Family history assessment may be accomplished via three routes: the genogram, the pedigree analysis, and the ecomap. Nurses have used genograms as a clinical tool for some time (Herth, 1989 and Puskar & Nerone, 1996). The genogram (a family systems version of the family tree) is truly important; yet, the construction of genograms is often neglected in today's packed clinical schedules. The ecomap examines the interactions of family members to the world outside the family (Hodge, 2000 and Wright & Leahey, 2001). The pedigree analysis, a graphic representation of a person's medical and biological history, is another important aid for helping clients and clinicians understand their risk factors for the spectrum of chronic illness (Olsen et al., 2004). The purpose of this article will be to review these three techniques with an emphasis on their usefulness in assessment of chronic health conditions and psychiatric comorbidity.
Case Analysis
Amy Stanley was ahead in the semifinal match for 14-year-olds at the regional tennis championships. She was leading well into the match when she seemed to get overconfident and stopped playing aggressively. She lost in a second-set tie breaker—a match it seemed she could have won.
Her parents Fred and Betty were watching. Betty was quiet and withdrawn. Fred was visibly upset at Amy's performance and mentioned to Betty, “Why does she always do this to herself. She's so good, yet she doesn't seem to want to win.”
In the car on the way home from the match, Fred turned to Amy and said, “You didn't seem to really want to win today.” Amy was quiet, looked out the car window and said to herself, “Maybe you're right.”
Fred was concerned about Amy's erratic play, and after the most recent match he discussed the situation with Amy's coach. The coach indicated to Fred that over the past year, he has observed Amy questioning her commitment to tennis. He has noticed that she doesn't practice with much intensity, and often needs to be talked into workouts and competitions. The coach acknowledged her considerable talents and told Fred that of all the juniors he has worked with, Amy has the most natural ability. The coach then suggested that Amy talk to Dr. Jane Hawthorne, a sports psychologist who had worked with many tennis players in the area. “She's very good, and knows a lot about the sport,” the coach said. Fred, though somewhat uncomfortable about the idea, talked it over with Betty and Amy, and Fred called Dr. Hawthorne for an appointment.
Dr. Hawthorne has an interesting perspective as a clinical sport psychologist. In addition to her skills in helping athletes improve their performances using relaxation, visualization, and goal setting, she also has a background in family systems theory and intervention. During her graduate training she took courses in systems theory, and during her clinical internship she received supervision in family therapy.
At many workshops and sport psychology conferences, she has learned skills in working with individual athletes, but she is also interested in working with ...