The following case example illustrates the use of a genogram.

Barb and Mike Haynes meet with Maria Garcia, Adult Services Worker. They indicate that they feel a moral obligation to continue caring for Ruth in their home, because Ruth spent most of her adult years caring for Mike and his brother and sister when they were children. Barb and Mike also indi- cate that they have a 2-year-old child, Erin, at home. This is a second marriage for both Barb and Mike, and they are paying for Mike’s son, Brian, to attend the state university. With such expenses, both believe they need to continue to work. Mike’s oldest sister, Mary Kruger, is a single parent who has two children in high school. Mary Kruger has a visual disability but has been able to be the primary caregiver for Ruth and Erin during the daylight hours when Mike andBarb are at work. Recently,Mary informedMike and Barb that caring for Ruth is becoming too diffi- cult and that some kind of alternative care is needed. Ms. Garcia suggests that adult day care for Ruthmay be a useful resource.

Mike adds that it is emotionally devastating to see his mother slowly deteriorate. He indicates he is in a double bind; he feels an obligation to care for his mother, but doing so is causing major disruptions in his family life. The stress has resulted in marital dis- cord with Barb, and he adds that both he and Barb have become increasingly short in temper and patience with Erin.

At this point, Ms. Garcia suggests it may be help- ful to graphically diagram their present dilemma. Together, the Hayneses and Ms. Garcia draw the ecomap shown in Figure 12.4. While drawing the map, Mike inquires whether Ruth’s medical condi- tion might soon stabilize. Ms. Garcia indicates that Ruth may occasionally appear to stabilize, but the long-term prognosis is gradual deterioration in men- tal functioning and in physical capabilities. The eco- map helps Mike and Barb see that even though they are working full-time during the day and spending the remainder of their waking hours caring for Erin and Ruth, they are becoming too emotionally and physically exhausted to continue doing so. During the past three years, they have ceased social- izing with friends. Now they seldom have any time to spend even with Brian. Feeling helpless and hopeless, they inquire if some other care arrangement is avail- able besides a nursing home. They indicate that Ruth

has said on numerous occasions, “I’d rather die now than be placed in a nursing home.” Ms. Garcia tells them of some high-quality adult group homes in the area and gives them the addresses.

After visiting a few of the care facilities, Barb and Mike ask Ruth to stay for a few days at one they particularly like. At first Ruth is opposed to going for a “visit.” But after being there a few days, she adjusts fairly well and soon concludes (erroneously, but no one objects) that it is a home she bought and that the people on the staff are her “domestic employees.” Ruth’s adjustment eases the guilt that Barb and Mike feel in placing Ruth in a care facility, and this results in substantial improvements in their marital relationship and in their interactions with Erin, Brian, and their friends.

A major value of an ecomap is that it facilitates both the worker’s and the client’s view of the client’s family from a systems and an ecological perspective. Sometimes, as happened in the case of the Hayneses, the drawing of the ecomap helps clients and practi- tioners gain greater insight into the social dynamics of a problematic situation.

Family System Assessment: The Genogram A genogram is a graphic way of investigating the origins of a client’s problem by diagramming the family over at least three generations. The client and the worker usually construct the family geno- gram jointly. The genogram is essentially a family tree. Murray Bowen is the primary developer of this technique (Kerr & Bowen, 1988). The genogram is a useful tool for the worker and family members to examine problematic emotional and behavioral patterns in an intergenerational context. Emotional and behavioral patterns in families tend to repeat themselves; what happens in one generation will of- ten occur in the next. Genograms help family mem- bers to identify and understand family relationship patterns.

Figure 12.5 shows some of the commonly used symbols. Together, the symbols provide a visual re- presentation of at least three generations of a family, including names, ages, genders, marital status, sibling positions, and so on. When relevant, additional items of information may be included, such as emotional difficulties, behavioral problems, religious affilia- tion, ethnic origins, geographic locations, occupations, socioeconomic status, and significant life events.

Sociological Aspects of Young and Middle Adulthood 559

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Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it. Daryl Highlight

The following case example illustrates the use of a genogram.

Chris Witt makes an appointment with Kyle Nolan, a social worker in private practice. Chris is distraught. He indicates that his wife, Karen, and two children are currently at Sister House, a shelter for battered women. Chris states he and his wife had a “scuffle” two days ago, and she bruised her face. Yesterday, when he was at work, she left home with

the children and went to Sister House. He adds that she has contacted an attorney and is now seeking a divorce.

