Balint work in England: lessons for American family medicine

The work of Michael and Enid Balint in developing case discussion seminars for general practitioners in England has important implications for the teaching of family medicine in the United States. Focusing on the physician-patient relationship, their seminars evolved from an emphasis on a psychiatric history taken by the physician to a more pragmatic concern with the process of the everyday brief consultation. The leaders of traditional Balint groups guide group members toward open discussion of case material by modeling listening, curiosity, and tolerance for group members. Seminar goals include increasing general practitioners' sensitivity to their patients' emotional problems and expanding the practitioners' repertoire of interventions in the medical interview. With modifications, Balint-type seminars have been incorporated into some general practice and family medicine training settings both in England and in the United States. The unique features of Balint seminars within the context of medical education are their nondidactic, participatory nature, their goals of an emotional change within the physician, and their focus on the physician-patient relationship.