Couple and family therapy has well-established benefits. Although the majority of clients benefit, some worsen, some show no positive change, and some drop out early. This suggests that existing treatment modalities require further advancement. One promising avenue to achieve advancement involves instituting, as the standard of care, formalized client feedback, which has been shown to improve outcomes. This paper is a non-systematic review that outlines several formalized feedback systems currently available and highlights each system's utility with application to couple and family therapy. While couple and family therapists have unique obstacles in therapy due to multiple therapeutic alliances, the use of formalized feedback has potential to strengthen alliances and improve outcomes for all clients who participate. We advocate for the use of formalized feedback in the training of new therapists and to augment the supervision process.Practitioner points • Encourage the couple and family therapy field to implement the use of formalized client feedback systems both clinically and in research • Demonstrate the importance of implementing formalized client feedback systems to decrease premature termination and improve client outcomes • Provide information about existing client feedback systems to give practitioners the opportunity to choose a method that most benefits their clients

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Findings suggest that interventions are needed to combat avoidant coping (behavioral disengagement, denial, substance abuse) predeployment because this way of coping is strongly related to negative outcomes. In addition, those who work clinically with these families should work to reduce avoidant coping strategies and any familial dynamics exacerbated by this way of coping.