Mental Health Genogram Guide for Therapy and Self-Awareness

Updated on: 09 July 2025 | 10 min read
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Mental Health Genogram Guide for Therapy and Self-Awareness

This comprehensive mental health genogram guide explains what a mental health genogram is, how to create one, its benefits, limitations and more. It maps family history and emotional patterns to reveal repeating mental health issues. See real world examples with templates and learn how therapists use this tool in practice.

What Is a Mental Health Genogram

A mental health genogram is a powerful visual tool that maps your family’s mental health history across multiple generations. Unlike a basic family tree, it highlights patterns of mental illnesses, emotional dynamics, and recurring psychological traits. Mental health professionals use genograms to gain deeper insights into a person’s background, while individuals can use them to understand how family history may be influencing their current mental well-being.

If you’re new to genograms, explore our comprehensive What Is a Genogram guide—covering its definition, uses, and all you need to know.

How to Create a Mental Health Genogram

Creating a mental health genogram helps you see the bigger picture behind emotional struggles. Whether for therapy or personal insight, it’s a meaningful way to explore how mental health patterns run in your family.

Step 1: Gather basic family information

Start by writing down names, ages (or birth/death dates), and relationships of your family members—going back at least two generations if possible (parents, grandparents, aunts, uncles, cousins, etc.).

Ask questions like:

  • Who are the key family members?
  • How are they related to each other?
  • Are they still alive? If not, how and when did they pass away?

Tip: Use a notebook or digital tool to keep track of what you find.

Step 2: Identify known mental health conditions

This is where you begin to layer in mental health-related information.

Look for any known or suspected issues like:

  • Depression
  • Anxiety
  • Bipolar disorder
  • PTSD
  • Substance abuse
  • Eating disorders
  • Personality disorders
  • Schizophrenia
  • Suicidal behavior

You can gather this through:

  • Conversations with family members (when appropriate)
  • Personal memory and observation
  • Medical or psychological records (if available)

Important: You don’t need a formal diagnosis to include something. If you suspect someone struggled with mental health but was never diagnosed, you can still represent that using a different symbol or a note.

Step 3: Add emotional relationships and key life events

Mental health is shaped not just by conditions, but also by emotional dynamics in a family.

Use different types of lines to show relationships:

  • Solid line: close relationship
  • Dashed line: distant
  • Zigzag line: conflict or tension
  • Double line: very enmeshed (overly close or dependent)
  • Broken line: cutoff or no contact

Also include major life events that may impact mental health, like:

  • Abuse or trauma
  • Divorce or separation
  • Loss of a child or parent
  • Financial hardships
  • Migration or war
  • Major medical illnesses

These context clues help make sense of the mental health issues you’re mapping.

Step 4: Choose your symbols and draw the genogram

Now, start organizing your genogram visually.

Use standard genogram symbols:

  • Square for males, circle for females
  • An “X” over a shape means the person is deceased
  • Different color codes or icons for different mental health conditions (e.g., blue for depression, red for substance abuse)

Place individuals on levels by generation:

  • Top row: grandparents
  • Middle: parents and their siblings
  • Bottom: you and your siblings/cousins

Connect family members with lines to show marriages, siblings, and children. Then, layer in your emotional relationship lines and mental health condition markers.

You can draw this by hand or use a free genogram maker.

Step 5: Analyze the patterns

Once your genogram is complete, step back and look for connections:

  • Do certain conditions appear across multiple generations?
  • Are there patterns of trauma or abuse?
  • How do emotional relationship lines correlate with mental health issues?
  • Are there patterns that might explain your own mental health experiences?

This analysis can help guide therapy, spark important conversations, or just give you a better understanding of how your family history has shaped who you are.

Mental Health Genogram Examples

In this section, we’ll explore a variety of mental health genogram examples to help you better understand how to create and use them.

