Uso de los genogramas como técnica diagnostica y evaluativa en la Unidad de Terapia familiar de la Clínica Universidad de Navarra

1. Nursing and the use of Genograms: evaluation of dysfunctional couples
**Tricas-Sauras, S., *Beunza Nuin, M.,* Cano Prous, A.,* Martín Lanas R., *Aubá Guedea, E.
*Diagnosis and Family Therapy Unit. Department of Psychiatry and Medical Psychology
University Hospital. **School of Nursing. University of Navarra. Spain.
INTRODUCTION
The Genogram is a graphical and descriptive representation of the family throughout time and of the relationships within its members (1). It is
an instrument that allows to organise the information of the interviews and to identify dysfunctional patterns of the family (2) (Fig. 1).
Genograms are useful to detect alterations in family relations as well as dysfunctional and recurrent trans-generational patterns (DART). Marital
infidelity is a multifaceted problem that frequently causes couples to enter marital therapy (3). Genograms help study the presence of infidelities
in previous generations in couples with dysfunctional dynamics, and are valuable to set the scenario for professional intervention.
OBJECTIVES METHODOLOGY
1. To explore the use of genograms in family therapy Research design: mixed methods, exploratory, descriptive in 235
research when consulting for infidelity. families. The SPSS v. 15.0 programme was used for data analysis
2. To identify dysfunctional and recurrent after qualitative management and categorisation of themes, using
transgenerational patterns (DART). the “stage-by-stage” Burnard’s method (4). Systematic Identification
3. To evaluate the eventual repetition of dysfunctional of themes and issues addressed in the interviews (5). Interviews
patterns in a cohort of families consulting at the were conducted with each of the spouses, who also completed a
Diagnosis and Therapy Family Unit. battery of tests (FAD, DAS, ACQ) (6-8) and a communication
questionnaire (RMICS) (9). The genograms were constructed with
GENOGRAMA
FIGURE 1: GENOGRAM EXAMPLE the data gathered, identifying DART patterns. The main patterns
studied were: infidelity, divorce/separation, mental disorder,
I S ui ci di o
Esq u izo fr en ia
substance abuse, alcoholism, and physical or sexual abuse.
Recurrent patterns were considered when occurring at least in two
IAM
E st eban B ert a J uan J uana A na Carlos E pifania
C án ce r ú te ro
out of the three family generations.
5h V irginia
Leu ce mia Tu mor Dia b et es Al co hó l ico
79
B eatriz Más im o E st íbali z MªS ol Fernando Marc os Laura Luis S ebas B ert a J uan A na P edro Ric ardo Daniel B eatriz E va
2h
4h 2h
FIGURE 2: DYSFUNCTIONAL RECURRENT PATTERNS
5h 8h
C ora zó n Pa ra da Dia b et es 84 79 Dep resi o ne s
ca rd ía ca
Bernardo María Joaquín Patricia
Al co ho l ismo
55 58 54 51 55
E speranz a J oaquín J osé I sabel Manuel
Luis Substance abuse
7h
Divorce/Infidelity
49 49
JUAN MATILDE
Depresión Mental Disorder
JOSÉ
m. 1982
21 17
LUCÍA RAFAEL
0 10 20 30 40 50
RESULTS
In our sample, 114 cases (57% of the families studied) presented any of the dysfunctional recurrent patterns previously described.
Mental disorder (32%; n=64), divorce/separation (47%; n=94), and substance abuse categories (17%; n=34) (Fig. 2) were
identified as the most recurrent patterns throughout generations. Those were identified according to the data obtained in the
interviews and subsequent analysis of each family as a “case study” (10). In 65% of the cases evaluating infidelity the male
spouse had been unfaithful vs a 35% of the cases were females were considered disloyal. In a third of those cases, an infidelity
DART pattern could be identified in previous generations.
The concept “abuse” was excluded because of the poor accuracy in the data of this category.
CONCLUSIONS
• Data obtained in this study highlighted the relevance of the use of the genogram within family therapy to detect potential DART
patterns, such as infidelity.
• More than half of the families studied complied with one or more recurrent dysfunctional patterns, among which mental disorder,
substance abuse, and divorce/separation stand out.
• The genogram provides a convenient and clear format to record information that may be underestimated in the family therapy
area, allowing professionals to indentify potential problems in a quick and graphical way.
• It is suggested the need to carry out future studies in order to clarify the repetition of dysfunctional patterns throughout
generations. This would be carried out by exploring larger samples of families in order to contrast our results.
BIBLIOGRAPHY
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mbeunza@unav.es, stricas@unav.es