. 2005. Extremely) 1) 2) 3) 4) 5) 6) 7) 8) 9) 10) 11) 12) Are you a talkative person? Are you rather lively? Do you enjoy meeting new people? Can you usually let yourself go and enjoy yourself at a lively party? Do you usually take the initiative in making new friends? Can you easily get some life into a rather dull party? Do you tend to keep in the background on social occasions? Do you like mixing with people? Do you like plenty of action and excitement around you? Are you mostly quiet when you are with other people? Do other people think of you as being very lively? Can you get a party going? 202 .) Please select one response for each question about your characteristics. (Not at All. Moderately.Appendix D Eysenck Personality Questionnaire-Brief Version : Extraversion Subscale (Sato. Very Much.
Role Ambiguity. (ROLE AMBIGUITY) I decide on my own how to go about doing the work. Uncertain. (ROLE CONFLICT) I do things that are likely to be accepted by one person but not accepted by others. 1970. (ROLE AMBIGUITY) I know exactly what is expected of me. (AUTONOMY) 203 . 1987) Please indicate how accurately each statement reflects your experiences working as a mental health service provider.Appendix E Role Conflict. (Very False. planned goals and objectives do not exist for my job. (ROLE CONFLICT) I rarely receive incompatible requests from two or more people. House. & Lirtzman’s. (ROLE AMBIGUITY) Explanations of what has to be done (on the job) are clear. Mostly True. Idaszak & Drasgow. (AUTONOMY) The job gives me considerable opportunity for independence and freedom in how I do the work. (ROLE CONFLICT) I work on unnecessary things. Very True) 1) 2) 3) 4) 5) 6) 7) 8) 9) 10) 11) 12) 13) 14) 15) 16) 17) I have to work on things that should be done differently. Slightly False. Job Autonomy Scales (Rizzo. Mostly False. (ROLE CONFLICT) I usually do NOT have to break a rule or policy in order to carry out my work. (AUTONOMY) The job gives me a chance to use my personal initiative or judgment in carrying out the work. (ROLE AMBIGUITY) Clear. (ROLE CONFLICT) I rarely receive an assignment without the resources to complete it. (ROLE CONFLICT) I feel uncertain about how much authority I have. (ROLE CONFLICT) I work with several groups of professionals that operate quite similarly. Slightly True. (ROLE AMBIGUITY) I'm not sure what my responsibilities are. (ROLE CONFLICT) I receive assignments without adequate resources and materials to complete them. please rate the statements based on your experiences overall. (ROLE AMBIGUITY) I know that I have divided my time properly. If you provide mental health services in multiple settings.
My job made me feel bored.Appendix F Job-Related Affective Well-Being Scale Below are a number of statements that describe different emotions that a job can make a person feel. supervisors. Rarely. My job made me feel excited. My job made me feel frightened. My job made me feel fatigued. My job made me feel depressed. My job made me feel energetic. My job made me feel disgusted.) has made you feel each emotion in the past 30 days.. coworkers. My job made me feel content. Sometimes. My job made me feel at ease. Quite Often. My job made me feel enthusiastic.g. My job made me feel discouraged. clients/patients. Please select ONE response to indicate the extent to which any part of your job as a mental health service provider (e. etc. Extremely Often 1) 2) 3) 4) 5) 6) 7) 8) 9) 10) 11) 12) 13) 14) 15) 16) 17) 18) 19) 20) My job made me feel angry. pay. My job made me feel relaxed. My job made me feel gloomy. My job made me feel ecstatic. Never. My job made me feel anxious. My job made me feel inspired. the work. My job made me feel calm. My job made me feel satisfied. My job made me feel furious. 204 .
(Note: Do NOT rate the items based on how often you or others genuinely feel or outwardly express the specified emotions during client/patient interactions). for mental health service providers to DISPLAY (outwardly express) the following emotions during interactions with clients/patients. Always. please select “Not Applicable”. Never. Sometimes.Appendix G Perceived Display Rules Questionnaire Please indicate how often it is acceptable. If you do not believe that a professional standard exists for displays of a given emotion. Not Applicable 1) 2) 3) 4) 5) 6) 7) 8) 9) 10) 11) 12) 13) 14) 15) 16) 17) 18) Boredom Enthusiasm Sadness Happiness/Joy Dislike/Contempt Neutral Emotions Admiration Anger Empathy Disgust Sympathy Frustration No Emotions Patience Fear/Anxiety Calmness Disappointment Excitement 205 . ACCORDING TO FORMAL OR INFORMAL PROFESSIONAL STANDARDS.
