title: Exploring family relationships in cancer risk counseling using the genogram.
abstract: OBJECTIVE
  The genogram is a tool that has facilitated counseling in family therapy and social work for many years. It is hypothesized that genograms may also be useful in genetic counseling, because they help the counselor to acquire more objective and consistent information from the client, as well as to incorporate family dynamics and psychosocial issues into the counseling approach.
  
  
  METHODS
  A pilot study of genograms used as an adjunct to genetic counseling was performed at Fox Chase Cancer Center's Family Risk Assessment Program. A questionnaire was developed to elicit genograms from 38 women at risk for familial breast and/or ovarian cancer. After standard pedigree expansion, a series of questions was asked about the consultand's relationship with other family members, communication patterns within the family, attitudes toward genetic testing, family reactions to cancer, roles individuals play in the family, and significant historical or anniversary events. Relationships were defined by the consultand as close, very close, conflictual, fused and conflictual, distant, or estranged.
  
  
  RESULTS
  The majority of relationship types reported by 38 individuals was "very close" or "close." Eighty-one % reported having close/very close relationships with their spouses, 83% reported close/very close relationships with their mothers, and 70% reported close/very close relationships with their fathers. The degree of familial cohesion as depicted by the genogram correlates positively with scores obtained on the standardized Social Adjustment Scale Self-Report (P = 0.01).
  
  
  CONCLUSIONS
  Given the family-wide implications of genetic testing, the genogram may offer important guidance in family-targeted interventions.
authors: Division of Population Science, Fox Chase Cancer Center, Cheltenham, Pennsylvania 19012, USA.
authors: M
authors: M
authors: Daly
authors: J
authors: J
authors: Farmer
authors: C
authors: C
authors: Harrop-Stein
authors: S
authors: S
authors: Montgomery
authors: M
authors: M
authors: Itzen
authors: J W
authors: JW
authors: Costalas
authors: A
authors: A
authors: Rogatko
authors: S
authors: S
authors: Miller
authors: A
authors: A
authors: Balshem
authors: D
authors: D
authors: Gillespie
mesh_terms: D000328:Adult; D001294:Attitude to Health; D001943:Breast Neoplasms / Q000235:genetics* / Q000517:prevention & control*; D003142:Communication; D005190:Family / Q000523:psychology*; D005260:Female; D005817:Genetic Counseling / Q000379:methods* / Q000523:psychology*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000235:genetics* / Q000517:prevention & control*; D010348:Patient Care Team; D010375:Pedigree; D010865:Pilot Projects; D015203:Reproducibility of Results; D012307:Risk Factors; D012380:Role; D011795:Surveys and Questionnaires