Genogram Questions to Ask
Genogram questions to ask a client, a patient or one of your own relatives when you have to get three generations of a family onto one page, whether you are a therapist, a social worker, a nurse or a student with an assignment due. The list follows the order the drawing is built in: consent and the household first, then who is related to whom, health, how people get along, culture and background, and last the patterns that only show once the page is full. Take the structure group in full and choose from the others according to what the genogram is for.
The questions
Each question, and why to ask it
Opening
Is it all right if I draw your family on paper while we talk, with the page where we can both see it?
Why ask it
Say what the drawing is for and who else will read it before you pick up the pencil. A person who watches it take shape corrects it as you go, and one who says no has told you to explain more, or to take notes now and draw afterward.
Who lives in your home right now?
Why ask it
Start here because it is easy to answer and nobody has to reach back in time. Draw these people first, ring the household with a dotted line as many keys do, then find out who used to live there and when they left.
Who do you count as family, whether or not you are related by blood or marriage?
Why ask it
The answer can add a godmother, a foster brother, an ex's mother or a best friend, and it sometimes leaves a parent out. Draw the chosen people too, joined by whatever line your key gives for a tie that is not blood or marriage, and notice who went unnamed.
Starting with you: what name do you go by, when were you born, and where do you fall among your brothers and sisters?
Why ask it
In a clinical genogram the person answering is the index person, usually drawn with a double outline so the eye finds them first. A student mapping their own family is the index person instead, and the relative being interviewed is placed in relation to the student. Either way, take the birth year and the sibling position now, since every other symbol is positioned around that one.
What has changed in the family lately, such as a birth, a death, a move, an illness or someone leaving home?
Why ask it
Recent changes are often tied to why the person is sitting with you, so write each one on the page with its month and year. With a relative it works as a warm-up, since news from the last year is easier to recall than a grandparent's wedding date.
Are there parts of the family's story you would like to go slowly on, or leave for another day?
Why ask it
Ask it before the hard sections so the person knows they can stop you. Whatever they name, write 'not today' beside it and do not come back to it by another route in the same sitting.
Family structure
What are your parents' names and ages, and are both still living?
Why ask it
Many keys put the father on the left and the mother on the right; with two mothers or two fathers, let the person say who goes where. Write the birth year by each symbol, and for a parent who has died take the year and the age at death now and hold the cause for the health section.
Were your parents married, living together or never a couple, and are they together now?
Why ask it
The line between two partners carries the dates: when they married or moved in, when they separated, when they divorced. If all the person has is 'when I was about six', write that, because a rough date still shows how old each child was when the household changed.
How many brothers and sisters do you have, oldest to youngest, counting half and step siblings?
Why ask it
Siblings hang from the parents' line in birth order from left to right, so settle the order before you draw. Find out which parent each half sibling shares, because that decides which couple line they hang from, and ask about twins, which most keys draw as two lines leaving one point.
Were there pregnancies that ended in miscarriage, stillbirth or abortion, or a child who died young?
Why ask it
Say first that this is asked of every family, then take whatever is offered without pressing for detail. These losses have their own small symbols and keep their place in the birth order. A student interviewing a relative can leave the question out unless the assignment calls for it.
Was anyone raised by someone other than their birth parents, through adoption, foster care or a relative stepping in?
Why ask it
Most keys use a dotted or dashed line for adoptive and foster ties, so the birth family and the raising family can both sit on the page. Two details are worth having: the child's age at the move, and whether contact with the birth parents went on.
What do you know about your mother's parents: their names, whether they are living, and how many children they had?
Why ask it
This is the third generation, and it is where knowledge thins out. Put a question mark beside every guess, set the aunts and uncles in birth order with the mother among them, and jot down which relative might know more.
And on your father's side, who were his parents and his brothers and sisters?
Why ask it
Compare how much the person knows about each side. One full branch and one nearly empty one says something about closeness, distance or a break, so ask how the difference came about.
Have you been married or in a long-term relationship, and when did each one begin and end?
Why ask it
Give every partner a separate line with its own dates, in the order your key sets out. A single slash across the line is the usual mark for a separation and a double slash for a divorce.
Do you have children, and who is each child's other parent?
Why ask it
Children by different partners hang from different couple lines, which is why the second half matters. Include stepchildren, grown children and any who live elsewhere, with birth years and where each one lives now.
Going back over everyone on the page, who has died, in what year, and at what age?
Why ask it
Mark each death with an X through the symbol and the year beside it. The years are worth the effort because later you will set them against whatever else happened in the family around the same time.
Among your grandparents, aunts, uncles and siblings, which couples separated or divorced, and how old were their children then?
