Balint International Round Table – July 4.2020

Author: Vladimir Vinokur —Dr. of Medical Sciences, Professor  of the Department of psychotherapy, medical psychology and sexology of the North-Western state medical University,  President of the Balint Association (Russia) – (Russia, Saint Petersburg)

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One of the premises of the necessity and already widespread and consistent existence of such an effective form of analytic supervision as Balint groups for doctors and psychologists, has been the analysis of the professional «well-being» of these specialists that shows that for quite seasoned people the need to get new information and high quality feedback from colleagues in different confusing and difficult cases — difficult most of all because of the nature of the patient’s communication — is quite high. The intensity of this need is often in a paradoxical way depends on the amount of experience — more seasoned doctors and psychologists demonstrate an even greater interest in exchanging experience and constructive discussions and thus the attention and support of their colleagues than younger doctors or psychologists. At the same time, there is an ongoing parallel process in a Balint group — if one of the supervision ideas in not viable, it will not find its place in treatment either. But what is experienced as «alive» in supervision usually successfully finds its place in treatment as well.

In the discussions of the recent decades centered around analysing Balint groups and their effectiveness in a number of foreign countries that have accumulated many years of experience of this work and study the necessity and usefulness of the legislative regulation of the «helping» professionals in Balint groups, there are active debates on whether such participation should be compulsory and whether it is useful or even harmful. Therefore it is worth noting that Michael Balint himself who deeply believed in the usefulness of those groups for the professional development of doctors and counselling psychologist, recommended to limit one’s efforts to inviting people to participate in this supervision work while presenting its usefulness in an active and reasoned fashion.

Balint pointed out that being open, non-directive, trusting and empathetic as well as an opportunity to exchange one’s thoughts and feelings freely and discuss difficult aspects of interaction with one’s clients cannot be forced on or dictated as a compulsory element of professional development or a formal stage of obtaining the license for doctors and mental health practitioners.

In the light of analysing the positive impact that the Balint supervision had on professional and personal growth of the therapists, Tom Stockman’s (2105) findings are also of interest. He studied the responses of a large group of young British psychiatrists and psychotherapists after they faced a formal requirement to participate in a Balint group as part of their continuous education directed at developing the skills of self-awareness and self-reflection, improving their communication with patients, increasing the awareness of their own emotional responses and reducing the level of «professional alexithymia». The participants of the study were offered a questionnaire where they had to express the degree of agreement or disagreement with the following statements using the 0 to 9 scale:

The study results show that in accord with the participants’ opinion, the experience of being in the group led to noticeable positive change. The highest scores were registered in the participants’ agreement with such statements as «The group helped me in developing self-understanding and reflection» and «The group helped me to develop a comprehensive understanding of the patient». These data also correlate with agreeing with other questionnaire statements like «The group helped me to feel more satisfied with my work» and «Working in the group improved my communication skills with patients».

During the recent years the International Balint Federation initiated active discussions on the necessity and possibility of the legislative regulation of the Balint groups work in the US and a number of European countries. In particular, what has been discussed is the compulsory term of participation for helping professionals working in the fields of education and medical or social work. The duration of this work and the criteria for the graduates who must comply have been the topic of discussion.

The experience of a number of countries in organising BG (Germany, UK, Sweden)……

The analysis of the successful work of the «compulsory» Balint groups shows that it relies on a clear and accurate technique that is provided by a properly trained and qualified leader. Different studies confirm the position of many authors including Guido Flatten (2016) that the participants of «compulsory» Balint groups experience the very style and presence of the leader as the most significant link in the group’s work. If we recall Sigmund Freud’s idea of psychotherapy as an «impossible profession», the analysis of the Balint group’s work — especially if it is compulsory — shows that this form of supervision for helping professionals allows to make their work at least a bit more «possible», less difficult and more successful due to the improved interaction between doctors and psychologists and their patients and a clearer understanding of the difficult nature of this communication by both participants.