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75 genogram questions for therapy sessions

A question bank organized by eight categories, from basic family structure to trauma, resilience and goal setting, ordered by depth and sensitivity, with clinical context for each category.
Updated October 2026 · Reviewed by the GenogramAI Clinical Team

Quick answer

Good genogram questions for therapy start with low-threat facts (who is in the family, births, marriages, deaths) and move toward relationships, emotional rules, medical and mental health history, culture, and trauma as trust grows. End with strengths and goals. Spread them over two to three sessions and follow the client's story rather than the list.

What questions do you ask for a genogram in therapy?

The genogram is only as powerful as the questions used to build it. Without the right questions, a genogram becomes a glorified family tree — names and dates without meaning. With targeted, clinically-informed questions, it becomes an assessment tool that reveals intergenerational patterns, hidden dynamics, and systemic roots of presenting problems.

These 75 questions are organized into eight categories that progress from low-threat factual questions (family structure) to increasingly deep and sensitive territory (trauma, emotional patterns, mental health history). This structure mirrors how a skilled clinician conducts a genogram interview — building rapport and safety before exploring vulnerable material.

Each category includes clinical context explaining why these questions matter and what patterns they are designed to reveal. You do not need to ask every question — use them as a flexible resource, selecting the questions most relevant to your client's presenting issues and your therapeutic framework.

CategoryQuestionsWhat it adds to the genogramWhat you draw
1. Family structureQ1-10The skeleton: every person, generation, partnership, child, loss and household.Squares and circles, partner lines, child lines, death and pregnancy-loss symbols
2. Relationship dynamicsQ11-20How people actually relate: closeness, conflict, cutoffs, triangles and alliances.Emotional relationship lines (close, fused, distant, hostile, cutoff) and triangles
3. Emotional patternsQ21-30The family’s unwritten rules about anger, sadness, affection and vulnerability.Notes beside people, plus emotional lines where a pattern repeats across generations
4. Medical & mental healthQ31-40Conditions, substance use and mental health history across generations.Medical quadrants (shaded parts of a person’s symbol), substance-use markers, age at onset
5. Culture & spiritualityQ41-50Ethnicity, religion, migration and the cultural rules behind roles and emotions.Cultural or religious labels, migration notes, a cultural genogram layer
6. Trauma & eventsQ51-60Losses, abuse, displacement, secrets and how the family coped.Abuse and trauma lines, event dates, a family timeline beside the genogram
7. Strengths & resilienceQ61-68Resources, role models, traditions and people who broke a pattern.Close and supportive lines, notes on strengths and resources
8. Goals & futureQ69-75The bridge from assessment to a treatment plan.Highlights on the patterns the client chooses to work on
The eight categories at a glance, in the order most clinicians ask them.

How to use this question bank

Start with Category 1 (Family Structure) in your first session. These questions are factual and non-threatening, making them ideal for building rapport while gathering essential structural data. In subsequent sessions, move into relationship dynamics, emotional patterns, and medical history as the therapeutic relationship deepens. Save trauma questions for when trust has been firmly established. Always end with strengths and goal-setting to leave the client empowered rather than overwhelmed.

How should you sequence genogram questions across sessions?

A suggested plan for spreading the 75 questions over three to four sessions. Treat the timings as a starting point: the client's pace and the presenting problem come first.
SessionCategories and questionsWhat to add to the genogramSuggested time
Session 1 (intake)Family structure (Q1-10), first relationship questions (Q11-15)Draw the skeleton live while the client talks; note gaps and avoided namesAbout 20-30 minutes of the session
Session 2Rest of relationship dynamics (Q16-20), emotional patterns (Q21-30), medical and mental health (Q31-40)Add emotional lines and medical quadrantsMost of a session
Session 3Culture and spirituality (Q41-50), trauma and significant events (Q51-60) once rapport is solidAdd cultural notes, trauma lines and a short timelineMost of a session; pace to the client
Session 3 or 4 (closing)Strengths and resilience (Q61-68), goal setting (Q69-75)Mark strengths and the patterns chosen for treatment15-20 minutes; end on strengths
A suggested sequence, not a protocol. Follow the client's lead when a sensitive topic comes up early.

Family structure questions: who is in the family?

