Κατανοώντας το συναισθηματικό περιεχόμενο της θεραπευτικής σχέσης

Why participate in a group?

Participation in a Balint group can help a health professional in many ways. The way in which it will affect the practitioner is related to the special characteristics of their occupation, their position and the particular characteristics of the setting in which they work.

Since the 1950s, when Balint groups took place for the first time in Great Britain, their goal was to strengthen general practitioners in dealing with difficult cases, through reinforcing the focus on the therapeutic relationship between the clinician and the patient. As time passed by, these groups were also applied to other medical specialists, as well as to mental health professionals and other professionals. Thereby, doctors of all disciplines, nurses, psychiatrists, psychologists, social workers, other clinical therapists (e.g. speech therapists, occupational therapists, physiotherapists) and educators of all educational levels, may be involved in a Balint group.

Balint groups may be part of new professionals’ training and can play an important role in helping them shaping their professional identity, as they begin to encounter patients and face unprecedented and often difficult emotions. Furthermore, Balint groups may be part of the ongoing training and personal development of more experienced professionals, who face the weight of mental exhaustion and reduced job satisfaction.

Participation in a Balint group can help professionals in many levels and the way in which it will affect them is related to the specific characteristics of their occupation, their position, the particular characteristics of the setting in which they work (e.g. hospital, private practice, school), their character, their emotional needs during a specific period and the expectations they have from the group. Relevant research until now and the personal testimonies of professionals who have had a Balint experience, illustrate the benefits one can gain from participating in a Balint group.

Understanding: Often the professional can feel confused about his/her feelings and about what is taking place in the patient’s mind and their relationship. This haziness can hinder therapeutic process and become an emotional burden for the professional. Through their participation in the group, doubt and confusion subside, the participants acquire better understanding of the therapeutic relationship and mobilize their own resources in order to cope more effectively with the present and future situations.

Capacity/Adequacy: The professional develops his/her ability for empathy and he/she enhances his/her ability to recognize his/her own feelings and the patient’s feelings and use this knowledge in order to help. Also the professional becomes able to better withstand listening to unpleasant feelings and his/her patience is reinforced. He/she learns to give more time to understand the therapeutic relationship and this way the emotional weight caused by the difficult cases is dealt more adequately and gradually becomes a challenge.

Exculpation/Distancing: The professional becomes aware of the limits of the impact he/she may have on the life of the patient, handles disappointment when treatment results are not the expected or desired and manage to face their weaknesses through the sharing of their experiences. Moreover, discussing about difficult feelings is helpful in understanding them and keeping a distance from his/her personal life. In addition, the structure of the group is that the presenting participant is also an observer, which allows him/her to distance himself/herself and see things from a different point of view, concerning his/her role and the relationship with the patient.

Boundaries: Often the professional identifies with the patient, has difficulty maintaining clear limits to the relationship and his/her role is not clear. This may create powerful feelings and inhibit treatment. Through the group the participant manages to distinguish the emotional weight he/she has to bear and redefine the boundaries in the relationship.

Security/ Freedom: In a Balint group the participant has the opportunity to present his/her own case or just to participate in the discussion of the case presented or simply listen without the obligation to speak, which creates a sense of freedom. The confidentiality, which is guaranteed by the group and the absence of criticism, fosters a sense of security over time, in which one can feel free to disclose his/her uncertainties and errors.

Something other than supervision and psychotherapy: Balint groups have important influences from psychoanalysis. However, they are not theoretically oriented, but intend to assist the professional in everyday practice. It is a process which fosters free associations and speculations, but without analysing the professional’s internal conflicts or the dynamic of the group, thus this procedure does not replace psychotherapy. The participants present the cases that create difficulty in them and the group listens carefully and then discusses without criticizing and provides support without giving direct guidelines or practical solutions. Participating in such a group appears to be more helpful than the mechanistic theoretical knowledge. The presenter uses as many of the ideas he/she believes that match with his/her way of thinking, while maintaining the sense of control he/she has on his job.

Job satisfaction: Finally, for many professionals the time they spent with the group is a pleasant break from a lonely professional life, during which they have the opportunity to share with their colleagues their concerns and frustrations. They feel relieved from painful experiences and often come to rediscover parts of their work that used to offer enjoyment to them. Their strength increases and the pleasant atmosphere of the group results in increasing the satisfaction deriving from their job and helps to avoid a possible burnout.

Lida Semidala- Avramopoulou

Psychologist- Developmental Psychologist (MSc) – Psychotherapist

 

Bibliography

Fitzgerald G., Hunter M. D. (2003) Organising and evaluating a Balint group for trainees in psychiatry, Psychiatric Bulletin 27, 434-436

Kjeldmand, D., Holmstrφm I. (2008) Balint Groups as a Means to Increase Job Satisfaction and Prevent Burnout Among General Practitioners, Annals of Family Medicine 2008;6:138-145. DOI: 10.1370/afm.813.

Kulenovic M., Blazekovic- Milakovic S. (2000) Balint Groups as a Driving Force. Collegium Antropologicum 24 Suppl. 1: 103–108, UDC 159.964

Roberts, M. (2012) Balint groups. A tool for personal and professional resilience, Can Fam Physician. Mar 2012; 58(3): 245.

Runkle C., Morgan L., Lipsitt E. (2006) Does Anyone Have a Case? The Balint Group Experience. Permanente Journal. Spring; 10(1): 59-60. Published online Spring 2006. PMCID: PMC3076988

The American Balint Society [homepage on the Internet] The American Balint Society; [updated 2005 May 5; cited 2005 May 19] Available from: http://familymed.musc.edu/balint/mission.html.

Zalidis, S. (2013) The role of Balint Groups in helping first clinical year medical students develop their professional identity and safeguard their boundaries. International Balint Conference, Heidelberg 7/9/13- 11/9/13

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