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GENOGRAM Azman Anuar
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Goals Disclaimer Participants in this CEP will gain:
Knowledge on the construction of genogram and the common symbols used Disclaimer
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Session’s outline Introduction 3 stages in drawing genogram
Stating the demographic data Simple genogram Complex genogram Reflecting the state of functioning of family members Drawing the relationships and roles Genogram and Ecomap Genogram as an interviewing tool Genograms as an intervention tool
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Source of information Monica McGoldrick, Randy Gerson and Sylvia Shellenberger (1999), 2nd Edn, Genograms: Assessment and Interventions, W W Norton, USA. Multicultural Family Institute (MFI), New Jersey website.
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Confidentiality
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Introduction Genogram is widely among those in the field of psychology, medicine, social work and other health care, human service and even legal fields. Genogram is known to be widely used by family therapists. It is a (family) therapist's version of a family tree. The organization of the genogram and its use of handy symbols permit the therapist and the patient to quickly identify and understand patterns in family history.
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Introduction Family therapist Monica McGoldrick and her colleagues at the Multicultural Family Institute of New Jersey have pioneered the use of genograms as a diagnostic tool, and as a method of helping families see patterns within their past and present. To know more on the assumptions on the use of genograms in the family systems perspectives, read pg. 6, Monica McGoldrick, Randy Gerson and Sylvia Shellenberger (1999), 2nd Edn, Genograms: Assessment and Interventions, W W Norton, USA. It is still a tool in progress. Symbols are evolving. Standardization is developed by the North American Primary Care Research Group in collaboration with leading family therapists. Source: MFI
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Business Genogram Genograms: A tool for understanding the family side of family business™ About the Program Any good consultation begins with a thoughtful and thorough assessment of the three family business circles: the family, the owners, and the business. This program is designed to develop family business advisors’ skills in assessing the family circle, using the genogram as a tool for mapping, exploring and understanding both the structural and process elements of a family system. The program includes detailed information about constructing genograms, as well as how to conduct both a structural and process analysis of the information. Case examples illustrate such key concepts as enmeshment, triangles, alliances, conflict groups, branch dynamics, birth order, and family developmental stages. In addition, workshop participants have an opportunity to create and reflect on their own family genogram. This personal exploration can be an opportunity to improve self-awareness about how our own family and life experience affects our professional work with families. Goals Participants in this seminar will gain: * Knowledge of how to use the genogram as a tool for assessing the structural and process elements of a family system. * Skills in assessing family dynamics and understanding their impact on the family business. * Understanding of how consultants’ perspectives can be influenced by their own family system dynamics. Source: Family Firm Institute,
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Family systems therapy Genogram
One of the best ways to begin therapy and to gain understanding of how the emotional system operates in a family system is to put together the family genogram. Studying the patterns of behavior, and how they relate to those multigenerational family, reveals new and more effective options for solving problems and for changing individual’s response to the automatic role one is expected to play.
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Commonly drawn genogram (e.g. 1)
2 generations
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Commonly drawn genogram (e.g. 2)
3 generations
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Commonly drawn genogram (e.g. 4)
3 generations
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Commonly drawn genogram (e.g. 3)
4 generations
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Commonly drawn genogram (e.g. 5)
4 generations
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Stages in drawing genogram Stages in genogram drawing
There are about three stages in drawing genogram. 1. Stating the demographic data Reflecting the state of functioning of family members Drawing the relationships and roles
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Stages in drawing genogram
Stating the demographic data Age Date of birth and death (cause of death) Marital/Relationship status Whereabouts (living arrangement) Income Occupation Education Ethnic Religious practices Trouble with the law
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Standard Basic Symbols
