How is Alcoholism Shown in a Genogram?

In modern genogram notation, alcoholism and other substance use disorders are typically indicated through the medical quadrant system. GenogramAI uses an orange fill in the lower portion of the person symbol (square for males, circle for females) to indicate substance use issues.

Medical Quadrant System

GenogramAI uses a four-quadrant system for medical conditions. The lower portion (or lower-left quadrant in detailed notation) is designated for substance use conditions, including alcoholism, drug addiction, and other chemical dependencies. This standardized approach allows quick visual identification of patterns across generations.

Notation Variations

Different practitioners and resources may use varying approaches to document alcoholism:

Half-Fill (Common)

Lower half of symbol filled with orange or a designated color. Most common in modern digital genogram software.

Quadrant Fill

Specific quadrant (typically lower-left) filled. Allows multiple conditions to be shown on one symbol.

Letter Notation

"A" for alcoholism, "DA" for drug addiction placed inside or adjacent to the symbol. Common in hand-drawn genograms.

Full Fill

Entire symbol filled when substance use is the primary focus of the genogram or clinical concern.

Documenting Recovery

It's equally important to document recovery from alcoholism. This provides a hopeful narrative and identifies potential resources within the family system.

Showing Recovery

GenogramAI uses a gray fill to indicate recovery from substance use. This distinguishes between active addiction (orange) and sustained recovery (gray).

Orange fill: Active alcoholism or substance use
Gray fill: In recovery (often with years noted, e.g., "15 yrs sober")
Split fill: Relapse/recovery cycles can be noted in annotations

Clinical Significance of Mapping Alcoholism

Documenting alcoholism in genograms serves critical therapeutic purposes:

Intergenerational patterns: Alcoholism often follows generational patterns. Seeing grandparents, parents, and siblings with the condition helps clients understand familial risk factors
Family systems impact: Addiction affects the entire family system—codependency, enabling behaviors, and role assignments become visible in the genogram
Treatment planning: Identifying who is in recovery can reveal potential sponsors, mentors, or family members who understand the recovery process
Risk assessment: Children of alcoholics (ACOAs) face increased risk; genograms help identify at-risk individuals
Trigger identification: Mapping family relationships can reveal relationship patterns that may trigger relapse

Distinguishing Types of Substance Use

Specificity in Documentation

While the orange quadrant broadly indicates "substance use," you may want to specify the type:

Alcohol: Most common, often with "ETOH" or "A" annotation
Opioids: Increasingly relevant, may note "Rx" for prescription-related
Stimulants: Cocaine, methamphetamine
Cannabis: May or may not be included depending on context
Polysubstance: Multiple substances, often noted as "poly"

How to Add Alcoholism in GenogramAI

GenogramAI makes documenting substance use straightforward:

Steps to Indicate Alcoholism:

1Click on a person to select them
2Open the person's details panel
3Under "Medical Conditions," select "Substance Use"
4Toggle "Recovery" if the person is in recovery
5Add notes for specifics (type of substance, years sober, etc.)

Therapeutic Considerations

Sensitive Documentation

When discussing alcoholism in family history:

Use non-judgmental language: "struggle with alcohol" rather than "alcoholic"
Ask about patterns: "How did alcohol affect your family growing up?"
Include context: Was it acknowledged? Hidden? What were the consequences?
Note protective factors: Who didn't drink? Who set boundaries?
Respect privacy: Some clients may not want this documented

Case Example

The Rodriguez family genogram reveals a three-generation pattern of alcoholism:

Grandfather (deceased): Alcoholism, died of liver disease at 62
Father (58): Recovered alcoholic, 20 years sober, active in AA
Uncle (55): Active alcoholism, estranged from family
Client (32): Recently acknowledged problematic drinking

This pattern helps the client understand their relationship with alcohol in context and identifies the father as a potential resource who has successfully navigated recovery.

Related Genogram Symbols

Mental Illness Symbol

Blue quadrant - often co-occurs with substance use

Recovery Symbol

Gray fill - indicates sustained recovery

Deceased Symbol

X through symbol - for deaths related to addiction

Estranged Relationship

Cutoff line - common in families with addiction

Frequently Asked Questions

What color represents alcoholism in a genogram?

GenogramAI uses orange for substance use disorders, including alcoholism. Other systems may use different colors or patterns. The key is consistency within your own documentation.

How do I show someone who drinks heavily but isn't diagnosed?

You can note "problematic drinking" or "heavy use" in the person's notes without applying the full substance use indicator. Alternatively, use the indicator but note "undiagnosed" or "suspected" in the annotations.

Should I include recreational drug use?

This depends on clinical relevance. If it impacts family dynamics, relationships, or health, include it. For occasional use with no apparent impact, it may not be necessary to document.

How do I show someone died from alcoholism?

Use both the substance use indicator (orange fill) and the deceased symbol (X through the shape). Add a death note specifying the cause, such as "liver cirrhosis" or "alcohol-related accident."

Genogram Symbol for Alcoholism