THE FAMILY

Foster et al. / IMPACT

JOURNAL:
OF THE
COUNSELING
GENOGRAM
AND
ONTHERAPY
COUPLESFOR COUPLES AND FAMILIES / January 2002

The Impact of the Genogram on

Couples: A Manualized Approach
Martha A. Foster
Gregory J. Jurkovic
Lisa G. Ferdinand
Lindi A. Meadows
Georgia State University

Genograms are widely used in clinical practice but are seldom the
focus of research. This report describes a beginning effort to
operationalize the clinical application of the genogram with couples
to improve the fidelity of the genogram’s use in future research. The
five-session manualized method focuses on the genogram interview
as a process-oriented intervention in which a couple collects family-
of-origin data, identifies key relational patterns, and makes linkages
between family-of-origin patterns and the current relationship. The
approach uses homework tasks to set the stage for subsequent ses-
sions and computer software to generate and update the genograms.
The use of the manualized approach with a premarital couple is pre-
sented, and individual and relational changes in the couple are dis-
cussed. Applications of the method in research, clinical training, and
intervention with couples are discussed.
T he genogram is an assessment and therapeutic tool used
widely with couples, individuals, and families in clinical
contexts and with helping professionals in training and in
supervision. In our clinical work with couples, we have
observed that the genogram interview can have a
disequilibrating effect. Partners are challenged to assume a
systemic perspective in relation to not only their own but also
their partners’ family process, facilitating their ability to
engage in mutual perspective taking and to contextualize rela-
tionship issues. The power of the genogram to effect such
changes derives, in part, from its visual-graphic nature. It lit-
erally confronts individuals with the recurrent and inter-
Authors’ Note: For further information on this approach, please
contact Drs. Martha Foster or Greg Jurkovic, Couple’s Research
Project, Psychology Department, Georgia State University, Univer-
sity Plaza, Atlanta, GA 30303; phone: (404) 463-9491; e-mail:
mfoster@gsu.edu or gjurkovic@gsu.edu. Order of authorship of the
first two authors was determined through a coin toss because they
contributed equally to this article. The authors wish to acknowledge
the Randy Gerson Memorial Fund and the American Psychological
Association Foundation for support of this work.
connected patterns within their families of origin and in their
current relationships. The net result is often an improvement
in the couple’s readiness to change and in their satisfaction
with their relationship.
Our observations are congruent with Bowenian theory,
which asserts that processing intergenerational information
with clients helps them to become meta to family dynamics,
to regulate anxiety in response to toxic relational issues, and
generally to adopt a more differentiated stance vis-à-vis sig-
nificant others (Bowen, 1978). Growth in self-differentiation
results in changes at both an intrapersonal and interpersonal
level. Intrapersonally, individuals become able to separate
their cognitive and emotional responses and to experience
each more fully. At an interpersonal level, differentiation of
self results in a greater capacity for balancing autonomy and
intimacy in relationships.
Despite the extensive clinical and training uses of the
genogram and its compelling theoretical foundation, the
genogram has attracted the attention of surprisingly few
researchers. Consequently, little is known about its direct and
indirect effects. The complexities of collecting and interpret-
ing the rich array of data generated by the genogram have
impeded research efforts. The research that has been con-
ducted has been focused largely on the usefulness of the
genogram in the field of family medicine and on issues of reli-
ability (see McGoldrick, Gerson, & Shellenberger, 1999).
In this article, we will describe our initial efforts to adapt
McGoldrick and colleagues’ (1999) genogram protocol for
research and clinical applications with couples. Our adapta-
tion will be used in future research on the impact of the
genogram on different intrapersonal and interpersonal pro-
cesses, such as (a) differentiation of self, (b) ability to think
systemically, (c) readiness to change, and (d) relationship sat-
isfaction. Another long-term goal is to evaluate the efficacy of
a manualized genogram program with couples seeking pre-
marital counseling or as an adjunct to treatment with clinical
couples.