Slightly Important. Moderately Important. 3) ..hide their emotions from clients. according to professional standards.suppress their feelings.Appendix H Adapted Emotional Abilities Scale The following items assess your perceptions of professional standards regarding mental health service providers’ management of their own emotions during client/patient interactions. ... 2) .. Very Important 1) .know when and how to express an appropriate emotion ... Based on professional standards for working with clients/patients..work to try to make themselves feel the emotion that they want to show.....not show their true feelings in emotional situations. how important is it for mental health service providers to… Not Important. Please indicate how important it is.control how they express their emotions to clients. for mental health service providers to engage in the specified behavior or internal process..try to make themselves feel a certain emotion so their emotional expressions are sincere 4) 5) 6) 7) 8) and not faked.express emotions that are different from those they are actually feeling.. . 206 .... . .
how frequently do you do each of the following when interacting with clients/patients? Never. Strongly Agree 1) When I want to feel more positive emotion (such as joy/amusement). (ATTENTIONAL DEPLOYMENT) 2) Try to actually experience the emotions that I must show. (FAKING) Just pretend to have the emotions I need to display for my job. I make sure not to express them. 2003. (FAKING) Put on a “show” or “performance” when interacting with clients. Slightly Agree. (REAPPRAISAL) When I’m faced with a stressful situation. (ATTENTIONAL DEPLOYMENT) Resist expressing my true feelings.Appendix I Emotional Labor Items (Brotheridge & Lee. Gross & John. Please indicate the extent to which you agree with each statement by selecting one of the following responses. (ATTENTIONAL 3) 4) 5) 6) 7) 8) 9) 10) DEPLOYMENT) Really try to feel the emotions I have to show as part of my job. 2003. Sometimes. I change what I’m 2) 3) 4) 5) 6) 7) 8) 9) 10) thinking about. (MASKING) Hide my true feelings about a situation. (REAPPRAISAL) When I am feeling positive emotions. (REAPPRAISAL) When I want to feel more negative emotion (such as sadness/anger). Slightly Disagree. Always 1) Make an effort to actually feel the emotions that I need to display to others. Rarely. (REAPPRAISAL) When I want to feel more positive emotion. (MASKING) 207 . Grandey 2003) On the average day at work. (FAKING) Put on a “mask” in order to display the emotions I need for the job. (MASKING) When I am feeling negative emotions. I make myself think about it in a way that helps me stay calm. (REAPPRAISAL) When I want to feel more negative emotion. Neutral. (MASKING) I keep my emotions to myself. Agree. (FAKING) The following questions ask about how you control (that is. (MASKING) I control my emotions by not expressing them. Disagree. (FAKING) Fake a good mood when interacting with clients. Often. (MASKING) Put on an act in order to deal with clients in an appropriate way. I change the way I’m thinking about the situation. Strongly Disagree. (REAPPRAISAL) I control my emotions by changing the way I think about the situation I’m in. I change the way I’m thinking about the situation. I am careful not to express them. regulate or manage) your emotions while interacting with clients/patients. I change what I’m thinking about.
I feel I’m positively influencing other people’s lives through my work. 1981) Please read each statement carefully and indicate how often you feel this way about your job by selecting one of the following responses. I have accomplished many worthwhile things in this job. I feel I’m working too hard on my job. Every Day 1) 2) 3) 4) 5) 6) 7) 8) 9) 10) 11) 12) 13) 14) 15) 16) 17) 18) 19) 20) 21) 22) I feel emotionally drained from my work. I feel burned out from my work. I feel I treat some recipients as if they were impersonal objects. Working with people directly puts too much stress on me. I feel like I’m at the end of my rope. I can easily create a relaxed atmosphere with my recipients. 208 . I feel very energetic. I feel exhilarated after working closely with my recipients. Once a week. I worry that this job is hardening me emotionally. I deal with emotional problems very calmly. I don’t really care what happens to some recipients. Working with people all day is really a strain for me. I feel recipients blame me for some of their problems. Once a month or less. I’ve become more callous toward people since I took this job. I feel fatigued when I get up in the morning and have to face another day on the job. A few times a month. I feel frustrated by my job. I feel used up at the end of the workday. I can easily understand how my recipients feel about things. I deal very effectively with the problems of my recipients. A few times a week.Appendix J Maslach Burnout Inventory– Human Services Survey (Maslach & Jackson. Never. A few times a year or less. In my work.
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