Genograms in play therapy

Genograms in play therapy
Presented by: Julie R. Plunkett lpc, lcpc, rpt-s

Genograms Genograms are most commonly credited to Monica McGoldrick.
The first edition of her Genograms: Assessment and Interventions was published in It was authored by Monica McGoldrick and Randy Gerson. It was revised and republished in 2008 by Monica McGoldrick, Randy Gerson and Sueli Petry Genograms come out of the Bowen Family Systems tradition as an assessment tool

Bowen Family Systems Therapy
Presented by: Julie R. Plunkett lpc, lcpc, rpt-s

Triangles A three-person relationship system
This is the smallest stable relationship system There is always an odd man out though Tension can be handled easier because it can be shifted from one person to another A person’s action in the triangle shows their emotional attachments to others in their life Contribute significantly to clinical problems. Kerr, M. E. (2016) One Family’s Story: A Primer on Bowen Theory. Washington DC: Georgetown Family Center

Triangles Image:

Differentiation of self
Everyone is affected by other people in their life but some are more able to withstand pressure for conformity from others The less developed a person’s “self” the more other people have influence over them The less developed the more likely they are to try to control the functioning of others They depend on the acceptance and approval of others Someone who has a more developed self acknowledges a realistic dependence on others while being able to manage conflict, criticism and rejection Kerr, M. E. (2016) One Family’s Story: A Primer on Bowen Theory. Washington DC: Georgetown Family Center

Nuclear Family Emotional System
Four basic relationship patterns that influence where problems occur in a family Problems begin during times of family tension Marital Conflict: Each spouse externalizes their anxiety on the other Dysfunction in one spouse: One spouse tries to get the other spouse to think and act in certain ways while the other spouse gives in Kerr, M. E. (2016) One Family’s Story: A Primer on Bowen Theory. Washington DC: Georgetown Family Center

Nuclear Family Emotional System
Impairment of one or more children: The spouses focus their anxiety on one or more of the children who then carry the symptoms Emotional distance: Family members distance from each other to reduce intensity of the relationship Kerr, M. E. (2016) One Family’s Story: A Primer on Bowen Theory. Washington DC: Georgetown Family Center

Family projection process
How parents transmit emotional problems to their children The projection process Parent focuses on a child due to fear that something is wrong with the child Parent interprets child’s behavior in a way that confirms their fear Parent treats child as if something is really wrong with the child. It becomes a self-fulfilling process as the parent tries to fix the problem and the child becomes dependent on the parent’s evaluation of their behavior. Kerr, M. E. (2016) One Family’s Story: A Primer on Bowen Theory. Washington DC: Georgetown Family Center

Multigenerational transmission process
How differentiation transmit across generations Transmission occurs from conscious teaching as well as unconscious programming of emotional reactions and behaviors. There will be at least one member of a sibling group who will be more or less differentiated than the parent First is the patterning after parents, then a mate who is at the same level as them. As the differentiation of siblings grows and passes through generations the differences become more distinguishable. Kerr, M. E. (2016) One Family’s Story: A Primer on Bowen Theory. Washington DC: Georgetown Family Center

Emotional cutoff Occurs when a person tries to deal with unresolved emotional issues with family members by reducing or cutting off emotional contact. One of the risks is making new relationships too important. People who are cutoff from their family try to create a substitute family The substitute family will be at risk for a repeat of family of origin patterns they are trying to avoid People who have healthy differentiation to their family of origin have more resolution of these issues. Kerr, M. E. (2016) One Family’s Story: A Primer on Bowen Theory. Washington DC: Georgetown Family Center

Sibling position Bowen theory includes the work of Walter Toman when working on sibling position Basic premise is that people who grow up in the same sibling position will have similar characteristics Characteristics of one position are more complementary than other positions Spouses’ sibling position affects the marriage relationship Functioning across people of similar sibling position based on family of origin issues Kerr, M. E. (2016) One Family’s Story: A Primer on Bowen Theory. Washington DC: Georgetown Family Center

Societal emotional process
How the emotional system affects behavior on a societal level This will affect both progressive and regressive periods in society Each generation react to the societal level of the previous one and the current one Societal systems will take on the characteristics of the people that are a part of the society Kerr, M. E. (2016) One Family’s Story: A Primer on Bowen Theory. Washington DC: Georgetown Family Center

