Appendix B _ FAMILY ASSESSMENT TOOLS APPENDIX 81 CONSTRUCTING ANO INTERPRETING A GENOGRAM PART 1. 1: GENOGRAM FORMAT* A. Symbols to describe basic family membership and str:ucture (include on genogram significa nt others who lived with or cared for family members-place them on U1e right side of the ~enogram with a notation about who they are. ) Male: D Index. Person (IP): Female: 0 Birth date-. SO. OS-Death date ~ [g]@ Marriage (give datel (Husband on left, wif-, on right): Y m. 70 Q Marital separation (give date): s. 83 < 7 Q IH. nh X living together n:ladonship or hat>On (give dat. r): 72 0 Divorce (g,se dat~): 0 d. 72 Q Cl\ltdren: list bv year of birth, beginning with oldest on left: Adopted or foue,r chlld rcn: Fratemel twins: Spontin eous ~bortion: fdendcal twins: ~ Induced abortion :. ~ Members of curl'en. tl P household (clrcle them): W~re c. hang:M ln custody have occ\Jrred. ple-il St: n. ote-: ~Rftence. Mc Goldrick. M. and Gerso,,, R. (1985). Genogrom In Femily. sssmorn. N-York: WW No'1on & Comc,eny, pp. 154-155 I I 0 I I Q D Prean~ncy:~ 6 mos. Stillbirth : ~ .... ______ _------... / ~ _,,' I ' ' I I I 449 