The Genogram Format for Mapping Family Systems E-Book By Monica McGoldrick The genogram has been established as a practical framework for mapping

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The Genogram Format for Mapping Family Systems PDF E-Book By Monica McGoldrick The genogram has been established as a practical framework for mapping and understanding family patterns. The word genogram
The Genogram Format for Mapping Family Systems PDF E-Book By Monica McGoldrick The genogram has been established as a practical framework for mapping and understanding family patterns. The word genogram is just a fancy term for a family tree that maps out who you belong to and some basic patterns of these belonging relationships. It is a language that has been established over the past 50 years to depict for clinicians some of the basic demographic, functioning, and relationship issues in families. Genograms include biological and legal members of a family but also pets, friends, and other kinship relationships. Genograms map out the basic biological and legal structure of the family--who was married to whom, the names of their children, and so on. Just as important, they can show key facts about individuals and the relationships of family members. For example, one can note the highest school grade completed, a serious childhood illness, or an overly close or distant relationship. The facts symbolized on the genogram also offer clues about the family's secrets and mythology, since families tend to obscure what is painful or embarrassing in their history. A genogram includes multiple types of family information: the basic facts: who is in the family, the dates of their births, marriages, moves, illness, deaths; information regarding the primary characteristics and level of functioning of different family members: education, occupation, psychological and physical health, outstanding attributes, talents, successes and failures; relationship patterns in the family: closeness, conflict, or cut off. Once the primary family information is indicated on the genogram, it is possible to examine it from the multiple perspectives of all family members. One genogram might emphasize the relationship patterns in a family, another might highlight the artistic patterns, another the patterns of illness, and so forth. A genogram is generally drawn from the point of view of a key person or nuclear family, going back in time at least two generations and forward to the children and grandchildren of the key person or people. Other genograms may be drawn to show in detail various branches of the family or aspects of their functioning and relationship. This standardized Genogram format is becoming a common language for tracking family history and relationships. Despite the widespread use of genograms by family therapists, family physicians, and other health care providers, prior to the first edition of Genograms: Assessment & Intervention in 1985, there was no generally agreed-upon format for a genogram. Even among clinicians with similar theoretical orientations, there was only a loose consensus about what specific information to seek, how to record it, and what it all meant. The standardized genogram format offered here was worked out in the early 1980 s by a committee of leading proponents of genograms from family therapy and family medicine, including such key people as Dr. Murray Bowen, Dr. Jack Froom, and Dr. Jack Medalie. They became part of a committee organized by the North American Primary Care Research Group to define the most practical genogram symbols and agree on a standardized format. Since the format was originally published in 1985, there have been a number of modifications recommended by different groups around the world. We see this format as a work in progress, Expanded use of genograms will undoubtedly extend the format further. For example, computers have led us to begin development of standard color coding for names, location, occupation, illnesses, etc. The symbols will surely be further modified in the future as they have been modified over the years. 1 Standard Symbols for Genograms Male Female Birth Date 41- Age 82- Death Family Secret Heterosexual Gay/Lesbian Transgender People Man to woman Woman to man Institutional Connections: Bisexual AA written on left above of symbol Therapist Location & Annual Income written above birth & death date m written inside symbol Significant Institutional Connection Pet Buddhist Therapist 59 an X through Symbol Age at death in box Death date on right above symbol Person who has lived in 2 + cultures 41- Immigration Boston $100, Marriage Couple Relationship Secret Affair Committed Relationship m 1970 Rel 95, LT 97 LT = Living Together Affair 95 LT 95 Marital Separation Divorce Divorce and Remarriage met 88,, m 90 s 95 m 90 s 95 d 97 m 90, s 95-96, s 96, d 97 m 03 remar 00, rediv 02 m 05 Children: List in birth order beginning with the oldest on left LW A Stillbirth Abortion Miscarriage Biological Child Foster Child Adopted Child Twins Identical Twins Pregnancy 2 Symbols Denoting Addiction, and Physical or Mental Illness Physical or Psychological illness Alcohol or Drug abuse Suspected alcohol or drug abuse Physical or Psychological illness in remission In Recovery from alcohol or drug abuse In recovery from substance abuse and mental or Physical problems Smoker S Obesity O Language Problem L Serious mental and physical problems and substance abuse Symbols Denoting Interactional Patterns between People spiritual connection Close Distant Close-Hostile Focused On Fused Hostile Fused-Hostile Cutoff Cutoff Repaired Physical Abuse Emotional Abuse Sexual Abuse Caretaker Annual income is written just above the birth & death date. Typically you would include the person s occupation and education near the name and the person s whereabouts at the top of the line connecting to the symbol. Symbol for Immigration = $100, John 59 Highland Park, NJ 52 C.P.A. m Arizona 35, Alicia P.h.D History Prof London $100, Peter M.B.A San Francisco $45, Mark B.A. Computers $28, Jenny H.S.+2 Secretary Lesbian couple whose daughter was conceived with egg of one partner and sperm donor. In Vitro Insemination Sperm donor Gay Couple whose daughter was conceived with sperm of John and an egg donor, and carried by surrogate mother till birth. Egg donor Surrogate Mother 3 Siblings of Primary Genogram Members are written smaller and higher. Spouses are written smaller and lower: Use an arrow to show family into which child moved Foster Children s Child Raised from Birth by His Granduncle and Aunt Household Household shown by encircling members living together (Couple living with their dog after launching Children) POLISH JEWISH Served in Vietnam Roman Catholic Symbol for Immigration Chicago $60, Ed 62 London $100, Sam LH 00 m Chicago $28, Jolie Therapist Chicago $40, Dog-Muff Judy Buddhism Siblings are written smaller and higher than IP. Spouses are written smaller and lower. Adopted Child A = 1 Use an arrow to show family into which child moved 10 Adopted at 5 4 1 Husband, His Current Wife and his Ex-Wives (who are shown lower and smaller). Husband s wives may go on left to be closest to him. Indicators 1st, 2nd etc. make clear the oader of his marriages. 