Balint seminar leaders: what do they do?

Balint seminars are part of the education of family practice residents in an estimated 30% of programs. Balint leaders are family physicians, psychiatrists, psychologists, and social workers with apprenticeship-type training. Balint leaders or Balint groups have never been formally evaluated.

We used multiple qualitative methods, including field observations, interviews, and focus groups. Field observations involved 12 Balint groups in 3 family practice residency programs. For comparison, we used videotaped seminars of 2 groups from the most recent Balint International meeting. In-person or telephone interviews were conducted with Balint leaders in a number of sites. We conducted focus groups with resident participants at each of the local sites.

Although differences were seen among groups influenced by the group leader and the makeup of the group, there were consistencies across all of the groups. Contrary to the usual description of Balint leadership, these residency groups functioned partially as support groups, attempted to relieve or dampen anxiety, had a hierarchical system with the leader as the teacher/controller, and served an educational and a developmental purpose.

Balint leaders and their groups in the program studied did not function as traditionally described by Balint. Further observations of more groups are needed to determine if this variation is unique to the programs studied or is a manifestation of the transfer of the Balint method from experienced practitioners to physicians in training. This information will be of benefit to the development of appropriate training for future Balint leaders and for the credentialing process now being developed by the American Balint Society.