Category 1 of 8 · Getting Started / Family Structure · Questions 1-10

Clinical context

Begin with factual, low-threat questions to map the basic family structure. These questions establish rapport, demonstrate the genogram process, and create the structural skeleton that you will layer emotional and clinical data onto in later categories.
  1. 1Who are the members of your immediate family? Can you name each person and their age?
  2. 2Tell me about your parents — are they still together? If not, when did they separate or divorce?
  3. 3How many siblings do you have, and where do you fall in the birth order?
  4. 4What do you know about your grandparents on both sides?
  5. 5Are there any half-siblings, step-siblings, or adopted members in your family?
  6. 6Has anyone in your family been married more than once?
  7. 7Are there any family members who have died? What were their ages and causes of death?
  8. 8Does anyone in your family live in a different country or far from the rest of the family?
  9. 9Are there any twins, triplets, or multiple births in your family?
  10. 10Has your family experienced any miscarriages, stillbirths, or infant losses?
Genogram example: Basic 3-Generation Template
The structural skeleton that Category 1 questions fill in: three generations with partner and child lines. Open this example

Relationship questions: who is close, distant or in conflict?

Category 2 of 8 · Relationship Dynamics · Questions 11-20

Clinical context

These questions move beyond structure to explore how family members actually relate to each other. Relationship quality is the heart of a genogram — the emotional lines between family members reveal the system's real architecture, which is often very different from the official family narrative.
  1. 11Who are you closest to in your family? What makes that relationship close?
  2. 12Are there any family members who do not speak to each other? What happened?
  3. 13How would you describe your parents' relationship with each other?
  4. 14Who in your family tends to be the peacemaker when there is conflict?
  5. 15Are there any relationships in your family that feel "too close" — where boundaries are blurred?
  6. 16Is there anyone in your family who is treated as the "outsider" or "black sheep"?
  7. 17When two people in your family have a conflict, does a third person usually get pulled in?
  8. 18Who holds the most power or influence in your family? How do they use it?
  9. 19Are there any family alliances — groups within the family that stick together?
  10. 20How do relationships in your family change during times of stress or crisis?
Genogram example: Emotional Triangulation
What relationship questions add: emotional lines and a triangle drawn over the family structure. Open this example

Emotional pattern questions: what were the family rules about feelings?

Category 3 of 8 · Emotional Patterns · Questions 21-30

Clinical context

Emotional patterns are often the most revealing layer of a genogram. Families develop implicit rules about which emotions are acceptable, how they should be expressed, and who is allowed to feel what. These rules are transmitted across generations with remarkable consistency, often outside conscious awareness.
  1. 21How was anger expressed in your family growing up? Was it acceptable to show anger?
  2. 22When you were sad as a child, how did your family respond?
  3. 23How did your family show love and affection? Was it openly expressed or more reserved?
  4. 24Were there certain emotions that felt "off limits" or forbidden in your family?
  5. 25Who in your family was most emotionally expressive? Who was most shut down?
  6. 26How did your parents handle disagreements between each other?
  7. 27Was there a family member whose mood seemed to control the entire household's emotional climate?
  8. 28How was vulnerability treated in your family — was it safe to be vulnerable?
  9. 29Did anyone in your family use humor, silence, or withdrawal to manage difficult emotions?
  10. 30Looking at your grandparents' generation, were similar emotional patterns present?

Medical and mental health history questions

Category 4 of 8 · Medical & Mental Health History · Questions 31-40

Clinical context

Medical and mental health history is critical for both clinical assessment and the client's own understanding of hereditary patterns. Many clients are surprised to discover that conditions they thought were uniquely theirs have appeared in multiple generations. This normalization can be profoundly therapeutic.
  1. 31Are there any medical conditions that seem to run in your family (heart disease, cancer, diabetes)?
  2. 32Has anyone in your family been diagnosed with depression, anxiety, or another mental health condition?
  3. 33Is there a history of substance use or addiction in your family (alcohol, drugs, prescription medications)?
  4. 34Has anyone in your family attempted or died by suicide?
  5. 35Are there any patterns of eating disorders or disordered eating in your family?
  6. 36Has anyone in your family experienced postpartum depression or perinatal mental health issues?
  7. 37What is the general attitude toward mental health treatment in your family? Is seeking help accepted or stigmatized?
  8. 38Are there family members who you suspect had undiagnosed conditions (someone who was always "nervous" or "moody")?
  9. 39How has physical health or illness affected family relationships and roles?
  10. 40At what ages did family members tend to develop health problems? Do you notice any patterns?
Genogram example: Medical Genogram Tutorial
A medical genogram: conditions drawn as shaded quadrants so patterns across generations are visible. Open this example