Societal emotional process
“The periods of regression seems related to factors such as the population explosion, a sense of diminishing frontiers, and the depletion of natural resources. Bowen predicted that the current regression would, like a family in a regression, continue until the repercussions stemming from taking the easy way out on tough issues exceeded the pain associated with acting on a long-term view. He predicted that will occur before the middle of the twenty-first century and should result in human beings living in more harmony with nature.” (p. 42) Kerr, M. E. (2016) One Family’s Story: A Primer on Bowen Theory. Washington DC: Georgetown Family Center

Presented by: Julie R. Plunkett lpc, lcpc, rpt-s
Genograms Presented by: Julie R. Plunkett lpc, lcpc, rpt-s

What is a genogram? Practical tool to help understand family patterns
A common tool for tracking family history and relationships The standardized genogram format in McGoldrick’s book came out of a committee in the early 1980s such as Murray Bowen, Jack Froom and Jack Medalie Record information about family members and their relationships over at least three generations Used to develop a hypothesis about clinical problems and how they come about in the family McGoldrick, M., Gerson, R., & Petry, S. S. (2008). Genograms: assessment and intervention. New York, NY: W.W. Norton & Co.

Why should I use a genogram?
Engage families Addressing resistance Clarify family patterns Reframe family issues Inform interventions Transform current relationships McGoldrick, M., Gerson, R., & Petry, S. S. (2008). Genograms: assessment and intervention. New York, NY: W.W. Norton & Co.

What is a genogram? Practical tool to help understand family patterns
A common tool for tracking family history and relationships The standardized genogram format in McGoldrick’s book came out of a committee in the early 1980s such as Murray Bowen, Jack Froom and Jack Medalie Record information about family members and their relationships over at least three generations Used to develop a hypothesis about clinical problems and how they come about in the family McGoldrick, M., Gerson, R., & Petry, S. S. (2008). Genograms: assessment and intervention. New York, NY: W.W. Norton & Co.

What is a genogram? Constructed in the first meeting and revised as new information becomes available. Assessment of the initial genogram drives formation of treatment A joining activity that allows the therapist to get to know the family Issues raised in the genogram allow the therapist to, “reframe, detoxify, and normalize emotion-laden issues. “(p. 5) Leads to systemic questioning that informs the clinician and helps the family begin to understand the systemic perspective McGoldrick, M., Gerson, R., & Petry, S. S. (2008). Genograms: assessment and intervention. New York, NY: W.W. Norton & Co.

What is a genogram? Allows the therapist to assess the relationships in the immediate family Shows the broader system as well, “extended family, friends, community, society and culture.” (p. 5) Assesses strengths and vulnerabilities Includes important non blood related people in the families life Major events and problems are noted McGoldrick, M., Gerson, R., & Petry, S. S. (2008). Genograms: assessment and intervention. New York, NY: W.W. Norton & Co.

Genograms in Multiple Contexts
Class/Socioeconomic Status Gender/Sexual Orientation Culture/Ethnicity/Race Geopolitical Structure Religion/Spirituality McGoldrick, M., Gerson, R., & Petry, S. S. (2008). Genograms: assessment and intervention. New York, NY: W.W. Norton & Co.

Spiritual Self Mind Intrapsychic self Body Physical Self Immediate Family Extended Family Friends and Community Culture Larger Society Ecology McGoldrick, M., Gerson, R., & Petry, S. S. (2008). Genograms: assessment and intervention. New York, NY: W.W. Norton & Co.

Context for assessing problems
Vertical Stressors Poverty, politics Racism, sexism, classism, homophobia Violence, addictions Family emotional patterns Myths, triangles, secrets Legacies, genetic abilities and disabilities Religious beliefs and practices McGoldrick, M., Gerson, R., & Petry, S. S. (2008). Genograms: assessment and intervention. New York, NY: W.W. Norton & Co.

Horizontal Stressors Developmental Life Cycle Transitions Unpredictable Accidents Migration Natural Disasters Chronic Illnesses Economics, Unemployment Historical Events Economic and Political Events McGoldrick, M., Gerson, R., & Petry, S. S. (2008). Genograms: assessment and intervention. New York, NY: W.W. Norton & Co.

