Draw-and-tell as a participatory action method for exploring family dynamics among South African communities

South African family life is shaped by diverse household forms, intergenerational care-giving, unequal material conditions, and shifting patterns of communication and responsibility. This study explored how adolescents, parents/legal guardians, and community practitioners described family dynamics in two Western Cape settings. A participatory action research-informed qualitative design was used, supported by Human-Centred Design principles during the discover and define phases. Draw and tell activities were used as a data-generation tool to support participants in describing family relationships, care practices, responsibilities, emotional connection, and harm. Participants were recruited from Cape Town (n = 44) and the Saldanha Bay Municipality area (n = 32), giving a main analytic sample of 76 participants. Participants created drawings or paintings, annotated their artwork, and discussed their representations during facilitated group workshops. Audio-recorded discussions were transcribed and analysed thematically. Eight interrelated themes were identified: 1) family composition and relational boundaries, 2) communication and emotional distance, 3) attentiveness and recognition of need, 4) responsibility and provision, 5) gendered and peer-based care-giving, 6) receiving care and feeling supported, and 7) shared care and belonging, and 8) harm. The findings show that family dynamics in these settings are negotiated through both everyday practices and structural pressures. Visual material did not replace verbal accounts. Instead, it helped participants anchor their narratives in concrete depictions of family life, especially where relationships involved silence, loss, role strain, affection, or abuse.