Balint group training: Theory and practice

Abstract

With regard to the many years of cooperation between the Balint Society of Serbia and the Faculty of Medicine in Belgrade (which, in recent years, has been realized through a promotional Balint workshop for GP residents), we believe that the application of the Balint method in continuous education would contribute to the improvement of doctors' professional performance. Balint education has shown excellent results for physicians of all medical specialties as well as for other healthcare professionals and associates (psychologists, special pedagogues, social workers, special education teachers, nurses) who want to improve their relationships with health care users, and it is especially helpful in the acquisition of skills necessary for working with "problem clients" as well as in the prevention of job burnout syndrome in healthcare professionals. The primary objective of this paper was to offer and present arguments on the importance of educational programs applying the Balint methodology, which is focused on the client-therapist relationship, and founded on psychoanalytic ideas. The secondary objective was to enhance awareness of the exceptional importance of the client-therapist relationship, which is of major therapeutic interest and essential to any treatment, and through participation and work in Balint groups, group members learn to understand and skillfully utilize the professional client/patient relationship. With its specific goals and methods, the education is beneficial to therapists, clients as well as health care institutions. A literature review was carried out regarding the previously published studies on the development, growth, and work dynamics of Balint groups and therapists i.e., counselors. Special attention was given to the discussions included in these studies, pertaining to the consequences of weaknesses, but also of strengths in the performance of Balint therapists. Attention was also paid to the issues related to the insufficient number of Balint groups and therapists that apply this practice in education, as well as to the support and assistance they are provided in regard to their work. The efficiency of Balint groups was also considered, including their contribution published in the literature, in addition to recommendations for overcoming this problem in the future. The founding father of this method, Michael Balint, a psychiatrist, started a training program for general practitioners (family physicians) more than 70 years ago, since he believed that they were specially overworked and burdened with a large number of patients and that improving doctors' knowledge in the field of psychology would facilitate their work. Later, this training program expanded, becoming more and more present in other branches of medicine. Today, Balint education is an integral part of medical studies and specialist training in psychiatry, gynecology, endocrinology, and family medicine in many European countries. Balint groups are intended for practitioners who professionally recognize the value of developing and deepening an empathic emotional relationship with their clients. These groups help doctors to reach a better understanding of a patient's overall condition, which in turn enhances the doctor's creative capacities to engage in the therapeutic process. In addition, the group process leads to a reduction in professional isolation that prevails among healthcare workers, contributing to the job burnout syndrome. Balint education enables a better connection between practitioners from different disciplines participating in the treatment. Thus, the Balint group members gain experience on the importance of alliance and cooperation in the treatment of their patients. Balint groups usually meet twice a month, during the academic year, giving participants the opportunity to become aware of what prevents them from having a better relationship with their clients as well as to find authentic answers that will reduce misunderstandings. Numerous studies have confirmed the importance of empathic relationships with clients in the provision of effective health care, and professionals also consider such relationships essential to their work. Balint groups are focused on reaching a better understanding through various associations, guided by a Balint leader, rather than on presenting ready-made solutions to a problem, which makes them applicable to a myriad of treatment situations.