Genograms

Drawing the genogram increases rapport, and often enables challenging or embarrassing data to be elicited more readily than through direct history taking.

Draw it on a piece of paper in front of the family rather than into a file. Children can often be engaged in helping the doctor to draw the tree.

                        (Termination of

                               Pregnancy)                                                                                    

A genogram displays at a glance  what would require several paragraphs of prose to communicate and should include:

1. All siblings with clear indications of their parentage; their age; stage of schooling; school attended; any diagnoses, or significant history of illness; any stillbirth, perinatal losses, or other childhood deaths and preferably also miscarriages and terminations
2. All significant relationships of both parents including any other issue, stepchildren, etc
3. Usually grandparents
4. Any very significant others who are not part of genetic family
5. A clear indication of who lives in the current family home
6. Where parents are separated, custodial and guardianship arrangements

Whilst an uncomplicated genogram is no guarantee of mental health, significant disruption to the genogram is always a guide to the importance of family factors in presentation. 

With experience a brief glance at a genogram will generate several useful hypotheses.

Certain mistakes are safely avoided if a genogram is present (for example, seeking consent from the wrong parent).