Genogram basics A graphic depiction of family members: Biologically Legally Emotional relations to each other Spiritual Goes back three generations from the individual plus children and grandchildren Standard Symbols For Genograms enogramsPlus.pdf

Basic Genogram Symbols
Heterosexual Female Male Gay/Lesbian Bisexual Family Secret 277 27 Identified Client X 59 Death an X through Symbol Age at death in box Death date on right Above symbol Transgender People Woman to Man Man to Adapted from:

m ’90 s ‘95 d ‘97 Divorce m 1970 Marriage met ‘88, m ’90, s ‘95 Marital Separation Adapted from:

Children: List in birth order beginning with the oldest on left 13 11 10 Biological Child Foster Adopted X Stillbirth Miscarriage Abortion Twins Identical Pregnancy Adapted from:

Symbols Denoting Addiction, and Physical or Mental Illness Physical or Psychological Illness Alcohol or Drug Use Suspected Alcohol or Drug Use Adapted from:

Taken from:

Relationship Questions
Questions from Genograms: Assessment and Interventions (p ): Are there any family members who do not speak to each other or who have ever had a period of not speaking? Are there any who were/are in serious conflict? Are there any family members who are extremely close? Who helps out when help is needed? In whom do family members confide? All couples have some sort of marital difficulties What sorts of problems and conflicts have you encountered? What about your parents’ and siblings’ marriages? McGoldrick, M., Gerson, R., & Petry, S. S. (2008). Genograms: assessment and intervention. New York, NY: W.W. Norton & Co.

Questions from Genograms: Assessment and Interventions (p ): How do each get along with each child? Have any family members had particular problems dealing with their children? What are the power dynamics in family relationships? Are there certain family members who have more power to define what will happen in relationships? This refers not just to family members who have charisma or emotional power in the family, but also specifically to family members who have more power because of their status in the family and/or in society because of gender, race, skin color Socioeconomic statuses, age and sexual orientation. McGoldrick, M., Gerson, R., & Petry, S. S. (2008). Genograms: assessment and intervention. New York, NY: W.W. Norton & Co.

Questions from Genograms: Assessment and Interventions (p ): Has any family member been focused on as the caretaker? The problematic one? The “sick” one? The “bad” one? The “mad” one? The “selfish” one? The strong one? The weak one? The dominant one? The submissive one? The successful one? The failure? Who is seen as warm? As cold? As caring? As distant? McGoldrick, M., Gerson, R., & Petry, S. S. (2008). Genograms: assessment and intervention. New York, NY: W.W. Norton & Co.

Contextual Factors From Genograms: Assessment and Interventions (p ): Institutional Affiliations: religious, business, political, or community service institutions; fraternities; professional, military, self-help, athletic, choir, TV, Internet, and hobby groups Physical/Psychological/Spiritual Activities: working out, meditation, yoga McGoldrick, M., Gerson, R., & Petry, S. S. (2008). Genograms: assessment and intervention. New York, NY: W.W. Norton & Co.

Contextual Factors From Genograms: Assessment and Interventions (p ): Support Systems (those that support the family and those that are supported by the family): neighbors, housekeepers, accountants, lawyers, doctors/chiropractors or other caretakers, hairdressers, God, children, pets Business and Governmental Institutions: legal system, political system, welfare system, social service, credit card companies, insurance companies Values or Interests: education, food, sports, music, art, outdoors, stock market McGoldrick, M., Gerson, R., & Petry, S. S. (2008). Genograms: assessment and intervention. New York, NY: W.W. Norton & Co.

Religious/spiritual genograms
From Genograms: Assessment and Interventions (p. 55): What meaning does religion or spirituality have for you in your everyday life? In your family’s life? In times of danger or crisis? What religious or spiritual rituals or beliefs did you grow up with? Have you changed them? What or who influenced the development of your sense of spirituality? Are your religious/spiritual beliefs a source of connection or conflict between you and other family members? Who understands or shares your religious/spiritual framework? McGoldrick, M., Gerson, R., & Petry, S. S. (2008). Genograms: assessment and intervention. New York, NY: W.W. Norton & Co.

