Family Genograms: Interpretation, Uses, and Symbols
Understanding Family Genograms
Primary Health Care fundamentally involves accompanying families under its care over time. Observing the home, family members, relationships within and beyond the household, community involvement, and work connections allows for:
- Identifying and understanding family dynamics.
- Planning interventions when required and desired by the family, fostering lasting relationships.
A genogram is defined as a graphic representation of family development over time or as a tool incorporating information categories for problem-solving.
- It was originally used by geneticists to study hereditary diseases.
- In the 1970s, family therapists, led by Murray Bowen, began using the genogram for complex family studies.
Genogram Interpretation Categories
- Composition and family structure
- Family life cycle
- Repeating patterns across generations:
- Repetition of morbidity patterns
- Repeating functional patterns
- Repeating relationship patterns
- Recovery of structural patterns
- Family balance/imbalance
Benefits and Uses of Genograms
Genograms allow healthcare professionals to:
- Combine biomedical and psychosocial information for a given family.
- Understand individuals within their family context and the family’s impact on them.
- Situate a health problem within its historical context.
- Clarify transgenerational patterns of illness, behavior, and health service use.
- Allow the healthcare team and patient to explore family myths and shift perspectives.
- Aid in marital and parent-child counseling.
- Possess both diagnostic and therapeutic value.
Genogram Symbols and Structure
In summary, this instrument uses symbols for people and lines for relationships. A genogram should represent at least three generations.
Basic Symbols
- Men are represented by squares (□).
- Women are represented by circles (○).
- The index person (the focus of the genogram) is marked with a double line around their symbol.
- Deceased individuals are marked with an ‘X’ inside their symbol (☒ or ⊗).
Pregnancy and Childhood Symbols
- Pregnancy: Triangle (△)
- Stillbirth (labor with dead fetus): Square with a cross inside.
- Miscarriage: Solid black circle (●)
- Abortion: A cross (X)
Relationship Lines
- Relationships (legal and biological) between family members are shown with connecting horizontal lines.
- Marriage: Solid horizontal line (───).
- Cohabiting / Unmarried Partnership: Dotted or dashed horizontal line (‑ ‑ ‑).
- Separation: One diagonal slash through the relationship line ( / ).
- Divorce: Two diagonal slashes through the relationship line ( // ).
Family Structure
- Children are connected to the couple’s relationship line via vertical lines.
- Children are ordered by age: oldest on the left, youngest on the right.
- Twins are shown with converging lines connecting their individual symbols to the parents’ relationship line.
- Very close relationships are represented by drawing a line encircling the symbols of the individuals involved.