Balint Groups Research Articles

The effectiveness of Balint groups at improving empathy in medical and nursing education: a systematic review and meta-analysis of randomized controlled trials

ObjectiveEmpathy is crucial for patient health. The Balint group is a commonly used method for empathy training. However, the impact of Balint groups on empathy remains unclear. This systematic review and meta-analysis of randomized controlled trials (RCTs) aims to assess the impact of Balint groups on empathy training among medical and nursing students, as well as doctors and nurses.MethodsThis review involved searching multiple databases for relevant articles. Rigorous eligibility criteria were applied during the screening of titles and abstracts, and during the selection of records. Following a full-text eligibility evaluation, two reviewers independently extracted data from the final selection of studies, and a meta-analysis was conducted. The standardized mean difference (SMD) was calculated to assess the systematic outcomes.ResultsA total of 11 studies were included in this systematic review and meta-analysis. Participants in Balint groups demonstrated a significant increase in empathy than those in the control group (SMD = 1.46, 95% confidence interval [CI] 0.86–2.06; p < 0.001). Studies conducted in China (SMD = 2.13, 95% CI 1.27–2.99; p < 0.001) revealed a greater impact of Balint groups on empathy than those conducted in France (SMD = 0.24, 95% CI 0.12–0.37; p < 0.001). The impact of Balint groups was significantly greater among physicians (SMD = 2.50, 95% CI 1.79–3.21; p < 0.001) and nurses (SMD = 2.88, 95% CI 1.34–4.43; p < 0.001) compared to medical students (SMD = 0.71, 95% CI = 0.35–1.06; p < 0.001). Participants who attended ten or more sessions (SMD = 2.37, 95% CI 1.35–3.39; p < 0.001) demonstrated better outcomes compared to those who attended fewer than ten sessions (SMD = 0.79, 95% CI 0.30–1.29; p < 0.01).ConclusionBalint groups are effective for empathy training among doctors, nurses, and medical students. Future research should incorporate patient-led measurements to evaluate empathy and ascertain the long-term impact of Balint groups on empathy training.Trial registrationPROSPERO registration number CRD42023488247.

The uptake and utility of a reflective practice group for psychiatry registrars in a state-wide forensic service.

It is essential that mental health clinicians have access to reflective processes where they may understand and make sense of emotional responses to patients, teams, and organisations. The authors share their experience of initiating and successfully running a reflective practice group, framed with Balint principles, for psychiatry registrars working in forensic settings across Victoria. We describe the process of setting up a Balint group for this professional population. Qualitative feedback was obtained from group members. The data was analysed thematically, regarding motivating factors for group attendance and feedback post pilot group. Overall, feedback on the pilot Balint group was positive, which led to the group being extended for recurring 6-month periods. We share an illustrative example of a complex case which could be formulated in a forensic psychiatry Balint group setting, alongside reflections of the facilitators of the group. Reflection is paramount for safe, effective mental health treatment, particularly in the context of forensic psychiatry. Our pilot results highlight areas where the approach of setting up a fledgling Balint group has been successful. We hope to inspire others to engage and participate in routine reflective practice.

Application of Balint Intervention Groups in Professional Communication in Medical Science Education