From Genograms: Assessment and Interventions (p. 55): Do you participate regularly in religious services or other religious practices? What are your sources of hope? What are your beliefs about God? How do you deal with transgressions that violate your conscience? Forgiveness? Have you had premonitions concerning life events? What does your religion say about gender roles? Ethnicity? Sexual orientation? How have these beliefs affected you and your extended family? McGoldrick, M., Gerson, R., & Petry, S. S. (2008). Genograms: assessment and intervention. New York, NY: W.W. Norton & Co.

From Genograms: Assessment and Interventions (p. 55): What role do music, prayer, meditation, reading, group participation, or good works have in your spiritual practice? Have any of your family members felt disillusioned about religion or had serious conflict with each other about religion? Have you or any of your family changed religion? If so, how did the family respond? Have you had spiritual experiences with friends or relatives who have died? Have you had encounters with spirits, ghosts, angels, or demons? Did you ever feel the intervention of a spirit on your behalf? McGoldrick, M., Gerson, R., & Petry, S. S. (2008). Genograms: assessment and intervention. New York, NY: W.W. Norton & Co.

Community genograms From Genograms: Assessment and Interventions (p ): What community institutions have members of your family belonged to? Where did they/do you go to socialize? What kinds of connections have you/they had with school? Work? Civic groups? Religious groups, fraternities or sororities? Were there ever groups you wanted to be a part of but from which you were or felt excluded. McGoldrick, M., Gerson, R., & Petry, S. S. (2008). Genograms: assessment and intervention. New York, NY: W.W. Norton & Co.

Community genograms From Genograms: Assessment and Interventions (p ): Are there significant groups in which you and others in your family are not in the same position? Are there groups in which you and your family are not in the same position as most of your community, such as if you are a Democrat in a Republican family, the darkest skinned member of the family the only family member who has gone to college, or the only Jewish family in a strongly Anglo community? McGoldrick, M., Gerson, R., & Petry, S. S. (2008). Genograms: assessment and intervention. New York, NY: W.W. Norton & Co.

Cultural genogram questions
From Genograms: Assessment and Interventions (p ): What ethnic groups, religious traditions, nations, racial groups, trades, professions, communities, and other groups do you consider yourself a part of? When and why did you or your family come to the U.S.? To this community? How old were family members at the time? Did they and do you feel secure about your status in the U.S.? Did they (do you) have a green card? Did they and do you feel secure about your status within your community? What language did they (do you) speak at home? In the community? In your family of origin? McGoldrick, M., Gerson, R., & Petry, S. S. (2008). Genograms: assessment and intervention. New York, NY: W.W. Norton & Co.

From Genograms: Assessment and Interventions (p ): What traumatic wounds have any of your racial or ethnic groups experienced? What burden do they carry for injuries their group committed against other groups? How have you been affected by the wounds your groups have committed, or that were committed against your groups? How have you been wounded by the wrongs done to your ancestors? How have you been complicit in the wrongs done by your ancestors? How can you give voice to your group’s guilt, your own sorrow, or your own complicity in the harm done by your ancestors? What would reparations entail? McGoldrick, M., Gerson, R., & Petry, S. S. (2008). Genograms: assessment and intervention. New York, NY: W.W. Norton & Co.

From Genograms: Assessment and Interventions (p ): What experiences have been most stressful for your family members in the U.S.? To whom do family members in your culture turn when in need of help? What are your culture’s values regarding male and female roles? Education? Work and success? Family connectedness? Family caretaking? Religious practices? Have these values changed in your family over time? McGoldrick, M., Gerson, R., & Petry, S. S. (2008). Genograms: assessment and intervention. New York, NY: W.W. Norton & Co.

From Genograms: Assessment and Interventions (p ): Do you still have contact with family members in your country of origin? Has immigration changed family members’ education or social status? What do you feel about your cultures of origin? Do you feel you belong to the dominant U.S culture? McGoldrick, M., Gerson, R., & Petry, S. S. (2008). Genograms: assessment and intervention. New York, NY: W.W. Norton & Co.

The genogram interview- Presenting Problem and Immediate household
From Genograms: Assessment and Interventions (p.62-63): Who lives in the household? How is each person related? Where do other family members live? Which family members know about the problem? How does each view it? And how has each responded? Has anyone else in the family ever had similar problems? McGoldrick, M., Gerson, R., & Petry, S. S. (2008). Genograms: assessment and intervention. New York, NY: W.W. Norton & Co.

