Balint Group Process An Introduction to Balint Group
Balint Group Process An Introduction to Balint Group Work
Collaborators American Balint Society Ritch Addison, Ph. D Greg Troll, MD Jillian Romm RN, LCSW Chiara Ghetti, MD Jeff Sternlieb, Ph. D Revised and edited for the BSANZ Di Nash Hamish Wilson
Dr Michael Balint Born in 1896 in Budapest, son of a GP Psychoanalytic training in Berlin and Budapest, emigrated to London worked at the Tavistock Clinic
Early ideas Michael and his 3 rd wife, Enid, began the training/research seminars for GPs after WW II to help GPs respond to the societal burden of trauma and its effects on patients and their families Realised they were also researching the doctor patient relationship 1957 “The Doctor, his Patient and the Illness” published, largely from group notes
Michael and Enid Balint “At the center of medicine there is always a human relationship between a patient and a doctor. ”
Balint Group work is not: a psychotherapy group an encounter group a traditional case consultation group a topic discussion group a place for prescriptive advice or didactic teaching
Characteristics of a Balint Group Usually fixed membership Usually two co-leaders who are paid by the group Focuses on the doctor-patient relationship
Characteristics of a Balint group The power of the group develops over time Members present an ongoing ‘case’ (patient or client) Focus on less obvious or less conscious aspects of relationship
Ground Rules Confidentiality Avoid advice Respect, Turn Taking No criticism
The Group Convenes Leader
Calling for the Case Leader Who’s got a case? Leader
Cases Patients we: ‘Take home’ with us Lose sleep over Feel conflicted over or feel strongly about Feel ambivalent about or we don’t want to see again for some reason
Cases Case are patients are also clients or patients who: leave us feeling unfinished ‘bubble up’ in any moment in our day Are ‘heartsink’ in some way for us.
Presentations are spontaneous no clinical notes no preparation the presenter speaks for around 5 minutes
Group Process Leader I do. Leader
The Case Arrives Leader Sophie is a 79 yr old blind woman…. Presenter Leader
Clarifying Questions Leader Are there any questions of fact? Presenter Leader
The Presenter gets to Listen Leader Lets let the presenter just listen while we ‘work the case' Leader Presenter
The Group Starts Working Leader I imagine Sophie to be… Presenter Leader
Imagining Patient and Doctor Leader If I were the doctor, I might feel… Leader Presenter
Group Exploration Continues Leader This image just popped into my mind of a… Leader Presenter
Functions of Group Members To: explore the doctor-patient relationship look inward, be imaginative, creative, look for less conscious aspects
Functions of Group Members To attend to and share about the case their: thoughts, images fantasies, associations hypotheses
Functions of Group Members to differentiate their own experience from that of the presenter to further the group’s empathic understanding
Balint Leaders create and maintain a safe space structure and hold the group over time protect the presenter and group members from intrusion
Balint Leaders encourage reflection, empathy and compassion attend to group development debrief with co-leader after each group
Functions of a Balint Group provides a safe place for emotional reflection on troubling cases helps the presenter to consider other understandings about the case
Functions of a Balint Group looks at blind spots and assumptions helps members to feel less isolated, less shame offers a way to new types of learning helps members to grow and develop
Benefits for clinicians Explore difficult or troubling situations Refine crucially important patientdoctor relationship skills Hear and learn from others’ cases
Benefits for clinicians To connect with others To experience the power of a group To remind ourselves what matters about our work To avoid burnout, increase engagement with others and increase resilience
Balint opportunities and training join a Balint group in your area, or a Skype group train with BSANZ Leadership Accreditation Pathway BSANZ Annual Balint Group Workshop International Balint Conferences and Congresses
Resources �Balint Society of Australia and New Zealand balintaustralianewzealand. org �American Balint Society americanbalintsociety. org �International Balint Federation balintinternational. com
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