Bowen's model has been adopted and developed by many prominent therapists.

Rather than attempt to summarise all of these developments, I shall focus on the applications of the model by Betty Carter and Monica McGoldrick which have influenced the practice of the Family Institute of Westchester in New York and the Family Institute of New Jersey.

Since the early 1980s, the work of Carter, McGoldrick and their colleagues has expanded Bowen's framework to include attention to the family life cycle (Carter and McGoldrick, 1980, 1988.)  As well as the 'vertical' flow of anxiety through the generations, Carter included an assessment of 'horizontal' stress as families move through various stages of the life cycle.  Vertical and horizontal patterns converge, as multigenerational tensions impact on the ways that life cycle tasks and disruptions are negotiated.  The stress of life cycle changes affects the choice of family of origin issues focused upon in the current generation.  Using a life cycle perspective, symptom development is viewed in the context of an unresolved adjustment to a life cycle task.

Acknowledging the significance of gender, race, ethnicity and class on a family's progression through life cycle stages was an important development in family assessment (eg. McGoldrick, Pearce and Giordano, 1982; Carter et al., 1988; McGoldrick, Anderson and Walsh, 1988; Herz Brown, 1991).

This much broader focus provides what Carter has called a 'multi-contextual lens'.

These variables are part of the context of the family's 'horizontal' story and underlie the potent themes of a family's multigenerational legacy.  Patterns of gender across the generations are viewed as powerfully contributing to the roles that people occupy in the family emotional system.  The inclusion of gender sensitivity in a Bowenian framework means that the therapist helps clients to look not only at patterns of relating over the generations but also to critique the roles they occupy in relationships.  Such a focus is not confined to the family system's gender expectations but includes questions that look for connections to socially defined gender roles.

Betty Carter, in developing her work from the women's project (Carter et al., 1988), has outlined how Bowen's key concepts (fusion, differentiation and triangles) need to be viewed differently from a feminist position.

Gender roles will determine the way men and women express fusion, with women socialised to be dependent and approval seeking and men socialised to withdraw and emotionally 'cut off'.  Carter asserts that the concept of fusion can easily be misused to pathologise the 'over-involved female' while overlooking the distant male.

With a 'gender sensitive lens', a Bowenian therapist validates rather than pathologises the relational concerns of women and explores ways that men can take responsibilities in this sphere.  The distancing of a male will be seen not only as a symptom of lack of differentiation but also as a socially prescribed reaction.

Likewise, the nature of a relationship triangle is influenced by gender related behaviour.

Carter illustrates the different ways a therapist might view a triangle with and without the feminist lens.  The triangle of a husband in a distant position, with his wife and mother in conflict, would be viewed by a feminist Bowenian therapist as 'a case of two women bumping into each other as each tries to carry out her family responsibilities in the face of the man's withdrawal' (Carter et al., 1988).  Interventions will respect the women's roles and dilemmas and focus on how the husband can choose to be more involved in both significant relationships.  Without such a lens, the detriangling strategy would typically be to have the husband set more boundaries with his mother - which has the effect of preserving the gendered stereotype of the 'possessive' mother in law.

The therapist is challenged to recognise that no intervention is free from societal constructs in regard to gender and power (including race, ethnicity, class and sexual orientation) so that 'every intervention will have a different and special meaning for each sex' (Carter et al., 1988).  Thus therapists expand their questioning to ask about the relational impact of each spouse's income and ethnicity.  The organisation of child care and housework is also explored.  Therapists are encouraged to challenge men's excuses that work prevents family involvement and women's expectations about financial support (Carter, 1996).  An awareness of the impact of therapists' own value system on their therapy is also stressed (Carter, 1992).

For Bowenian therapists in the nineties, the core of Bowen's theory of symptom development and change remains unaltered.  What has been added is attention to how wider socio-political issues of power and hierarchy are played out as couple or family problems.  A broad range of systemic techniques such as restorying and circular questioning can readily be incorporated into the model (Carter and McGoldrick, 1988).