Balint Groups Research Articles

Balint in the Animal World: Balint Groups for Veterinary Professionals.

Veterinary medical providers face many of the same stressors related to the therapeutic relationship that human medical providers face, and have reported high rates of emotional distress as an aspect of Veterinary practice. Balint Group work is relatively novel in Veterinary Medicine, and the Balint method has yet to be evaluated in the veterinary community. We hypothesized that applying the Balint method in veterinary medicine would be feasible and offer similar benefits to veterinary providers. The authors offered monthly in-person Balint groups, co-led by two American Balint Society trained leaders and evaluated feedback from Balint group attendees to determine the value and feasibility of adapting Balint groups from Human Medicine to veterinary professionals. Balint groups were offered to the veterinary community at a non-profit urban specialty and emergency hospital. During the pandemic, the group transitioned to an online format. All participants were sent an anonymous email survey to collect feedback about their experience. Monthly Balint Groups were offered to veterinary professionals, with traditional Balint structure and parameters and co-led by ABS trained leaders. Feedback was obtained, indicating that Balint Group discussions were helpful to Veterinarians. Balint Groups are a useful tool for veterinary professionals and are likely to provide similar benefits to those enjoyed by human healthcare providers.

Psychodynamic Psychiatry in Singapore.

The authors provide an overview of the history of psychiatric services and training in Singapore, and the more recent introduction of psychodynamic psychotherapy training for psychiatric residents. They describe the current state of psychodynamic psychiatry services in the public healthcare system, including efforts at fostering psychodynamic thinking in nonpsychiatric community partners via community mental health integrated care programs and activities such as Balint Groups. They discuss current challenges in psychodynamic practice, such as the impact of language and culture on the Singaporean individual's receptiveness to psychodynamic psychotherapy, as well as systemic challenges in funding and expanding psychodynamic services. They highlight future directions, including challenges and opportunities for the local psychodynamic community in Singapore.

The Goldilocks of Social Justice Education: Balint Groups as a Curricular Intervention to Support Equitable Health Care.

While there is consensus within the medical profession on the importance of ensuring future physicians are well versed in issues of social justice, there is little consensus on how to best achieve this. Traditional methods of didactic lectures or case-based learning, with an emphasis on the transmission of knowledge, run the risk of reinforcing the very inequities they are aiming to disrupt. The classroom experiences do not call on trainees to act on issues of social justice beyond discussing imagined actions in a carefully constructed case. Balint Groups offer an alternate pedagogy that align with a more interpretative style of teaching and offer an opportunity for meaningful engagement with issues of social justice. In Balint Groups, students are engaged in cases where the presenter has participated directly in the clinical encounter. While these cases tend to focus on relational dilemmas between the doctor and patient, the dilemma can also highlight an internal dilemma between competing professional identities - such as the biomedical expert and the socially conscious professional. Imagined agency is removed and the group is tasked with reflecting on the dissonance created by these two competing identities. While the use of Balint Groups as a curricular intervention offers exciting opportunities to promote social justice, there are cautions. First, Balint Groups operate within the dominant discourse of medical education and facilitators must be sensitive to how this may position the presenter; second, it cannot be forced - it must arise from the case presented.

Research Cum Training: Assumptions, Balint's Method, and Future Directions.

Michael Balint conducted several multi-year training programs for general practitioners designed to teach lessons from a psychoanalytic perspective on the relationships doctors have with their patients and contribute to their healing skills. This group process evolved, and it was described along with an elaboration of significant researched observations of interferences in those relationships. There were several other similar multi-year experiential group endeavors conducted and/or inspired by Michael and Enid Balint which were designed to further investigate the subtleties in relationships between doctors and patients. However, none have been done since the late 1990's. Instead, research about the impact of Balint group impact has been dominated by the evidence-based approach to all medical research, and it has been typified by variations on randomized controlled, double blind research methodologies. A recent literature review has highlighted the limited results of such studies along with questions about methodological approach. However, the authors continue to support the search for appropriate dependent variables to validate the value of Balint groups for physicians. This paper identifies and examines the implicit assumptions that underly current research efforts. In addition, there is an exploration of Michael Balint's approach to "research cum training" along with describing his assumptions and the results of his research approach. In addition, recommendations are made to extend the work of the work of uncovering healing dynamics in doctor patient relationships.