THE FAMILY JOURNAL: COUNSELING AND THERAPY FOR COUPLES AND FAMILIES, Vol. 10 No. 1, January 2002 34-40
© 2002 Sage Publications

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 Foster et al. / IMPACT OF THE GENOGRAM ON COUPLES 35

To achieve these goals, the first origin and, later on, reflecting on
step is to systematize the process of family patterns and toxic issues.
using the genogram with couples. Sessions are sequenced to focus
Currently, there is disagreement in The manual, which is first on each partner’s historical rela-
the literature regarding the use of the tionships within his or her family of
genogram as a clinical instrument to designed to improve the origin. Later sessions focus on the
collect and organize family historical couple’s relationship. By focusing
data and the use of the genogram as a fidelity of the genogram’s initially on family-of-origin rather
clinical process to effect change than couple issues, partners are
(McGoldrick et al., 1999). A focus on implementation in research encouraged to examine what each
the former has led to research ques- brings to the relationship from his or
tions about the genogram’s reliability with couples, is focused her family of origin. This process
and validity—the kind of questions also encourages the couple to create
asked of psychological measurement more . . . as a process- emotional space between them to
tools. We are more interested in sys- gain perspective on themselves, each
tematizing the process of the genogram oriented intervention than other, and their relationship. Although
interview with couples to facilitate the tendency to fuse is common to all
changes (Dunn & Levitt, 2000) than as an assessment tool. couples, it is particularly true for
in obtaining a psychometrically many engaged couples. Processing a
sound multigenerational data set as genogram can help fused couples to
an outcome (Coupland, Serovich, & disengage emotionally to develop a
Glenn, 1995). We strongly concur with Bowen (1978) that it more differentiated relationship.
is the conjoint processing of the genogram with a well- Consistent with Bowenian theory, the therapist assumes
differentiated therapist that is more important than obtaining multifaceted roles including that of data collector, coach, edu-
a detailed and accurate record of the client’s family history. cator, and cocollaborator. Much of the therapist’s role is
To evaluate the impact of the genogram interview, we Socratic in nature, for example, posing questions, drawing
decided to work initially with premarital couples. These cou- attention to relational dilemmas and patterns across the gen-
ples do not typically present with a focal conflict, yet they are erations, challenging beliefs and assumptions, and encourag-
motivated to explore relationship issues. Consequently, they ing thinking in the face of strong emotion. The therapist also
allowed us to use the genogram in a more delimited fashion helps the couple to reevaluate their sense of urgency about
than would be possible with clinical couples. We created a problematic issues in their relationship. The couple is often
structure in which the relevance of genogram information driven to find immediate solutions. The therapist conveys
was highlighted early in the process, for example, by intro- through both his or her nonreactive stance and direct tuition
ducing them to key Bowenian concepts that they could apply that success in relationships requires each partner to learn to
to their own families and their couple relationship. understand and tolerate the anxiety associated with conflict
To illustrate our work, we will first describe our and difference. Rather than focusing on problem solving, the
manualized approach to processing the genogram with cou- therapist uses conflict and differences within both the couple
ples. Next, we will present a case along with the empirically and their respective families of origin as vehicles to bring the
based procedures that we have used to evaluate the effects of individual into focus and to define his or her own position.
the genogram. Finally, we will discuss implications of our This kind of work is done most effectively by therapists who
work for research and applications with clinical and themselves are self-differentiated and able to maintain a
nonclinical couples. nonanxious presence while perturbing the couple’s system
(Friedman, 1991).
MANUALIZED GENOGRAM
APPROACH WITH COUPLES SESSION DESCRIPTIONS
AND OBJECTIVES
To capture the clinical use of the genogram with couples,
our approach involves multiple sessions that are devoted to Session 1
both family data collection and to a theoretically driven
inquiry and interactive process. Specifically, the program Couples are introduced to the notion that family history
consists of five weekly sessions with additional time devoted plays a role in how couples come together and work out prob-
to posttesting. Between sessions, couples are assigned home- lems in their relationship. Demographic information, length
work, such as gathering information from their families of of relationship, and level of couple commitment are ascer-

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36 THE FAMILY JOURNAL: COUNSELING AND THERAPY FOR COUPLES AND FAMILIES / January 2002
tained. To establish a baseline measure of functioning, cou-
ples complete questionnaires, which include measures of
conflict resolution strategies (Conflict Tactics Scale) (Straus,
1979), the ability to think abstractly about relationships
(Awareness of Couple Issues) (Ulrici, 1984), readiness to
change (Stages of Change Questionnaire) (Prochaska,
DiClemente, & Norcross, 1992), differentiation of self (Per-
sonal Authority in the Family System Questionnaire) (Wil-
liamson, Bray, & Malone, 1984), and perceptions of close-
ness or distance to significant others (Inclusion of Other in the
Self Scale) (Aron, Aron, & Smollan, 1992).
