In my Health/Mental Health in Social Work Practice class the other day, we were given an vignette to read and analyze. As my group discussed the case, I worked on compiling a genogram:
Read more, after the break!
You are a clinician working in an agency serving families and children. You are in a session with self referred Caucasian couple, 42 year old Denise and 45 year old Bob. Denise appears tired, with little emotional affect, her hair is not washed and she is substantially overweight for her height; during the interview she states she is too tired to fight anymore, that Bob is never home and she is left to care for the four children ages fourteen, twelve, ten and four years of age. Bob has his arms crossed for much of the session, states that Denise is not taking care of the house, the children or herself and that being at home is a nightmare for him. He works and is going to school part time. Bob reports that he is interested in separating as he is feeling attracted to other women at his school and that Denise has been in “a rut” for years.
You learn that Denise’s father died in 2002 and her mother came to stay at the house. The mother has early signs of disorientation and the children take turns watching the grandmother so that she doesn’t “wanter off”. The twelve year old was caught viewing pornography on the internet at school six months prior to the appointment. The ten year old has been diagnosed with ADHD for two years. The four year old attends preschool and the preschool reports tha tthe child has been picked up late at least twice per week for the last six months.
Following the appointment, the husband comes back into the room and says he is nervous because he is waiting for the results of an AIDS test and thinks that the clinic may have called and spoken to his wife.
In groups of three or four, please provide an assessment of the situation.
Over this past summer, I have come to love genograms. They are tedious – the above took me 15 minutes to complete with the vignette (editing layers, chosing colors, scaling text, etc) – but they provide a treasure trove of information about the client, their family history, and support systems. I especially love for clients to see patterns of behavior in their family histories (which was most effective with clients of Domestic Violence).
My genograms take two sessions to complete, is much more concise, tidy, and professional looking (i.e. phrases like “wants out” do not appear).
What do you think?