The genogram interview- Presenting Problem and Immediate household
From Genograms: Assessment and Interventions (p.62-63): What solutions were attempted by whom in those situations? When did the problem begin? Who noticed it first? Who is most concerned about it? Who is least concerned? Were family relationships different before the problem began? How have they changed? What other problems existed before this problem began/ what other problems have developed since the problem began? Has the problem been changing? For better or for worse? In what ways? McGoldrick, M., Gerson, R., & Petry, S. S. (2008). Genograms: assessment and intervention. New York, NY: W.W. Norton & Co.

The genogram interview- The Current situation
From Genograms: Assessment and Interventions (p.63): What has been happening recently in your family? Have there been any recent changes in the family (e.g., people coming or leaving, illnesses, job problems)? McGoldrick, M., Gerson, R., & Petry, S. S. (2008). Genograms: assessment and intervention. New York, NY: W.W. Norton & Co.

The genogram interview- The Wider Family Context
From Genograms: Assessment and Interventions (p.64): Let’s begin with your mother’s family. Your mother was which one of how many children? When and where was she born? Is she alive? If not, when did she die? What was the cause of her death? If she is alive, where is she now? What does she do? McGoldrick, M., Gerson, R., & Petry, S. S. (2008). Genograms: assessment and intervention. New York, NY: W.W. Norton & Co.

From Genograms: Assessment and Interventions (p.64): What does she do? How far did she go in school? Is she retired? When did this happen? When and how did your mother meet your father? Did they marry, and if so, when? McGoldrick, M., Gerson, R., & Petry, S. S. (2008). Genograms: assessment and intervention. New York, NY: W.W. Norton & Co.

From Genograms: Assessment and Interventions (p.64): Had she been married before? If so, when? Did they separate or divorce or did the spouse die? If so, when was that? Did she have children by any other relationship other than your father? What is she like? How is her health? How do you get along with her? How do others get along with her? McGoldrick, M., Gerson, R., & Petry, S. S. (2008). Genograms: assessment and intervention. New York, NY: W.W. Norton & Co.

The genogram interview- The informal kinship network
From Genograms: Assessment and Interventions (p.73): To whom could you turn when in need of financial, emotional, physical, and spiritual help? What roles have outsiders played in your family? Who outside the family has been important in your life? What is your relationship to your community? McGoldrick, M., Gerson, R., & Petry, S. S. (2008). Genograms: assessment and intervention. New York, NY: W.W. Norton & Co.

The genogram interview- The informal kinship network
From Genograms: Assessment and Interventions (p.73): Did you ever have a nanny, caretaker, or babysitter to whom you felt attached? What became of her or him? Has anyone else ever lived with your family? When? Where are they now? What has been your family’s experience with doctors and other helping professionals or agencies? McGoldrick, M., Gerson, R., & Petry, S. S. (2008). Genograms: assessment and intervention. New York, NY: W.W. Norton & Co.

The genogram interview- Tracking Family Process
From Genograms: Assessment and Interventions (p.74): What will happen in the family if the problem continues? If it goes away? What changes do family members imagine are possible in the future? McGoldrick, M., Gerson, R., & Petry, S. S. (2008). Genograms: assessment and intervention. New York, NY: W.W. Norton & Co.

The genogram interview- Difficult questions about individual functioning
From Genograms: Assessment and Interventions (p.75): Serious Problems Has anyone in the family had a serious medical or psychological problem? Been depressed? Had anxieties or fears? Lost control? Has there ever been any physical or sexual abuse? Are there any other problems that worry you? When did that problem begin? Did you seek help for it? If so when? What happened? What is the status of that problem now? McGoldrick, M., Gerson, R., & Petry, S. S. (2008). Genograms: assessment and intervention. New York, NY: W.W. Norton & Co.

From Genograms: Assessment and Interventions (p.75): Work Have there been any recent job changes? Unemployment? Do you like your job? Who else works in your family? Do they like their work? McGoldrick, M., Gerson, R., & Petry, S. S. (2008). Genograms: assessment and intervention. New York, NY: W.W. Norton & Co.

From Genograms: Assessment and Interventions (p.75-76): Finances How much income does each member generate? Does this create any imbalance in family relationships? If so, how is the imbalance handled? How does the economic situation compare with that of relatives? Is there any expected inheritance? Are there family members you support or whom you may need to care for in the future? McGoldrick, M., Gerson, R., & Petry, S. S. (2008). Genograms: assessment and intervention. New York, NY: W.W. Norton & Co.

