What is an Genogram?

A genogram is a visual family mapping tool. Genograms allow clinicians and clients to diagram a client’s family history through at least three generations. Genograms illustrate family relationships to show parentage and birth order across the generations, similar to a family tree. Genograms, however, go beyond this type of surface-level information included in a family tree, to capture in-depth details about family functioning and processes.

Genograms are an important assessment and intervention tool in social work practice that allow client and clinician to explore family relationship dynamics.

Working together, clients and clinicians create genograms to provide insight into a client’s family relationships over time, with a focus on intergenerational relationship patterns.

Constructing a genogram in a therapeutic session is a means of gathering vital family information that forms a basis for deepening clients’ self-understanding and supports the clinician’s ability to recommend effective interventions. The genogram is a complex tool capturing a wide range of family information, including family conflicts, health and mental health histories, communication patterns, and the evolution of relationships.

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Why Use Genograms?

Genograms are useful assessment tools that foster clients’ understanding of historical family patterns that might impact current behaviors, relationships, and functioning. From a social work perspective, individuals are embedded within many different systems that impact their lives, and the genogram emphasizes this systems theoretical perspective with a focus on the family. The family is perhaps the most important and universal system with which clients interact. Family systems influence an individual’s behavior, attitude, belief system, and cultural identity from one’s earliest days, and they play an important role in shaping one’s roles and relationships in society.

Use As An Assessment Tool

As an assessment tool, the genogram allows client and clinician to examine family structure in detail, and capture clinically-relevant information related to the quality and characterization of relationships. After capturing this information together, client and clinician can explore the ways in which family processes play out across generations.

The genogram can also be used as an intervention tool. Research has found that the act of creating the genogram itself has therapeutic benefits for clients. Further, genograms assist clinicians in understanding the origins of client behaviors and the sources of presenting problems. This information guides clinicians to effective intervention recommendations that are based in a client’s family system.

How to Create a Genogram

Genograms can be created by hand using paper and pencil, or computer-generated through online of software based genogram tools. Genograms use a complex combination of symbols – shapes, colors, lines, and captions – to depict family information, following specific guidelines.

The first step is to add symbols representing each family member, and lines that connect them. Circles are used to depict females and squares are used to depict males, with other shape and symbol combinations available to depict individuals who do not identify with sex and gender binaries. The name and age of each individual is written within the shape.  Attention should be paid to the size of each symbol, with primary family members drawn as larger symbols and spouses or partners as smaller symbols.  Each generation of family members is placed beneath the preceding one (grandparents at the top, then parents, then children), and children are written in descending birth order from left to right (oldest child farthest left).

Relationships between each family member should be depicted using the appropriate line – solid horizontal lines denote marriage, solid vertical lines denote parentage, dotted lines illustrate non-married relationships. The Multicultural Family Institute’s guide provides a complete list of the standard symbols and lines used in genograms that can be used for even the most complex of family situations.

Once individual family members and their basic connections have been added, client and clinician should discuss the specifics of each individual and relationship. This will include information pertinent to family history (previous marriages or relationships, miscarriages, living situations), as well as individual characteristics that are important to note (addiction, physical or mental illness, immigration status, annual income). A person’s education and occupation may be written next to their name,  and their current location and date of marriage or divorce can be added as well. Finally, the quality of relationships between each individual should be explored and noted using different line types to characterize the relationship (close relationship, physical abuse, distant relationship, caretaking relationships). Arrows at the end of these relationship lines signify the direction of the relationship (one-sided or mutual).

Example: Genogram for Nancy Jones

Jones Family Genogram

Best Practices for Making a Genogram with Clients

Genogram capture a wealth of information, therefore the system of symbols utilized is standardized and complex. Creating a genogram might require a bit of practice before constructing one with a client. When using genograms in session with clients, the following best practices are recommended:

  • Clearly identify the client and make the genogram client-centered
  • Be sure to determine and depict all members of a family system going back at least three generations.
  • Ensure that the type of relationship or connection is specified for as many family members as possible, but especially those relationships that directly involve in the client.
  • Capture as much family history and individual information as possible.
  • Strive to focus on family strengths and resilience.

Genograms As a Starting Point For Discussion

The most important practice to remember in creating a genogram with clients is to use this assessment tool as a starting point for discussion, opening opportunities for client and clinician to evaluate connections to family members and gain understanding of the client’s family history as it relates to current functioning. Creating a genogram is a participatory activity that is best accompanied by constant and meaningful dialogue between client and clinician as they work together to visualize and assess the client’s family system.