A Comprehensive Guide to Ecomaps and Genograms Use in Family Assessment

A genogram is a tool that creates a visual display of a family tree. On the other hand, an ecomap is a visual display of a patient’s ecology’s informal and formal systems. This article provides a more detailed approach to these tools and their application in family assessments.

Background of Ecomaps and Genograms

Health is one of the most significant aspects of today’s society. But unfortunately, most people feel that health is a highly controlled factor that can be controlled through a healthy lifestyle and regular checkups.

However, health is highly influenced by a range of factors, such as family genetics, community lifestyle, and medical histories, which can lead to rapid changes in an individual. In this case, family ecomaps and genograms are essential tools that can help identify a person’s family history to identify underlying factors that may affect their health outcomes.

When working with families, there is often limited information and understanding of the family’s frame of reference. However, health providers must develop the necessary skills to understand a patient’s family frame of reference to make accurate decisions about the patient’s healthcare. In this case, genograms and ecomaps can help gain information about context, perspective, and frame of reference for families.(ecomaps and genograms)

Genograms in Family Assessment

The genogram is a tool to collect information on the family’s structure and caregiving patterns over time. It is a format for drawing a family tree displaying the family information for at least three or more generations. Ideally, genograms are best developed with families over different meetings to present an accurate picture of the family.

A genogram record organizes and displays family information that may be sensitive and elicit a range of emotions from the family members. In this case, identifying the family’s history and child-rearing patterns over generations can help engage families to provide their stories.

In this case, while asking families to describe situations about the patient’s progress, nurses need to ask them to describe how they dealt with similar situations in the past to assess the successful coping mechanisms available to the family. 

Some families may feel you’re prying on the information if you are collecting information quickly. This approach may reduce their trust in you, which may affect the effectiveness of the decision-making process and patient outcomes.

In this case, you must collect information naturally by linking questions to specific tasks that are clear to the family. Once they trust you, exploring issues regarding their previous experiences is easier, which may have influenced the patient’s health outcomes.

A genogram can help identify members of the family’s kinship system involved in caring for the patient, including those from the past and those who may provide them with care in the future.

While family dynamics and environments change over time, this genogram can help depict these changes at one point in time. Ideally, a genogram is a dynamic tool that should be updated over time to highlight the changes that the family has experienced and its structural support system and ecology.

Genogram Symbols

  • Males are indicated by a square, while circles indicate females. However, in instances where one does not know the sex of a family member, one can indicate this by a triangle.
  • A married couple is indicated by a solid line that connects a square and a circle.
  • Nurses should use a double slash through the solid line for divorced couples. However, an intimate relationship between adults that is not marriage is indicated by a dotted line. 

Ecomaps in Family Assessment

An ecomap allows health providers to assess the adequate resources and support systems available to patients, their parents, primary caregivers, and future caregivers. While a genogram is useful in visualizing the family structure and caregiving patterns across generations, an eco map depicts a family’s relationship with its external environment.

Ideally, an ecological assessment examines a family’s relationships to its experiments, the boundaries, and the relationship between individual family members and the environment. in this case, it helps to identify the strengths, needs, resources, and deficits.

Ecomaps are comprised of circles representing a system that interacts with the family, which may be sources of support or conflict. However, systems with which the family has no contact can also be included in the ecomap, especially if the family needs to develop a relationship with the system.

For instance, families with children who require special medical services need access to quality healthcare. However, if the family does not have this access, it can still be included as a system to identify the unmet needs experienced by the family. 

Ecomap Symbols

  • The circles in the ecomap represent the various systems in the family’s environment.
  •  The lines between the circles represent the assessments of quality and the relationship between the system.
  •  The solid line represents a strong relationship, while the dotted line represents a strained relationship. Nonetheless, harsh marks are drawn through the line to indicate a stressful relationship between family members. 

Family Assessment

During a family assessment, nurses should collect accurate data for the families using these tools to identify the health problems and plan for intervention. Additionally, these tools give nurses direction on the amount of information identified. This process follows the steps below.

  • Assessment of the family history
  • Analysis of the family history
  • Family intervention
  • Formal evaluation
  • Nurse reflection


Genograms and ecomaps are analytical tools that can help to perform family assessments. They provide insights into the possible causes of an illness, its effect on family members, and how they cope with the issue. It can also help to identify any resource deficit which can influence health outcomes.

Family Assessment Video Guide


What is the use of genograms and ecomaps in nursing practice?

These tools provide a framework for discussing family history and relationships.

Which therapy uses genograms?

Genograms are mainly used in structural family therapy, where therapists can use the tool to observe different structural relationships with other family members and identify any dysfunctional pattern which harms health outcomes.

Which diseases can be assessed using a genogram?

Genograms can assess genetic diseases such as heart disease, cancer, diabetes, alcoholism, schizophrenia, depression, and Alzheimer’s.

What is a three-generation genogram?

A three-generation genogram is a graphical representation of a family tree that considers families of up to three generations. In this case, they include the grandparents, children, and grandchildren.

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