43 43 Transgender People Gay Lesbian Bisexual Pet Pink Triangle As most everyone knows, the pink triangle is a symbol taken directly from the Nazi concentration camps. Usually when concentration camps and Nazis are mentioned, most people tend to think of Jews and the Jewish Holocaust (for good reason). But the fact that a large number of homosexual prisoners were in those same camps is an often ignored or overlooked fact of history. The real story behind the pink triangle begins prior to World War II. Paragraph 175, a clause in German law, prohibited homosexual relations (much like many states in the U.S. today have laws against "crimes of nature"). In 1935, during Hitler's rise to power, he extended this law to include homosexual kissing, embracing, and even having homosexual fantasies. An estimated 25,000 people were convicted under this law between 1937 and 1939 alone. They were sent to prisons and later concentration camps. Their sentence also included sterilization, most commonly in the form of castration. In 1942, Hitler extended the punishment for homosexuality to death. Prisoners in Nazi concentration camps were labeled according to their crimes by inverted colored triangles. "Regular" criminals were denoted by a green triangle, political prisoners by red triangles and Jews by two overlapping yellow triangles (to form the Star of David, the most common Jewish symbol). Homosexual prisoners were labels with pink triangles. Gay Jews- the lowest form of prisoner- had overlapping yellow and pink triangles. This system also created a social hierarchy among the prisoners, and it has been reported that the pink triangle prisoners often received the worst workloads and were continually harassed and beaten by both guards and other prisoners. The Pink (and Black) Triangle Pink Triangle: Gay liberation groups in the 1970's started using the pink triangle as a symbol for the gay rights movement. Black Triangle: The black triangle represents lesbians and feminists as a symbol of pride and solidarity. Gay men were forced to wear pink triangles placed point down on both the left shirt sleeve and right pant leg. These men were sent to the camps under German law, Paragraph 175, which made illegal not only same-sex sexual acts, but also embraces, and even male homosexual fantasies. The law did not cover homosexuality in women. Authorities responded to this oversight by sending supposed lesbians to the concentration camps wearing black triangles, under the charge of being asocials Source: Man to woman Woman to man Note: Pink/Black Tri
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Pink Triangle As most everyone knows, the pink triangle is a symbol taken directly from the Nazi concentration camps. Usually when concentration camps and Nazis are mentioned, most people tend to think of Jews and the Jewish Holocaust (for good reason). But the fact that a large number of homosexual prisoners were in those same camps is an often ignored or overlooked fact of history. The real story behind the pink triangle begins prior to World War II. Paragraph 175, a clause in German law, prohibited homosexual relations (much like many states in the U.S. today have laws against "crimes of nature"). In 1935, during Hitler's rise to power, he extended this law to include homosexual kissing, embracing, and even having homosexual fantasies. An estimated 25,000 people were convicted under this law between 1937 and 1939 alone. They were sent to prisons and later concentration camps. Their sentence also included sterilization, most commonly in the form of castration. In 1942, Hitler extended the punishment for homosexuality to death. Prisoners in Nazi concentration camps were labeled according to their crimes by inverted colored triangles. "Regular" criminals were denoted by a green triangle, political prisoners by red triangles and Jews by two overlapping yellow triangles (to form the Star of David, the most common Jewish symbol). Homosexual prisoners were labels with pink triangles. Gay Jews- the lowest form of prisoner- had overlapping yellow and pink triangles. This system also created a social hierarchy among the prisoners, and it has been reported that the pink triangle prisoners often received the worst workloads and were continually harassed and beaten by both guards and other prisoners.
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Types of Relationships: Married
Legal Separation in fact EMA
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Types of Relationships: Not Married
EMA
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Basic Symbols for Order and Type of Birth
Children: List in birth order beginning with the oldest on left
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Sample of simple genogram – 2G
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Multiple marriages and Divorces
complex genogram Multiple marriages and Divorces How do you reflect a family where parents (either one or both) are divorced and remarried? Is it like these? >>>
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Sample 1 of genogram showing multiple marriages
Is it like this? >>> Or this? >>>
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Sample 2 of genogram showing multiple marriages
Or this? >>>
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Multiple marriages and Divorces
complex genogram Multiple marriages and Divorces How do you reflect a family where parents are divorced and remarried? Husband who has two previous failed marriages Wife with two previous marriages and has one child from each marriage, including current marriage
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Multiple marriages and Divorces: Husband with current and ex-wives
1st m ’81 d ‘86 2nd m ’90 d ‘00 3rd m ’02 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” and “3rd” etc make clear the order of his marriages.
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Multiple marriages and Divorces: Wife with current and ex-husbands
1st m ’81 d ‘86 2nd m ’90 d ‘00 3rd m ’02 6 16 22 Wife, her current husband and her ex-husbands (who are shown lower and smaller). Wives’ previous relationship are shown on left to keep children in birth order, since they remained in her custody.
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Multiple marriages and Divorces
complex genogram Multiple marriages and Divorces How do you reflect a family where parents are divorced and remarried? Both spouses have history of remarriages Wife has previous two failed marriages , has one child in each marriage, age 14 (M ) and 9 (M) while husband has one failed marriage with a son age 8. They have a son, age 3, from current marriage. They were married in 2002. Wife has three failed marriages and only one son from the 3rd marriage. Husband has 4 failed marriages , one child each from 2nd (26/M), 3rd (16/M) and 4th (11/M) marriage. From their current marriage, they have a 2 yr old son. Married in 2002.