Cultural and spiritual background questions

Category 5 of 8 · Cultural & Spiritual Background · Questions 41-50

Clinical context

Cultural and spiritual context shapes everything in a family system — from how emotions are expressed to how illness is understood to what roles men and women are expected to play. Ignoring culture in a genogram assessment produces an incomplete and potentially misleading picture.
  1. 41What cultural or ethnic background does your family identify with?
  2. 42How important was cultural identity in your family growing up?
  3. 43Did your family practice a religion or spiritual tradition? How central was it to daily life?
  4. 44Were there generational differences in how strongly family members identified with their culture?
  5. 45How did cultural values influence family roles — for example, expectations for men vs. women?
  6. 46Did anyone in your family immigrate? How did that experience shape the family?
  7. 47Were there cultural expectations around marriage, career, or education that influenced family decisions?
  8. 48How did your family's cultural background influence how they handled emotions, conflict, or grief?
  9. 49Were there any cultural traditions or rituals that were important to your family?
  10. 50Has your family experienced discrimination or marginalization related to cultural identity?

Trauma and significant event questions

Category 6 of 8 · Trauma & Significant Events · Questions 51-60

Clinical context

Trauma is often the most significant — and most hidden — layer of a family genogram. Intergenerational trauma can shape family dynamics for generations, even when the original traumatic event is no longer consciously discussed. Approach these questions with sensitivity and only after rapport has been established.
  1. 51Has your family experienced any major losses that significantly affected the family system?
  2. 52Are there events in your family history that are considered "off limits" to discuss?
  3. 53Has anyone in your family experienced physical, sexual, or emotional abuse?
  4. 54Did your family go through any major financial hardships, job losses, or economic crises?
  5. 55Were any family members affected by war, political violence, or forced displacement?
  6. 56Has your family experienced the sudden or unexpected death of a family member?
  7. 57Are there family secrets that you are aware of? How have they affected the family?
  8. 58How did your family cope with traumatic events — did they pull together or fragment?
  9. 59Have you noticed trauma responses (hypervigilance, avoidance, emotional numbing) in family members across generations?
  10. 60Are there patterns of re-traumatization in your family — similar traumatic events happening in multiple generations?
Genogram example: PTSD and Trauma Transmission
Trauma questions often reveal patterns that repeat across generations. Open this example

Strengths and resilience questions

Category 7 of 8 · Strengths & Resilience · Questions 61-68

Clinical context

A genogram that only maps dysfunction tells an incomplete story. Every family also has strengths, resources, and resilience patterns. Identifying these is essential for strength-based treatment planning and helps clients see their family as a source of resources, not just problems.
  1. 61What are you most proud of about your family?
  2. 62Who in your family do you consider a role model, and why?
  3. 63What strengths or positive traits seem to run in your family?
  4. 64How has your family shown resilience in the face of adversity?
  5. 65Are there family traditions or rituals that bring the family together and strengthen bonds?
  6. 66Who in your family is the person others turn to in a crisis?
  7. 67What values were most emphasized in your family, and which do you want to carry forward?
  8. 68Is there a family member who broke a negative pattern — what did they do differently?

Goal-setting questions: which patterns does the client want to change?

Category 8 of 8 · Goal Setting & Future · Questions 69-75

Clinical context

These forward-looking questions bridge the genogram assessment into treatment planning. They help clients move from understanding their family patterns to actively choosing which patterns to continue, which to modify, and which to break entirely.
  1. 69Now that you can see these family patterns, which ones do you most want to change?
  2. 70What family patterns are you worried about repeating in your own life or passing to your children?
  3. 71If you could change one thing about how your family relates to each other, what would it be?
  4. 72What strengths from your family do you want to intentionally carry into your own relationships?
  5. 73How do you want your family genogram to look different in the next generation?
  6. 74Are there relationships in your family that you would like to repair or strengthen?
  7. 75What would "breaking the cycle" look like specifically for you and your family?

How do you adapt genogram questions for couples?

The same bank works with couples: each partner answers about their own family of origin, ideally with the other partner listening. A few questions do most of the work.

Ask each partner in turn

  • Q13: how would you describe your parents’ relationship with each other?
  • Q26: how did your parents handle disagreements?
  • Q21 and Q23: how were anger and affection expressed?
  • Q45: how did cultural values shape what was expected of men and women?
  • Q67: which family values do you want to carry forward?