Dear Editor The purpose of this research is to familiarize professors and students of medical sciences with the concept of Balint groups. Michael Balint created the Balint groups in 1957 in order to better understand the relationships between family doctors and their patients (1, 2). According to Michael Balint, in addition to medical education, doctors should also have proper communication skills and characteristics with patients (2, 3). Balint groups are one of the effective methods to improve therapist-client relationships in the form of 90-minute sessions, held weekly to monthly, over several years (4, 5). Each Balint group consists of 6 to 10 members with one to two leaders or facilitators. In these groups, usually, one person presents the desired topic, which can be the condition of a patient, in a period of 3 to 5 minutes, and the desired topic is discussed for an hour or more. All topics discussed in the group are confidential, and the leader emphasizes creating a safe environment that is based on trust and acceptance. The members of the group take turns expressing their opinions on the topic, and finally, the group leader summarizes the opinions, and the final result is obtained (6). Doctors in these groups have meetings to discuss their performance, the psychological aspects of their work, and the relationship between the doctor and the patient (1, 7). One of the goals of Balint groups is to increase one's knowledge by reporting on one's patient, discussing the topic in a safe environment, finding one's mistakes due to the feedback of others, and correcting one's emotional experiences in relation to the patient. Balint group members reveal their innermost feelings and experiences in order to be able to talk about a topic. In this way, members share their content with other group members in a non-judgmental environment. The group members benefit from the feedback of others and compare their experiences with the contents of other colleagues (8). Group discussions about feelings have the benefit of making people more aware of their feelings, thus enabling them to analyze and organize their information. Emotions and feelings in clinical work can be useful for patients if they are tolerated and understood by the doctor (9). Due to the rapid development of technology, the improvement of educational methods, and attention to the needs of patients, the importance of the Balint group should be given more attention due to the change in demographic characteristics (1). As a result, Balint groups have gradually been emphasized in medical education (10). In Balint groups, with the participation of students, the duration is shorter than in normal Balint groups, and the leader may be more active in describing their experiences (11). The presence of students in Balint groups leads to the development of empathy skills among medical students (12). For example, students are placed in a real and uncomfortable clinical situation to observe their reactions and increase their empathetic abilities, thus becoming more patient-centered (12, 13). Studies show that doctors who were part of Balint groups during their student period have a higher sense of control and satisfaction in their work environment. Also, these groups improve the skills of giving bad news in students (11). By attending these classes, students can use the professors' experiences with problematic issues in dealing with patients, which they have not observed during their studies. Improving doctor-patient relationships, reducing job burnout, and managing stress and anxiety are other benefits of participating in Balint groups (1). Medical schools should create an environment for students that will lead to progress in their socialization process (14). Therefore, it is suggested that Balint groups be used to improve teacher-student relationships in medical education.

The effect of balint practice on reducing stress, anxiety and depression levels of psychiatric nurses and improving empathy level

ObjectiveTo explore the effect of Balint Group in improving stress, negative mood and empathy of psychiatric nurses.MethodIn March 2022-March 2023, 150 psychiatric nurses from four hospitals in Lanzhou were selected for the study, randomly grouped into experimental group and control groups (75 per group), the experimental group participated the Balint Group activities biweekly, the control group only attended mental health knowledge lectures. Job stress, negative emotion and empathy of the two groups before and after the intervention were evaluated and compared by using job stressor Scale, coping style Assessment Scale, self-assessment scale for depression, self-assessment Scale for anxiety and Jefferson Empathy Scale.ResultsAfter intervention, the job stressor scale and coping style evaluation of nurses in the two groups were significantly decreased, and the experimental group was lower than the control group (P < 0.05). The depression and anxiety of nurses in the two groups were significantly improved, and the experimental group was better than the control group (P < 0.05). The differences in the total score and dimensions of Jefferson Empathy scale in the experimental group after intervention were higher than those in the control group (P < 0.05).ConclusionBalint group activities can effectively relieve the stress, depression and anxiety of psychiatric nurses, and improve the ability of empathy at work.

Balint groups' possible role in self-care and job satisfaction of general practitioners-Aqualitative study.

Concerns are growing when it comes to the shortage of primary care physicians, therefore it seems necessary to take acloser look at job satisfaction and self-care as one of many influences on career choice. Ahigher job satisfaction reduces the risk to experience burnout and job-related stress and in addition it will contribute to staying in the profession. The objective of this study is to investigate the impact of regular participation in Balint groups on job satisfaction and self-care among general practitioners. Descriptive qualitative study with semi-structured expert interviews of 7general practitioners. Thematical analysis of data and narrative summary. Atotal of 402 coded segments were categorized into 8main themes and 39subthemes. Interviewees emphasized changes in self-care and job satisfaction as aresult of Balint work and mentioned Balint work as aburnout prophylaxis for themselves. Competences that were learnt or improved through Balint work were described as well as aspects such as feedback and connection with colleagues or professional challenges and difficulties. The results of the study give rise to the assumption that regular participation in Balint groups might help to improve self-care, resilience, and contribute to job satisfaction. Further research is needed before ageneral recommendation can be made. Many positive aspects were described by the experts, while no harmful negative influences of Balint work were identified.