1st 2nd 3th m 85 d 89 m 90 d 00 m 02 2 Wife, Her Current Husband and her Ex-Husbands (who are shown lower and smaller). Wife s previous relationships are shown on left to keep children in birth order, since they remained in her custody. 1st 2nd 3th m 83 d 88 m 89 d 93 m Couple with 3 year old, showing their previous spouses (smaller) and those spouses new partners (even smaller) 1st 2nd 1st m 94 d 99 m 02 m 94 d 98 m 90 d Couple living with their joint child and her child from a previous relationship. The other spouses of the partners are shown smaller and lower on either side of the present household, indicated by a dotted line m 77 d 80 m 85 d 89 m 81 d 86 m 90 d 93 m 87 d 90 m 95 d 97 m 92 d 97 lo. m 02 m 99 d Genograms record information about family members and their relationships over at least three generations. They display family information graphically in a way that provides a quick gestalt of complex family patterns; as such they are a rich source of hypotheses about how clinical problems evolve in the context of the family over time. Once you master this format you will want to learn the interpretive principles upon which genograms are based (see Genograms: Assessment and Intervention, W. W. Norton, 2008), and possibilities for software, which can record genogram information and store it for retrieval for research purposes. In our view the symbols make genograms the best shorthand language for mapping and summarizing family information and describing family patterns. Genograms allow you to map the family structure clearly and to note and update the map of family patterns of relationships and functioning as they emerge in a clinical session. For a clinical record, the genogram provides an efficient summary, allowing a person unfamiliar with a case to grasp quickly a huge amount of information about a family and to scan for potential problems and resources. While notes written in a chart or questionnaire may become lost in the mass of information, genograms are immediately recognizable and can be expanded and corrected at each clinical visit as one learns more about a family. They can be created for any moment in the family s history- showing the ages and relationships of that moment to better understand family patterns as they evolve through time. Genograms make it easier for us to keep in mind the complexity of a family s context, including family history, patterns, and events that may have ongoing significance for patient care. Just as our spoken language potentiates and organizes our thought processes, genograms, which map relationships and patterns of family functioning, help clinicians think systemically about how events and relationships in their clients' lives are related to patterns of health and illness. Gathering genogram information should be an integral part of any comprehensive, clinical assessment, if only to know who is in the family and what are the facts of their current situation and history. The genogram is primarily an interpretive tool that enables the clinician to generate tentative hypotheses for further evaluation in a family assessment. It cannot be used in a cookbook fashion to make clinical predictions. But it can sensitize the clinician to systemic issues, which are relevant to current dysfunction and to sources of resilience. Scanning the breadth of the current family context allows the clinician to assess the connectedness of the immediate members of the family to each other, as well as to the broader system- the extended family, friends, community, society and culture, and to evaluate the family s strengths and vulnerabilities in relation to the overall situation. Consequently, we include on the genogram the immediate and extended family members, as well as significant non-blood kin who have ever lived with or played a major role in the family s life. We also note relevant events (moves, life cycle changes) and problems (illness, dysfunction). Current behavior and problems of family members can be traced on the genogram from multiple perspectives. The index person (the I.P. or person with the problem or symptom) may be viewed in the context of various subsystems, such as siblings, triangles, and reciprocal relationships, or in relation to the broader community, social institutions (schools, courts, etc.), and socio-cultural context. 6 Genograms let the calendar speak by suggesting possible connections between family events over time. Patterns of previous illness and earlier shifts in family relationships brought about through loss and other critical life changes, which alter in family structure and other patterns can easily be noted on the genogram. Computerized genograms will soon enable us to explore specific family patterns and symptom constellations, which provide a framework for hypothesizing about what may be currently influencing a crisis in a particular family. In conjunction with genograms, we usually include a family chronology, which depicts the family history in chronological order. A computerized program for gathering and mapping genogram information with a data base will in the future make it a lot easier for the clinician to track family history, because a chronology will be able to show events for any particular moment in the family s history. Genograms need to show not just the biological and legal members of a family, but also the network of friends and community essential for understanding the family. This includes current relationships, but also the relationships that came before and live in the person s heart, giving hope and inspiration in times of distress. It is also important to show the context around the biological and legal family in order to understand a family in context. Such people include those who live in one s heart, some long dead, and some in daily life, who could offer a loan, your husband or children out, or give you strength and courage, you are in a crisis. It is this kinship network, not just the biological relatives, and not just those who are alive now, who would be relevant to know about if you want to understand clients or access their resources. Such genograms are important to illustrate in greater depth the context around the immediate family. Family history always evolves in the context of larger societal structures: cultural, political, religious, spiritual, socio-economic class, gender, racial and ethnic structures, which organize each member of a society into a particular social location. It is important always to think of the genogram in its broader context. At times we actually define the resources and institutions of the community to highlight families access or lack of access to community resources (which can be noted around the genogram). Many have been attempting to expand genograms to take these larger social structures into account in understanding genogram patterns. 7 We look forward to the continued evolution of genograms to enable us to better illustrate the larger cultural levels along with the specific individual and kinship dimensions of family patterns. 8
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