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Multiple marriages and Divorces: with current and ex-spouses
1st m ’94 d ‘99 m ’90 d’92 3 8 14 97- 02- 2nd m ’94 d ‘98 9 96- 91- m ’02 Yr 2005 Where do you reflect non-marital relationship? It is reflected at the end of the married relationship – see eg on page 16, fig 2.4 Couple with three year old son, showing their previous spouses (smaller symbols) and those spouses’ new partners (even smaller symbols) 32
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Multiple marriages and Divorces: with current and ex-spouses, children and living arrangement
1st m ’77 d ‘80 m ’85 d ‘89 m ’94 d’99 10 2 11 03- 95- m ’02 Yr 2005 2nd m ’81 d ‘86 3rd m ’87 d ‘90 4th m ’92 d ‘97 94- 55- 65 - 40 50 16 89- 23 82- m ’90 d ‘93 Couple living with their joint child and wife’s child from previous marriage. The other spouses of the partners are shown smaller and lower on either side of the present household. How do we show custody over children? Couple living with their joint child and wife’s child from previous marriage. The other spouses of the partners are shown smaller and lower on either side of the present household. 33
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Adding more information: Income, education, occupation and place of living
Income is written above the birth and death date. (my preference: to state it below the occupation) Include the education and occupation near the name. The person’s place of living should be written at the top of the line connecting the symbols. $20K/m 40-’99 $15K/m 57- 59 50 T Bo Lee Surgeon W SL Doctor m. ‘76 NY UK $8K/m 77- $?K/m 81- 83- 30 26 24 T Ah Lee PhD/Psych Lecturer T Oh Lee Degree/ Journalist T Er Lee Undergraduate
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Stages in drawing genogram Stages in genogram drawing
Reflecting the state of functioning of family members This means including data such as Medical Emotional Behavioural (working history, drinking pattern, etc) Look out for patterns of functions within and across generations such as Substance abuse Incest Violence Suicide, etc Noting these may help to understand the client’s current adaptation to the situation and may provide ideas on how to address it.
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Lightly shaded or striped
Symbols denoting addiction/substance abuse and medical or physical illness Lightly shaded or striped Substance Abuse Mental or physical problems In recovery from substance abuse and mental or physical problems S Smoker O Obesity L Language problem Other problems
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Types of Medical Conditions: just for information only
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Other information: Significant Institutional relationship
18 depression on medication Counsellor SAF Psychiatrist 15 Drug Rehab Ctr Therapist Depression Date/yr 1st offence Her, K, Name Edn Occupation
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Sample of genogram with substance, medical and physical problems
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$1200 35- $0 35- 3-room flat, HDB High blood P Diabetic Semi-ambulant 65 65 L Name Edn? Artisan Name Edn? Housewife UK $? 60- UK $0 63- depression on medication 48 45 ? Norman /English Edn? Job? Norma /Malay Edn? Unemployed ? m.85 s. ’00 d. ‘02 UK 90- 87- 87- 90- 90- 87- 87- depression on medication 16 19 18 4 2 8 18 Name Name Name Schooling Name Schooling Name Edn? NSF IDR GCE ‘O’ Student MGF GCE ‘A’ Student SAF Psychiatrist Counsellor 2005
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Stages in drawing genogram Stages in genogram drawing
Drawing the relationships and roles
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Types of Family Relationship
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Interactional Relationship Patterns Between People
Slight variation
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Type of Emotional Relationship
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$1200 35- $0 35- 3-room flat, HDB High blood P Diabetic Semi-ambulant 65 65 L Name Edn? Artisan Name Edn? Housewife UK $? 60- UK $0 63- depression on medication 48 45 Norman /English Edn? Job? ? Norma /Malay Edn? Unemployed ? m.85 s. ’00 d. ‘02 UK 90- 87- 87- 90- 90- 87- 87- depression on medication 15 19 18 4 2 8 18 Name Name Name Schooling Name Schooling Name Edn? NSF IDR GCE ‘O’ Student MGF GCE ‘A’ Student SAF Psychiatrist Counsellor 2005
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Sample of genogram
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Sample of genogram
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Genogram + Ecomap It is common to supplement the use of genogram with ecomap. This will provide more richer information, involving the greater social circles
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Genogram + Ecomap
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Points to note Making genogram may not be a one-time exercise
Gradual improvements will have to be made over time as more information are gathered A template should be made. New genograms depicting different themes should be made to reflect and see any significance (resource, medical history, etc).