Virtual Balint Groups During COVID-19: Exploring Race and Equity in a CHC-Based Family Medicine Residency Program.

The Lawrence Family Medicine residency was created in the 1990s as the first community health center- sponsored residency with the goal of reducing health disparities. Balint groups have been a part of the wellbeing and behavioral health curriculum for many years. The population of Lawrence, MA is primarily a resource-poor, Latinx, immigrant population. In March of 2020, the Covid pandemic highlighted health disparities in this community. The spike in cases in 2020 also impacted the residency community with overwhelming needs of sick and dying patients in newly created, resident and faculty-run Covid units. Our early ignorance about transmission, prophylaxis, treatment and even prognosis made the work incredibly difficult. George Floyd’s murder added the additional stress of social unrest in response to a persistent pattern of racism and unequal justice. To help process trauma residents felt working in terrifying conditions, often in medically futile situations with patients who spent their last hours without family at the bedside, we turned to biweekly Balint groups and added additional resident support sessions on the off weeks. Residents seamlessly adopted videoconferencing as the Balint platform, allowing them to attend a group session without risk of infection. The residents, being a diverse group, were able to offer multiple perspectives and process the traumatic issues of disproportionate suffering for their patients, uncertainty and frustration of the COVID-19 pandemic and systemic racism. We found a video Balint group permitted residents to explore their divergent experiences and feelings and offer support to each other in a very uncertain time.

Stigma towards mental illness and help-seeking behaviors among adult and child psychiatrists in Hungary: A cross-sectional study.

Stigma towards people with mental health problems is a growing issue across the world, to which healthcare providers might contribute. The aim of the present study was to explore psychiatrists' attitudes towards their patients and link them to psychosocial and professional factors. An online questionnaire was used to approach the in- and outpatient psychiatric services across Hungary. A total of 211 trainees and specialists in adult and child psychiatry participated in our study. Their overall stigmatizing attitudes were measured, with focus on attitude, disclosure and help-seeking, and social distance dimensions by using the self-report Opening Minds Stigma Scale for Health Care Providers (OMS-HC). Multiple linear regression analyses were performed to elucidate the dimensions of stigma and its association with sociodemographic, professional and personal traits. Stigmatizing attitudes of close colleagues towards patients were statistically significant predictors of higher scores on the attitude [B = 0.235 (0.168-0.858), p = 0.004], the disclosure and help-seeking subscales [B = 0.169 (0.038-0.908), p = 0.033], and the total score of the OMS-HC [B = 0.191 (0.188-1.843), p = 0.016]. Psychiatrists who had already sought help for their own problems had lower scores on the disclosure and help-seeking subscale [B = 0.202 (0.248-1.925), p = 0.011]. The overall stigmatizing attitude was predicted by the openness to participate in case discussion, supervision or Balint groups [B = 0.166 (0.178-5.886), p = 0.037] besides the more favorable attitudes of their psychiatrist colleagues [B = 0.191 (0.188-1.843), p = 0.016]. The favorable attitudes of psychiatrists are associated with their own experiences with any kind of psychiatric condition, previous help-seeking behavior and the opportunity to work together with fellow psychiatrists, whose attitudes are less stigmatizing. The perception of fellow colleagues' attitudes towards patients and the openness to case discussion, supervision and Balint groups were the main two factors that affected the overall attitudes towards patients; therefore, these should be considered when tailoring anti-stigma interventions for psychiatrists.

