Fillable Printable Basic Genogram Symbols Template
Fillable Printable Basic Genogram Symbols Template
Basic Genogram Symbols Template
CMP 105Adapted from: Power, Thomas A., ACSW.
Family / Child Assessme ntFamily Matters: A Layperson’s Guide to
12/2005Family functioning. Hathaway press,
SJNew Hampshire, 1992
The Basic Genogram Symbols
Male: Female: Birth Date Age – inside symbol Death Date Death = X
8-10-’41 10-4-2001
w
ritten above written inside written above
left of symbol symbol right of symbol
MarriageLiving Together, Affair, Lesbian Couple Gay Couple
or Intimate Relationship
m. 1970 LT 1975
LT 1991 LT 1993
LT = Living Together
Marital Separation DivorceGetting back together after Divorce
m. 1970 s. 1985 m. 1970 d. 1987 d. 1987 rema r. 1990
Children: List in birth order beginning with the oldest on the left
’77 ’77 ’79 ’81
’70 ’73 ’76 ’83 ’83 ’85 ’85
Stillbirth
Miscarriage Abortion Pregnancy
Biological Foster Adopted Twins Identical Twins
Child Child Child
•Two people who are married are connected by lines that go down and across, with the husband on
the left and the wife on the right.
•Couples that are not married are depicted with a dotted line.
•Children are drawn left to right, going from the oldest to the youngest.
34
2725
22
M
A
Permanent Resource Book
Symbols Denoting Drug, Alcohol, and/or Mental Problems
In Recovery from Serious mental orDrug/Alcohol Abuse
Drug or Alcohol Suspected Drug or Alcoholphysical problem & Physical or Mental
Abuse Abuse Abuse problem
Symbols Denoting Interactional Patterns between People
Close DistantClose-Hostile Foscused On
Fused Hostile Fused-Hostile Cutoff
Sexual Abuse Physical Abuse
