25: Diagramming Families For Assessment
Out of family systems theory has come a useful way of assessing families in which the families themselves can participate. The purpose of this chapter is to examine the implications of the family systems approach and to introduce some assessment tools that have been developed. The assessment process and procedures described here depend upon the mutual engagement and participation of both the Children’s Service Worker and family.
The use of diagrams to describe complex family relationships can reduce or replace the use of lengthy written narrative. The four methods of diagramming discussed in this chapter are:
- Genograms, used to describe and gain insight into relationships and roles within the family unit
- Culturagram, used to help staff recognize the cultural differences between families. By completing the Culturagram, staff develop a better understanding of the family's needs and can begin to plan for appropriate interventions on an individual, family, and community basis
- Ecomaps, used to document the family unit’s relationship to outside systems
- Time Lines, used to observe the relevant events experienced by the family and
- Sequences of Behavior, used to observe the behavior patterns that surround the presenting problem.
By using the various methods of diagramming, the Children’s Service Worker and family may learn something about the relationships within the family, the location of the family’s boundaries, and the variety and quality of the family’s connections to outside systems. In addition to assessment, the use of these diagramming methods may be useful as:
- Interviewing tools that can be used with individuals, couples, or the entire family
- A way to facilitate participation by providing a clear structure and can assist people who might have difficulty entering into discussion
- Helpful additions to the case recording, since they give a clear quick view of the family and
- Tools for organizing information to assist in the case planning and preparation for services.
Family Participation is Crucial
The use of these assessment methods recognizes the family as the most knowledgeable source of information about itself. As the kind of data requested is concrete and not extremely personal, their use encourages an interviewing style that tends to be non-threatening. Most people will more readily discuss themselves and their backgrounds under these circumstances and share more personal information as rapport is established.
The use of these methods offers the Children’s Service Worker an opportunity to observe and engage the family in their environment. Having the family members sit beside the worker and assist in a diagram’s completion (rather than across the table in an adversarial position) is a good example of how this method fits in with family-centered approach to providing social services. It leads the family to open communication and insight into their past and present. Through these methods, the worker and family can learn about:
- Who the family is - their names, ages, relationships, occupations, and religion
- Roles in the family and who performs them - Are grandparents, older children or others involved in the parenting? Do members identify any unfulfilled tasks? Who is perceived as having the most power in this family?
- Family rules - What are the family rules regarding decision making; child care; discipline; intimacy/distance; expressions of love and anger? What are the rules with respect to relationships between generations?
- The family communication - Are there identifiable channels of communication? Who communicates to whom and how?
- The relationship system(s) - How do members of this family feel about the other members? Who is close to whom in this family? Are there identifiable alliances? What are the major conflicts within the family from the point of view of each member?
- The family through time - What is the significant history about the development of the family (marriage, children, etc.)? What are the significant themes, patterns, events in the family history, major losses, changes, and how has the family handled them?
- The family network - What persons or systems are important to the family? Outside the immediate family, where does the family turn for support?
- How does the family "fit" in relation to larger society? Are there problems with other organizations, schools, work, church, etc.?
For example, while charting the mother’s family of origin on a genogram, the Children’s Service Worker can explore how the mother perceived her parents and siblings. This can lead to how, why, and when she left home and married. In turn, this information can lead the worker into exploring the initial attractions and expectations the mother had about her marriage and lead her to discuss her current perceptions and frustrations. The same process can be duplicated to obtain information from other family members.
The genogram is basically a family tree diagram that includes social data.
It can include as much information as the Children’s Service Worker thinks is needed in order to make a thorough assessment of the family. Names, ages, significant family events, marriage dates, etc., are examples of information to include on the genogram.
Hartman (1978) points out that the use of a genogram provides a picture of the family system through time. It enables an individual to step out of the system, examine it, and gain insight into complex family dynamics that have developed over time and how they affect the current situation.
Figure 1 - Brief Genogram
3 persons in household;
Father and mother divorced;
Ages included on figures;
2 teenagers in custody of mother;
1 female child died at age 5;
Father has close ties to daughter,
conflictual ties to mother and son.