Modelling vulnerability: qualitative study of the Balint process for medical students

BackgroundHealth professionals in training may be overwhelmed by the emotional dimensions of their work. Balint groups have been proposed as an intervention to support students to process emotional aspects their encounters with patients. The aim of this study was to explore medical students’ emotional experiences of a Balint group during their psychiatry attachment.MethodsMedical students completing a six week clinical attachment in psychiatry took part in weekly Balint group sessions. Five sessions were audio-recorded, transcribed and coded by members of the research team and an independent researcher co-coded all transcripts. Themes were discussed and refined over three rounds of coding.ResultsFour themes were identified: the Balint process as a container to enable vulnerability; becoming attuned to clinical and professional encounters; an evolving sense of identity within the medical hierarchy; and, the need for self-preservation to retain empathy for others.ConclusionThe Balint structure provides medical students with a secure and emotionally resonant experience. Medical students’ engagement with the Balint process, even over a relatively short time period, teaches them how to reflect on difficult emotions associated with clinical encounters. Early exposure during a psychiatry placement may benefit students in terms of understanding relationship dynamics and the need for self-integration and lifelong reflection over the course of their medical career.

The Balint Group Experience for Forensic Mental Health Professionals

AimsBalint groups were initially set up to meet the needs of GPs in better understanding the emotional aspects of complex doctor-patient relationships. They have since been taken up in the training of psychiatrists, GPs, and medical students, having been shown to improve communication skills and sensitise participants to their own psychological processes. Working as a Care Coordinator in a Forensic Community team is a highly challenging role where, by definition, there is the spectre of risk of harm to others. There is very little published data on the use of Balint groups in nursing populations, even less so in the Forensic mental health setting. The aim of this project was to evaluate a longitudinal Balint group for mental health professionals in the Forensic service of Cambridge and Peterborough NHS Foundation Trust, and to report on the perceived benefits to attending in terms of personal and professional development.MethodsThe evaluation used a standardised mixed methods approach, with the sample consisting of members of the Forensic South Community Service Balint group n = 5. For the evaluation period the job roles were solely clinical nurse specialists, taking a snapshot of the group between September 2020 and January 2022. The group met monthly for one hour virtually, led by Dr Arends, a specialist registrar in psychiatry with appropriate training in Balint leadership. The format in sessions was in keeping with the Balint method, as per The Balint Society, emphasising confidentiality. Data were gathered via survey tool, adapted from the literature using Likert scales and white space questions to identify barriers and facilitators.ResultsParticipants scored the group highly across the board in terms of acceptability, clinical impact, and fidelity measures. Notably 60% strongly agreed and 40% agreed the group was a safe place to express and process anxieties and frustrations about their work. All participants either agreed or strongly agreed the group had changed the way they think and practice, and that they felt able to consider their clinical encounters in a new light.ConclusionFacilitators identified were of increased team working through cohesion and notably of increased appreciation for the functional and symbolic elements of the symptoms their patients presented with, suggesting that the value of the group existed in its providing of space to metabolise the often intense demands of Forensic patients, together and as a team. The main theme within barriers to the group processes were external in terms of other clinical demands requiring prioritisation.

Psychodynamic Psychiatry Education and Training for Doctors

AimsBackground and Aim: Psychodynamic psychiatry training seminars are a blended supervision and experiential style approach to training health care professionals in reflective practice and formulation. They apply psychodynamic theory through case formulations, seminars, and Balint groups so that health care staff can improve their communication style, formulation skills and enhance their appreciation for patients with complex mental health problems. Our aim is to evaluate the provision of our psychodynamic psychiatry training sessions for doctors in psychiatry, gastroenterology, and emergency medicine, and to evaluate the perceived benefits of attending in terms of personal and professional development.MethodsMethods: The evaluation used a standardized mixed-methods approach, with the sample consisting of psychiatry core trainees (n = 9), gastroenterology higher trainees (n = 4), and emergency medicine doctors (n = 10). The evaluation period was between October 2021 and January 2022. Data were gathered via a survey tool, adapted from the literature using Likert scales and free text questions to identify barriers and facilitators to the sessions.ResultsResults: All participants (n = 23) scored the group highly across the board in terms of acceptability, clinical impact, and fidelity measures. All participants reported that they have a better appreciation of group dynamics, the impact of the doctor's humanity and personality on their clinical work, and the symbolic meaning of the patient's symptoms. Notably, approximately 60% reported that the sessions were relevant to their ongoing training needs and that 95% of participants felt the sessions were a safe place to express and process anxieties and frustrations about their work. All participants either agreed or strongly agreed the group had changed the way they think and practice, and that they felt able to consider their clinical encounters in a new light.ConclusionConclusion: This evaluation reports early findings on psychodynamic psychiatry teaching for different medical groups. Overall, the participants felt the sessions were relevant to their training and improved their personal and professional development. Key benefits of the group were highlighted and included increased insight into the emotional and symbolic aspects of the patient's symptoms and clinical issues, team working through cohesion, and the humanity of the doctor in the clinical relationship with the patient. This suggests that the sessions provide a much-needed space to process and reflect on the often-intense demands of clinical work, individually and as a team. The main theme within barriers to the group processes was external in terms of other clinical demands requiring prioritization.