Balint groups: an effective tool for improving health professionals’ perceived well-being

BackgroundPhysician burnout is a common problem that negatively impacts their well-being and patient care. Balint groups (BGs) deal with doctor-patient relationships. Previous studies that have demonstrated the positive effects of BGs are descriptive and based on small sample sizes. This study aims to evaluate the perceptions of health professionals who participated in BGs, determine the impact of BGs on their personal and professional well-being, and identify the factors related to these positive outcomes.MethodsOn January and February 2023 the authors have distributed a questionnaire to 142 healthcare providers in a conference and internet networks. Most respondents were family physicians.ResultsParticipation in BGs is seen to have a positive impact on healthcare professionals’ perceived well-being and professional development. Respondents who had participated in the BG reported a reduction in burnout, increased empathy, and enhanced professional identity and relationships with patients and colleagues. The study also highlighted the importance of duration of participation in BG, with attendance longer than 5 years linked to significantly more positive outcomes compared to less than 1 year. In a logistic regression analysis two factors were significantly associated with self-reported well-being: attending BGs for more than five years and perceiving BGs as a means of relieving burnout.ConclusionsThe findings suggest that medical organizations should encourage the regular availability of BGs to support physicians’ well-being.

Intervention Programs Targeting Burnout in Health Professionals: A Systematic Review.

Burnout is an occupational syndrome, with a higher prevalence in professionals whose close involvement with other people is significant. There is a great diversity of professionals at risk of burnout, and therefore the implementation of intervention programs is relevant, as helping people to maintain their mental and emotional health enables them to become more meaningfully involved in their communities and become more effective and active global citizens. We aimed to review systematically the characteristics of interventions targeting burnout in health professionals. The search was conducted in three databases: Scopus, Web of Science, and PubMed, following the PRISMA model, and 16 eligible articles were identified between 2012 and 2023. Mindfulness showed great efficacy in preventing burnout, by reducing stress levels and promoting empathy. In addition, relaxation and breathing techniques, yoga, and music therapy showed to improve burnout and occupational stress levels. Balint groups have also helped slow the progression of burnout. Implications about the need for future research to foster the promotion of well-being and mental health of health professionals are mentioned. Mindfulness, relaxation and breathing techniques, yoga, music therapy and balint groups proved to be effective in preventing burnout.

How does guided group reflection work to support professional identity formation in postgraduate medical education: A scoping review

Purpose In postgraduate medical education, guided group reflection is often applied to support professional identity formation. However, little is known about how guided group reflection is shaped and how it works. Our scoping review synthesizes existing evidence about various approaches for guided group reflection, their aims, components and potential working mechanisms. Methods We conducted a scoping review using JBI (Joanna Briggs Institute) guidelines for conducting scoping reviews. We searched PubMed, PsycINFO, EMBASE and ERIC databases for all research articles published in English or Dutch in an iterative team approach. The articles were extracted and summarized quantitatively and qualitatively. Results We included 71 papers (45 primary research papers and 26 non-empirical papers including program descriptions, theoretical concepts and personal experiences). We identified a diversity of approaches for guided group reflection (e.g. Balint groups, supervised collaborative reflection and exchange of experiences), applied in a variety of didactic formats and aims. We distilled potential working mechanisms relating to engagement in reflection, group learning and the supervisor’s role. Conclusions There are significant knowledge gaps about the aims and underlying mechanisms of guided group reflection. Future systematic research on these topics is needed to understand the effectiveness of educational methods, that can help facilitate learning conditions to best shape professional identity formation (PIF) in educational curricula.