Why ask it
Point to one pair at a time on the page instead of asking once in general, because a quiet divorce two generations back is easy to skip. The children's ages are the useful part: they show who grew up in one household and who grew up moving between two.
Who has remarried or found a new partner, and who came into the family with them?
Why ask it
Blended families crowd a page quickly, so draw each new household as its own cluster and leave space around it. Check who sleeps where during the week, since the legal picture and the daily one often differ.
Health
Which physical illnesses have turned up in the family, such as heart disease, diabetes, cancer, stroke or dementia?
Why ask it
Point at each symbol in turn instead of asking in general, because people forget an uncle until you touch his square. Add the age when the illness was found, even as loosely as 'in her forties', and if the genogram is for a health history ask the clinician who will read it which conditions they need listed.
What did each person who has died die of?
Why ask it
Expect family versions such as 'her heart' or 'old age', and record them in the person's words with a question mark. Where the cause matters for a medical history, mention that a death certificate or an older relative may confirm it, and leave the checking to the person.
Has anyone been diagnosed with or treated for depression, anxiety, bipolar disorder, schizophrenia or another mental health condition?
Why ask it
Put on the drawing only what was diagnosed or treated, and note who said so. A relative described as 'difficult' or 'moody' belongs in your notes in those words, not on the page as a diagnosis made from a distance.
Was there someone the family thought was unwell, or 'not right', who never saw anyone about it?
Why ask it
Older generations often had no name for what they lived with, so this catches what the diagnosis question misses. Take down the family's own phrase and what the relative actually did, such as staying in bed for months or vanishing for days.
Has anyone in the family had a problem with alcohol, drugs, gambling or prescription medicines?
Why ask it
Follow with who considered it a problem, because the drinker and the people around them frequently disagree. Then note whether the person stopped, in what year, and what changed at home when they did.
Has anyone in the family died by suicide or tried to end their life?
Why ask it
Keep the same level tone you used for heart disease. Decide beforehand what happens if the subject turns out to be close to home: a clinician follows their service's procedure, and a student stops the interview, stays with the person and helps them reach someone they trust or a local crisis line.
Who has lived with a long illness or a disability, and who did the caring?
Why ask it
The second half usually tells you more than the first. Link the caregiver to the person cared for with a note, and find out what the caring cost: school, a job, or the chance to leave home.
Relationships
Who are you closest to in the family, and what does that closeness look like day to day?
Why ask it
Begin the relationship lines with a good one. Ask for evidence, such as daily calls or being first to hear news, so that 'close' on your drawing means the same thing from one pair to the next.
Which two people in the family clash the most, and what is it usually about?
Why ask it
A zigzag line is the common mark for conflict. The topic of the fights often matters less than how long they have run, so get the year it started and whatever else was happening in the family then.
Is there anyone in the family who has stopped speaking to someone else altogether?
Why ask it
A cutoff is commonly shown as a line with a break in it, and it deserves a date and the story as this person understands it. Find out who still keeps in touch with both sides, because that relative is carrying messages for everyone.
Are any two people in the family so close that everyone else feels shut out?
Why ask it
Some keys call this tie fused or enmeshed and give it a triple line. Do not label it from one remark: get an example, such as a mother and grown son who speak several times a day and decide everything together, and let the person say whether it helps or stifles.
When two people fall out, who gets pulled in to take sides or carry messages?
Why ask it
You are looking for triangles, where a third person steadies a strained pair. Children are often the ones recruited, so check who played that part when your interviewee was small and whether they still do.
Who did you go to as a child when you were frightened or upset?
Why ask it
Comfort does not always come from a parent, and this shows where it did come from. If the answer is 'nobody', stay quiet with that for a moment, write it down, and do not interpret it aloud.
How would you describe your parents' relationship while you were growing up?
Why ask it
Request a scene, such as a typical dinner or a long car ride, because words like 'fine' hide a great deal. Repeat the question for each set of grandparents and see whether the descriptions echo.
Has any relationship in the family involved violence, abuse or control that you feel able to tell me about?
Why ask it
Tell the person in advance what you would have to pass on, and learn from your supervisor or agency what the reporting rules are where you work. Never raise it with other family members in the room, and a student doing an assignment with a relative can leave it out entirely.
Which relationship has changed the most over the years, and what was going on when it shifted?
Why ask it
A line on a genogram is a snapshot, so write a date beside any that used to look different. Shifts often sit near a death, a birth, a wedding or a move, and it is better for the person to make that connection than for you to offer it.
Who shows up when someone in the family is ill, short of money or in trouble?