Complex Case Management Workshop for Trainees &Trainers - a Quality Improvement Project -to Enhance the Understanding of the Case Management and Complexity in People With Intellectual Disabilities for Senior Trainees and Early Career Consultants

AimsWhilst there is always more to learn within any speciality, the particular zone of development for senior trainees and early career consultants is the management of the complex case. The factors underpinning complexity are varied, and can range from aspects of the service user such as complexity and severity of disorder and/or multi-morbidity, to aspects of their local social networks, to complexities arising from the service or care environment. The aim of this workshop was to offer a safe space for senior trainees and early career consultants to work through some principles that might be helpful, particularly where things seem to be getting into a pickle.Methods•A 60-minute slot was proposed, as part of the Northwest Learning disability academic teaching forum.•The structure of the workshop borrowed the informality and spirit of support from Balint groups.•Attendees were prepared to talk about one of their cases anonymously, and why they might be getting into a pickle.•Soundings were taken and a particular case chosen to workshop in more detail, as an exemplar for others.•Each session focused on one or two themes from the wider set of themes suggested by the CCaRM framework (Spurrell, Potts & Shaw, 2019) currently being used by Greater Manchester and Lancashire SST to expedite their work.•Each session concluded with an evaluation discussion of workshop usefulness.Results•There were 6 virtual workshops in first PDSA cycle (June 2021-Nov 2021)•Each workshop lasted approximately 100–120 minutes, with 8–12 people attended in each session.•The intention for the workshop was to include senior trainees and early career consultants who are within the NWLD forum however junior trainees, senior consultants and other MDT professional also became part of the sessions.•Each session concluded with an evaluation discussion of workshop usefulness•Qualitative feedback has been collated and analysed from the evaluation discussion.•The information derived from the qualitative analysis indicates that there is a substantial need for regular complex case discussions for the purposes of enhanced care delivery and improved patient outcomesConclusionThis approach helped in enhancing the understanding of the case management for people with intellectual disabilities among forum membersWe consider that the online workshops is a success and are planning further-PDSA 2 in order to create competent and well-rounded ID psychiatrist in the future in Northwest region.

Exploring the Barriers to Discussing Unconscious Racial Bias in Psychiatry Trainees

IntroductionRacism is present in most aspects of our society, including healthcare. Differences in health outcomes, and in the quality of mental health treatment for people coming from ethnic minority groups have been demonstrated in the literature. Psychiatry trainees are required to understand the impact of structural inequalities and power differences within mental health services, and to be able to deliver clinical care that is equitable for all.ObjectivesTo provide psychiatry trainees with a space to reflect on unconscious racial bias in clinical work and to explore potential barriers when talking about such topics.MethodsA Race and Equality Reflective Group for psychiatry trainees was organised as an opportunity to discuss unconscious racial bias. Due to an insufficient number of registrations, the session was cancelled. An anonymous feedback questionnaire was sent to all trainees to understand reasons behind this, and to explore potential barriers to participation. The results were analysed and were brought back to a regular Balint group for further exploration.Results Twelve trainees filled in the questionnaire. The main themes identified included this topic being a sensitive issue (5; 41.7%), discomfort in trainees (5; 41.7%), insufficient time to participate (4; 33%) and timetable clash (3; 25.9%). Barriers to discussing unconscious racial bias and inequality were identified in further exploration with trainees. The tendency for groups to adopt a split position that was observed, mirrors the dynamics seen in institutional racism.ConclusionsThis work has highlighted the need for ongoing focused, facilitated educational spaces where these issues can be openly discussed and reflected upon.DisclosureNo significant relationships.