Mr. Nolan inquires as to the specifics of the “scuffle.” Chris says he came home after having a few beers. His dinner was cold, and he “got on” Karen for not cleaning up the house. He adds that Karen then started mouthing off, and he slapped her to shut her up. Mr. Nolan inquires whether such

Deceased husband’s pension plan

(sufficient for Ruth’s financial needs)

Ruth’s friends (no longer

contact Ruth)

Richard—Ruth’s other son

(no longer has contact with

Ruth)

Metro Transit (Mike has been a bus driver for

13 years)

Porta Bella Restaurant

(Barb has been a waitress for

9 years)

Dean Medical Clinic

(treats Ruth for Alzheimer’s disease)

State university

(Brian is majoring in computer science

and living in a residence

hall)

Mary— Mike’s sister

(primary caregiver during the day for Erin and Ruth) Friends

(Barb and Mike have mutual friends, but now are usually

too busy to socialize with

them)

Erin 2

Barb 38

Jim 44

Mike 42

Ruth 62

Brian 19

Divorced Divorced Married 4 years

M ar

y is

e xh

au st

in p

ro vi

di ng

c ar

Liz 37

Pat 44

Barb’s parents

(retired and moved to Florida; Barb seldom sees

them)

St. James Church (Barb attends but

Mike does not)

FIGURE 12.4 Sample Ecomap: Barb and Mike Haynes

20 13

560 Understanding Human Behavior and the Social Environment

incidents had occurred in the past. Chris indicates, “A few times,” and adds that getting physical with Karen is the only way for him to “keep her in line.” He says he works all day long in his small business

as a concrete contractor, while his wife sits at home watching soap operas. He feels she is not doing her fair share and the house usually looks like a disaster.

Mr. Nolan asks Chris if he feels that getting phys- ical with his wife is justifiable. He responds, “Sure,” and adds that his dad frequently told him, “Spare the rod, and spoil both the wife and the kids.” Mr. Nolan asks Chris if his dad was abusive to him when he was a child. Chris indicates that he was and adds that to this day he detests his dad for abusing him and his mother.

Mr. Nolan then suggests that together they draw a family tree, focusing on three areas: episodes of heavy drinking, episodes of physical abuse, and traditional versus modern gender stereotypes. Mr. Nolan ex- plains that a traditional gender stereotype includes the husband as the primary decision maker, the wife as submissive to him, and the wife as primarily re- sponsible for domestic tasks. The modern gender ste- reotype involves an egalitarian relationship between husband and wife. After an initial reluctance (Chris expresses confusion as to how such a tree would help get his wife back), Chris agrees. The resulting geno- gram is presented in Figure 12.6.

The genogram helps Chris to see that he and his wife are products of family systems that have strik- ingly different values and customs. In his family, the males tend to drink heavily, have a traditional view of marriage, and tend to use physical force in inter- actions with their spouses and children. Upon ques- tioning, Chris mentions that he has at times struck his own children. Mr. Nolan asks Chris how he feels about repeating the same patterns of abuse with his wife and children that he despised his father for using. Tears come to his eyes, and he says one word, “Guilty.”

Mr. Nolan and Chris discuss what Chris might do to change his family interactions and how he might best approach his wife to request that she and the children return. Chris agrees to attend AA (Alco- holics Anonymous) meetings and a therapy group for batterers. After a month of attending these meet- ings, Chris contacts his wife and asks her to return. Karen agrees to return if Chris stops drinking (most of the abuse occurred when he was intoxicated) and if he agrees to continue to attend group therapy and AA meetings. Chris readily agrees. Karen’s parents express their disapproval of her returning.

For the first few months, Chris Witt is on his best behavior, and there is considerable harmony in the

21 21-year-old male

Deceased male (died at age 67)

Deceased female (died at age 32)

33-year-old identified female client

27-year-old identified male client

23-year-old female

Couple separated (/) in 1981, divorced (//) in 1983

Unmarried couple living together since 1982, with a 4-year-old son

Married couple with an adopted daughter

Married couple (married in 1982)

Married couple with two children: an 8-year-old daughter and a 3-year-old son

Married couple, wife pregnant

m 82

8 3

s 81; d 83

FIGURE 12.5 Commonly Used Genogram Symbols

20 13

Sociological Aspects of Young and Middle Adulthood 561

Witt family. Then one day Chris has to fire one of his employees. Feeling bad, he stops afterward at a tavern and drinks until he is intoxicated. When he finally arrives home, he starts to verbally and physi- cally abuse Karen and the children. This is the final straw for Karen. She takes the children to her par- ents’ house, where they stay for several days until they are able to find and move into an apartment. She also files for divorce and follows through in obtaining one.

