Usefulness of Genogram in Clinical Interviewing

With the advent of family systems theory, the symptoms in individual were considered to be reflective of dysfunctions or pathologies in large systems and were conceptualized in broad system terms. Ludwig von Bertalanffy introduced the idea of General Systems Theory (GST). He understood systems and emphasized on the fact that “the whole is more than a sum of its parts,” meaning that “an entity investigated be resolved into, and hence can be constituted or reconstituted from, the parts put together, these procedures being understood both in their material and conceptual sense” (von Bertalanffy, 1967).

These system concepts are widely used in the field of psychology and perhaps more in respect of family. The family systems theory is an umbrella term for a variety of clinical perspectives that date back to 1950’s and 1960’s where in the family is considered to be the most important emotional system to which most of us ever belong; and has an impact on the individual functioning. In line with this, Bateson (1955) carried out the first systemic research and postulated that the family of the patient with schizophrenia was shaping his/her thought processes through the often bizarre communication requirements imposed (Bateson et al, 1956).

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The inclusion of a systemic viewpoint called for a more holistic approach as it offered a consideration of the question ‘where?’ in terms of ‘where’ the client’s problems are located in the time and place of their personal and family history (Evans & Gilbert, 2005). The practice of family therapy is grounded in these set of basic assumptions about the mutual influence of family members and the interplay of individuals, family and socio-cultural processes (Bateson, 1977).

For the same, genogram as a tool has been thought to facilitate the uncovering of the systemic factors and helps in getting insight related to development of behaviours. Murry Bowen, Jack Froom and Jack Medalie were the primary proponents of genograms to be utilized to understand the context within which individual functions (McGoldrick, Gerson & Shellenberger, 1999). In its basic form the genogram is a graphical representation of the family structure (Carter &McGoldrick, 2005). It helps in showing the bonds between family members, important life events, accidents, moves and occupations in the family, thus providing a tangible map to highlight complex relational patterns and functioning (Forster, Gipson & Reed, 2000). At a wider level, it also includes the medical, behavioural, genetic, cultural and social aspects of the family system.

The efficacy of this multigenerational genogram is well established as an assessment and intervention tool within family therapy. As an assessment tool, it is used to gather and compile information about the family over several generations into a manageable format. The therapists have come to use the genogram for recordkeeping, assessing families and designing strategic interventions. Wachtel (1982) in line with this suggested using genogram as a “quasi projective technique” in family therapy, revealing unarticulated fears, wishes and values of the individual in the family. The therapist could identify the family issues, patterns and assumptions that had possible relevance to current situation. Watts and Shrader (1998) explored the presence of violence against women in Zimbabwe and Latin America in quantitative and qualitative study. These researchers offered genograms as a research interview tool to document patterns of decision-making, conflict and vulnerability within families. The genogram was found to be a useful way to obtain a structured, visual representation of complex patterns of association and interaction between individuals; a concise way of summarizing much of the data collected, and in both studies it was often used as a reference tool when reviewing questionnaires or during follow-up interviews with the same respondent along with use for respondents with limited literacy skills.