Why ask it
It puts the family's working support on the page beside its strains. In health and social care the answer also suggests who could realistically help with a discharge or a care plan, so check whether that relative lives near enough to do it.
Culture and background
Where did each side of the family come from, and who made the move to where you live now?
Why ask it
Write the place and the year above the person who moved, even when the move was between regions and not between countries. Their age at the time, and who traveled with them, shows which generation grew up between two places.
What cultural or ethnic background does each side of the family identify with, and how much does it shape everyday life?
Why ask it
Use the person's own words for the group and never guess from a surname or from how someone looks. The second half separates a label from something lived, and siblings often answer it differently.
What religion or spiritual tradition was each side raised in, and who still practices?
Why ask it
Note it per person, since one household can hold a devout grandmother, a lapsed parent and a convert. A good follow-up is whether changing faith, or leaving one, cost anyone their place in the family.
What was expected of the sons in the family, and what of the daughters?
Why ask it
Listen for who was sent to college, who was kept home to help and who inherited the house or the business. Put the same question about the grandparents' generation, and mark where an expectation was dropped or where somebody refused it.
Has anyone married or partnered with someone of a different religion, culture, race or class, and how did the family take it?
Why ask it
Reactions to these marriages are remembered for generations and sometimes explain a cutoff you drew earlier. Three things to collect: who objected, who came around, and how the couple's children were raised.
Which languages are spoken in the family, and who speaks which with whom?
Why ask it
Look for the point where a language stops, such as grandchildren who cannot talk easily with a grandparent. For anyone in health or social care it also raises a practical matter: who would need an interpreter, and whether a child has been doing that job.
What work did each generation do, and how far did each person get in school?
Why ask it
Jot occupation and schooling beside each adult. A first graduate, a business that failed or a trade handed down three times all show what this family expects of its members.
Has anyone in the family been in trouble with the law or spent time in jail or prison?
Why ask it
Write the years away beside the symbol and leave the offense out unless the person offers it. The detail worth having is who ran the household and raised the children during the absence, which can explain a closeness or a grudge you drew earlier.
How does the family feel about getting help from outside, from a doctor, a counselor, a social worker or a faith leader?
Why ask it
A clinician may get more use from this answer than from any other on the sheet, since it suggests who will back the person's contact with you and who will resist it. Find out who the family did turn to in a past crisis, and whether it helped.
Patterns and review
What part did each person play growing up: the responsible one, the peacemaker, the joker, the one everybody worried about?
Why ask it
Offer the examples, let the person supply their own labels, and write each beside its symbol. Then go up a generation and see who held the same part among the parents and their siblings.
Who are you told you take after, and what do you make of that?
Why ask it
Being 'just like your grandfather' can be a compliment or a warning, depending on the grandfather. Pencil a faint link between the two symbols and find out who makes the comparison and at what moments.
Looking down the generations, what do you see happening more than once?
Why ask it
Hand over the page and wait, because a repeat the person finds for themselves lands better than one you point out. Typical finds are the same age at a first child, the eldest daughter doing the caring, or a rift between a father and a son in each generation. Treat every one as something to discuss, not a forecast.
What else was going on in the family around the time of each death, divorce or big move?
Why ask it
Line up the dates you collected: a death and a divorce within twelve months, a child's troubles beginning the year a grandparent fell ill. A short timeline under the drawing makes these easier to spot, and the person can say whether the link feels real to them.
What were the unspoken rules at home about feelings, money and disagreement?
Why ask it
Prompt with 'What would have happened if you had cried, asked what something cost, or said no to your father?' The rules account for behavior the lines alone cannot show, and a couple can compare the rules each of them brought in.
Is there a subject or a person the family does not talk about?
Why ask it
You are asking whether a secret exists, not for its contents. If the person chooses to tell you, find out who else knows and agree together whether it goes on the page or stays off the record.
What has this family come through, and what got it through?
Why ask it
A genogram filled only with illness and rifts reads as a list of damage. Record strengths with equal care, such as the aunt who took in three children, a faith, a sense of humor or the habit of showing up, and say them back to the person before you finish.
Which pattern would you like to end with you, and which would you be glad to pass on?
Why ask it
Here the drawing stops being a history and becomes something the person can act on. In therapy or care planning the answer often supplies a goal in the person's own words; in an assignment it makes a strong closing reflection.
Have I drawn anything wrong, and who could fill in the gaps?
Why ask it
Read the page back branch by branch and let the person correct names, dates and lines. Circle the question marks they want to chase, agree who will ask which relative, and put today's date on the sheet, since a genogram goes out of date.
How was it to go through all this, and what would you like done with the drawing?