Substance Abuse and Addiction Genogram

Substance Abuse and Addiction Genogram for Mental Health Genogram Guide
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Substance Abuse and Addiction Genogram

Genogram Template for Relationship Types

Genogram Template for Relationship Types for Mental Health Genogram Guide
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Genogram Template for Relationship Types

Mental Health Genogram Example

Mental Health Genogram Example for Mental Health Genogram Guide
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Unresolved Trauma and PTSD Genogram

Unresolved Trauma and PTSD Genogram for Mental Health Genogram Guide
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Generational Depression Genogram

Generational Depression Genogram for Mental Health Genogram Guide
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How Therapists and Counselors use Mental Health Genograms

Therapists use mental health genograms to understand emotional patterns and family history. It helps them see how past generations may influence a person’s current mental health. Here’s how they use them in practice:

1. In assessment and diagnosis

During the early stages of therapy, therapists use genograms in psychology to get a clearer picture of the client’s background. This helps with both diagnosing conditions and understanding the context around them.

How it helps:

  • Uncover family patterns: Therapists may notice repeated mental health conditions like depression or addiction across generations, which might suggest a genetic or learned pattern.
  • Spot environmental influences: For example, if several family members experienced trauma or unstable home environments, a therapist might explore how this shaped the client’s emotional development.
  • Clarify root causes: Rather than looking only at present symptoms, a genogram helps therapists trace issues back to long-standing family dynamics or unresolved emotional pain.

By mapping out this history, therapists can make more informed diagnoses that consider both biological and relational factors.

2. For treatment planning

Once the therapist understands the client’s family and mental health background, they can use that insight to build a customized treatment plan.

How it helps:

  • Target specific issues: For example, if the mental health genograms reveal a pattern of emotional neglect, the treatment plan may include work on self-worth and attachment styles.
  • Identify risk and protective factors: A genogram can show which family members provide support, and which may contribute to stress or harm. This can help a therapist decide how to involve or set boundaries with certain people.
  • Set therapy goals: Based on what the genogram shows, goals may include breaking unhealthy generational patterns, improving communication, or processing past trauma.

It helps move therapy from surface-level conversations to deeper, more strategic healing work.

3. To enhance family therapy sessions

In family therapy, mental health genograms can act as a shared map of family dynamics. This helps everyone involved see the bigger picture—and often leads to new understanding.

How it helps:

  • Facilitates open dialogue: Seeing their family story mapped out helps individuals talk about sensitive issues with less blame and more objectivity.
  • Uncovers hidden dynamics: Families may not be aware of how long-standing tensions or behaviors affect others. The genogram helps bring this to light visually.
  • Encourages empathy: When people see patterns—like how a parent’s anxiety may stem from their own childhood trauma—they can understand each other more compassionately.
  • Tracks progress: As therapy moves forward, families and therapists can revisit the genogram to see how relationships and roles are shifting.

It becomes a practical and emotional anchor for ongoing therapy work.

Benefits of Using Mental Health Genograms

Whether used in therapy or for personal insight, mental health genograms help people see patterns that are often invisible in day-to-day life.

Here are the key benefits, explained in detail:

1. Makes mental health patterns visible

Genograms visually map recurring issues like depression or anxiety across generations, helping identify connections that impact current mental health.

2. Increases self-awareness and understanding

Genograms reveal how family history shapes emotions, behavior, and mental health, helping individuals better understand themselves.

3. Supports therapy and healing

Therapists use genograms to explore a client’s background, uncover root issues, and personalize treatment for effective emotional healing.

4. Improves family communication and relationships

Mental health genograms can facilitate open conversations in therapy or family settings. They help families talk about difficult topics with more empathy and understanding, promoting healthier interactions and emotional connections.

5. Identifies risks and protective factors

Mental health genograms show both the challenges and strengths present in a family. They help identify which relationships provide emotional support and which ones may contribute to stress or harm, aiding in creating balanced coping strategies.

