An Intro to Balint Work
What are Balint groups?
The daily encounter with patients' suffering can evoke strong emotions in doctors, therapists and other health professionals, such as:
- Feelings of hopelessness when confronted with an incurable disease
- Helplessness in situations where understanding is lacking
- Anxiety facing uncertainty
- Guilt over potential mistakes or failures
- Anger over unreasonable demands and requests from patients
- Sadness over the suffering of those who have become close acquaintances
Michael Balint developed a method of group work for doctors to investigate what happens when doctors meet with their patients. He called this groups “training cum research” and he explained the method in his famous book: “The doctor, the patient and the illness”. Recognizing his name in the present days, a Balint group is a gathering of doctors who discuss cases in a confidential setting. These cases typically stem from various interactions between doctors and patients that have strained their relationship or conflicted with the doctor's personal values. The group is usually led by a mental health professional and/or an experienced family physician who are trained in the Balint method, both accredited by their national Balint societies. Groups generally consist of 5 to 12 doctors who meet weekly or monthly for about an hour and a half. Today, Balint groups are common and sometimes mandatory as part of the training in family medicine in many places around the world.
Objectives of Balint groups:
- Foster investment in interpersonal communication and understanding it as a significant element in the healing process
- Enhance the doctor's understanding of the patient
- Establish a framework for examining and understanding the boundaries, and the ideal distance or closeness of the doctor-patient relationship to promote healing
- Enable doctors to recognize their own feelings towards patients (such as anger, over-identification, affection) and evaluate their impact on treatment
- Help doctors identify their own blind spots
- Promote education and research on the doctor-patient-illness relationship
- Improve the doctor-patient relationship to prevent burnout and enhance personal and professional development, maturation and satisfaction.
What is a “traditional” Balint Group?
It consists of 6-12 doctors with 1-2 leaders and it meets regularly. Meetings usually last for 1-2 hours and the group continues for 1 or more years. The method is that of case presentation without notes.
What happens in a Balint group?
The leader asks “Who has a case?” The presenter who volunteers tells the story of a consultation, this is not a standard case presentation, but a description of what happened between the doctor and the patient. It need not be long, complicated or exciting but something that is continuing to occupy the presenter’s mind. It may be puzzling, or has left the presenter feeling angry, frustrated, irritated or sad.
The group discusses the relationship between the doctor and patient and tries to understand what is happening that evokes these feelings. The feelings which the patient evokes are significant and may be reflected in the presenter or in the group. This facilitates the understanding of the patient.
What can a Balint group do?
- It provides an opportunity for doctors to reflect on their work
- It can provide an outlet for anxieties and frustrations generated by their work
- It can arouse a doctors’ interest in patients whom they have previously found upsetting, annoying or “difficult”
- It can open minds to other possibilities, both of diagnosis and day to day management
- The group provides support and improves communication with patients and other professionals
- It can improve job satisfaction, the patient’s perception of care and help to prevent burn-out
What does a Balint group not do?
- It does not tell the doctors “how to do” their work
- It does not provide easy answers
- It will not solve all doctors’ problems with patients