From Genograms: Assessment and Interventions (p.75-76): Finances Are there any extraordinary expenses? Outstanding debts? What is the level of credit card debt? Who controls the money? How are spending decisions made? Are these patterns different from the ways money was handled in the families of origin? Does anyone have a gambling or overspending problem? McGoldrick, M., Gerson, R., & Petry, S. S. (2008). Genograms: assessment and intervention. New York, NY: W.W. Norton & Co.

From Genograms: Assessment and Interventions (p.76): Drugs and Alcohol Do any family members routinely use medication? What kind and for what? Who prescribed it? What is the family’s relationship with any physician? Do you think any members drink too much or have a drug problem? Has anyone else ever thought so? What drugs? When? What has the family attempted to do about it? McGoldrick, M., Gerson, R., & Petry, S. S. (2008). Genograms: assessment and intervention. New York, NY: W.W. Norton & Co.

From Genograms: Assessment and Interventions (p.76): Drugs and Alcohol How does the person’s behavior change under the influence of the drug? How does the behavior of others change? Has anyone ever been stopped for an alcohol- or drug-related offense (DWI)? McGoldrick, M., Gerson, R., & Petry, S. S. (2008). Genograms: assessment and intervention. New York, NY: W.W. Norton & Co.

From Genograms: Assessment and Interventions (p.76): Trouble with the Law Have any family members ever been arrested? For what? When? What was the result? What is that person’s legal status now? Has anyone ever had his or her driver’s license revoked? McGoldrick, M., Gerson, R., & Petry, S. S. (2008). Genograms: assessment and intervention. New York, NY: W.W. Norton & Co.

From Genograms: Assessment and Interventions (p.76): Physical or Sexual Abuse Have you ever felt intimidated in your family? Have you or others ever been hit? Has anyone in your family ever been threatened with being hit? Have you ever threatened anyone else in your family or hit them? Have you ever been threatened in any other way within your family? Have you or any other family members ever been sexually molested or touched inappropriately by a member of your family or someone outside your family? By whom? McGoldrick, M., Gerson, R., & Petry, S. S. (2008). Genograms: assessment and intervention. New York, NY: W.W. Norton & Co.

The genogram interview- Essentials of a brief genogram interview
From Genograms: Assessment and Interventions (p.79-80): What are family members’ most pressing concerns? What information might family members want shared or kept from other family members? Who has been the greatest source of love or inspiration to family members? What are the greatest challenges the family members feel they are facing? What question would the family members most want answered by the clinician? McGoldrick, M., Gerson, R., & Petry, S. S. (2008). Genograms: assessment and intervention. New York, NY: W.W. Norton & Co.

The genogram interview- strengths
From Genograms: Assessment and Interventions (p.80): Your family seems to have had a great deal of courage to face the problems you describe, in light of the resistance of others in your family to acknowledge these difficulties. You seem to be a family of survivors after all the problems you have struggled with: sexual abuse, violence, addiction, and mental illness. You seem very caring in spite of the anger and despair that you have often struggled with. McGoldrick, M., Gerson, R., & Petry, S. S. (2008). Genograms: assessment and intervention. New York, NY: W.W. Norton & Co.

Family patterns Critical life events through a time line Births Deaths
Moves and migration Coincidences Critical life changes, transitions, and traumas Anniversary reactions Historical events: social, economic and political McGoldrick, M., Gerson, R., & Petry, S. S. (2008). Genograms: assessment and intervention. New York, NY: W.W. Norton & Co.

Sexual genogram questions
From Genograms: Assessment and Interventions (p ): What overt and covert messages did partners receive from their families regarding sexuality? Intimacy? Masculinity? Femininity? What might other members of the family say about these issues? Who was the most open sexually? Emotionally? Physically? Who was most closed? How did that affect other family members? How was sexuality or intimacy encouraged? Discouraged? Controlled? Taught? Did previous generations differ in the messages they gave? McGoldrick, M., Gerson, R., & Petry, S. S. (2008). Genograms: assessment and intervention. New York, NY: W.W. Norton & Co.