6. Helps break generational cycles

Mental health genograms reveal negative patterns across generations, helping individuals break unhealthy cycles and create healthier emotional environments.

Limitations of Using Mental Health Genograms

Mental health genograms help reveal emotional patterns but have limitations. They should be used carefully, especially in therapy, education, or personal contexts.

1. Incomplete or inaccurate information

Not all family histories are fully known, and many mental health conditions may go undiagnosed or unspoken. This can lead to gaps or assumptions in the genogram, which may affect how patterns are interpreted.

2. Subjectivity in interpretation

The way a person remembers or perceives family relationships can be influenced by personal experience or bias. This means the emotional dynamics shown in a genogram may not fully reflect the perspectives of other family members.

3. Risk of oversimplification

Mental health genograms can sometimes make complex emotional issues look more straightforward than they are. Mental health is influenced by many factors—biological, environmental, and social—and a genogram may not capture the full picture.

4. Emotional distress or discomfort

Creating a genogram can bring up painful memories, family secrets, or unresolved trauma. For some individuals, revisiting this information without the right support may cause emotional overwhelm or distress.

5. Cultural limitations

Mental genograms are based on certain Western psychological models and may not fully reflect family structures, roles, or belief systems in all cultures. This can lead to misunderstandings or a mismatch between the tool and the individual’s background.

References

ResearchGate. (n.d.). (PDF) The use of family genogram in psychiatric social work practice. [online] Available at: https://www.researchgate.net/publication/326471420.

‌Joseph, B., Dickenson, S., McCall, A. and Roga, E. (2022). Exploring the Therapeutic Effectiveness of Genograms in Family Therapy: A Literature Review. The Family Journal, 31(1), pp.21–30. doi:https://doi.org/10.1177/10664807221104133.

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FAQs About Mental Health Genograms

Who can benefit from using a mental health genogram?

Mental health genograms are useful for therapists, counselors, psychology students, and individuals looking to better understand their emotional background. They’re especially helpful in therapy, family counseling, and trauma recovery work.

What kind of information is included in a mental health genogram?

A mental health genogram may include:

  • Diagnosed or suspected mental health conditions (e.g., anxiety, depression, bipolar disorder)
  • Substance abuse
  • Family roles (e.g., caregiver, scapegoat)
  • Emotional dynamics (e.g., close, distant, or conflictual relationships)
  • Major life events (e.g., divorce, trauma, death)

Is it ethical to include family members’ mental health conditions in a genogram without their consent?

If you’re creating a personal genogram, it’s common to include observations or known diagnoses based on your experience. However, in therapy or clinical practice, therapists must handle such information ethically—avoiding labels and maintaining confidentiality.

How far back should I go when creating a mental health genogram?

Most genograms cover three generations: yourself, your parents, and your grandparents. If possible, you can include great-grandparents or extended relatives, especially if their experiences had a strong emotional impact on the family.

What mental health conditions can be tracked in a genogram?

A mental health genogram can be used to track a wide range of conditions, including depression, anxiety, bipolar disorder, PTSD, schizophrenia, eating disorders, addiction, and personality disorders. It can also reflect emotional patterns like abuse, neglect, or codependency—even if there’s no formal diagnosis.

What are mental health genogram symbols?

Mental health genogram symbols are standardized icons used to visually represent family members, relationships, and psychological conditions on a genogram. These symbols go beyond basic shapes—using lines, arrows, and markers to show patterns like conflict, support, mental illness, or trauma.

With Creately, you don’t need to memorize or manually draw these symbols. Its intuitive drag-and-drop interface comes preloaded with all the essential genogram symbols, making it easy for therapists, students, and individuals to create detailed and accurate mental health genograms in minutes.

Author
Amanda Athuraliya
Amanda Athuraliya Communications Specialist

Amanda Athuraliya is the communication specialist/content writer at Creately, online diagramming and collaboration tool. She is an avid reader, a budding writer and a passionate researcher who loves to write about all kinds of topics.

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