General practice as a unique discipline. 

Knowledge about diagnosis and treatment is necessary but not sufficient for good clinical practice. General practice presents many unique challenges:

• psychosomatic symptoms;
• complex mind-body interactions;
• relationships with patients over long time periods;
• time constraints;
• non-compliant patients;
• patients who for many reasons the doctor finds emotionally difficult;
• patients who seem difficult to help.
• the GP as the medical professional carrying ultimate responsibility (the buck stops here).

The Balint approach focuses on these types of difficulties rather than on specific diagnoses. It seeks to understand the meaning of a patient's behaviour and symptoms. Without this kind of understanding, there are many patients in general practice who are difficult to help. Conversely, there are many patients who are best helped in a general practice context with its advantages of continuity of care, integration of the psychological and the physical and knowledge of the whole family and community.

Balint group participants thus develop increasing respect for the specialty of general practice. They realize how much it is an art as much as a science. They increasingly appreciate the opportunities general practice presents to engage with patients as people in meaningful ways.

Professional support.

GPs typically have little or no opportunities to share their experiences with each other, particularly their feelings and the details of their interactions with patients. They often have little sense of how emotionally difficult and challenging  their work can be and how much their colleagues may be facing similar difficulties. Sharing these experiences in a Balint group provides tremendous mutual support.  

Professional development.

Balint groups do not teach specific treatment modalities, such as cognitive behavioural therapy and interpersonal psychotherapy, but directly address the doctor-patient relationship, which needs to be used with skill in applying any treatment approach.

The focus on understanding rather than offering solutions contributes to a growth in each GP's personality. The GP may become aware of their particular blind spots which create habitual and unhelpful ways of responding to particular sorts of patients or situations and become freer to respond more accurately to the needs of the patient.  They may also become aware of their individual strengths. Participants are taught how to use their own feelings and responses to the patient to understand their patient better, rather than their responses becoming sources of stress or acted on in unhelpful ways. The GPs become able to treat a wider variety of patients than before and do so more effectively and with less personal stress. The boring patients become interesting and the difficult patients become a welcome challenge! Participants often report finding their work more stimulating and enjoyable, and feel their participation has reduced work stress and prevented or reversed burn-out.

Balint groups are not therapy groups for doctors, although they may in fact be therapeutic; but the growth in participants' personalities occurs through a focus on their professional interactions and not through explicit disclosure of their personal lives.

Balint groups are unique.

Medical education has been profoundly influenced by the Balint approach, and some feel it has been superseded by other approaches and is of historical interest only. But no other approach to general practice education offers the same combination of respect for general practice as a unique discipline; focus on the doctor-patient relationship; applicability to a broad range of patients, doctors and treatment approaches; the opportunity to follow cases over a period of time; and the safety, support, intimacy and opportunity for professional growth provided by an ongoing group setting with a trained leader.