Heard, Valued, Empowered: Utilising a Quality Improvement Framework to Improve Trainee Experience

AimsFeedback from doctors in training (DiT) through the Scottish Training Survey has highlighted poor trainee experience within Psychiatry at St. John's Hospital, Livingston. Research suggests that a healthy, happy and engaged workforce experiences lower levels of burnout and provides higher quality patient care. Our aim was to improve the experience of DiT working within the department and thereby improve patient care.MethodsWe utilised the Wellbeing, Conditions and Rota Evaluation (WeCaRE) framework. This is a user-friendly quality improvement (QI) framework designed to improve trainee experience. As part of WeCaRE, questionnaires and ‘what matters to you’ conversations were undertaken with ten DiT (foundation doctors, GP trainees, and core psychiatry trainees). From the issues raised, trainees were empowered to co-create change ideas and use Plan-Do-Study-Act (PDSA) cycles to address the issues. Finally, the questionnaire was repeated to complete the loop.This approach created an open, listening environment with clear communication channels from trainees to consultants and management. This allowed us to identify themes for improvement. These included induction, education opportunities, clinical supervision and escalation policies.In collaboration with trainees, three improvement teams were formed, each of which addressed an issue through a PDSA cycle. These were: 1.Unclear referral pathway to Psychiatry resulting in inefficiency. The team co-created a flowchart identifying how to appropriately refer to Psychiatry, which has reduced the number of inappropriate bleeps.2.Unclear escalation policies and consultant cover. The trainees worked with the multidisciplinary team to generate a clear escalation pathway.3.Significant variation in content and documentation of clerking – the data collected helped drive change through the utilisation of an electronic clerking checklist.Other issues were raised and quickly addressed without requiring a PDSA cycle. Such issues included provision of on-call rooms, parking spaces, improvements to induction, starting a Balint Group for trainees, and changing the mode of administration of Pabrinex.ResultsDuring the five-month period those who experienced joy in work several times a week or more increased from 0%-86%. Those who always felt a valued member of the team increased from 29%- 86%. Those with overall job satisfaction increased from 0%-75%ConclusionDiT experience comprises more than rota compliance. It includes well-being, psychological support, professional development, teamship and more. This project has demonstrated considerable improvement in trainee experience through utilising the WeCaRE framework. This highlights the power of listening to, valuing and empowering trainees, whilst utilising data as a vehicle to drive change.

Balint Group Sessions for Medical Students, a Pilot Study

AimsCore trainees in psychiatry all complete a year of Balint group sessions. These sessions are invaluable, as improved awareness of our own thoughts and feelings is a crucial part of our development as clinicians. We considered that it may have been helpful to have started these sessions at an earlier stage of medical training, for example, in medical school.MethodsWe approached the University of Liverpool School of Medicine and proposed a pilot Balint programme with 4th year medical students rotating through psychiatry in Cheshire Wirral Partnership Trust.Sessions were conducted in 4-week blocks, corresponding with the students’ psychiatry rotations. To allow sufficient time for all students to contribute in each hour-long session, groups were limited to a maximum of 7 students. Each group was allocated 2 facilitators and was conducted on Microsoft Teams because of COVID-19-related restrictions. Facilitators had fortnightly supervision with a consultant psychotherapist.At the end of each 4-week block, anonymous feedback was collected. Small alterations were made to the programme during the course of the pilot in response to attendance rates, punctuality and feedback.Results18 (approximately 50%) of the students from the first 3 cohorts submitted feedback: •All said the experience helped them reflect more on their interactions with patients and colleagues and improved their insight into how others think/feel in caring for patients.•94% said they enjoyed it; they thought they would use the skills they had developed; and they would participate again in future if given the option.•83% said 4 sessions was ‘just right’, 11% said ‘not enough’ and 6% said ‘maybe too much’;•72% rated their overall experience of the programme as ‘excellent,’ 17% as ‘good,’ 11% as ‘fair’.Free-text feedback was positive. Students valued the opportunity to reflect on the emotions and interpersonal dynamics experienced in clinical scenarios. Critical feedback was mostly around a preference to have sessions face-to-face and a desire to have more sessions.As facilitators, the experience has helped us increase our reflective capacity and gain confidence in leading, managing group dynamics and setting boundaries.ConclusionStudent experience of the Balint programme was positive for the majority. From a facilitator perspective, we found the experience rewarding and beneficial for professional development. Currently only approximately 1/3 students rotate through this trust and can therefore benefit from the sessions. This pilot study provides supporting evidence for extending the scheme to all 4th year Liverpool University medical students.

