McGoldrick Ch. 3

Question 1

connectedness

Answer 1

all family
members are involved in whatever happens to one member of the
family, because their connections are both vertical and horizontal.
We want to use that connectedness as the basis for moving away
from “identified patient” approaches.

Question 2

structure of the genogram interview

Answer 2

1. Gather information about the current household (who is in it)?
2. Explore the origin of the presenting problem - where did it come from
   and what have people done about it so far?
3. Ask about any recent significant changes (living conditions,
   employment, finances, unexpected losses, transitions)
4. Once you have the horizontal landscape mapped, begin tracing the
   issues vertically

Question 3

scapegoat

Answer 3

Remember! The Index Person (IP) is likely the Identified Patient (IP)
for the family (i.e. the scapegoat)

Question 4

factors

Answer 4

◆ Sociocultural, sociopolitical, and socioeconomic
◆ Cultural heritage and historical functioning
◆ Finances (Income & Debt; Control; Access)
◆ Beliefs, religious affiliation, and spiritual values
◆ Language and acculturation status
◆ Connectedness to community (social support / institutional)
◆ Migration History (displacement; what happens to “migration
stress”?)
◆ Informal kinship networks (Who helps in times of need?)

Question 5

coping & adaptation

Answer 5

What we want to know is how the family has historically and
currently responds to crises and loss. This also means asking
after their perspectives on the future (using the “miracle question”
from BSFT; what are barriers to family success).

Question 6

Power Pyramid

Answer 6

Figure 3.1 in McGoldrick text

Question 7

priorities & organizing information

Answer 7

Repetitive symptoms and patterns
Over- and under-functioning members
Repetitive relationship dysfunction
Date convergence (anniversaries / age of onset of illness)
Impact of untimely life cycle transitions
Missing information

Question 8

essentials of a brief interview

Answer 8

Where is the stress coming from?
What are the resources available to the family?
What do the members want?
How did you get here (referral sources)

Question 9

1st session

Answer 9

1. Demonstrate accurate empathy
2. Close sessions focusing on family strengths
3. Clarify that more exploration is to come
4. Give the clients a copy of the Genogram

Question 10

vertical stressors

Answer 10

Vertical Stressors: reciprocal occurrences between the past and present (inherited / the
cards your family was dealt)
○ Family attitudes
○ Expectations
○ Secrets
○ Legacies (both positive and negative)

Question 11

horizontal stressors

Answer 11

Horizontal Stressors: located in the present and future (predictable life cycle transitions
and unpredictable losses)
○ Sociocultural
○ Political
○ Religious
○ Economic
○ Community-based
■ Often see dynamic interplay between and within horizontal and vertical
stressors
★ Unexpected Life Stressors