In many ways, this is not a success case (in reality, many cases are not). The genogram, however, was useful in helping Chris realize that he had acquired,

and was acting out, certain dysfunctional family pat- terns. Unfortunately, he was not yet fully ready to make lasting changes. Perhaps sometime in the fu- ture he will be more committed to making changes. At the present time, he has returned to drinking heavily.

The ecomap and the genogram have a number of similarities. With both techniques, users gain insight into family dynamics. Some of the symbols used in the two approaches are identical. There are also dif- ferences. The ecomap focuses attention on a family’s interactions with groups, resources, organizations, associations, other families, and other individuals.

47 57 59

Loren Rebecca

30 26

54 55

Richard Marge Mildred

Emma LeRoy

Traditional view of marriage; used to drink

heavily

Traditional view of

marriage

Nondrinker; modern view of

marriage

Social drinker; modern view of

marriage

Episodes of heavy drinking; modern view of

marriage

Episodes of heavy drinking;

incidents of spouse abuse; traditional

view of marriage

2832 25

ChrisDan

Linda

Janet

m 89

m ?m 61

s 90, d 91

Loretta

Marvin

Gail Bill Karen

Ce ng ag e Le ar ni ng

20 13

562 Understanding Human Behavior and the Social Environment

The genogram focuses attention on intergenerational family patterns, particularly those that are problem- atic or dysfunctional.

Family Problems and Social Work Roles Thorman (1982) points out that although each fam- ily is unique, conflicts and problems within families tend to cluster in four major categories: (1) marital problems between the husband and wife; (2) difficul- ties between parents and children; (3) personal prob- lems of individual family members; and (4) stresses imposed on the family by the external environment.

Family problems do not necessarily fall neatly into one or another of these categories. Frequently, families experience more than one category of prob- lems. Nor are these problem categories mutually exclusive. Many times one problem will be closely related to another. Consider, for instance, the wife and mother of a family who is a department store manager and the primary breadwinner for her fam- ily. The store at which she has been working for the past 11 years suddenly goes out of business. Despite massive efforts, she is unable to find another job with similar responsibilities and salary. This can be considered a family problem caused by stresses in the environment. However, this is also a personal prob- lem for the wife andmother. Her sense of self-worth is seriously diminished by her job loss and inability to find another position. She becomes cranky, short- tempered, and difficult to live with. The environmen- tal stress she is experiencing causes her to have diffi- culties relating to both her children and spouse. The entire family system becomes disturbed.

A family therapy perspective sees any problem within the family as a family group problem, not as a problem on the part of any one individual mem- ber (Okun & Rappaport, 1980). Social workers, therefore, need to assess the many dimensions of the problem and the effects on all family members.

The first category of problems typically experi- enced by families ismarital problems between the hus- band and wife. Although problems between spouses affect all family members, intervention may target a subsystem of the family—in this case, the marital sub- system. In other words, a social worker may work with the couple alone instead of the entire family to solve a specific problem. When the marital pair gets along better, the entire family will be positively affected. A marital problem case example follows.

Gianna and Mark Di Franco were married in 1998. Both had been previously divorced. Gianna

had two children from a prior marriage, and Mark had four. Gianna was a financial planner who owned her own company. Mark was vice president of a much larger company. Both earned about the same amount. On the night before they were married, Mark presented Gianna with a prenuptial agreement. It stated that the assets each brought into the mar- riage would be kept separate, and would be the prop- erty of the person bringing it into the marriage if a divorce occurred. The agreement also stated that each spouse would pay an equal share of the family expenses. Mark said he would not marry Gianna un- less she signed the agreement. Gianna did not want to call off the wedding, so she signed the agreement.

After three years of marriage, Gianna had twoma- jor concerns. First, when Mark became angry with her, he would refuse to talk to her—often for as long as two weeks. Gianna often did not know “what she did wrong.” Mark, after pouting for a while, would eventually start talking again. When she asked why he’d stopped communicating, he’d always respond, “If you can’t figure it out, I’m not going to tell you.”

