Balancing Act: Evidence-Based Strategies for Dual Caregiving Professionals

Updated: Aug 13

As a clinical psychologist and working mother, I have observed and experienced the profound psychological toll of dual caregiving roles. The phenomenon of role strain, particularly prevalent among healthcare professionals who are also primary caregivers at home, presents unique challenges.

Understanding Dual Caregiver Stress

The psychological literature identifies several key constructs relevant to dual caregiver experiences. The Conservation of Resources theory posits that psychological stress occurs when individuals perceive a threat to their valued resources—including time, energy, and emotional capacity. For dual caregivers, the constant depletion of these finite resources without adequate replenishment creates a state of chronic stress that can manifest in both psychological and physiological symptoms.

The work-family conflict theory further elucidates three primary forms of interference: time-based conflict (competing demands for time), strain-based conflict (stress in one domain affecting performance in another), and behavior-based conflict (incompatible behavioral requirements across roles). However, there is some good news: certain coping strategies (described below) can actually result in work-family enrichment.

The Physical Cost of Caregiving

Professionals with primary caregiving responsibilities at home experience higher rates of emotional exhaustion, anxiety, and depression compared to their non-caregiving counterparts. Neurobiological research using cortisol sampling demonstrates that dual caregivers exhibit dysregulated hypothalamic-pituitary-adrenal (HPA) axis functioning, with elevated cortisol levels persisting well into evening hours—a pattern typically associated with chronic stress states and increased vulnerability to both mental and physical health complications.

Coping Strategies

It is clear that dual caregiving is both physically and mentally burdensome, but what should we do about it? Here are various empirically-supported strategies that I also utilize myself!

Cognitive-Behavioral Techniques:

"Role transition ritual"—a 10-minute structured activity performed when moving between professional and personal caregiving contexts
- I personally do this every day to some degree. I use my super fun L.A. commute to listen to audiobooks, music, news, etc. to delineate the transition from home to work (and vice versa). I also always immediately change when I get home from work into a nightgown/loungewear and slippers – This is literally like “taking the day off” of me and transitioning into the home version of me.
Practice cognitive reframing techniques using the ABC model (Activating event, Belief, Consequence) to challenge unrealistic expectations
- Personally, this is hard for me to do in the moment. But it can be really helpful after-the-fact to understand one’s triggers and behaviors. Example: I flip out and yell at the kids for being too loud/rough/whatever while I am trying to make dinner.
  - Activating event: Kids are yelling/fighting/stomping around,
  - Belief: “I can’t deal with all this commotion while I am trying to make dinner after working all day!”
  - Consequence: I yell and feel like sh*t about it.
  - Later, I reflect on this chain of events and see that I get easily overstimulated in the evenings, and things like loud noises are dysregulating for me. Now I understand that I need to set the kids up for success and engage them in a quieter activity (art, crafts, reading) or have them play in the backyard where the sounds are muted for me inside the home.
Implementation of the "STOP" technique: Stop, Take a breath, Observe thoughts and feelings, Proceed mindfully.
- Again, hard for me to do in the moment, but helpful when I do it!
- You can see a ridiculous video of me practicing this technique HERE.

Social Support:

Conduct social network mapping to identify current support resources and gaps
Implement reciprocal support arrangements with other dual caregivers
Establish professional peer consultation groups focused on caregiver-specific challenges

Mindfulness:

Daily 20-minute mindfulness practice using body scan or breath awareness techniques
- There are many apps out there along with free content on YouTube if you prefer guided activities.
Integration of "micro-mindfulness" practices: 2-3 minute breathing spaces between activities
- Even 30 seconds does the trick for me when I’m short on time!
Mindful caregiving practices: bringing present-moment awareness to routine caregiving tasks
- Love this one. When I am frustrated with say brushing my 4-year-olds teeth while she wriggles like a slippery eel, I can remind myself that there will be a day when I will never brush her teeth again. This helps me appreciate the experience in a mindful way.

Division of Labor:

The Fair Play system
- If you are in a partnership, this system is amazing. This method helps conceptualize and organize the division of labor in a household. Importantly, this technique captures invisible labor (of which women traditionally take on at greater levels).