A genogram is most useful in assessment when it covers at least three generations. This can provide an intergenerational history that can assist in identifying extended family support systems.
Instructions for Completing a Genogram:
- Begin by diagramming the members of household. Symbols describe the sex of the individual. A male is indicated by a square; a female is indicated by a circle.
A triangle is used to indicate if the sex of the person is unknown (i.e. the sibling of a great-grandparent or a still-born child whose sex is unknown).
An "X" through a figure indicated the person is no longer living.
- Draw connecting lines between these symbols to describe the composition of the family system. (See Figure 2 on the next pages).
Marital separation is indicated by a single slash along the connecting line; a divorce is indicated by two slashes.
Location of the slashes on the connecting line denotes which parent has custody of the children. See the genogram in Figure 1. The slashes on the marital line indicate the couple is divorced. The location of the slashes set the father off from the children and indicates the mother has custody of the children.
Additional lines are drawn between the symbols to describe the emotional quality of the relationships. (See Figure 3).
- Children born to the couple are drawn below the parents and the child’s symbol is connected to the line between the parents, starting with the oldest to the left.
Twins are connected to one another and a single line connects their line to their parent’s line.
Again, additional lines are drawn to describe the type of relationship that exists between the children and the parents or between the siblings.
- A dotted line drawn around the group of individuals denotes the household composition.
- Repeat the process vertically and horizontally to include persons in the extended family.
Grandparents are connected and diagrammed above the parents (vertically). Connecting lines extend from the grandparent’s line to the parent.
Repeat the process horizontally, as needed, to include the aunts, uncles, and cousins of the children.
- Upon obtaining the skeletal structure of the family, it is important to fill in the diagram with identifying and historical information, such as:
- Names, birthdates, and death dates that are written next to the person figures;
- The age of the individual can be written inside the person figure for quick reference;
- Marriage dates and dates of separation and divorce are written next to the connecting lines between the indi-viduals.
- Occupations, interests, and descriptive characterizations, health condition, etc., can be written next to the individual.
- Information that further describes the family unit, such as race, income, religion, ethnic or cultural influences family can be written in the border.
FIGURE 2. Conventions of Diagramming Family Structure
Two spouses each previously married; wife had two children, husband had none; current couple has one in-common child.
Wife’s four marriages: 2 children in first; 1 child in second; 3 children in third; 2 children in fourth.
FIGURE 3. Diagramming Emotional Relationships
intense relationship cut-off
conflictual relationship cut-off
distanced relationship cut-off
intense conflictual relationship
Written Narrative on Roosevelt Family Genogram:
Household family consists of seven members: Father is Franklin, born in 1882. Mother is Eleanor, born in 1884. They were married in 1905. Their relationship is a distant one.
Their marriage has produced six children; five male and one female: Anna, born in 1906; James, born in 1907; Franklin, born in 1909, and died in 1909; Elliot, born in 1910; Another child named Franklin, born in 1914; John, born in 1916.
Franklin (father) has a half brother, "Rosie," 28 years his senior. His father, James Roosevelt, was born in 1828 and married his first wife, Mary Rebecca, in 1853 when she was age 22. Rosie was their only child. Mary Rebecca died in 1876. James remarried to Sara Delano, Franklin’s mother, in 1880. At age 52, he was twice Sara’s age. Franklin, born two years later was their only child. James died in 1900, age 72. Franklin has an intense relationship with his mother. Sara’s relationship with Eleanor is conflictual, resulting in an in-law triangle.
Eleanor Roosevelt is the oldest of three children born to Elliot Roosevelt and Anna Hall. Elliot, born in 1860 married Anna in 1883. Anna was born in 1863. Elliot was related (relationship unknown) to Franklin’s father. Eleanor had a brother, Elliot Jr., who was born in 1889; he died of scarlet fever in 1893. Another brother, Hall, was born in 1891.
- Begin by diagramming the members of household. Symbols describe the sex of the individual. A male is indicated by a square; a female is indicated by a circle.