Tele-Balint under the microscope: What really happens in Tele-Balint groups?

Balint groups provide a safe space for clinicians to discuss difficult cases, with the aim of deepening the clinician-patient relationship and providing space for self-introspection and personal development. During this COVID-19 period, mental health clinicians need a platform to undergo professional supervision and peer learning sessions, which can be provided for by Tele-Balint sessions. This study aims to understand the workings of Balint groups in a multi-disciplinary team, through exploring the experience and perceptions of mental health clinicians in a tertiary obstetrics- and paediatrics-focused hospital in Singapore towards Tele-Balint groups, and examining if these groups can address their professional needs. A mixed-methods study was conducted. 26 mental health clinicians who had participated in Tele-Balint groups since March 2020 completed a semi-structured questionnaire, and 12 of them were interviewed. Qualitative analysis of interview transcripts was performed. Qualitative analysis revealed 5 themes. The first 4: professional and personal growth of clinicians, providing emotional support to clinicians, burnout in clinicians: what contributes and what helps, and psychological safety, address whether Tele-Balint groups meet clinicians' needs. The last theme, evolution of nature of Balint groups, addresses whether Tele-Balint groups meet clinicians' needs during the time of a pandemic. Tele-Balint group participation was found to be beneficial in facilitating personal and professional growth, providing emotional support and preventing burnout, despite some limitations. Members should maintain flexibility towards the Balint process, in order to accommodate others who have differing needs, especially in a multi-disciplinary group.

Effect of Balint Group Combined with MBSR on Psychological Crisis of Nurses in Public Health Emergencies: A Randomized Controlled Trial

Effect of Balint Group Combined with MBSR on Psychological Crisis of Nurses in Public Health Emergencies: A Randomized Controlled Trial

Exploration of the Effect of Balint Group Psychological Intervention on Occupational Burnout of Orthopedic Nurses

Exploration of the Effect of Balint Group Psychological Intervention on Occupational Burnout of Orthopedic Nurses

Integration of theoretical principals of psychosomatic medicine and practice of Balint supervision in physicians in the promotion of effective professional communication

The review of the Russian and foreign literature on the relationships of psychosomatic medicine and Balint supervision of physicians was conducted. We selected and analyzed articles from MEDLINE / PubMed Elibrary.ru, Scopus databases during from 1990 till 2020, international medical journals and collections of scientific papers as well as relevant references in the bibliography of the analyzed articles. The search was carried out with the usage of search queries of various combinations of the specified key words.The “philosophy” of psychosomatic medicine and the theory of Balint supervision have the evident common historical grounds. Psychosomatic medicine and Balint supervision are united by the conception that the patient’s perceptions about his/her illness, related to it experiences and behavior as well as their relationships to his/her unconscious are very important in the therapy process. That means that the experiences and behavior of a physician related to the complicated communication with the patient are important as well. The patient has to be no more a passive object of the care so the process of therapy obtains the character of interpersonal communication and the mutual influence between the patient and the physician. This point is what Balint supervision is focused at. The technology of Balint group work helps physicians to shift an emphasis in the clinical practice from the disease-centered to the patient-centered approach. The analysis of Balint groups effectiveness provided during more than fifty years brought an evidence that Michael Balint presented very efficient method which helped physicians in different medical fields and psychologists reduce their emotional arousal in the treatment of “difficult” patients who are patients with psychosomatic disorders very frequently. The integrative relationships between basic approaches of psychosomatic medicine and Balint supervision in physicians and psychologists are described. The history of the relations and common principles related to the attention to the complexed issues of physician-patient communication and the therapy in psychosomatic disorders which becomes more successful due to the impact of analytical Balint supervision, are analyzed. The significance of Balint groups work in the training of the health care professionals, who are treating patients with psychosomatic disorders, difficulties and perspectives of implementation of Balint group method into the system of education and training of general practitioners, psychiatrists and psychotherapists are presented.

