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The family as a system: genogram, family life cycle and Rolland's model
The family doctor treats a person within a family: the genogram shows three generations of relationships and illness, the life cycle explains when a family is vulnerable to crisis, and Rolland's model describes how a chronic illness "meets" the life stage of the patient and the family.
Why it matters in the exam
Every family medicine paper has a genogram: describe in words what is drawn, identify an inheritance pattern (autosomal dominant, recessive, X-linked), and choose a recommendation that the information supports. Other questions ask "what does Rolland's developmental model describe?" or match a life-cycle stage to its typical task.
The tested point is that chronic illness affects the whole family, and that its impact depends both on the illness (onset, course, outcome, disability) and on the life stage at which it strikes.
In genogram questions it helps to translate the drawing into one clear sentence — who the index patient is, in which generation, and which relatives were ill — and only then choose the recommendation. Questions about an exhausted main caregiver in the family also appear.
Key points
- Genogram — at least 3 generations; square male, circle female, X deceased.
- Dominant — every generation, father to son; recessive — siblings; X-linked — sons through mothers.
- Life cycle: crises at the transitions between stages.
- Rolland: type of illness × illness phases × life cycle.
- Chronic illness is an event for the whole family.
Summary table
| Tool or concept | What it describes | How it is read | Use in the exam |
|---|---|---|---|
| Genogram | At least 3 generations, relationships, illnesses and events | Square — male, circle — female, X — deceased, double line — index patient, slash — separation | Describe in words and identify a pattern |
| Autosomal dominant pattern | Affected in every generation, father-to-son transmission | About 50% of an affected person's children | E.g. BRCA, Lynch syndrome |
| Autosomal recessive pattern | Affected siblings, healthy parents, sometimes consanguinity | 25% for each pregnancy of two carriers | E.g. cystic fibrosis |
| X-linked recessive pattern | Affected sons through carrier mothers, no father-to-son transmission | Daughters of an affected man — carriers | E.g. haemophilia |
| Family life cycle | Leaving home, couple, young children, adolescents, "launching" children, later life | Each stage has tasks; crises at transitions | Match stage to task |
| Rolland's model | Illness (onset, course, outcome, disability) × illness phases (crisis, chronic, terminal) × life cycle | "Centripetal" periods (young children) versus "centrifugal" ones (adolescents) | Understand burden and plan intervention |
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Sources
- McGoldrick M, Gerson R, Petry S. Genograms: Assessment and Treatment, 4th edition (2020) — Genogram construction and interpretation
- Rolland JS. Families, Illness, and Disability: An Integrative Treatment Model, 1994 (and later updates) — The family systems–illness model
- McGoldrick M, Garcia Preto N, Carter B. The Expanding Family Life Cycle, 5th edition (2016) — Stages of the family life cycle
Sources are given for further reading; the text is written afresh and not copied from them.
Reviewed by the Examqo AI Professor · 2026-11-06. The text may contain errors; when in doubt, check the source.