In addition, we constructed a three-generation family his-
tory worksheet that each partner independently completes to
the best of his or her ability in the session. We photocopy the
worksheets for our records and assign the partners the task of
contacting their families before the next session to complete
the worksheet.
Between the first and second session, the therapist enters
the worksheet information for each partner into Genogram
Maker Plus (Gerson & Shellenberger, 1999), a computer soft-
ware program that generates a genogram. Using the computer
program allows us to modify the genogram easily as more
information becomes available.
Session 2
One of the objectives of the second session is to increase
curiosity about the ways that patterns in family of origin influ-
ence each partner and the dynamics within their relationship.
Another goal is to facilitate the couple’s ability to see their
own relationship as part of an enduring and evolving
multigenerational process. These objectives are addressed
through a series of steps.
At the beginning of the session, the couple is given a hard
copy of the computer-generated genogram. The symbols and
layout of genograms are explained. Next, the information
gathered by the couple during the week is reviewed in session
and written onto the hard copy of the genogram. This infor-
mation is later entered into the Genogram Maker. While
reviewing the new information, the therapist explores the
couple’s experience of gathering information from family
members and uses their genograms as a springboard to intro-
duce key Bowenian concepts, such as differentiation of self,
fusion, reactivity, triangulation, and emotional cutoff.
At the conclusion of the session, the couple is given a
homework assignment designed to immerse them in the pro-
cesses of their respective families of origin. The assignment is
multifaceted: (a) Collect stories from parents and grandpar-
ents about key transitions and challenges in their relational
histories (e.g., their courtship, wedding, illnesses, losses),
(b) choose a relationship (e.g., father-son, mother-daughter,
sibling) and trace it through several generations, and (c) iden-
tify a source of tension, conflict, or a “hot spot” in the family.
The couple is encouraged to use these tasks as a way of
reflecting on the family systems concepts presented earlier in
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the session. It is not expected that the couple will complete all
of the homework, but it is hoped that they will find one of the
assignments compelling. The results of the homework pro-
vide a focus in the next session for family-of-origin work.
Session 3
During this session, the couple is engaged in a dialogue
with the therapist about the homework tasks. The family sys-
tems concepts presented earlier are applied to the relational
patterns in each family.
Each member of the couple is asked to remain focused on
his or her own family of origin. Although this appears to be a
simple request, it is often difficult for couples. One or both
may be pulled to focus on the other’s family of origin given
that it is often easier to see patterns in a family system in
which one is less emotionally invested. Focusing on the
other’s family of origin is also a way to avoid or postpone con-
fronting issues within one’s own family. When this happens,
we redirect the partners to focus on their own families of ori-
gin and take the opportunity to highlight the various ways in
which the emotional system operates in families (e.g., how
anxiety limits one’s ability to assume a meta perspective on
family of origin).
Processing historical issues is difficult for some couples
because they move readily to focus on their own relationship,
minimizing the impact of transgenerational patterns. We
acknowledge the importance of their relationship concerns
but do not delve into the couple relationship in this session.
The couple is reassured that their current issues will be
addressed in subsequent sessions.
The homework assignment made at the end of this session
bridges the focus from family of origin to the couple relation-
ship. Each partner is asked to consider ways that the relational
patterns identified in the family of origin might explain con-
flicts that are current between them and might enhance or
challenge the couple relationship in the future. Anticipating
that insight about another’s family comes more readily than
insight about one’s own. We caution them to keep the focus on
their own family of origin rather than that of their partner and
to refrain from sharing their observations with each other
until the next session.
Session 4
The focus of the fourth session is on helping the couple
make connections between their families of origin and their
own relationship. This goal is facilitated in various ways. For
couples who want to deal with conflict, this is the point at
which conflicts are explored and are placed in the context of
each partner’s family of origin. Other couples who are not
identifying conflict as a concern are encouraged to consider
one or more issues that carry some emotional power for them
(e.g., holiday rituals, attitudes about health and money, rela-
tionships with extended family).