Then look across both genograms

  • Where do the two families handle conflict in opposite ways?
  • Which partner’s family model shows up in current arguments?
  • Are there divorce, affair or cutoff patterns in either family?
  • What expectations about money, roles and closeness collide?
  • Which strengths from each family can the couple build on?

For the full approach, including focused genograms and a worked example, see genograms for couples therapy.

Tips for effective genogram interviews

Follow the client, not the list

These questions are a resource, not a script. If a client spontaneously shares something about trauma while you are asking about family structure, follow that thread. The genogram serves the therapeutic relationship, not the other way around.

Build the genogram visually in session

Draw the genogram as the client speaks — either on paper, a whiteboard, or using a tool like GenogramAI. Seeing the family diagram take shape in real-time often triggers additional memories and insights that would not surface from conversation alone.

Note what is not said

Silences, deflections, and topic changes are as clinically meaningful as answers. If a client consistently avoids questions about a particular family member or topic, that avoidance pattern is itself a crucial data point about the family system.

Always include strengths

Genogram interviews that focus only on dysfunction leave clients feeling pathologized. Always include Category 7 (Strengths & Resilience) to ensure the genogram captures the family’s resources, not just its wounds. End sessions on strengths whenever possible.

Genogram questions for therapy vs. genogram interview questions

This page is a session script for clinicians: questions ordered by sensitivity and spread across sessions. For a general interview guide you can use outside therapy (school assignments, family history projects, nursing and social work assessments), see genogram questions to ask.

Frequently asked questions

When should I use genogram questions in therapy?

Genogram questions are most commonly used during the intake or assessment phase of therapy, typically in the first 1-3 sessions. However, they can be introduced at any point when family history becomes relevant — for example, when a client describes a recurring relationship pattern, when trauma surfaces, or when family-of-origin issues are clearly influencing present-day functioning. Many therapists revisit and expand the genogram throughout the course of treatment.

How many genogram questions should I ask in one session?

Most therapists spread genogram questions across 2-3 sessions rather than asking all 75 in a single sitting. A typical intake genogram session covers family structure (10-15 questions) and begins exploring relationship dynamics. Deeper questions about trauma, emotional patterns, and mental health history are often explored in subsequent sessions as rapport develops and the client feels safe enough to share sensitive information.

Should I follow the questions in order?

No. The categories provide a framework, but effective genogram interviewing follows the client's narrative. Start with factual, low-threat questions about family structure to build comfort, then follow the client's lead into more sensitive territory. If a client mentions a family conflict while describing family structure, explore it — don't force them to wait until you reach the "relationship dynamics" category.

How do I handle resistance to genogram questions?

Resistance is clinically meaningful information. If a client avoids questions about certain family members or topics, note the avoidance pattern itself — it often mirrors the family's own communication patterns (topics that are "off limits" in the family tend to be off limits in therapy too). Normalize the difficulty, offer the option to return to the topic later, and never force disclosure. The genogram is a therapeutic tool, not an interrogation.

Can I use these questions with couples or just individual clients?

These questions work beautifully with couples. Having each partner answer genogram questions about their own family of origin — often in the presence of the other partner — builds mutual understanding and empathy. When Partner A hears that Partner B grew up in a family where anger was never expressed, it recontextualizes their current conflicts. Many couples therapists create side-by-side genograms for both partners.

What is the difference between genogram questions for therapy and genogram interview questions?

Genogram questions for therapy are ordered by sensitivity and spread across sessions so that rapport is built before trauma, mental health and family secrets are explored, and they end on strengths and goals. A general genogram interview guide, like the one on our genogram questions to ask page, is better suited to school assignments, family history projects and one-off assessments.

What family of origin questions should I ask?

Family of origin questions cover how your parents related to each other, how conflict, anger and affection were handled, which emotions were off limits, what roles men and women played, and which patterns you want to keep or change. In this bank they are mainly questions 11-30 (relationships and emotional patterns) and 61-75 (strengths and goals).

Free downloadable guides

Print-ready PDFs you can reference anytime, no sign-up required: What is a genogram (beginner guide) and the complete genogram reference.

Related guides

Genogram questions to askGeneral genogram interview question guideGenogram in family therapyHow therapists use genograms in clinical practiceGenogram for counseling studentsGuide for students learning genogram assessmentMedical genogramRecording health and mental health history with quadrantsCultural genogramMapping culture, migration and spiritualityTrauma genogramMapping intergenerational trauma safely