Fostering empathy in Chinese medical students: the role of Balint groups facilitation

Fostering empathy in Chinese medical students: the role of Balint groups facilitation

Emotional meanings attributed to sexual experiences reported by Brazilian Men with Head and Neck Cancer seen at a Public University Oncologic Outpatient Service: A Qualitative Study

Introduction“What can and what cannot I do in a sexual relationship?” |In this way, a middle-aged man with HNC - Head and Neck Cancer, under chemotherapy or radiotherapy, asks. This doubt is raised to the oncologist, radiotherapist, nurse or psychotherapist. Apparently, his concern is objective, considering he has a severe diagnosis and important treatments. However, underlying the manifest doubt, there are symbolic constructions in his mind that generate anguish. The health professionals’ response must go beyond information. They also must understand the symbolic emotional meanings associated with the patient’s speech. This attitude will bring a psychotherapeutic effect to the ill man.ObjectivesTo interpret symbolically sexual and emotional experiences reported by male patients diagnosed with HNC under outpatient treatment in a public specialized clinical unit.MethodsWe used the CQM - Clinical-Qualitative Method (Turato. Portuguese Psychos. J, 2000 2(1): 93-108). For data collection, the main researcher used the Semi-Directed Interview with Open-ended Questions In-Depth and Field Notes. The employ of the Seven Steps of the CQCA - Clinical-Qualitative Content Analysis (Faria-Schützer et al. Cien Saude Colet. 2021; 26(1): 265-274) brings us to discussion categories. The sample was closed with 12 patients according to the information saturation strategy (Fontanella et al. Cad Saude Publica. 2008; 24(1): 17-27). The interviews were conducted by the first author of this abstract, a male nurse, as part of his master’s research at a postgraduate course in Oncology. The findings were validated by peer reviewers from the Lab of Clinical-Qualitative Research at the State University of Campinas.ResultsTwo categories were chosen for this presentation: ‘The dyad perceived in the felt body and the experienced body’, and ‘The body re-signified between the sexual and affective dimensions’. The body symbolized before and after the illness experiences a movement in phenomenological consciousness that leads to external changes in its attitudes. The patient needs now to ask himself and others what this body can - or cannot - do. The severely ill body imposes new meanings for life and sexuality. It does not cancel the wish but asks for a new channelling of your psychic/sexual energies.ConclusionsThese findings indicate that patients with HNC want to talk about sexuality and ask about the risks of sexual activity, contrary to what the common view supposes. Traditional Balint groups met with the multidisciplinary team can be beneficial for doctors and nurses to deal with their own emotional limitations. Furthermore, the Consultation-Liaison Psychiatry, under the approach of psychosomatic medicine, focuses on the care of patients with behavioural and emotional manifestations, together with the work of the oncologists.Disclosure of InterestNone Declared

The effectiveness of Balint group work on the quality of work life, resilience, and nurse-patient communication skills among psychiatric nurses: a randomized controlled trial.

Balint group training has gained popularity in medical practices as an intervention designed to enhance the quality of life, well-being, and communication skills of healthcare practitioners. Psychiatric nurses, in particular, encounter distinct challenges and stressors inherent in their profession, necessitating the development and implementation of effective interventions to assist them in coping with the difficulties they experience. In this vein, the current study aimed to investigate the effectiveness of Balint group training on quality of work life, resilience, and nurse-patient communication skills among psychiatric nurses. Thirty psychiatric nurses from Razi Hospital in Tehran were recruited via the purposeful sampling method in 2022 and were randomly assigned to either the Balint group, consisting of eight weekly one-hour training sessions, or a control group. Participants completed the Walton Quality of Work Life Questionnaire, Connor-Davidson Resilience Scale, and Communication Skills Scale before and after the intervention. The data were analyzed using the Analysis of Covariance (ANCOVA). The study found no significant differences between the Balint group and the control group in terms of quality of work life, resilience, and nurse-patient communication skills. Findings suggest that Balint group training was not an effective intervention for improving the well-being and communication skills of psychiatric nurses. However, the study highlights the need for further investigation into the potential factors that may explain the lack of significant gains and offers insights for future research in this area.

Positive effect of Balint group on burnout and self-efficacy of head nurses in China: a randomized controlled trial.