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Genogram as an interviewing tool
Interview using genogram. The three stages has covered a substantial part of the genogram interview. For a detailed outline, see part 2 of the handout.
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Genogram as an interviewing tool
Interpreting the genogram. It depends on the ‘factual’ information shared by clients and counsellor’s knowledge in identifying composition, themes, patterns, counsellor’s perspective, etc and work with the client to generate discussion and understanding on the issue(s) raised.
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A little exercise A remake of a genogram (individual) A new construction of a new genogram (in group of four) Duration: 25 minutes
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Exercise material – for individual
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Exercise material – for individual: redrawing the genogram
Commonly drawn genogram (e.g. 5) 4 generations
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Softwares available GenoPro is a unique software perfectly suited for creating quick computer-generated genograms. By entering key information, such as names of family members, key life events, emotional relationships, and social relationships, the user can easily create a multi-generational genogram of their family system or of their patient's family system. The genogram thus created becomes a graphical picture of the family, helping the user to identify patterns of behavior and dysfunctions that need to be addressed.
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Constructing own genogram
Our perspectives can be influenced by our own family system dynamics.
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Hers Malaysian Chinese 1 4 Graduate Ex-bank mgr Doctor (2 clinics)
PA 37- S 34- R Sec Sch 940718 L L A 56- 57- Ro 60- SS RS 901110 S R 930508 KDGT 04 52- M 59- A Q 900809 R A 921004 H S 951126 980529 1 4 A 65- 62- NR 96- NH 98- AH 00- RW 63- M Z F D 921031 941004 960307 A N 001219 64- Z 69- M H 970527 70- H 020626 Graduate Ex-bank mgr Doctor (2 clinics) Diploma Snr Sup A level Homemaker Ex-counsellor CAAS/Mgr Snr Reg. Manager Teacher/Pri A lelve Technician Ex-teacher Chinese 66- R S Malaysian Counsellor Pri Retired Fireman Muslim – adopted by Muslim family Born in Malaysia
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His Indian Chinese? 29 41 40 32 30 42 1 4 Graduate Homemaker
67- 68- SH 69- 40 SZ 76- 32 FA M I 64- 30 Z H 79- A A 40- Z E 42- 42 AH 66- Z H R S AS 92- NAD 94- MAR 96- 97- AHA 02- MSJ NSH 03- NS 91- 93- 95- HZ HR MI 010309 NM 031211 Chinese? Indian No record 1 4 A 65- R 62- NR NH 98- 00- Graduate Homemaker Ex-counsellor Counsellor O lvl Despatch Foodstall x 2 Pri Retired Ex-plumber Born in Malaysia 05- Diploma KDGT Teacher N lvl Clerk Snr Sup Snr Nurse ITE Nurse SCDF
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29 41 S 67- 68- SH 69- 40 SZ 76- 32 FA M I 64- 30 Z H 79- A A 40- Z E 42- 42 AH 66- Z H R S AS 92- NAD 94- MAR 96- 97- AHA 02- MSJ NSH 03- NS 91- 93- 95- HZ HR MI 010309 NM 031211 Chinese? Indian No record O lvl Despatch Foodstall x 2 Pri Retired Ex-plumber Homemaker Born in Malaysia 05- Diploma KDGT Teacher N lvl Clerk Snr Sup Graduate Snr Nurse ITE Nurse SCDF PA 37- 34- R Sec Sch 940718 L L A 56- 57- Ro 60- SS RS 901110 S R 930508 04 52- M 59- A Q 900809 R A 921004 H S 951126 980529 1 4 A 65- 62- NR NH 98- 00- RW 63- M Z F D 921031 941004 960307 A N 001219 M H 970527 70- 020626 Ex-bank mgr Doctor (2 clinics) A level Ex-counsellor CAAS/Mgr Snr Reg. Manager Teacher/Pri A lelve Technician Ex-teacher Chinese Malaysian Counsellor Fireman Muslim – adopted by Muslim family Interesting data: * Number of siblings * Kampung of parents * Children * Ethnic background of mother/mil * Fathers/fil and mothers/mil * Upbringing background/SES
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Genogram – sample answer
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