Balint in the time of COVID-19: Participant and facilitator experience of virtual Balint groups compared with in-person.

BackgroundCurrent literature highlights peer and psychological support as important for staff well-being, to cope in pandemic conditions.AimsOur organisation increased Balint group provision during unfamiliar challenges of COVID-19. This unique context allowed comparison of multiple new virtual and face-to-face (F2F) Balint experiences.MethodFollowing March 2020 lockdown, four existing Balint groups for doctors in psychiatry moved to online, with two new groups established virtually in specific response to the pandemic. All participants and facilitators of these virtual Balint groups were sent a questionnaire to anonymously rate their experience and provide qualitative feedback.ResultsThe response rate was 89% for participants (51 respondents) and 100% for facilitators (5 respondents). Participants found both formats supportive; providing a space to talk, feel heard and validated, helping work feel less stressful. Participant ratings slightly favoured F2F, but some prefer to continue virtually. Facilitators felt virtual attendance was easier, but adherence to conventional Balint group structure and format more difficult.ConclusionsParticipant and facilitator responses demonstrate Balint groups, when both F2F and virtual, were experienced as a source of support and connectivity, being valued across different psychiatry grades. Notable virtual benefits seem to be limited to more practical aspects, that is, time, flexibility, logistics and accessibility. There are expressed challenges of virtual Balint; however, some participants still favour this format going forward. Our findings endorse virtual Balint as a welcomed means of emotional well-being, peer support and developing psychotherapeutic competencies during pandemic-related restrictions, with potential to extend beyond COVID-19.

How can learning effects be measured in Balint groups? Validation of a Balint group questionnaire in China

BackgroundBalint groups aim to reflect doctor-patient relationships on the basis of personal cases. This study reports the validation of a questionnaire aimed at the identification of learning processes among Balint group participants in China.MethodsThis multicenter cross-sectional study was conducted during Balint group sessions in Beijing, Guangzhou and Shanghai. A heterogeneous sample of different professional groups was intended to adequately capture the reality of Balint work in China. After a Balint group session, the participants were asked to complete the Mandarin version of the Balint group session questionnaire (BGQ-C) and the group questionnaire (GQ), an internationally validated instrument to assess central dimensions of therapeutic relationships during group processes.ResultsQuestionnaires from n = 806 participants from 55 Chinese Balint groups, predominantly comprising individuals with a medical background, were analyzed. Most participants were female (74.6%), and the average age was 34.2 years old (SD = 9.4). The results indicated good to very good reliability (Cronbach’s α = .70 to .86; retest rs = .430 to .697). The verification of the construct validity of the BGQ-C showed satisfying convergent (rs = .465 to .574) and discriminant validity (rs = -.117 to -.209). The model was tested with a confirmatory factor analysis of a three-factor model (standardized root mean square residual = .025; comparative fit index = .977; Tucker-Lewis index = .971). The 3 empirically identified scales resulted in good model fit with the theoretical dimensions of Balint work postulated in the literature: “reflection of transference dynamics in the doctor-patient relationship”, “emotional and cognitive learning” and “case mirroring in the dynamic of the group”. Due to the high correlations between the factors, a single-factor model was possible. A group comparison between the German and Chinese samples showed different loadings across cultures.ConclusionsThe BGQ-C is a quick-to-complete, item-based measuring instrument that allows the relevant dimensions of Balint group work to be recorded. This study suggests good psychometric properties of the Chinese version. Nevertheless, it must be assumed that the composition of constructs in the two countries is different.

Application of Balint groups activity to relieve anxiety among newly recruited nurses

Application of Balint groups activity to relieve anxiety among newly recruited nurses