Burnout is common among nurses and can lead to negative outcomes of medical care. This study aimed to explore the effectiveness of Balint groups to reduce burnout in head nurses in a Chinese hospital. This was a randomized controlled trial with a pre- and post-test. A total of 80 head nurses were randomly assigned to either a Balint group (n = 40) or a control group (n = 40). Participants participated in Balint group for a period of 3 months. Participants in both groups completed the Maslach Burnout Inventory-Human Services Survey and the General Self-Efficacy Scale at the beginning and end of the study. Balint group members also completed the Group Climate Questionnaire-Short Form. In the Balint group, 33 participants attended all Balint groups, while the 40 participants in the control group had no intervention. Analysis of variance with repeated measures demonstrated a statistically significant difference on the Maslach Burnout Inventory subscale of sense of personal achievement (F = 9.598, p = 0.003) between the Balint and control groups. However, there were no significant differences between the groups on the subscales of emotional exhaustion (F = 0.110, p = 0.740) and depersonalization (F = 0.75, p = 0.387), and the General Self-Efficacy Scale (F = 0.709, p = 0.403). Balint groups helped reduce burnout among head nurses in terms of personal achievement.

Is the Balint Group an Opportunity to Mentalize?

The Balint group, a time‐tested and efficacious resource for fortifying resilience among helping professionals, is explored in depth in this article through a case vignette. Despite its demonstrated efficacy in assisting professionals handling challenging cases, the Balint method's adoption remains inexplicably limited. We hypothesize that this restraint is due to a deficient understanding of the method's mechanics, operational processes and outcomes. In response, we offer a contemporary interpretation anchored in the theoretical framework of mentalization, aligning with current psychotherapeutic standards. The article underscores the Balint group's remarkable utility, akin to other mentalization‐based therapeutic methods, in navigating intricate cases, emotionally demanding situations and circumstances that exceed the expertise and experience of the professional. By highlighting this, we hope to broaden the acceptance of the method, enable systematic assessment of its effectiveness and augment training for group leaders and participant commitment. This endeavour represents both a nod to the research‐centric approach originally espoused by Mihály Bálint and an embrace of the growing emphasis on evidence‐based methodology in medicine and psychotherapy. Ultimately, we aim to illuminate the potential of the Balint group and promote its extensive application in support of helping professionals.

Attitudes of psychiatrists towards people with mental illness: a cross-sectional, multicentre study of stigma in 32 European countries

Mental health-related stigma occurs among the public and professionals alike. The lived experience of mental illness has been linked to less stigmatising attitudes. However, data on psychiatrists and the relationship between stigmatising attitudes and psychotherapeutic activity or case discussion groups remains scarce. A cross-sectional multicentre study was performed in 32 European countries to investigate the lived experiences and attitudes of psychiatrists toward patients with mental illness as well as the relationship between stigma, psychosocial and professional factors. The self-reported, anonymous, internet-based Opening Minds Stigma Scale for Health Care Providers was used to measure the stigmatising attitudes. The survey was translated into the local language of each participating country. All participants were practising specialists and trainees in general adult or child and adolescent psychiatry. The study took place between 2nd October, 2019 and 9th July, 2021 and was preregistered at ClinicalTrial.gov (NCT04644978). A total of 4245 psychiatrists completed the survey. The majority, 2797 (66%), had completed training in psychiatry, and 3320 (78%) worked in adult psychiatry. The final regression model showed that across European countries more favourable attitudes toward people with mental illness were statistically significantly associated with the lived experience of participants (including seeking help for their own mental health conditions (d=-0.92, 95% confidence interval (CI)=-1.68 to-0.15, p=0.019), receiving medical treatment for a mental illness (d=-0.88, 95% CI=-1.71 to-0.04, p=0.040), as well as having a friend or a family member similarly affected (d=-0.68, 95% CI=-1.14 to-0.22, p=0.004)), being surrounded by colleagues who are less stigmatising (d=-0.98, 95% CI=-1.26 to-0.70, p<0.001), providing psychotherapy to patients (d=-1.14, 95% CI=-1.63 to-0.65 p<0.001), and being open to (d=-1.69, 95% CI=-2.53 to-0.85, p<0.001) and actively participating in (d=-0.94, 95% CI=-1.45 to-0.42, p<0.001) case discussion, supervision, or Balint groups. Our study highlights the importance of psychotherapy training, supervision, case discussions and Balint groups in reducing the stigmatising attitudes of psychiatrists toward patients. As the findings represent cross-national predictors, Europe-wide policy interventions, national psychiatric education systems and the management of psychiatric institutions should take these findings into consideration. National Youth Talent Award (Ministry of Human Resources, Hungary, (NTP-NFTÖ-20-B-0134). All authors received no funding for their contribution.