All couples are also asked to examine the roles that they
may have played in their families of origin (e.g., high
achiever, savior, clown) and to reflect on how these roles may
be influencing their current relational patterns. Sometimes
the role is recapitulated in the current relationship, whereas at
other times the new partner is inducted to play the familiar
role. The couple is asked to look at the complementarity of
roles in their family of origin as a way of increasing their
awareness of the complementary patterns in their current rela-
tionship. The couple is encouraged to examine the benefits
and liabilities of their role behavior and to assess whether they
choose to continue such behavior in their current relationship.
The homework at the conclusion of this session is intended
to help the couple to consider further their relationship in light
of the patterns within their respective families of origin. We
used the technique of circular questioning (Penn, 1982) in a
written assignment that asked them to assume a metaperspec-
tive on themselves, their partner, and each of their families.
The assignment consisted of the following six questions that
each partner answered independently: What did you learn
that was new about your family? What do you think your part-
ner learned that was new about your family? What are the
implications of this for your relationship? What do you think
your partner learned that was new about his or her family?
What did you learn that was new about your partner’s family?
and What are the implications of this for your relationship?
Session 5
In the final session, we used the circular questions from the
homework to facilitate the couple’s integration of their expe-
rience working with the genogram and their ability to appre-
ciate the larger familial context of their relationship. They are
asked to share with one another their answers to the various
questions and to dialogue about differences.
Because processing genogram material often uncovers
toxic issues and problems, we also help the couple to assess
such concerns and to determine a plan for handling them. For
example, a referral for couple or individual therapy, financial
counseling, or consultation about a spiritual or religious con-
flict may be recommended.
To mark the couple’s successful completion of the pro-
gram, they are given an updated hard copy of their
genograms. The genogram software described earlier facili-
tates the production of these genograms. It appears that cou-
ples appreciate this concrete representation of their experi-
ence. Posttesting is conducted at the end of this session or
scheduled for a later time.
CASE STUDY
Ben, 24, and Marie, 23, were a young engaged couple who
first met in college but did not date until after graduation.
Both had bachelor’s degrees and worked in the business
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Foster et al. / IMPACT OF THE GENOGRAM ON COUPLES 37
world. Ben was proud of the fact that he had already pur-
chased his own home. Ben was talkative, friendly, and made
jokes, whereas Marie was more quiet, reflective, and serious.
Each was attractive and socially skilled. Neither had ever par-
ticipated in any form of psychotherapy.
After the couple completed the measures and the
genogram worksheet during the initial session, they were
given the homework assignment of gathering additional
information and stories from their families of origin. They
seemed open and willing to do their first assignment.
Ben and Marie were smiling when they arrived for the sec-
ond session. Marie had e-mailed her 80-year-old great aunt
who had done extensive work on their family genealogy.
Marie also had telephoned her mother several times to gather
family information and stories. Ben had also contacted his
parents to obtain information about his extended family.
Marie was the youngest of three children. Although her
parents did not know each other very well, they married
because Marie’s mother became pregnant. They had a distant
marriage. Spending more and more time apart, they eventu-
ally divorced during Marie’s late adolescence. Her father
soon remarried, and her mother remained single.
Although Marie worked in the same field as her father, she
was not close to him. He had worked long hours while Marie
was a child and had periods of heavy drinking. She saw very
little of him. By contrast, she is very close to her mother
whom she described as the primary caretaker and disciplinar-
ian for her and her siblings growing up. Now that Marie is
older, she is more of a friend and confidant to her mother and
worries about her being alone.
Ben was the eldest of three children. His parents met after
each had graduated from college. His father had had a brief
prior marriage. Ben’s mother grew up in a large, enmeshed
extended family from whom she distanced when she married
Ben’s father. They have been happily married for 26 years
despite the stress of frequent job moves.
Although as a child Ben looked up to his father and wanted
to emulate him, growing up he spent most of his time with his
mother. He acknowledged that he has been “a bit of a mama’s
boy,” and as an adult he has allowed her to make decisions for
him, including how to decorate his new home. Ben’s mother,
who lived out of town, stayed with Ben once or twice a week
when traveling for her job. Her visits often interfered with
Ben and Marie’s plans, which troubled Marie more than Ben.
