How to Construct Genograms, Part 2
There are different ways to develop a genogram although they are all generally similar. The common differences found are in the signs being slightly different.
For example: a death in a family may be shown as the sign:
However, some professionals show a death in the family by the sign:
Although not a huge difference, it may cause some confusion. This material will attempt to provide you with a fairly common way of designing and implementing a genogram which will help you in your practice.
Before developing the genogram, it is important to have all relevant information. The most efficient and time-effective way to obtain this information is to interview the client and if possible interview family members and friends of the client. By interviewing more than one source, you will obtain more accurate results. However, this may not always be possible due to time constraints and other family members and friends not wanting to or are unable to attend counselling.
How do you know what information to obtain to formulate the genogram? There are a number of areas you may focus on in developing the genogram including:
- the client ie. the name, age, gender and occupation
- the client’s main concerns
- the client’s immediate family and their name, birth date, age, gender and occupation
- how they are related ie. are they all biologically related, related by marriage, etc.
- does the client’s immediate family have similar concerns/patterns
- does the client’s immediate family know about the client’s concerns
- what has been happening recently in the family ie. illnesses, divorce, death
- the wider family such as parents, grandparents, uncles, aunties, etc. including their name, birth date, age, gender, occupation or whether retired, death date (if relevant). It is wise to include at least three generations in a genogram.
- concerns the wider family may have had ie. abuse, drug and alcohol dependency, anxiety, depression, etc.
- ethnic and cultural history of the family
- socioeconomic status of the family
- the relationship between family members
The following Power Wheel may be used to help assess patterns of abuse and violence if these are concerns for your client. It gives you areas to focus on as well as the types of things the client may have experienced either as a victim or as an abuser.
Emotional Abuse: Putting her down, calling her names, making her think she’s crazy, playing mind games, stonewalling.
Intimidation: Putting her in fear by looks, actions, gestures, loud vices, smashing things, destroying property, stalking, driving car at excessive speed.
Physical Abuse: Slapping, shoving, choking, biting, pushing, entrapment, punching, beating, kicking, grabbing, pulling hair, stabbing, shooting, killing.
Isolation: Controlling what she does, who she sees or talks to, where she goes. Denying her access to car. Deliberately removing her from her support system.
Threats: Threatening to hurt partner physically or emotionally. Threats to commit suicide, have affair, divorce, report her to welfare, take away children or emotional support system.
Using Male Privilege: Treating her like a servant. Making all “big” decisions. Acting like “big” decisions. Acting like “Master of the House,” neglecting “second shift” housework, parenting, & home responsibilities.
Economic Abuse: Trying to keep her from getting or keeping a job. Controlling her access to money or knowledge about money.
Using Immigration Status: Using her undocumented status to threaten her with deportation, loss of children, job, medical care, etc.
Using Children: Being abusive or controlling with children, being underresponsible about parenting, making partner feel guilty about the children, using children to pass messages, using visitation to harass her.
Sexual Abuse: Making partner do sexual things against her will, attacking sexual parts of her body, criticizing her sexual performance, having outside relationships, exposing her to HIV by not practicing safe sex, using abusive patterns of seduction, having sex after assaulting her, repeatedly pursuing her for sex.
Source: McGoldrick, M., Gerson, R. & Shellenberger, S. (1999). Genograms: Assessment and Intervention. New York, NY: W.W. Norton & Company, Inc.
When asking questions, you may come up against client’s who are resistant to the concept of the genogram. Obviously general counselling skills are used to overcome the resistance such as eye contact, rephrasing, encouragers, etc. However, one suggestion for overcoming this resistance includes demonstrating how the clients concerns may be related to past familial issues so the client may see the connection.
Another issue that may arise when questioning the client about his or her issues and family may occur when asking about sensitive issues such as serious medical or psychological problems, work situation, financial situation, trouble with the law, and physical or sexual abuse. It is about being sensitive to this information and again using your general counselling skills to make the client feel comfortable in disclosing the information.
Once you have the required information, the counsellor can then put the information together and assess what is important to the genogram. McGoldrick, Gerson and Shellenberger (1999) have suggested the following priorities when assessing relevant information:
- Repetitive symptoms, relationship or functioning patterns across the family
- Coincidences of dates
- The impact of change
In the next post, we will look at some basic symbols used to create genograms.