Therapists’ Experience of Using the Genogram in Systemic Family and Couples Therapy

Abstract

Genograms are a widely used tool, well grounded in systemic theory. However the claims made in the literature regarding the therapeutic use and effects of the genogram have not been empirically explored or verified. This study therefore aimed to examine the extent to which the use and effects of genograms in clinical practice reflect the claims made in the literature. This study asked: what therapeutic tasks the genogram is used for, the specific pathways the genogram facilitates those tasks, and the mechanisms salient to the genogram that adds to clinical practice. Ten qualified Family Therapists participated in semi-structured interviews discussing their experiences. A Thematic Analysis was conducted. Five themes were identified: therapist-family joining; systemic exploration; therapist hypothesizing; family perturbation through cognitive change; family perturbation through experiential and behaviour change. This study found that genograms were used in some of the ways described in the literature: engagement, information gathering, hypothesizing and intervention aimed at cognitive change. The usefulness of the genogram was found to extend beyond ‘engagement’ and ‘information gathering’ to ‘therapist-family joining’ and ‘systemic exploration’ respectively. However, this study did not find the genogram was used to explore emotions, nor as an intervention aimed directly at behaviour change; instead, change at the experiential level was reported. The pathways the genogram facilitates therapeutic tasks are delineated, as are the mechanisms salient to the genogram that adds to clinical practice. Recommendations for further research were made. This included repeating this study with therapists from different training backgrounds, as well as undertaking a quantitative study examining genogram outcomes in terms of a measurable change in presenting problems.