Balint groups. ST1. 2015

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Michael Balint

What we think psychoanalysis is?

Who was Michael Balint. A Hungarian psychoanalyst Born 1896, son of a GP Came to Manchester in 1939 as a refugee Appointed 1945 as a psychoanalyst at the Tavistock clinic, London Began his work with GPs in 1950s – the Balint Group was born. This was to study doctor-patient relationships within small groups. 1957 – his seminal work – ‘The Doctor, his Patient and the Illness” was published

psychoanalysis

Balint Groups Consists of 6-12 doctors and 1-2 leaders. Meets regularly over 1 or more years - Meetings usually last 1-2 hrs Method is that of case presentation without notes What can a Balint group do: provides opportunity for you to reflect on work and provide an outlet for anxieties and frustrations generated from work. It can open your mind to other possibilities. What a Balint group does not do: it does not tell you how to do things or provide easy answers. It will not solve all your problems but may help you understand the patient more.

What is the point of balint work? To get a better understanding of the doctor-patient relationship To provide training, not therapy. To help GPs learn how to listen and to understand what their patients are really saying To provide insight into how a patient’s feelings could induce similar emotions in the doctor To achieve this - doctor should provide current cases that are giving him/ her particular cause for thought (could be distress, puzzlement) and discussion should focus on the relationship between doctor and patient.

Benefit of Balint work Balint work helps us explore doctor-patient relationships and deepen our understanding of it Promotes the use of ‘doctor as the drug’ Makes you a better GP Helps avoid burnout Makes work more interesting Less likely to get complaints Makes work less stressful - really !

What happens in a Balint Group Case discussion 1. Everyone sits in a big circle. 2. The doctor then gives a more complete explanation of the case. 3. The group is then allowed to ask the presenting Dr. questions about the case- 10 to 15 minutes 4. The presenting Dr then moves his/her chair about 1 ft outside of the circle. 5. The remaining Drs then discuss the case until it's apparent that the discussion is drying up. 6. The presenting Dr is then invited back into the group (they move their chair back in!) and talks about things that they have considered or learnt as a result of the discussion.

Group rules All discussions within the group are confidential Presenter volunteers the story of a consultation – need not be long or exciting but something that occupies the presenter's mind. It may be puzzling or causing frustration or sadness. Group listens without interruption and then, when finished, asks questions to clarify the case – KEEP IT FACTUAL. The group then continue to discuss the case, without the presenter, concentrating on the doctor-patient relationship and what is happening to evoke these feelings. The presenter joins the group at the end and has her say to respond. We finish on time !