The culturagram focuses on ten aspects of culture, including time in the community, legal status, reasons for relocating, languages spoken at home and in the community, health benefits, holidays and special events, impact of crisis events, values about education, work and family, and cultural and religious institutions.
The culturalgram should be completed with the family within the first 30 days of the case opening. The culturagram should be updated when there is a change in family dynamics. Areas to cover include:
Time in the Community: How long have you been in the community? Each family member's time in the community may be different, especially in families that immigrate.
Legal Status: Different people inside the same family can have different legal statuses. There are illegal immigrants, people who have Green cards, there may be refugees, or people who have been given special status based on a fear of persecution based on religions/political opinions, race, nationality, or membership to certain groups. Legal status can contribute to people avoiding needed medical or social services because there is a lot of fear of having their immigration status known.
Immigration: Why did you choose to live here? You could be working with newly immigrated families, or families that have been your area for years or even decades. It is important to ask why they selected here. You may find that people came to be close to other family members, or for economic reasons, or for political/religious persecution.
Language Spoken: Does the family speak more than one language? What language(s) are they stronger in? Often families speak one language at home and another in the community.
Health Benefits: What do families seek treatment for? When do they go to the doctor? Many people have very different beliefs about diagnosis and treatment. In the United States, well-child clinics are available from the time children are born. But many other countries you only go to the doctor if you or your children are very sick. The same may be true for rural families or families struggling economically.
Holidays and Events: There may be holidays that the larger society celebrates but also holidays that are important to the family unit.
Impact of Crisis Events: What crises have the family experienced? Crisis families tend to go through two types of crises. First is the developmental crisis, where you can see every kind of new stage of life can lead to a developmental crisis. The other type of crisis a family experiences is the "Out of the Blue" crisis. These are usually unexpected events such as: accidents, sudden illness, violence, unemployment, and death. It is important to look at all of these traumatic and crisis events because they really affect a family.
Family, Education, & Work Values: What are the families thoughts on education and work? Is the family hierarchical or egalitarian? Each family is set up and organized differently and it is important to look at what are the family myths, rules, and what is unique for the family.
Cultural Institutions: Is the family involved with ethnic social clubs? Next, consider religion because many families are involved with church, temples, or mosques. Religion and spirituality is very important to understanding the culture of the family.
Other: Additional values that the family feels are important to their culture.
Briefly, the ecomap is a way of mapping the family system in its world. It provides the family and Children’s Service Worker with a way of actively gathering data about itself and drawing conclusions about that data. This method of diagramming depicts the family in their dynamic ecological system. Other important systems that influence the family are included in the ecomap. Ann Hartman describes the following functions of the ecomap. The mapping procedure:
- Portrays an overview of the family in their ecological situation
- Pictures the important nurturant or conflict-laden connections between the family and the world
- Demonstrates the flow of resources, or lacks and deprivations and
- Highlights the nature of the interfaces and points of conflicts to be mediated, bridges to be built, and resources to be sought and mobilized.
Instructions for Ecomapping:
- Draw a large circle in the middle of the map. This represents the members of household.
- Inside the large circle, draw a genogram that describes the makeup of the household. It is often useful to add names and ages. Limited space may prevent adding additional descriptive information.
Use the symbols that are normally used in genograms (see figure #1).
- Inquire into what outside systems influence the family unit and its members. Examples of these outside systems may include work, extended family, church, school, health care, social welfare, recreation, and friends.
Draw smaller circles around the large household circle and label them to represent the outside systems.
- The next step is to begin to draw the connections of the family unit and its individuals to the various systems in their environment. These connections are indicated by drawing lines between the family and the circles representing the outside systems.
Some of the connections may be drawn to the family unit as a whole or to the individual members. This differentiation demonstrates the way the various family members are connected to the environment.
The nature of the connection is described by the type of line that is drawn:
- A solid or thick line represents a strong connection
- Three solid lines indicates the strong connection is an intense relationship
- A broken line indicates a tenuous relationship
- A zig-zagged line shows a stressful or conflictual relationship
Refer to Figure #2 for other variations and examples for diagramming emotional relationships.
- A solid or thick line represents a strong connection
- Next, indicate the direction of the flow of resources, energy, or interest by drawing arrows along the connecting lines.