Gianna’s second concern was financial. Mark be- came president of his company and received a big in- crease in salary. Gianna, on the other hand, saw her earnings sliced nearly in half as the stockmarket drop in the early 2000s resulted in much less business for her company. She asked Mark several times to pay more of the family expenses. He always pulled out the prenuptial agreement and said he wanted to pay his extra money into trust funds for his four children.

The financial situation and the communication problem became such major issues for Gianna that she went to see a family social worker. The social worker indicated that progress on these issues could only be made if Mark came in for joint counseling. Mark at first refused to go. Gianna had to give him an ultimatum: “Either go with me for counseling, or I’m filing for divorce.”

Mark relented and went for counseling with Gianna. At first, he refused to change the prenuptial agreement, but eventually he realized that if he didn’t pay more of the household expenses, and if he didn’t start communicating with Gianna about his con- cerns, she was going to file for divorce. He thus agreed to pay more of the family expenses. However, the communication issue was more of a hurdle for him. He was raised in a family in which he learned the pattern of not communicating from his father, who also would stop speaking for a week or two to his wife when he was angry with her. Gianna adopted

Sociological Aspects of Young and Middle Adulthood 563

the strategy of making a counseling appointment for Mark and her whenever Mark stopped talking to her for a day or two.

Richard B. Stuart (1983) developed a Couple’s Pre-Counseling Inventory, which is used to assess a couple’s problems. Each member of the couple is asked to fill out the questionnaire separately. Later, answers can be shared during counseling, and mis- conceptions each has about how the other person feels can be clarified. Areas that are evaluated include happiness with the relationship; caring behaviors liked, and perceptions of caring behaviors liked, by the partner; communication; how conflict is man- aged; how moods and other aspects of personal life are managed; sexual interaction; how children are managed; willingness to make changes; marital his- tory; and specific goals each person wants to pursue.

Such an instrument provides an excellent mecha- nism for assessment because misconceptions between partners can be clearly pinpointed. For instance, un- der the topic of sexual interaction, members of the couple are asked to respond to a variety of statements, indicating their levels of satisfaction with the issue involved. The range is from 5, which means “very satisfied,” to 1, which means “very dissatisfied.” One statement concerns “the length of our foreplay.” If one partner is very satisfied and the other very dissatisfied, this is clearly an area that needs to be addressed.

The second major type of family problem in- volves relationships between parents and children, including parents’ difficulties controlling their chil- dren and, especially as children reach adolescence, communication problems.

There are many perspectives on child manage- ment and parent-child communication techniques. Two major approaches are the application of learn- ing theory and Parent Effectiveness Training (PET), developed by Thomas Gordon (1970). Practitioners can help parents improve their control of children by assessing the individual family situations and teaching parents some basic behavior modification techniques. Behavior modification involves the ap- plication of learning theory principles to real-life situations. Practitioners can also teach the use of PET techniques. (The application of learning theory principles to positive parenting was discussed in Chapter 4, and PET was described in Chapter 8.)

Personal problems of individual family members make up the third category of problems typically experienced by families.

For example, John and Tara Altman brought their 12-year-old-son, Terrell, into treatment because for two years he had shown decreasing interest in doing his schoolwork. His grades also slowly fell from a B average to one D (in physical education) and the rest Fs. The school system was considering recommending that Terrell repeat the seventh grade. John and Tara asked the social worker to “inspire” Terrell to become refocused on his schoolwork. The social worker asked Terrell why his grades had slid. He replied that his mom and dad used to help him with his schoolwork, but they had stopped showing much interest in him. In fact, it seemed that his par- ents had stopped talking to one another in the past two and a half years.

At this point, the social worker decided to meet at the next session with just John and Tara to explore what was happening between them. At that session, Tara revealed she had discovered two and a half years earlier that John had had a brief affair with one of her best friends shortly after they were mar- ried, and she was unable to forgive him. At first, she was furious with John, but now she had become so depressed that she was on Prozac. She had given up talking to John, and they had not been intimate since her discovery. John acknowledged that he had had the affair, and said he was trying to do everything in his power to restore their former relationship. John added that he had thrown himself into his work as an electrician in order to escape his wife’s wrath. He was also concerned that Tara was drinking too much. Tara said alcohol helped her escape the pain of knowing that John had had an affair. And she was seriously thinking about divorcing John once Terrell graduated from high school.