Why ask it
Leave a few minutes for this so the person does not walk out with three generations stirred up and nowhere to put it. Explain where the page will be kept and who can see it under your service's or school's rules, and offer a copy if those rules allow.
How to take a genogram interview
Practical guidance for the conversation itself
Setting up the interview
Decide what the drawing is for
A nurse taking a health history usually needs conditions and ages across three generations and can keep the relationship lines light. A therapist or social worker wants the lines, the roles and the dates when things changed. A student should read the assignment brief for what has to appear. The purpose decides which of the six groups gets most of your time.
Explain it in one sentence, then ask
Try something like 'I would like to draw a map of your family so I can see everyone at once, and you can leave anyone or anything out.' Say who will see the page and where it will be kept. In a service, ask your supervisor what consent has to be recorded there; for coursework, ask your instructor whether names must be changed.
Learn one key before you sit down
The basics are widely shared: squares for men, circles for women, a horizontal line for a couple, children hanging below in birth order, an X through the symbol for a death. Past that point, textbooks and software differ on the marks for gender identity, adoption and kinds of relationship. Follow the key your course or agency follows, and print a legend on the drawing itself so the next reader is not guessing.
When the interviewee is your own relative
Students are often sent to a parent or grandparent. Tell them it is for a class, name who will read it, and make clear they can refuse any question. You are on the page as well, so expect to hear things about your own branch, and decide beforehand what you would prefer not to hand in.
Drawing while you listen
Build the skeleton first
Names, births, deaths, couples and children for all three generations go down before any health note or relationship line. That part is the quickest and the least loaded, and it lets the person get used to the page before the harder questions arrive.
Give yourself room
Turn a large sheet sideways, place the index person's generation in the lower middle, and work in pencil. Remarriages and big sibling groups always need more width than you allowed. A messy first draft that you redraw afterward is normal.
Write years, not only ages
An age is wrong within a year, while a birth year stays true. Put the years of birth and death by each symbol, the years of marriage and separation on the couple line, and the date of the interview in a corner.
Show what is uncertain
A question mark beside a guessed date or a rumored diagnosis stops hearsay from hardening into fact when someone else reads the page. Note whose account it is too, since a second relative may draw the same family quite differently.
Save the relationship lines for a second pass
Zigzags and triple lines laid over a crowded structure turn into a tangle. Add them in a second color, or on a copy, once the structure and the health notes have settled.
Pacing and the hard questions
Go from facts to feelings
The order of the list is deliberate: who and when, then health, then how people get along and where the family comes from, then what it all adds up to. Asking about a cutoff before the person has named their siblings feels like prying. Once the map is half built together, it feels like the obvious next question.
Introduce the sensitive ones
Before pregnancy loss, suicide, substance use or abuse, give a line of warning such as 'The next few are things I ask every family, and you can pass on any of them.' Then ask in the same voice as before and wait for the answer.
Know your next step before you ask about risk
If an answer suggests someone is in danger now, a clinician follows their service's procedure, and a student stops the exercise and gets help from the instructor or a local crisis service. What must be reported, and to whom, depends on your role and on where you work, so find out before the interview and tell the person at the start.
Split it over two sittings
Three generations with dates, health and relationships is a lot for one meeting, and tired people give thin answers. Stop at a natural break, usually after structure and health, and let the person check dates with relatives before you come back for the rest.
Close on what holds the family up
Do not let the last thing discussed be the worst thing on the page. Finish with the question about what the family has come through, read the strengths back, and check how the person is doing before they leave.
Mistakes that weaken a genogram
Taking one account as the whole truth
The page shows the family as one member sees it on one day. A sister might draw the same parents with different lines between them. Say so in your write-up, and where it matters, find out whether another relative could add their view.
Diagnosing people you have never met
Writing 'depression' beside a great-uncle because he was said to be gloomy puts a clinical label on a rumor. Keep the family's words in quotation marks and reserve diagnoses for what was actually diagnosed.
Reading a repeat as fate
Three generations of early divorce or heavy drinking is something to talk about, not a prediction about the person sitting with you. Present each pattern as a question, and leave any conclusion about inheritance or risk to a professional qualified to give one.
Filling the page until nobody can read it
Every extra abbreviation and line makes the drawing harder to use. For a health history, a relationship mark on every pair is clutter; for therapy, a full list of operations is. A second sheet or a timeline beats smaller handwriting.
Forgetting whose information it is
A genogram holds health and private details about relatives who never agreed to appear on it. Store it as your service's or school's rules require, change names for coursework if your instructor asks, and do not show it to other family members without the interviewee's say-so.