Online Balint Groups in Iran during the Covid-19 Pandemic.

When Covid-19 was declared a pandemic, most people felt helpless, fearful, and demoralized while health care workers put their own lives at risk to support and heal others. The uncertainties expressed by experts and the ambiguous and protracted nature of the pandemic compounded the sense of frustration caused by the scarcity of protective equipment and effective medications. This combination of factors led to exhaustion, burnout, and moral injury. As a result, mental health practitioners worldwide realized that health care staff needed to stay motivated and resilient. Our contribution in this regard was to start Balint groups throughout Iran, online, for a full year. We learned some lessons worth sharing. Our insights were wrapped around challenges but proved helpful to preserve the integrity of delivering medical services in times of crisis.

Lack of awareness of neurogastroenterology and motility within medical education: Time to fill the gap.

Disorders of gut-brain interaction (DGBI), previously referred to as functional gastrointestinal disorders, affect 40.3% of adults in the general population and are diagnosed in 34.9% of new adult referrals to secondary care gastroenterology services. Despite their high prevalence, studies published in this issue of Neurogastroenterology and Motility by investigators based in Germany, the UK, and the USA demonstrate a mismatch between the clinical burden of DGBI and their representation in medical school and postgraduate curricula. This review outlines the salient findings of these studies and explores why and how negative perceptions toward DGBI exist, including factors related to misinformation and internalized stigma. The authors propose a selection of strategies to ameliorate physicians' attitudes toward and knowledge of neurogastroenterology and motility including linking trainees with dedicated clinician mentors with an interest in motility, exposing trainees to expert patients who can enhance empathy, extending Balint groups into gastroenterology training, and offering motility apprenticeships in specialist units. Urgent improvements to medical school and postgraduate curricula are required to ensure the longevity of this subspecialty field in gastroenterology, and to ensure the needs of a sizeable proportion of gastroenterology patients are appropriately met.

A mixed-methods SWOT analysis of a medical student Balint group programme

Background Balint groups use case-based discussions to explore, reflect on, and enhance the clinician-patient relationship. They facilitate the development of empathy and reflective practice and reduce burnout. This study aimed to explore how the benefits of a traditional Balint group format can be accessed and optimised for medical students during a one-year pilot programme. Methods Eight medical student Balint groups ran for six weeks during 2022–2023, with 90 students participating. Themes were identified from student feedback using qualitative content analysis. Group leaders kept reflective session notes and used these alongside student feedback to undertake a strengths, weaknesses, opportunities, and threats analysis. Results Strengths of the programme were emotional containment, learning to reflect, and community identity. Weaknesses were themed as strange situations, dragging along, and facilitator as an object. Opportunities were identified in expanding the scope and sharpening focus. Psychological defences and the engagement dilemma threatened the future success of the Balint group programme. Discussion Medical student Balint groups provide a unique space to combine learning and emotional support with personal, professional and community development. However, the traditional Balint group format may need adapting to be widely accessible to undergraduate learners. Sustainably integrating Balint groups into the medical school curriculum requires ongoing engagement work at both an individual and organisational level.

Effectiveness of a modified Balint group process on empathy and psychological skills employing Kirkpatrick's evaluation framework.

