Starting a New Balint Group including working online

Starting a new Balint Group

The Balint Society is keen to support the development of new Balint groups whether they are face to face or online.  We want to uphold and sustain the core of our work in the Balint tradition maintaining the focus on the clinician – patient relationship.

If you are thinking of starting a Balint group the Society can offer an initial discussion about what a Balint group is and the practicalities of setting up a group, including groups starting out online. You can get in touch with us through our administrator Julie Saxton administrator@balint.co.uk 

What are the essentials for a Balint group?

  • Members

Ideally a minimum of 8-10 people, to allow a large enough group even when someone is away, but 6-8 committed people can work well. An online group will probably be smaller (see recommendations on starting a new group online below). They may be all doctors (GPs, psychiatrists, hospital doctors) or include nurses, counsellors, psychologists or anybody who works therapeutically with patients/clients and who wants to discuss their work in a confidential environment, and who can meet regularly. Multi-professional groups can be very productive. Working online now enables members to be drawn from geographically distant localities.

When looking for potential members try contacting local professional organisations who will have lists of members who can be circularised. Talk to the Local Medical Committee, GP tutors, postgraduate tutors or deans, ‘First 5’ coordinators, locum groups, other professional groups e.g. counselling and psychotherapy charities and organisations. Email fliers with relevant information about the group and costs are helpful.

  • One Leader or Preferably Two

Leaders must have experience of being a Balint group member, and usually are either a Balint Society Accredited Leader or working towards this. Ideally one leader would have training in psychodynamic psychotherapy or similar work. It may also be helpful for one leader to come from the same professional group as most of the members as they will understand the context and difficulties of their work. The leaders would normally meet prior to each meeting and organise a time for debriefing together after each group. Supervision is important for leaders and additionally leaders might have the opportunity of attending a local peer supervision group. The Balint Society may be able to put you in touch with a suitable supervisor and peer group.

  • A Place

If meeting face to face then a room which is large enough for the group to sit comfortably in a circle, available for all meetings and free from intrusion. Changes of venue, especially if unplanned, can be very disruptive to a group. Sometimes, an institutional base, such as a clinical department or educational body, which is supportive towards Balint work is available. An independently run group can often work well with more freedom to set its own rules and standards. For venues consider health centres, hospital educational rooms, or community venues and counselling and psychotherapy charities and organisations.

If meeting online good internet connectivity is essential. We strongly advise using a computer or laptop as an essential requirement but not tablet or mobile due to their small screen size. This enables all participants to be visible throughout the discussion to everyone. Further recommendations on the practical requirements are here – Balint Zoom Guidelines.

Getting started

Ensure that leaders meet in advance with plenty of time to discuss their aims, experience and agendas, and also plan the details of how the group will work and how they will arrange leadership roles between them. Decide a regular time and place in which the group will take place. Setting up a preliminary taster meeting can be useful. At the first meeting, make sure everyone is introduced, everyone is clear about the aims of Balint work, and also what the ground rules for the group will be. It is important to establish ways of communicating between leaders and group members and to ensure group members know future group dates well in advance.

Starting a new group online

Geographically distant members can now come together to form a group online.

In contrast with transferring a pre-existing group to this format, this should be particularly carefully planned as it is probable that group members will not be familiar with each other.

In addition to the above advice on getting started, Balint Society leaders with experience in online group work have found the following recommendations helpful:

  • Two experienced leaders are highly recommended, at least one accredited with the Balint Society; leading a group online can require more focus and attention than in a face to face group.
  • Decide on the maximum number of participants bearing in mind what can be seen easily on the screen, and also duration and frequency of meetings.
  • Consider if there are any exclusion criteria you would apply to potential participants, for instance that they are emotionally ready for reflection and the work required through the Balint structure.
  • Interview all potential members online to ensure they have appropriate expectations, commitment and technology.
  • Sharing of information about work and personal aspects prior to meeting may be advisable but leaders’ opinions on this can differ.
  • Send a preparatory email describing the plan for the first session. This may include advice on visibility on screen (e.g. position, lighting), phone numbers for leaders in case of connection failure, and any recommended reading.
  • Leaders should discuss how they plan to run the meeting. For instance, one may be the ‘moderator’ admitting members from the waiting room, dealing with technology and timing, with the other focusing more on the group process and emotional state of the group. These roles can be discussed in the group and swapped in different sessions.
  • In the first meeting allow plenty of time for introductions, up to half the session.
  • Suggest that members join meetings 5-10 minutes early to allow for last minute technical problems and for informal chat.
  • At the start agree how leaders will communicate with each other: for example being explicit in the group rather than using the chat facility privately. Covert signals that may be exchanged subtly by leaders within a face to face meeting are not usually possible in an online meeting.
  • Discuss with the group whether a method of signalling intention to speak is desirable, such as raising a hand or using the online hand symbol.
  • ‘Sit back’ of the presenter can be achieved by moving further from the computer screen.
  • Allow time after the meeting for leaders to privately review the session
  • Consider supervision requirements, either from a supervisor or peer group supervision.

Financial considerations

  • Running Costs

Groups are expected to pay their own running costs and will therefore need members to commit to a regular financial contribution. It is important to be clear about this from the start. It is usually best to ask for payment for several months, a term or even a year in advance, as this encourages commitment and regular attendance. Consider offering the first meeting without charge, giving members an opportunity to try it first.

  • Leaders’ Fee

Many leaders will need or expect to be paid, especially those who are self-employed (analysts or psychotherapists). A reasonable fee seems to be about £60-£75 per hour.

  • Participants’ Fee

Most face to face groups charge participants between £15 and £25 per 90-minute session. When there are fewer members within a group (for instance online) this may increase the fee although working online without the need for room hire may also influence the cost.

If you wish to move your Balint group online or would like further consultation/supervision in doing so we encourage you to get in touch with Julie Saxton our administrator, in the first instance at administrator@balint.co.uk who will be able to deal with or forward on your query to other Council members as appropriate

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