What happens in a Balint group?

What can I expect of a Balint Group?

Balint Groups these days meet both face-to-face and screen-to-screen, with one or two trained leaders, and a cohort of committed members. During meetings lasting mostly for 1½ to 2 hours, clinicians are invited to present cases from their own practice. After listening to the presenter’s story, group members discuss the case, focusing on the clinician-patient relationship. A presentation and discussion usually occupies about 45 minutes, leaving time to discuss two cases per meeting. 

What happens?

The presenter tells the group about the case in a brief and informal way. Without notes, the presenter describes experiences of the interaction with the patient, such as their own feelings and reactions, the atmosphere in the consulting room, and anything they are finding difficult. The presenter is free to describe any patient, often choosing one who has elicited strong feelings, such as distress, frustration, surprise, difficulty, puzzlement or uncertainty. 

Group members’ task is to seek to imagine what it might be like for both clinician and patient, as they explore the interaction between them. The group is encouraged to speculate, to engage with the heart of a case, and to consider clues about the nature of the presenter’s interaction with the patient. The aim is to understand the situation in a deeper way, to imagine the feelings and perspective of both the patient and the presenter, without judgement, advice, or solutions. 

A task of the leaders is to protect presenters from interrogation or criticism, so they are freed to listen and reflect on the group’s thinking. A non-threatening atmosphere of mutual respect provides a chance to sit with uncertainty and complexity, free of pressure to know the answer.

 The clinician’s response to the patient often provides valuable clues about the patient’s psychological difficulties. Group members’ diverse personalities, life experiences and blind spots, may reveal several ways to understand a case. The group provides a place to express feelings, be they pleasurable or painful, in an atmosphere of camaraderie, intimacy and support.

 What are the benefits?

Presenters may find themselves less defensive in subsequent interactions with their patients developing a capacity to acknowledge how patients might feel. They may discover an increased repertoire of interventions and find new approaches to recurring problems.

Regular participants develop better listening and observation skills. Benefits accrue to both clinicians and patients when clinicians can examine their own reactions to patients, a capacity which grows with self-awareness and self-reflection. Participants experience the generativity of working as a group, discovering increased creativity, richness, and integration in their thinking. As they gain sensitivity and skill in addressing psychological aspects of their patients’ problems, participants often describe growing professional satisfaction.