Many additional stories were reported by the couple about
their grandparents. By the end of the second session, they
were comfortable with the process and reported learning
much more about their extended families than they had previ-
ously known. Toward the end of the second session, the thera-
pists used the family stories to generate questions and ideas
regarding Bowenian concepts. For example, the sense of
intrusion that Marie experienced in relation to Ben’s mother
was discussed in terms of triangulation and enmeshment. The
38 THE FAMILY JOURNAL: COUNSELING AND THERAPY FOR COUPLES AND FAMILIES / January 2002
couple actively participated in this dialogue and began to gen-
erate some of their own hypotheses about family dynamics
and possible routes of change.
For their homework between the second and the third ses-
sions, Ben and Marie both chose to trace a family relationship
across several generations. Marie looked at sister relation-
ships—her grandmother and her great aunt, her mother and
her aunt, and her sisters and herself. She was struck by the
similarities in these relationships that spanned three genera-
tions. Each generation included a sibling who was extro-
verted, controlling, and confronting of her family and a sib-
ling who was more introverted, gentle spirited, and conflict
avoidant. In the course of reviewing these relationships,
Marie was struck by her own tendency to keep the peace.
In this session, Marie also began to consider prominent
themes and issues in her family, such as values about
women’s education, women’s achievement, and women’s
independence. From her mother and her grandmother, both
accomplished professionally, she had taken the belief that
“women do and they cannot count on men.” In addition, the
long-standing pattern of emotional cutoff between her father
and his sister, and more recently between her father and her-
self, was identified.
For the third session, Ben had traced father-son relation-
ships across generations in his family and had found themes
related to fairness and independent choice. His paternal
grandfather, influenced by his military background, tended to
be strict, formal, and not openly affectionate with his chil-
dren. Because he had been cut out of the family will for choos-
ing a military career over the family business, fairness was
extremely important to Ben’s grandfather. Although not dem-
onstrative with his children, he strove to deal fairly with them.
Ben’s father was more intentionally loving and openly affec-
tionate with Ben and his siblings, but he also deeply valued
fairness. His strong message to his children was that he would
be proud of them whatever their career choice.
In contrast to his father’s direct and sometimes emotion-
ally reactive style, Ben tended to avoid conflict in a manner
similar to his mother. Rather than deal directly with differ-
ence, Ben’s mother and her family tended to triangulate
through gossip and indirect communication. Her extended
family members, who all lived within a few miles of each
other, were very involved in each other’s lives in both support-
ive and intrusive ways. The process of exploring these pat-
terns in his mother’s family led Ben to conclude that he would
like to be more selective about what he would share with his
family and what he would keep private. Ben also acknowl-
edged that he had let his mother and, to a lesser extent, his
father make decisions and do too much for him to avoid con-
flict. He began to think about how he might relate differently
to them.
The fourth session focused on how the patterns and issues
identified in their respective families had an impact at the
level of the couple relationship. Most striking was the extent
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to which each partner’s similar styles of conflict avoidance
kept them at stalemate on important issues. Also identified
were some dynamics of overfunctioning and underfunction-
ing. For example, the more Marie attended to the details of
their social life, the less responsibility Ben took for planning
activities for the couple.
In the fifth session, the homework assignment involving
circular questions was reviewed. Each partner had insight
about significant patterns in his or her family of origin and
how these patterns resonated in their own relationship. Ben
talked about how his passivity and overinvolvement with his
mother (e.g., allowing her to visit unannounced and to deco-
rate his house) compromised his relationship with Marie. He
considered setting clearer boundaries with his mother, includ-
ing thinking through how his parents would likely react to
such a change (i.e., discomfort and hurt from his mother but
support from his father). In addition to this desire to relate dif-
ferently in his own family, Ben also reported that he under-
stood more about Marie’s family and felt increased support
for her.
Marie’s conversations with her mother and grandmother
about women’s roles led her to consider how women, includ-
ing she herself, overfunctioned in her family. The couple’s
recurrent struggle over issues of taking responsibility (e.g.,
for household tasks, for setting limits with Ben’s mother) sug-
gested that this issue was toxic for them. Marie tended to step
in and take charge, whereas Ben dismissed his inaction as
“lack of attention to details.” In this session, the homework
exercise that pulled for perspective taking helped them to step
back from this repeated sequence to see more clearly how the
roles they each played were well learned in their own
families.
Normally, these five sessions compose the genogram pro-
gram. Ben and Marie, however, requested an additional ses-
sion to address some of the issues that had been raised
between them. Given that the program was still in develop-
ment and the couple was highly motivated, we agreed to con-
tinue to meet to learn more about the impact of this approach.
