Genograms: Seeing Patients and Families

Abstract

The genogram is a practical, patient-centred tool that permits family physicians (FPs) to gather and record basic family information. The “skeletal” genogram identifies the patient's family members and their medical histories. It offers the physician a quick visual reference for understanding the patient's context, the family’s influence, and the family's role in the patient's illness experience. Specifically, the genogram highlights genetic and family patterns of illness, indicates areas to consider for primary and secondary prevention, identifies the patient's risk for specific health problems and the need for screening, and assists in the development of a differential diagnosis and management plan. The “expanded” genogram builds on the basic genogram information by focusing on the identification of six specific categories: family structure, life-cycle stage, pattern repetition across generations, life events and family functioning, relational patterns and triangles, and family balance and imbalance. The expanded genogram provides the physician with a systemic assessment of the patient’s and the family’s biopsychosocial concerns and level of functioning. It can also be used as a therapeutic tool for both patients and families.