Intercultural Balint Work

  • Volker Haude


The concept of Balint groups, as developed by M. Balint, has been described and further conceptualised for its currently widespread use in clinical and non-medical education, as well as during supervision. Given the multicultural and multiracial reality in Western societies, one would expect aspects of diversity to permeate the Balint method of supervising the physician or therapist–patient relationship. Until now, however, there has been a lack of relevant research dealing with the cultural dimension in Balint groups, a shortcoming which this paper seeks to address by highlighting relevant unconscious issues on individual characteristics, group dynamics and group leadership that may lead to inherent difficulties within Balint work with intercultural groups. Balint group sessions are proposed as being a container for cultural questions and should thus be adapted towards the role of the group leader in order to create an atmosphere of cultural awareness.


Intercultural Balint groups Physician/therapist–patient relationship Group dynamics Group leading techniques Unconsciousness Transcultural Supervision 


  1. 1.
    Kastrup MC, Dymi K. Training in cultural competence. Nervenheilkunde. 2017;7:508–11.Google Scholar
  2. 2.
    Hayes JA, Owen J, Bieschke KJ. Therapist differences in symptom change with racial/ethnic minority clients. Psychotherapy. 2015;52(3):308–14.CrossRefPubMedGoogle Scholar
  3. 3.
    Balint M. The doctor, his patient and the illness. London: Pitman Medical Publishing; 1964.Google Scholar
  4. 4.
    Drees A. A prismatic Balint group in Kuwait. Torture J. 2005;15(1):59–62.Google Scholar
  5. 5.
    Leggett A. Transcultural issues in the dynamics of a Balint clinical reflection group for community mental health workers. Transcult Psychiatry. 2012;49(2):366–76.CrossRefPubMedGoogle Scholar
  6. 6.
    Rosenberg E, Richard C, Lussier M-T, Abdool SN. Intercultural communication competence in family medicine: lessons from the field. Patient Educ Couns. 2006;61:236–45.CrossRefPubMedGoogle Scholar
  7. 7.
    Balint M. Training general practitioners in psychotherapy. Br Med J. 1954;1:115–20.CrossRefPubMedPubMedCentralGoogle Scholar
  8. 8.
    Balint M. The structure of the training-cum-research-seminars. J R Coll Gen Pract. 1969;17:201–11.PubMedPubMedCentralGoogle Scholar
  9. 9.
    Balint E, Norell JS. Six minutes for the patient: interactions in general practice consultation. London: Tavistock Publications; 1973.Google Scholar
  10. 10.
    Lakasing E. Michael Balint—an outstanding medical life. Br J Gen Pract. 2005;55(518):724–5.PubMedPubMedCentralGoogle Scholar
  11. 11.
    Rüth U. Classic Balint group work and the thinking of W.R. Bion: how Balint work increases the ability to think one’s own thoughts. Group Anal. 2009;42:380–91.CrossRefGoogle Scholar
  12. 12.
    Foulkes SH, Anthony EJ. Group psychotherapy. Harmondsworth: Penguin Books; 1957.Google Scholar
  13. 13.
    van Roy K, Vanheule S, Inslegers R. Research on Balint groups: a literature review. Patient Educ Couns. 2015;98(6):685–94.CrossRefPubMedGoogle Scholar
  14. 14.
    Flatten G, Möller H, Aden J, Tschuschke V. Designing the doctor-patient relationship: how beneficial are Balint groups and for whom? [Die Arzt-Patient-Beziehung gestalten. Wie nützlich sind Balintgruppen und für wen?]. Z Psychosom Med Psychother. 2017;63(3):267–79.PubMedGoogle Scholar
  15. 15.
    Kjeldmand D, Holmström I. Difficulties in Balint groups: a qualitative study of leaders’ experiences. Br J Gen Pract. 2010;60(580):808–14.CrossRefPubMedPubMedCentralGoogle Scholar
  16. 16.
    Kutter P. Direct and indirect (‘reversed’) mirror phenomena in group supervision. Group Anal. 1993;26:177–81.CrossRefGoogle Scholar
  17. 17.
    Razum O, Saß AC. Migration and health: intercultural opening remains a challenge [Migration und Gesundheit: Interkulturelle Öffnung bleibt eine Herausforderung]. Bundesgesundheitsbl. 2015;58:513–4.CrossRefGoogle Scholar
  18. 18.
    Foulkes SH. Therapeutic group analysis. New York: International Universities Press; 1964.Google Scholar
  19. 19.
    Scholz R. The foundation matrix: a useful fiction. Group Anal. 2003;36(4):548–54.CrossRefGoogle Scholar
  20. 20.
    Stucke W. The Balint group [Die Balintgruppe]. Cologne: Deutscher Ärzte-Verlag; 1982.Google Scholar
  21. 21.
    Baecker D. What is culture for? [Wozu Kultur?]. Berlin: Kulturverlag Kadmos; 2000.Google Scholar
  22. 22.
    Karterud S, Stone WN. The group self: a neglected aspect of group psychotherapy. Group Anal. 2003;36(1):7–22.CrossRefGoogle Scholar
  23. 23.
    Oppenheim-Gluckman H. Reading Michael Balint: a pragmatic clinician. London: Routledge; 2015.CrossRefGoogle Scholar
  24. 24.
    Goodyear-Smith F, Buetow S. Power issues in the doctor-patient relationship. Health Care Anal. 2001;9(4):449–62.CrossRefPubMedGoogle Scholar
  25. 25.
    Özdaglar A. “Somehow different” – about difficulties in German-Turkish psychoanalysis. [“Irgendwie anders” – Über Schwierigkeiten in deutsch-türkischen Psychoanalysen]. Psyche. 2007;61(11):1093–115.Google Scholar
  26. 26.
    Sengun S. Migration as a transitional space and group analysis. Group Anal. 2001;34(1):65–78.CrossRefGoogle Scholar
  27. 27.
    Weinberg H. The culture of the group and groups from different cultures. Group Anal. 2003;36(2):253–68.CrossRefGoogle Scholar
  28. 28.
    Pines M. The group as a whole. In: Brown D, Zinkin L, editors. Psyche and the social world: developments in group-analytic theory. London: Jessica Kingsley Publishers; 2000. p. 47–59.Google Scholar
  29. 29.
    Lutwak N. Shame, women, and group psychotherapy. Group. 1998;22(3):129–43.CrossRefGoogle Scholar
  30. 30.
    May M. Shame! A system psychodynamic perspective. In: Vanderheiden E, Mayer CH, editors. The value of shame. Heidelberg: Springer; 2017. p. 43–59.CrossRefGoogle Scholar
  31. 31.
    Cabral R, Smith T. Racial/ethnic matching of clients and therapists in mental health services: a meta-analytic review of preferences, perceptions, and outcomes. J Couns Psychol. 2011;58(4):537–54.CrossRefGoogle Scholar

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© Springer Nature Switzerland AG 2020

Authors and Affiliations

  • Volker Haude
    • 1
  1. 1.Medical PsychotherapyRheda-WiedenbrückGermany

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