From Genograms: Assessment and Interventions (p ): Were there ways that members of your family did not conform to the sexual or intimacy mores of their religious background? What was the impact of this? Were there secrets in your family regarding intimacy, sex, or abuse? Incest? Other sexual abuse? Unwanted pregnancies? Extramarital affairs? Pregnancy before marriage? Abortions? Marriage of cousins? McGoldrick, M., Gerson, R., & Petry, S. S. (2008). Genograms: assessment and intervention. New York, NY: W.W. Norton & Co.

From Genograms: Assessment and Interventions (p ): What questions might you have been reluctant to ask about sex or intimacy regarding your family’s genogram? Who might have answers? How could you approach people? How was the concept of birth control dealt with? How was erotic material such as books or magazines with sexual content dealt with? McGoldrick, M., Gerson, R., & Petry, S. S. (2008). Genograms: assessment and intervention. New York, NY: W.W. Norton & Co.

From Genograms: Assessment and Interventions (p ): How were stronger sexual media such as pornography dealt with? How do you deal with sexual media now in your relationship? What were the rules about monogamy in the relationships you saw? Was attraction to other people and talking about it all right? Were extramarital affairs or visits to prostitutes tolerated or discussed? Who are these issues dealt with now in your relationship? ? McGoldrick, M., Gerson, R., & Petry, S. S. (2008). Genograms: assessment and intervention. New York, NY: W.W. Norton & Co.

From Genograms: Assessment and Interventions (p. 112): Were there family members in previous generations who had an intimate relationships were influenced by their ethnicity? Poverty? Success? Gender? Sexual orientation? Immigration? Language difficulties? Race? Have members of your family married out of their ethnic, class, or religious background? How did that affect others in the family? How do you think it affected their sexual and intimate relationship? How do the values of your religious or cultural background influence your own views of sexuality and intimacy? Are there ways in which they are different? McGoldrick, M., Gerson, R., & Petry, S. S. (2008). Genograms: assessment and intervention. New York, NY: W.W. Norton & Co.

From Genograms: Assessment and Interventions (p. 112): Were there people whose pattern of sexuality or intimacy did not conform with your family’s cultural or gender norms? How were they reacted to by others in the family? How would you want to change the message you give the next generation regarding sexuality and intimacy from the messages you received in your family? How were the norms in your family similar to or different from the norms in your partner’s family of origin? How do you think those differences may affect your sexual and intimate relationship? McGoldrick, M., Gerson, R., & Petry, S. S. (2008). Genograms: assessment and intervention. New York, NY: W.W. Norton & Co.

From Genograms: Assessment and Interventions (p ): How do you think you have done as a couple navigating the differences? What shared values have you arrived at about sexual issues? How did factors such as prejudice or oppression affect your family and personal development as a sexual person? What were your first sexual experiences like? How did you feel about them then? How do you feel about them now? McGoldrick, M., Gerson, R., & Petry, S. S. (2008). Genograms: assessment and intervention. New York, NY: W.W. Norton & Co.

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Image: http://healingreligion.com/PS1012/images/fig_88.jpg

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Presented by: Julie R. Plunkett lpc, lcpc, rpt-s
Family play genograms Presented by: Julie R. Plunkett lpc, lcpc, rpt-s

Genogram vs. play genogram
With a genogram the clinician conducts a session in which genogram material comes from the conscious, or left hemisphere of the brain. With the pay genogram, the right hemisphere is used, the unconscious, affective, metaphorical, creative and flexible information. Play genogram focuses on thoughts and feelings of everyone in the family, including themselves. Sori, Catherine F. The Therapist's Notebook for Children and Adolescents, 2nd Edition. Routledge, VitalBook file.

The traditional genogram relies on what clients are willing or able to share verbally. It is often done earl on before trust is fully formed. Reluctance to share due to loyalty, privacy, fear of showing someone in a negative light, fear of appearing not “Normal”. Ambivalence about the therapeutic process Control over information that is shared or withheld Difficulty with verbal communication Sori, Catherine F. The Therapist's Notebook for Children and Adolescents, 2nd Edition. Routledge, VitalBook file.

Play genograms have fewer verbal communication demands Symbolic and metaphoric language Expand communication Externalize their internal world Sori, Catherine F. The Therapist's Notebook for Children and Adolescents, 2nd Edition. Routledge, VitalBook file.

