5 ways a Genogram can help you understand your therapy client

When I first began working in the perinatal and infant mental health sector, I hadn't heard all that much genograms. We’d touched on them in University, I’m sure, but it was more often used as a way of mapping out a family, not as the powerful assessment and therapy tool I have since discovered they are.?

It's especially useful in working with perinatal clients and families. Children (even unborn babies) must always be considered in the context of their families, communities and culture, which is why the genogram is the natural starting place for any child or adolescent assessment. Genograms can be used in "play" assessments with children as young as three years old as a way of engaging them to talk about their families. Ultimately, genograms are effective in therapy with clients across the lifespan.

What is a genogram?

In its most basic form, a genogram is like a family tree. A map of who you belong to. It’s a visual representation of family members and other significant people in a person’s life.?

However, genograms are much more than just a family tree. In a therapeutic context, genograms can help us explore relationship patterns more deeply. It can help clients build empathy for their parents and grandparents and understand their circumstances in a greater sociocultural context.

A genogram is an integral part of a comprehensive perinatal and family assessment.?

Genograms contain the history of pain as well as the trajectory of survival, resilience, and hope.”– Monica McGoldrick,?The Genogram Casebook,?2016

5 ways a genogram can help you better understand your therapy client

1.?????It identifies intergenerational trauma.?A genogram can track family issues through space and time. It helps us discover any untimely losses or trauma the family have had to deal with in the past. Stolen generations, migration, separation from birth families, and family breakdowns; all of these things can inform clients' presenting issues. When we explore three or more generations in a genogram, it helps centre clients, and they come to understand their heritage. It reminds them they are not alone in their struggles.

2.?????Shows attachment relationship patterns.?Repetitive patterns often become apparent when we create a genogram with our clients. Genograms suggest possible connections between family events over time. It helps us understand the client’s relationships with others and whether there is enmeshment and/or withdrawal from relationships.

3.?????It’s an organising tool.?Genograms provide a natural structure to a therapeutic assessment and it’s a collaborative process. It opens up a conversation with clients in comparison to formal mental health interviews. It’s also an easy way to help clients tell their stories and through active listening, to build trust.?

4.?????Genograms helps your client identify their strengths. It offers a framework for understanding the present stresses, the past struggles and the resources that will be available to you and your client during therapy. When clients have a visual representation of major life events, family breakdowns as well as losses, it can help them recognise their inner strength and what they have within them to survive.?

5.?????It informs formulation.?I particularly love the narrative element of creating a genogram. As a writer and storyteller, going back to the beginning, before the client was even born and their parents too, helps me understand their lives in a greater context. With a genogram, you can establish rapport, get a sense of the presenting problem, as well as the client's context, background and life cycle patterns, and you can bring this all together in your formulation. Much of what they are struggling with in the present moment can be explained in their history.

Genograms are a powerful assessment and therapeutic tool to use with clients. It fits in nicely with a psychodynamic, attachment-based and systemic approach to therapy. Genograms are particularly useful in perinatal, child & adolescent, couple and family therapy.?

This article was first published at Lauren Keegan Psychology.

Want to know more about genograms?

Join me in my online workshop on 8th December 2022 at 12pm AEDT on how to effectively use genograms in trauma-informed practice. Book your spot here. Can't make the live event? The recording will be sent out to all registered participants within 48 hours of the event.

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