Ben entered the sixth session with a broad smile and
announced that he felt that he had made a change in his rela-
tionship with his parents. He had talked with both of them
about his need to be more independent and responsible and
requested that they, particularly his mother, help him by doing
less for him (e.g., refrain from giving him money and from
assisting with decorating). In addition, during the week that
his mother had stayed at his house, he did not change the plans
that he had made with Marie. Ben observed,
I don’t think I realized how much I was allowing my mother to
overfunction for me. I attributed it to, “Oh well, that’s just the
way my mother is, that’s the way she’ll always be.” Seeing
how frustrating that role was for Marie, I said to myself, Hey, I
am an adult. That’s the way it’s always been, but maybe I
should make changes. It’s time to grow up.

Following his talk with his parents, he reported feeling
“much, much better” and described the genogram work as
having been a catalyst for change. Marie described her own
growing awareness that she had choices in her interactions
with others. Rather than her typical pattern of avoiding con-
flict, she had allowed herself to get angry with Ben about an
issue between them and had insisted that they deal with the
problem directly. Following this session, the couple returned
in a week to complete the posttesting.
DATA
The pretest and posttest data indicated that the couple had
moved closer toward their families of origin, as well as to each
other, and at the same time their levels of differentiation of
self increased. On the global score and on nearly all of the
subscales of the Personal Authority in the Family System
Scale, Ben and Marie reported changes in the direction of
increased self-differentiation and enhanced personal func-
tioning. For example, on the subscale assessing spousal inti-
macy, both Ben and Marie reported increased feelings of
closeness with each other. Positive change was also noted for
both on the dimension of fusion/individuation between part-
ners. On the subscale tapping relationships with parents and
family of origin, both Ben and Marie showed a reduction in
reported levels of fusion and triangulation with parents over
time. The most significant change was a marked drop on the
subscale tapping intergenerational intimidation, with both
Ben and Marie feeling significantly less intimidated by their
parents. These scores were consistent with scores on an addi-
tional measure tapping interpersonal closeness, the Inclusion
of Other in the Self Scale. Marie perceived herself becoming
closer to Ben and closer to her father. Ben perceived himself
becoming closer to both parents. On the Awareness of Couple
Issues measure, both Marie and Ben improved in their ability
to think systemically about relationship issues.
DISCUSSION
In this article, we have described our initial efforts to
examine the impact of the genogram with couples on rela-
tional and individual functioning. To operationalize the inde-
pendent variable in our research (i.e., the clinical application
of the genogram), we have drawn from Bowen (1978) and
McGoldrick and colleagues (1999) to construct a five-session
manualized approach supplemented with software developed
by Gerson and Shellenberger (1999). The manual, which is
designed to improve the fidelity of the genogram’s implemen-
tation in research with couples, is focused more on the use of
the genogram as a process-oriented intervention than as an
assessment tool where the focus is on the collection of com-
pletely accurate and reliable historical information.
As the case study illustrates, a manualized approach holds
promise for systematically investigating hypotheses concern-
ing the multifaceted effects of the genogram with couples.
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Foster et al. / IMPACT OF THE GENOGRAM ON COUPLES 39
Our work with this couple and others in our pilot project has
provided suggestive data for the impact of the genogram on
both self-differentiation and on the ability to think about rela-
tional issues in a more complex systemic fashion. Whether
these preliminary findings are valid must be determined
through controlled research, which we are currently
undertaking.
Further investigation examining the clinical utility and
effectiveness of our manualized approach is warranted
because of its implications not only for research but also for
training and clinical work with couples. As noted earlier,
empirical research of Bowenian theory and practice is limited
due in large measure, we suspect, to the lack of operational-
ization of key constructs and techniques. Although the work
of McGoldrick and her colleagues provides important guide-
lines for the Bowenian use of the genogram in clinical con-
texts, it lacks the procedural detail necessary for rigorous
research in this area. The manual that we developed opera-
tionally defines the genogram process with couples. We also
anticipate that the manualized approach will prove useful
with students and trainees.
Teaching Bowenian therapy to graduate students, includ-
ing the clinical application of the genogram, can be a chal-
lenging process. Beginning students, in their efforts to collect
family data accurately and completely, often miss the collab-
orative process of discovery that Bowen intended. Our
manualization of the genogram can be used as a training tool
in both classes and laboratory settings, providing beginning
students with a structured, hands-on experience in collecting,
organizing, and interpreting family-of-origin data with
nonclinical couples. We have found that using the manual in
this way helps bridge theory and practice for students and
deepens their understanding of both.