- Finally, write a word or two beside the connecting lines or smaller circles to further describe, clarify or highlight information drawn on the ecomap.
Figure 5. Example of Ecomap
It is important for the Children’s Service Worker to study the family’s presenting problem and its function within the family system. The presenting problem is usually the behavior which brought the family to the attention of the Division. The techniques presented here to assist in this study are:
- Time lines and
- Diagramming the sequence of behaviors.
The same type of non-confrontive interviewing techniques that are used when completing genograms and ecomaps should also be applied when completing time lines and behavior sequences. Use of these methods should come after the completion of the genogram and ecomap. This should allow the Children’s Service Worker an opportunity to develop rapport with the family. The family may be more willing to share information about the presenting problem when rapport is established.
Time lines are used to identify the significant events experienced by the family. By plotting these events on a linear line, this method can help determine the onset of the presenting problem and what was generally going on before and after the onset. (See Figures 6 and 6a.)
Instructions for Completing a Time Line:
The Children’s Service Worker may start anywhere in time, but it may be more useful to focus on significant events (such as the birth of a child, loss of a job, death of a family member) that surround the presenting problem. This will usually be the incident that brought the family to the attention of the Division, such as an incident of abuse:
- Mark the particular date(s) that identifies the onset of the presenting problem on the line(s).
- Next, mark the significant events as reported by the family that led up to the presenting problem behavior.
These can immediately precede the presenting problem but may also have been in the more distant past.
- Next, mark any significant events that followed the presenting problem. This can demonstrate the event(s) experienced by the family after the problem’s onset and its consequences.
- Inquire into whether the presenting problem had occurred before. Mark the significant events that surround any previous incidents. This should help determine if this is an acute or chronic problem.
The Children’s Service Worker may also use a line for each household member if it is more helpful to track the events surrounding an individual. (See Figure 6a.)
Sequences of Behavior
Sequences of behavior that surround the presenting problem can be diagrammed in a circular manner. This allows the Children’s Service Worker and family to see how the presenting problem is embedded within precise sequences of observable family behaviors. It can help gain insight into:
- What behaviors act as antecedents to the presenting problem so that the antecedents can be avoided or altered
- How the family members react to the presenting problem behaviors and how the family system is influenced by the problem behaviors
- What functional aspects the presenting problem serves within the family system and why it has become ingrained within the family and
- How these repetitious sequences may create counter-productive patterns that the family might have become accustomed to.
Instructions for Diagraming Behavior Sequences
- Mark the presenting problem behavior on a point on a circle (Daughter runs away).
- Inquire into what observable behavior immediately preceded the problem behavior (Dad left home).
- Inquire into what observable behavior preceded this behavior (Dad and Mom were fighting). Follow this process backwards to document the series of behaviors (Dad was drinking) that eventually led up to the presenting problem.
- Next, inquire into what observable behavior immediately followed the presenting problem behavior (Mom seeks Dad for help).
- Inquire into what observable behavior immediately followed this behavior (Dad finds Daughter). Follow this process forward to diagram the series of behaviors that followed the presenting problem. (Dad and Daughter return home together; Mom and Dad reconcile; Dad starts drinking again; Mom and Dad fight again, etc.)
Sources: This chapter was adapted from Understanding Families, written by Jo Ann Allen, with contributions by Eloise Cornelius and Consuelo Lopez, and edited by Kittsu Swanson. It was developed under Contract #105-79-1107 for the Children’s Bureau, Administration for Children, Youth and Families, Office of Human Development Services, United States Department of Health and Human Services.
The instructions for completing genograms and ecomaps were adapted from "Diagrammatic Assessment of Family Relationships," Social Casework (October 1978), and "An Ecological Framework for Assessment," from the book Finding Families, 1979, both authored by Ann Hartman.
Figures No. 2 through 5, and 7 are used with the permission of the National Resource Center on Family Based Services, The University of Iowa School of Social Work, Oakdale, Iowa.
Technical assistance was provided by the National Resource Center on Family Based Services for information on diagramming time lines and sequences of behavior.