What is a Balint Group?
A Balint group is a group of clinicians who meet regularly to present clinical cases in order to improve and to better understand the clinician-patient relationship. It focuses on enhancing the clinician’s ability to connect with and care for the patient sustainably.
A session begins with a member's presenting a case for the group to discuss During the facilitated discussion, the group members gain new insights about the patient's and clinician’s perspectives and their experiences with each other.
A Balint group usually has two leaders who facilitate the process. The success of a group depends on its members being honest, respectful, and supportive of divergent opinions. The content of the group is confidential. A Balint group may meet for months or longer, and group cohesion and trust develop over time.
Rochelle Frank, MD
Dr. Frank is a Balint trained leader and has been leading Balint groups and Balint related groups (Connect the Docs) for physicians and medical students since 2012. In 2013 she created Connect the Docs for the The Permanente Medical Group in Kaiser North Valley which since that time remains an active region wide program throughout Kaiser Northern California. She is the Co-Chair of the California Northstate University College of Medicine Wellness Committee, a member of the SSVMS Joy of Medicine Committee and previous member of the AAN Live Well ELA committee and Kaiser North Valley Physician Wellness Committee.
Marissa Pierce, MFT
Marissa Elena Pierce is a licensed Marriage and Family Therapist who has worked for Kaiser Permanente as an Employee and Physician Assistance Program Consultant providing individual, couple’s and family counseling to physicians and staff for the last eight years. Marissa has been teaching Connect the Docs, Balint-like groups since 2013. Most of her career has been spent providing services in healthcare organizations including Healthnet, UCSF, San Francisco General Hospital and Stanford Medical Center. Marissa has a long-standing interest and experience in group work both personally and professionally.
More about Balint Groups:
Excerpts from A Brief History and Introduction to Balint Group Process
Laurel C. Milberg, PhD, American Balint Society
Balint training is named after Michael Balint, a Hungarian born British psychoanalyst who did considerable professional work with general practitioners around the psychological implications of general practice, that is to say, the challenges of integrating psychiatry and medicine. In the 1950's, Balint and his wife Enid began a unique type of case discussion group for general practice physicians about cases in their practice.
Balint groups are basically a case discussion where material of the group is based on presentation of current ongoing cases that give the presenter cause for thought, distress, surprise, difficulty, puzzlement, or uncertainty, the kind that stay with you long after they leave the office. Dead or unconscious patients, or ones with whom there can be no ongoing relationship are discouraged. Unlike other medical case discussions, the purpose is to increase understanding of the patient's problems, the doctor's response to the patient and his/her communication NOT to find solutions, offer advice, question the presenter, out do the presenter or teach medical or psychological content. The group is encouraged to speculate freely and present divergent views.
The group is not therapy for the personal self of the doctor, though participants stand to learn about their professional selves; their reactions to patients, their blind spots, allergies and habitual response modes to patients. These are usually private realizations which are not probed in the group discussion. The experience of being in a Balint group can be very supportive, but it is not a support group, nor is it a group to discuss general issues.
How it works: The group does the work, not the leaders. A case is presented which not only reports, but manifests the patient's state of mind and the doctor's response to the patient. The group takes on the case as if it were theirs, becoming aware of the feelings aroused in them by the patient as well as what the patient may be experiencing. In this way the skill used to understand the doctor patient relationship in Balint groups is empathy for both doctor and patient. Often, the group, or members of the group may unconsciously enact various aspects of the doctor patient relationship, providing an opportunity to learn even more. The result can be a shift in perception or attitude about the patient and a clearer understanding of the patient's problem, which in turn can help the doctor get unstuck in the relationship and find a more helpful role with the patient.
For more information about Balint Groups, visit the American Balint Society's website.