In the last 15 years, a substantial number of studies have tested the theoretical validity of Bowen family systems theory. A review of this basic research provided empirical support for the relationship between differentiation and chronic anxiety, marital satisfaction, and psychological distress. Bowen's assumption that couples with the same level of differentiation marry was not supported. His specific theories of sibling position and triangulation also received little empirical support. Research on multigenerational transmission has generally ignored Bowen's theoretical perspective, and more research needs to test Bowen's claim that his theory is universal. In addition, researchers still need to examine the effect of differentiation on child functioning, physical health problems, and adaptability.

The term high conflict is used regularly across various literatures; such as divorce, family court, and psychotherapy; to describe relationships that are mired in conflict. Despite its widespread use, the term has not been precisely defined in a clinically meaningful way. This article offers a definition of high conflict based on a synthesis of previous literatures related to high conflict, observations of court personnel, and the authors' own clinical experiences working with this population. A case study illustrates the pervasive negative exchanges and hostile insecure emotional environment that characterize these couples. The implications of this definition for clinical practice are also discussed.

Relationships between grandparents and grandchildren provide an excellent framework for integrating family theory and family methodology. Systematic differences as a function of age, gender, life expectancy, and health as played out through generations suggest some topics are best studied by disentangling variability between and within families. Using data from 1,345 grandchildren (52% girls, mean age 13.69 years, range 9 to 20) reporting on 3,664 grandparents, we compare results obtained from studying grandparent-grandchild relationships individually and at the family level. Results suggest important predictors of relationship quality at the within-subject and between-subject levels. Future research should more carefully integrate each level into theory and design.

This study examines the relationship between the therapeutic alliance and distress using the couple rather than the individual as the unit of analysis. One hundred and seventy-three couples receiving treatment for relational distress at two university clinics participated in this study. The actor-partner interdependence model was used to analyze the relationship of each partner's between- and within-system alliance scores and distress at session four. Results provide support for actor effects on relational distress for both male and female partners and for actor effects on psychological distress for female partners. Limited support was found for partner effects on distress. Furthermore, results indicate that the alliance between partners is a stronger predictor of improvement in early sessions in comparison with the alliance between the individual and the therapist.

The Revised Dyadic Adjustment Scale (RDAS; Busby, Crane, Larson, & Christensen, 1995) is a measure of couple relationship adjustment that is often used to differentiate between distressed and non-distressed couples. While the measure currently allows for a determination of whether group mean scores change significantly across administrations, it lacks the ability to determine whether an individual's change in dyadic adjustment is clinically significant. This study addresses this limitation by establishing a cutoff of 47.31 and reliable change index of 11.58 for the RDAS by pooling data across multiple community and clinical samples. An individual whose score on the RDAS moves across the cutoff changes by 12 or more points can be classified as experiencing clinically significant change.

This article describes the Marriage and Family Therapy Practice Research Network (MFT-PRN). The MFT-PRN is designed to build a professional community based on practice-informed research and research-informed practice, increase the diversity of participants in MFT research, and unify researchers and clinicians. Clinics choose measures from a list that best represent their clinic needs. Clients' outcomes are assessed regularly, and therapists receive immediate graphical feedback on how clients are progressing or digressing. Data are pooled to create a large and diverse database, while improving client outcomes. We will discuss advantages of the MFT-PRN for researchers, therapists, clients, and agencies, and provide one model that we hope will inform other collaborative clinical-research models in the field of marriage and family therapy. Video Abstract is found in the online version of the article.

Aim It is increasingly important for mental healthcare providers and researchers to reliably assess client change, particularly with common presenting problems such as anxiety. The current study addresses this need by establishing a Reliable Change Index of 6 points for the GAD-7. Method Sample size included 116 online community participants using Amazon’s Mechanical Turk (MTurk) and archival data for 332 clinical participants. Participants completed measures of the GAD-7 and the MDI in 2 rounds. Using previously established cutoff scores and Jacobson and Truax’s (1991) method, we establish a Reliable Change Index which, when applied to 2 administrations of the GAD-7, indicates if a client has experienced meaningful change. Results For the GAD-7, the mean score for the clinical sample was 10.57. For the community sample at Time 1, the mean score was 4.14. A Pearson’s correlation was computed to assess the 14-28-day test-retest reliability of the GAD-7, r(110) = .87, indicating good test-retest reliability. Conclusion Using the RCI equation, this resulted in an RCI of 5.59. For practical use the RCI would be rounded to 6.

By focusing on improving the therapeutic alliance with high-conflict coparenting cases as well as clients with higher levels of distress, therapists may be able to increase client retention.