National Registry of Evidence-based Programs and Practices (NREPP)
Internal Family Systems (IFS) Therapy
Program Description
Internal Family Systems (IFS) Therapy is a psychotherapeutic modality developed in the mid-1980s, based on the observation that clients sometimes experience subpersonalities that come into internal conflict when dealing with challenges. The IFS model likens these subpersonalities to an “internal family.”
The IFS model uses mindfulness-based and other strategies to help people resolve internal conflicts in a satisfactory way. During sessions, therapists actively encourage participants to practice self-compassion toward subpersonalities and an internal dialogue. Participants attend individual sessions or group meetings with trained IFS therapists.
The Center for Self Leadership offers progressive levels of training in IFS, from beginning (Level 1) through advanced (Level 3). Participants in these trainings learn both IFS theory and technique, gaining the knowledge and skills needed to understand and actively use IFS with individuals, couples, children, families, and groups. Information and training regarding IFS is provided through multiple sources.
| Outcome: General Functioning and Well-Being | |
| Program Effects Across all Studies | This program is effective for improving general functioning and well-being. The review of the program yielded strong evidence of a favorable effect. Based on one study and three measures, the average effect size for general functioning and well-being is .56 (95% CI: .30, .69). Click here to find out what other programs have found about the average effect sizes for this outcome. |
| Key Study Findings | At the end of the 9-month intervention, participants in the intervention group reported a statistically significant reduction in two measures of joint pain and a measure of physical functioning, compared with participants in the control group (Shadick et al., 2014). |
| Measures | Shadick et al. (2014): RA Disease Activity Index (RADAI) joint score (total number of painful joints); the 100-mm visual analog scale (VAS); and the Short Form-12 (SF-12) physical function score |
| Additional Details | This outcome was also assessed at a 21-month follow up (Shadick et al., 2014). Follow-up findings are not rated and therefore do not contribute to the final outcome rating. |
| Outcome: Anxiety Disorders and Symptoms | |
| Program Effects Across all Studies | This program is promising for reducing phobia, panic, and generalized anxiety disorders and symptoms. The review of the program yielded sufficient evidence of a favorable effect. Based on one study and one measure, the effect size for phobia, panic, and generalized anxiety disorders and symptoms is .32 (95% CI: -.12, .76). Click here to find out what other programs have found about the average effect sizes for this outcome. |
| Key Study Findings | At the end of the 9-month intervention, participants in the intervention group showed a greater, but statistically nonsignificant mean improvement in anxiety, compared with the control group (Shadick et al., 2014). |
| Measures | Shadick et al. (2014): Spielberger State–Trait Anxiety Inventory (STAI) |
| Additional Details | This outcome was also assessed at a 21-month follow up (Shadick et al., 2014). Follow-up findings are not rated and therefore do not contribute to the final outcome rating. |
| Outcome: Physical Health Conditions and Symptoms | |
| Program Effects Across all Studies | This program is promising for improving physical health conditions and symptoms. The review of the program yielded sufficient evidence of a favorable effect. Based on one study and one measure, the effect size for physical health conditions and symptoms is.23 (95% CI: -.22, .67). Click here to find out what other programs have found about the average effect sizes for this outcome. |
| Key Study Findings | At the end of the 9-month intervention, there was no statistically significant difference in disease activity between the intervention and control groups (Shadick et al., 2014). |
| Measures | Shadick et al. (2014): Disease Activity Score–28–C–reactive Protein 4 (DAS28–CRP4) |
| Additional Details | This outcome was also assessed at a 21-month follow up (Shadick et al., 2014). Follow-up findings are not rated and therefore do not contribute to the final outcome rating. |
| Outcome: Self-Concept | |
| Program Effects Across all Studies | This program is promising for improving personal resilience/self-concept. The review of the program yielded sufficient evidence of a favorable effect. Based on one study and two measures, the average effect size for personal resilience/self-concept is .27 (95% CI: -.04, .43). Click here to find out what other programs have found about the average effect sizes for this outcome. |
| Key Study Findings | At the end of the 9-month intervention, participants in the intervention group reported a statistically significant increase in self-compassion, compared with participants in the control group, but there were no significant group differences in arthritis self-efficacy (Shadick et al., 2014). |
| Measures | Shadick et al. (2014): Neff Self-Compassion Scale and Arthritis Self-Efficacy Other Symptoms Scale |
| Additional Details | This outcome was also assessed at a 21-month follow up (Shadick et al., 2014). Follow-up findings are not rated and therefore do not contribute to the final outcome rating. |
| Outcome: Depression and Depressive Symptoms | |
| Program Effects Across all Studies | This program is promising for reducing depression and depressive symptoms. The review of the program yielded sufficient evidence of a favorable effect. Based on one study and one measure, the effect size for depression and depressive symptoms is .46 (95% CI: .01, .90). Click here to find out what other programs have found about the average effect sizes for this outcome. |