What is it? A genogram that utilizes an array of miniature people, animals, and objects that represent each family member. Helps illuminate family members views of each other. Utilizes families creativity, fantasy and imagination Expands views of relationships and conflicts. Elaborates on family stories, rumors or legends, both accurate and rumor Helps share secrets or family understandings Can be used to show a hoped for future McGoldrick, M., Gerson, R., & Petry, S. S. (2008). Genograms: assessment and intervention. New York, NY: W.W. Norton & Co.

What do I do? Give directions Give examples if needed
Observe the selection process Observe interactions while making choices Observe problem solving and family style when dealing with conflict McGoldrick, M., Gerson, R., & Petry, S. S. (2008). Genograms: assessment and intervention. New York, NY: W.W. Norton & Co.

Uses for play genograms
To bypass resistance Elicit disclosures that reveal perceptions of self and others Externalization of the problem More open discussion of difficult emotional material “Miniaturize” the problem to make it manageable Projection on the miniatures allows a safe distance to address issues McGoldrick, M., Gerson, R., & Petry, S. S. (2008). Genograms: assessment and intervention. New York, NY: W.W. Norton & Co.

Uses for play genograms
Focusing on a particular time in the past Represent resources and resilience Expand a conflict in the immediate family to the extended family Imaginary conversations between the miniatures Discuss discarded selections Moving around figures to face other members of the family McGoldrick, M., Gerson, R., & Petry, S. S. (2008). Genograms: assessment and intervention. New York, NY: W.W. Norton & Co.

Individual and family play genograms
Purpose: To bring alive the three-generational play genogram in an interactive way that is fun for the whole family. It allows for a more symbolic expression using symbols, drawings, or metaphors of any type that is more in line with play therapy. Include not only biological and legally related family members but also friends and pets. Directions: The family is presented with a collection of play and sand miniatures and then is invited to choose those miniatures that best show their thoughts and feelings about everyone in their family, including themselves. This first activity is followed by others, such as asking clients to choose symbols to represent the nature of their relationships with others. Or, how they would like to see their family in the future. This can be done with any aspect of the genogram that the therapist decides they want to assess or bring focus on to the family. Sori, Catherine F. The Therapist's Notebook for Children and Adolescents, 2nd Edition. Routledge, VitalBook file.

Individual Play Genogram
Two Part Instructions: “I’d like you to choose a miniature or miniatures that best shows your thoughts and feelings about everyone in the family, including yourself. Place the miniature on the circle or square that represents the person for whom you chose the miniature.” (Sori, 2015). “Now choose a miniature or miniatures that best shows your thoughts and feelings about the relationship you have with every person in your family, and place that miniature somewhere between you and the other person on the genogram.” (Sori, 2015) Sori, Catherine F. The Therapist's Notebook for Children and Adolescents, 2nd Edition. Routledge, VitalBook file.

Family Play Genogram All family members are involved in choosing miniatures and placing them on their own genogram drawing. “The instructions are exactly the same: I’d like each of you to choose a miniature that best shows your thoughts and feelings about everyone in the family, including yourself. Place the miniature on the circle or square that represents the person for whom you chose the miniature.” (Sori, 2015). Sori, Catherine F. The Therapist's Notebook for Children and Adolescents, 2nd Edition. Routledge, VitalBook file.

Family Play Genogram Issues
Do they all do it at the same time or should one person go first? What if a miniature is seen as negative, insulting, or critical? Discuss the genograms and choices with the family. Use open-ended questions. Do not make interpretations or give explanations. Expand on the metaphors. Stay in the metaphor, have the client “become” their miniature and enact a situation and act it out. Sori, Catherine F. The Therapist's Notebook for Children and Adolescents, 2nd Edition. Routledge, VitalBook file.

Family Play Genogram Issues
“Note: Over time, I have found it to be important to record information that is presented as soon as the session is complete (see Handout 3.2). At times, I videotape family sessions and review the tapes to make sure that family interactions are observed and the meaning of metaphors pondered and understood.” (Sori, 2015). Sori, Catherine F. The Therapist's Notebook for Children and Adolescents, 2nd Edition. Routledge, VitalBook file.

Handout 3.2 Family Play Genograms Data Recording Form
Sori, Catherine F. The Therapist's Notebook for Children and Adolescents, 2nd Edition. Routledge, VitalBook file.

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