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Azman Anuar

GENOGRAM. Azman Anuar. Goals. Participants in this CEP will gain: Knowledge on the construction of genogram and the common symbols used. Disclaimer. Session ’ s outline. Introduction 3 stages in drawing genogram Stating the demographic data Simple genogram Complex genogram

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Azman Anuar

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  1. GENOGRAM Azman Anuar

  2. Goals Participants in this CEP will gain: • Knowledge on the construction of genogram and the common symbols used Disclaimer

  3. 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

  4. 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.

  5. Confidentiality

  6. 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.

  7. 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.

  8. 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, www.ffi.org

  9. Family systems therapyGenogram • 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.

  10. Commonly drawn genogram (e.g. 1) 2 generations

  11. Commonly drawn genogram (e.g. 2) 3 generations

  12. Commonly drawn genogram (e.g. 4) 3 generations

  13. Commonly drawn genogram (e.g. 3) 1G 2G 3G 4G 4 generations

  14. Commonly drawn genogram (e.g. 5) 1G 2G 3G 4G Commonly drawn genogram (e.g. 5) 4 generations

  15. 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

  16. Stages in drawing genogram Stage 1 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

  17. Standard Basic Symbols Man to woman 43 43 Transgender People Gay Lesbian Bisexual Pet Woman to man Note: Pink/Black Tri

  18. 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.

  19. Types of Relationships:Married Legal Separation in fact EMA

  20. Types of Relationships:Not Married EMA

  21. Basic Symbols for Order and Type of Birth Children: List in birth order beginning with the oldest on left

  22. Sample of simple genogram – 2G 15 18

  23. 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? >>>

  24. Sample 1 of genogram showing multiple marriages Is it like this? >>> Or this? >>>

  25. Sample 2 of genogram showing multiple marriages Or this? >>>

  26. 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 Multiple marriages and Divorces complex genogram

  27. 1st m ’81 d ‘86 2nd m ’90 d ‘00 3rd m ’02 Multiple marriages and Divorces:Husband with current and ex-wives 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.

  28. 1st m ’81 d ‘86 2nd m ’90 d ‘00 3rd m ’02 22 16 6 Multiple marriages and Divorces:Wife with current and ex-husbands 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.

  29. 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. Multiple marriages and Divorces complex genogram

  30. Multiple marriages and Divorces:with current and ex-spouses 2nd m ’94 d ‘98 96- 9 m ’02 1st m ’94 d ‘99 1st m ’90 d’92 97- 02- 91- 14 8 3 Yr 2005 Couple with three year old son, showing their previous spouses (smaller symbols) and those spouses’ new partners (even smaller symbols)

  31. Multiple marriages and Divorces:with current and ex-spouses, children and living arrangement 55- 65 - 50 40 m ’85 d ‘89 1st m ’77 d ‘80 2nd m ’81 d ‘86 m ’90 d ‘93 3rd m ’87 d ‘90 m ’02 m ’94 d’99 4th m ’92 d ‘97 95- 03- 82- 89- 94- 10 23 16 11 2 Yr 2005 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.

  32. Adding more information:Income, education,occupation andplace of living Income is written above the birth and death date. (my preference: to state it below the occupation)Include theeducationandoccupationnear 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

  33. Stages in drawing genogram Stages in genogram drawing Stage 2 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.

  34. Other problems Smoker Obesity Language problem S O L Symbols denoting addiction/substance abuse and medical or physical illness Mental or physical problems Substance Abuse Lightly shaded or striped In recovery from substance abuse and mental or physical problems

  35. Types of Medical Conditions:justfor information only

  36. Other information:Significant Institutional relationship Name Edn Occupation Name Edn Occupation Therapist Depression Date/yr depression on medication 15 18 Name Edn Occupation Name Edn Occupation Counsellor Depression Date/yr Drug Rehab Ctr SAF Psychiatrist 1st offence Her, K, Date/yr Depression Date/yr

  37. Sample of genogram with substance, medical and physical problems

  38. $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 45 48 ? ? Norman /English Edn? Job? Norma /Malay Edn? Unemployed m.85 s. ’00 d. ‘02 UK 90- 90- 87- 90- 87- 87- 87- 18 4 2 19 depression on medication 16 8 18 Name Name Name Schooling Name Schooling Name Edn? NSF IDR GCE ‘O’ Student MGF GCE ‘A’ Student SAF Psychiatrist Counsellor 2005

  39. Stages in drawing genogram Stages in genogram drawing Stage 2 Drawing the relationships and roles

  40. Types of Family Relationship

  41. Interactional Relationship Patterns Between People Slight variation

  42. Type of Emotional Relationship

  43. $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 45 48 ? Norman /English Edn? Job? ? Norma /Malay Edn? Unemployed m.85 s. ’00 d. ‘02 UK 90- 90- 87- 90- 87- 87- 87- 18 4 2 19 depression on medication 15 8 18 Name Name Name Schooling Name Schooling Name Edn? NSF IDR GCE ‘O’ Student MGF GCE ‘A’ Student SAF Psychiatrist Counsellor 2005

  44. Sample of genogram

  45. Sample of genogram

  46. Genogram + Ecomap It is common to supplement the use of genogram with ecomap. This will provide more richer information, involving the greater social circles

  47. Genogram + Ecomap

  48. 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).

  49. 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.

  50. 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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