| Key Study Findings | At the end of the 9-month intervention, participants in the intervention group showed a greater, but statistically nonsignificant mean improvement in depressive symptoms, compared with the control group (Shadick et al., 2014). |
| Measures | Shadick et al. (2014): Beck Depression Inventory (BDI) |
| Additional Details | This outcome was also assessed at a 21-month follow up (Shadick et al., 2014). Follow-up findings are not rated and therefore do not contribute to the final outcome rating. |
| Shadick et al. (2014) | |
| Study Design Narrative | Through a computer algorithm, rheumatoid arthritis participants were randomly assigned to either the IFS program or a rheumatoid arthritis educational program. The rheumatoid arthritis education group served as a minimal-attention control, meeting once as a group and then receiving monthly mailed educational information about rheumatoid arthritis. These mailings were followed up by a phone call from a research assistant to reinforce the information. |
| Sample Description | A total of 79 adults with a rheumatologist’s diagnosis of rheumatoid arthritis participated in the study (39 in the intervention group and 40 in the control group). The mean age was 58 years. Approximately 90% of the sample was female and 92% was white. Mean duration of the disease was approximately 16 years. |
STUDIES REVIEWED
SUPPLEMENTAL AND CITED DOCUMENTS
OTHER STUDIES
* Dissemination and implementation information was provided by the program developer or program contact at the time of review. Profile information may not reflect the current costs or availability of materials (including newly developed or discontinued items). The dissemination/implementation contact for this program can provide current information on the availability of additional, updated, or new materials.
Implementation/Training and Technical Assistance Information
Training for IFS is organized through the Center for Self Leadership (CSL). Trainers attend two annual retreats and collaborate on training-related issues and curricular reviews through separate monthly conference calls. Trainers are experienced, licensed psychotherapy professionals who teach the IFS model across the United States and internationally. Trainings are held at conference or retreat centers or on university campuses. International trainings (averaging five trainings per year with 25–28 participants) have taken place at a number of locations. Three consecutive levels of extensive training are available, supported by a comprehensive training curriculum that involves the participants’ personal immersion in the actual model. Trainees learn both IFS theory and technique, gaining the knowledge and skills required to actively use the IFS model with individuals, couples, children, families, and groups.
Individuals who complete Level 1 Training may earn IFS certification by completing a rigorous process to ensure their proficiency in the IFS model. This process includes demonstrations of competence through recorded mock and live sessions, consultation sessions, and/or participation in advanced training. There are currently over 200 IFS-certified therapists and practitioners, who are accessible through a searchable online registry. Annual IFS conferences have been held for over a decade.
IFS provides an adherence manual that includes a definition of every construct and all stages of the unburdening process through integration. These constructs represent the basis for a recently developed 15-item fidelity scale, which is designed to ensure adherence. In addition, an IFS therapist-competency scale has been constructed.
Dissemination Information
The Center for Self Leadership operates a resource website (www.selfleadership.org), which includes a series of key IFS articles, along with an online store. The Foundation for Self Leadership’s website (www.foundationifs.org) was unveiled in late 2013 and is being expanded gradually. In addition, there are dozens of websites of IFS practitioners that include information and testimonials about IFS.
Summary Table of RFDI Materials
| Description of item | Required or optional | Cost | Where obtained |
|---|---|---|---|
| Implementation Information | |||
Internal Family Systems Therapy (Guilford, 1997), a book written for psychotherapists. The book has been published in several editions and translated into many languages, including French, Portuguese, and Korean. |
Required | Contact program supplier: http://www.selfleadership.org | |
Introduction to the Internal Family Systems Model (Trailheads Press, 2001), translated into French and Spanish |
Required | Contact program supplier | |
You Are the One You’ve Been Waiting For, Bringing Courageous Love to Intimate Relationships (Trailheads Press, 2008) |
Required | Contact program supplier | |
Demonstration DVDs, led and narrated by Dr. Richard Schwartz, have been produced to show clinical work using IFS for treating a number of mental disorders. |
Required | Contact program supplier | |
Training Level 1 (a foundational training of over 100 hours in two formats: two 1-week retreats or six long weekends) |
Required | Contact program supplier | |
Training Level 2 (an intermediate training of over 70 hours) |
Required | Contact program supplier | |
| Training Level 3 (an advanced training of over 35 hours) | Required | Contact program supplier | |
| Dissemination Information | |||
IFS fidelity scale (providing model constructs and research adherence tool) |
Optional | http://foundationifs.org/research | |
The Foundation for Self Leadership’s website provides dozens of websites of IFS practitioners that include information, news, and testimonials about IFS. |
Optional | http://foundationifs.org | |