Fillable Printable Basic Genogram Symbols Template
Fillable Printable Basic Genogram Symbols Template
Basic Genogram Symbols Template
CMP 105 Adapted from: Power, Thomas A., ACSW.
Family / Child Assessme nt Family Matters: A Layperson’s Guide to
12/2005 Family functioning. Hathaway press,
SJ New 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
Marriage Living Together, Affair, Lesbian Couple Gay Couple
or Intimate Relationship
m. 1970 LT 1975
LT 1991 LT 1993
LT = Living Together
Marital Separation Divorce Getting 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
27 25
22
M
A
Permanent Resource Book
Symbols Denoting Drug, Alcohol, and/or Mental Problems
In Recovery from Serious mental or Drug/Alcohol Abuse
Drug or Alcohol Suspected Drug or Alcohol physical problem & Physical or Mental
Abuse Abuse Abuse problem
Symbols Denoting Interactional Patterns between People
Close Distant Close-Hostile Foscused On
Fused Hostile Fused-Hostile Cutoff
Sexual Abuse Physical Abuse