The social worker helped John and Tara see that Terrell’s lack of interest in school was related to his parents’ showing little interest in him; it was also his way of adapting to the animosity between John and Tara. The social worker helped Tara see that she needed to either divorce John now or let go of focus- ing on the pain she felt about the affair. After con- siderable reflection, Tara said she wanted to find a way to let go. The social worker helped her learn to tell herself “Stop” whenever she began to think about the affair, and to then think instead of positive attributes about John and her family. This process of learning to let go took Tara about three months to fully implement.

During this period, both Tara and John focused much more of their attention, in positive ways, on

564 Understanding Human Behavior and the Social Environment

Terrell. He began refocusing on his schoolwork, his grades began to improve, and he also became more contented.

The Altman family provides a good illustration of a family-owned problem.All three familymembers were hurting emotionally. Terrell was the identified client, but all three family members needed to make changes in order for the family to function more effectively.

The fourth category of problems frequently found in families includes problems caused by factors outside the family. These problems may include inadequate income, unemployment, poor housing, inadequate access to means of transportation and places for recreation, and lack of job opportunities. Also included in the multitude of potential problems are poor health, inadequate schools, and dangerous neighborhoods.

To begin addressing these problems, social workers need effective brokering skills. That is, they need to know what services are available, and how to make a connection between families in need and these services.

Many times, appropriate services will be unavail- able or nonexistent. Social workers will need to advo- cate, support, or even help to develop appropriate resources for their clients. Services that do not exist will need to be developed. Unresponsive agency ad- ministrations will need to be confronted. Legal assis- tance may be needed. There are no easy solutions to solving such nationwide problems as poverty or poor health care. This is an ongoing process, and political involvement may be necessary. Such environmental stresses pose serious problems for families, and social work practitioners cannot ignore them.

Social Work with Organizations As defined in Chapter 1, organizations are “(1) social entities that (2) are goal-directed, (3) are designed as deliberately structured and coordinated activity sys- tems, and (4) are linked to the external environment” (Daft, 2007, p. 10). Social entities involve groups of people, all having their own strengths, needs, ideas, and quirks. Organizations are goal-directed in that they exist to accomplish some purpose or meet some need. As an activity system, an organization is made up of a coordinated series of units accomplish- ing different tasks yet working together to achieve some common end. Finally, organizations are in con- stant interaction with other people, decision makers, agencies, neighborhoods, and communities in the

external social environment as they strive to achieve goals.

It is imperative that social workers have an exten- sive knowledge of organizations. As Chapter 1 indi- cates, working with organizations is one of the systems in which social workers are expected to have expertise. Highlight 12.12 expands on the importance of social workers’ being skilled in understanding and analyzing organizations. Several theories of organiza- tional behavior are presented in this section. These different theories provide a variety of perspectives for viewing and analyzing organizations.

The Autocratic Model The autocratic model has been in existence for thou- sands of years. During the Industrial Revolution, it was the predominent model for how an organization should function. This model depends on power. Those who are in power act autocratically. The message to employees is, “You do this—or else”; an employee who does not follow orders is penalized, often severely.

Anautocraticmodel uses one-way communication— from the top to the workers. Management believes that it knows what is best. The employee’s obliga- tion is to follow orders. Employees have to be per- suaded, directed, and pushed into performance, and this is management’s task. Management does the thinking, and the workers obey the directives. Under autocratic conditions, the workers’ role is obedience to management.

The autocratic model does work in some settings. Most military organizations throughout the world are formulated on this model. The model was also used successfully during the Industrial Revolution, for example, in building great railroad systems and in operating giant steel mills.

The autocratic model has a number of disadvan- tages. Workers are often in the best position to iden- tify shortcomings in the structure and technology of the organizational system, but one-way communica- tion prevents feedback to management. The model also fails to generate much of a commitment among the workers to accomplish organizational goals. Fi- nally, the model fails to motivate workers to put forth an effort to further develop their skills (skills that often would be highly beneficial to the employer).

The Custodial Model Many decades ago, when the autocratic model was the predominant model of organizational behavior, some progressive managers began to study their

Sociological Aspects of Young and Middle Adulthood 565

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The following case example illustrates the use of a genogram.

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