A narrative history of the American Balint Society 1990-2020.

An historical narrative tracing the inception, evolution, structure, educational focus, integration with international Balint movements and challenges to future growth of the American Balint Society (ABS) is enlivened and deepened by twelve Balint autobiographies that follow it. The ABS in choosing to create its historical narrative is confronting a vitally important project both for its members, and for many healthcare educators and clinicians. Both are deeply invested in promoting and preserving the integrity of the personal relationship between the provider and the client. The Society is striving not only to understand its past, but to educate itself through a contextual awareness of how to preserve a personal education for future healthcare providers. To truly understand how the Balint enterprise emerged in the USA, one must "hear" from the people who experienced and wanted to share the transformative insights of participation in Balint seminars. To "hear" their stories and to honor the diversity of perspectives within the organization the authors asked ABS members with long and committed involvement to write their personal "Balint Autobiographies." These authors tell a collective, personal and professional story that is truly integral with an ABS narrative history. Readers may find, amidst their narratives, gems of insight and instruction about the Balint Seminar process, its leadership and possibly indications of where the ABS could head in the future. However, the real significance of the history of the ABS lies in its potency to stimulate critical reflection on the true purpose(s) of the Society, to elicit new and stronger personal incentives in ABS members, and to initiate challenging, inquiring, and supporting reverberations in the medical-educational-insurance-business-governmental subculture in which it participates.

Essential characteristics of effective Balint group leadership.

OBJECTIVE: Balint work in the United States has suffered from a lack of written material on how Balint group leaders structure and guide group process. This study identified characteristics of effective Balint group leadership by gathering information from experienced Balint leaders. METHODS: We used evaluations of the leadership methods used by 21 Balint group leaders assembled at an American Balint Society workshop to pilot test the Society's credentialing process. Free text and rating data from leader evaluation forms were analyzed using qualitative text analysis and factor analysis. We also conducted focus groups. RESULTS: Convergence was seen on several characteristics across all sources of data. Effective Balint leaders operate to create a safe environment and move the group toward a new understanding of a specific doctor-patient relationship. Specific leader behaviors include protecting the presenter from interrogation, encouraging open speculation by group members, avoiding premature solutions, and tolerating silence and uncertainty. DISCUSSION: Although Balint group leaders rely on behaviors common to other small-group methods, they create a space and purpose markedly different from that seen in other small groups in medical education. Balint group leaders model and create a safe environment for shared, creative speculation and a more empathic experience of the doctor-patient relationship.