What you technically need, what is well received, what should be avoided — a practice report from outreach family work and mobile counselling.

Why the setting changes everything in a home visit

In the office, the counsellor is the host. On a home visit, the family is. This shift affects every gesture, every question and every methodological move — including, and especially, the genogram. Anyone who fails to reflect on this produces resistance without knowing where it comes from.

Home visits are standard in youth welfare, family support, outreach nursing and parts of addiction counselling. The genogram is often the medium that establishes relationship and diagnostics in one move — but only if the setting fits.

Materials list

What I have carried in my bag for years — with no claim to completeness:

  • Large paper (at least A3, preferably A2 on a roll). Never A4 — it looks stingy and is structurally too small for three generations.
  • Three pens in different colours. Black for structure, blue for close relationships, red for conflicts. More colours confuse.
  • A clipboard or solid surface — kitchen tables have crumbs, coffee tables are often too wobbly.
  • Stickers/sticky notes for notes that can be removed later — for example, hypotheses that should not yet be spoken aloud.
  • A cloth for covering the work if interrupted (door, phone, children).
  • No tablet during first contact. Digital genogram software is great, but in the family's living room it feels distancing.

What is well received

Working on the floor. When children are involved, the floor is often the most egalitarian place. Grandparents tend to prefer the table (to spare their knees), parents often too — but deliberately offering the floor as an option measurably changes the atmosphere.

Letting the family draw. Instead of drawing yourself, hand the pen to the oldest child ("You know the family best") or ask the grandfather to draw his parents' generation. Distributing power over the pen distributes power over the image.

Allowing small anecdotes. "My father always used to say…" — sentences like these are gold. The office lacks the frame for them. In the living room, a whole different depth often opens up.

What should be avoided

Don't have the TV turned off. If the family leaves it on, that is information — they are signalling how much attention they are giving the appointment. Even asking for silence comes across as intrusive.

No symbol lectures. Anyone who says "let me briefly explain the symbolism" has already lost the home-visit atmosphere. Introduce symbols in passing, when they are needed.

Don't go beyond three generations. In the office, one tends to keep asking. On a home visit, the family's fatigue is reached more quickly. Three generations — parents, grandparents, client — are comfortably doable in 90 minutes.

Think about data protection and GDPR. Home visits generate notes with sensitive data. These belong in a lockable bag, never openly on the table or in the car.

Practice vignette

Family with two adolescent sons, outreach youth welfare. First home visit after an escalation at school. I bring A2 paper and three pens. The mother seats me at the kitchen table, the sons are on the sofa, the father is standing. After 10 minutes I ask: "Which of you knows the family's history best?" — the father. I give him the black pen and step back a pace. The sons look over after 5 minutes, come closer, add uncles and cousins. The conversation carries itself.

After the home visit

Take a photo of the paper genogram before I leave. It stays with the family — that, too, is part of the setting shift. In the office I take the original with me; on a home visit I leave it there, with a request not to put it away.

The digital transfer into the file (e.g. with GenoEasy or otherwise) I do in the evening at the office. That combines the warmth of the home-visit atmosphere with the professional documentation duty.

Further reading