To evaluate, using Kirkpatrick's evaluation model, a modified Balint group (BG) by adding 5-10 min at the end of the session, where the facilitators will debrief the residents about critical themes mentioned in the session. A quasi-experimental study with a mixed-method design was conducted among family medicine residents over 1 year, using focus groups and validated tools filled by residents and their corresponding patients. The residents' empathy through self and patient evaluation, psychological skills, and satisfaction with the educational activity were measured. The focus group revealed that the residents were aware of the change and considered it a closure to the encounter, helping decrease some uncertainty. Most of the residents did not consider the change helpful. Using validated instruments, BG was ineffective at improving the residents' empathy and psychological skills. There was a statistically significant main effect of time on Psychological Medicine Inventory (PMI) scores, F (1,13) = 7.709, p = 0.016. Debriefing at the end of BG by the facilitators about key themes may help give the residents closure, decrease the uncertainty, and make them more aware of their feelings. Nevertheless, Balint groups are still not very well accepted by the residents, and they prefer direct feedback and support groups.

A Mixed-Methods SWOT Analysis of a Medical Student Balint Group Programme

AimsBalint groups explore the clinician-patient relationship, with benefits for empathy, resilience, and interpersonal skills. Their use with medical students is increasing, but more research is needed to understand how their benefit, feasibility and accessibility can be optimised. We aimed to explore this over a one-year pilot of a medical student Balint group programme.MethodsAn explanatory sequential mixed methods design was used. Eight medical student Balint groups ran for six weeks during 2022–2023, with 90 students participating. Students completed quantitative and qualitative feedback at the end of each cohort. Themes were identified using qualitative content analysis. Balint group leaders kept reflective session notes and used these alongside student feedback to undertake a strengths, weaknesses, opportunities and threats analysis of the programme.ResultsStudents reported a neutral to slightly positive experience of the groups. Strengths were coded as containment, learning, and community identity. Students identified weaknesses due to pace, facilitation, and anxiety. Threats to the future success of the Balint group programme were related to engagement and the group being perceived as inauspicious and intimidating. Potential opportunities to develop the Balint group programme included widening participation and sharpening focus. The strengths, weaknesses, opportunities, and threats identified by the group leaders were in line with those of the students, but also acknowledged the broad range of ethico-legal material discussed by students, timetabling and organisational challenges. A range of opportunities were identified for how the Balint group programme could optimally enrich the clinical curriculum.ConclusionIntegrating successful Balint groups into the medical school curriculum is challenging on individual and organisational levels. However, students perceive value in these groups, and they provide a unique space to combine learning and emotional support with personal, professional and community development. Ongoing consideration is needed to optimally and sustainably incorporate Balint groups within the undergraduate medical curriculum.

Psychodynamic psychotherapy in the diagnosis and treatment of gender dysphoria

Relevance. In this article, we consider the possibilities of a psychodynamic psychotherapeutic approach in the diagnosis and treatment of gender dysphoria on the example of a clinical case. Gender dysphoria refers to the distress that may accompany a mismatch with the patient's biological sex and assigned gender. In the past few years, there has been an increase in the number of patients requesting the restoration of congenital anatomical sex characteristics due to regret after genderaffirmation surgery (GAS). Recent studies have shown that one of the key regrets after GAS is inadequate psychological and psychiatric evaluation in determining whether GAS is an indication.Case study. In this article, we explored how psychodynamic psychotherapy can be used to diagnose and treat disorders associated with gender dysphoria in the case of a 21-year-old man who presented with symptoms that met the diagnostic criteria for two conditions: unspecified gender dysphoria 302.85 (F64.1) and transvestic disorder with autogynephy 302.3 (F65.1) according to DSM-5. The main symptom appeared when the patient was at pre-school age and has been a constant concern ever since. The symptoms disappeared after psychodynamic psychotherapy, which lasted 11 months. Evaluation of psychotherapeutic effects 2 years after the completion of psychotherapy showed the stability of the results achieved.Conclusion. Based on our analysis, we concluded that the use of psychodynamic psychotherapy for patients with gender dysphoria helps recognize neurotic conflicts that may underlie transgender symptoms, and thereby reduce the likelihood of a diagnostic error in determining the presence of indications for GAS. Looking at cases of gender dysphoria in Balint groups can also be of great help in understanding the etiology of gender dysphoria symptoms.