The manual can also guide enrichment activities and clini-
cal work with couples. We are particularly interested in its
application to premarital or precommitment counseling, a
field that has been dominated by skills-based approaches
(Silliman & Schumm, 2000). Although these approaches
improve couples’ communication and conflict-resolution
skills, a Bowenian strategy targets different processes (e.g.,
self-differentiation) that have putative effects at multiple lev-
els (i.e., individual, couple, and family of origin). As the pop-
ulation in the United States has become increasingly diverse,
clinicians are serving more mixed ethnic, racial, religious,
and same-sex couples. A Bowenian approach appears well
suited for these couples as they grapple with deeply rooted
sociocultural differences and tensions. As noted earlier, the
approach also lends itself to work with premarital or
precommitment couples who are typically enmeshed.
Although normative, such enmeshment makes it difficult for
these couples to obtain perspective on their issues in counsel-
ing. The genogram can serve as an excellent tool for helping
them to contextualize their relationship and to plant seeds
40 THE FAMILY JOURNAL: COUNSELING AND THERAPY FOR COUPLES AND FAMILIES / January 2002
resulting in not only greater individualization but also genu-
ine intimacy.
There is some evidence that skills training influences self-
differentiation (Griffin & Apostal, 1993); it would be interest-
ing to ascertain whether a Bowenian approach, such as the
one we have developed, improves relationship skills. In our
clinical experience, it does. The two approaches, in fact, may
work synergistically and consequently might be productively
combined as an enrichment and premarital counseling strat-
egy. For example, if the manualized genogram is used ini-
tially, further in-depth exploration of the patterns and issues
identified could begin following the fourth session. At that
point, the therapist could introduce skills training and related
activities (e.g., money management). In addition to placing
these interventions in context, the genogram may motivate
the couple to acquire new skills. For example, if an emotion-
ally costly, multigenerational pattern of poor spousal rela-
tionships had been identified in an individual’s genogram,
then his or her incentive to interdict the pattern at his or her
generation might significantly increase.
Clinical couples could also benefit from our manualized
genogram approach. Depending on the therapist’s theoretical
orientation, the manual might be used during the initial
assessment phase or as a growth-inducing intervention fol-
lowing crisis/symptom–focused work or skills training.
Recent case examples provided by Dunn and Levitt (2000)
illustrate the power of combining genogram work with other
kinds of therapy.
On a cautionary note, we recognize that there may be sev-
eral contraindications to the use of our manualized approach.
Couples in crisis, in particular those in which violence is a
factor, require immediate risk management. In addition, in
light of the fact that the approach depends on the participants’
willing exploration of family history, couples who are insuffi-
ciently motivated would probably not be good candidates.
Finally, this approach is intended for use in clinical and
research contexts by therapists who have a working knowl-
edge of Bowenian theory and some clinical experience with
couples.
In light of the multiple implications of our manualized
genogram approach, we are pursuing further investigation of
its application to research, training, and clinical activities. It is
hoped that our work will spawn increased systematic study of
Bowenian theory and practice and lead to creative integra-
tions of Bowenian concepts and techniques with other enrich-
ment and therapeutic approaches.
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Martha A. Foster, Ph.D., is a faculty member and director of the
Clinical Psychology Training Program in the Department of Psy-
chology at Georgia State University. Her research focuses on sys-
tems models of family adaptation to disability, family intervention
with high-risk children, and systems approaches with couples. She is
an approved supervisor for the American Association for Marriage
and Family Therapy and maintains a clinical practice in couple and
family therapy.
Gregory J. Jurkovic, Ph.D., is a faculty member in the Department
of Psychology at Georgia State University. His research focuses on
child and family adaptations to different stressors (e.g., immigra-
tion, war, divorce) and on couples therapy from a systemic perspec-
tive. He is an approved supervisor for the American Association for
Marriage and Family Therapy and maintains a clinical practice
with couples and families.
Lisa G. Ferdinand, L.C.S.W., is a clinical social worker and a doc-
toral student in clinical psychology at Georgia State University.
Lindi A. Meadows, M.A., is a doctoral student in clinical psychology
at Georgia State University.