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Internal Family Systems: Exploring Its Problematic Popularity

Internal Family Systems (IFS) is a theory of mind organization developed by Richard Schwartz in the 1990s, which posits that the mind is an internal system of parts that exist separately and in conversation with one another. While this approach, on the surface, sounds like many theories of psychotherapy (e.g., any theory that discusses how contradictory internal experiences co-exist), IFS is unique in its labeling and separation of such parts into “vulnerable” and “protective” categories, and into roles like “exile,” “firefighter,” “manager” and “Self.” IFS focuses on helping clients have their “parts” be in conversation with the goal of decreasing psychological symptoms. More specifically, an IFS therapist encourages clients to embody different parts of self in session, encouraging clients to verbalize needs, wants, and past hurts from the perspective of each part. This can include facilitation of splitting and dissociative processes, as well as therapist questions pertaining to each part’s past or present experience at the exclusion of other parts (IFS Institute, 2024).

Notably, there is a strikingly small evidence-base in the literature for IFS, particularly given that it was developed 30 years ago. Three studies show some support for the acceptability or effectiveness of IFS with specific presenting concerns: depression, rheumatoid arthritis-related pain, post-traumatic stress disorder (PTSD), and dissociation (Haddock et al., 2016; Hodgdon et al., 2022; Shadick et al., 2013). Despite the limited research with selective samples, the IFS website makes sweeping claims about its healing power: “IFS is much more than a non-pathologizing, evidence-based psychotherapy to be used in a clinical setting. It is also a way of understanding personal and intimate relationships and stepping into life” (IFS Institute, 2024).

Furthermore, IFS usage appears to be increasing. We have noticed increasing numbers of trainees, supervisors, and colleagues who report using IFS across ranging presenting concerns (notably beyond concerns studied in treatment trials). Per the authors’ investigation, as of April 2024, 45,764 psychotherapists on PsychologyToday.com mentioned using IFS. There also appears to be an extensive number of posts about IFS on popular social media sites, which have become major sources of official and unofficial mental health information (Cook et al., 2017). Also per the authors’ investigation, on Instagram, there were 30,875 posts with #ifstherapy and 74,154 with #internalfamilysystems tags, and, on Tik Tok, there were 3 million posts mentioning “Internal Family Systems Therapy” and 1.2 million posts mentioning to “Internal Family Systems Technique.” Given its increasing popularity, IFS should be examined regarding potential for harm as its application has expanded to clients with ranging diagnoses, severity levels, and personality structures, as evidenced by the spanning diagnoses that IFS psychotherapists claim to treat on PsychologyToday.com (See Psychology Today, 2024). Additionally, it is possible that the proliferation of IFS in the mental health ecosystem is due to a need for more structured and robust training on empirically supported psychotherapy, as well as trauma-informed psychotherapy.

Potential Harms of the Overapplication of Internal Family Systems

We believe that the current expansion of IFS across psychotherapy and social media has moved beyond its evidence base. The existing literature has excluded those with psychosis, and, based on our clinical observations in hospital and private practice settings, there is possibly an overapplication of IFS to individuals experiencing psychotic symptoms either due to an underlying schizophrenia-related disorder, mood disorder, or severe trauma-related disorder. We are not the first to express concern about IFS application to those with psychosis or reality testing difficulties (Deacon & Davis, 2001). Our concern is that encouraging splitting of the self into parts for those who struggle with reality testing might be disorganizing. We also know from the complex trauma literature that a primary goal of treatment for dissociative disorders and complex trauma is a careful, phasic approach that encourages integration of dissociated parts and experiences (e.g., Courtois & Ford, 2016). Encouraging conversation between parts and telling clients what to label parts of self (e.g., firefighter) without significant sensitivity to ways this could exacerbate splitting of self-states could be dangerous for some. Additionally, IFS practitioners have faced litigation from past clients regarding introduction of false memory (e.g., Doe v. Riverside Partners, 2022), possibly facilitated by splitting of self-states and decreased reality testing. As such, there is potential for harm. Clinicians using IFS who have not received sufficient training in trauma-informed care may be at particular risk of misusing IFS in ways that cause such harm.

Increased Popularity of Internal Family Systems

Many early career psychotherapists have graduated from programs that have required “Research Methods,” “Counseling Techniques,” and “Counseling Theories” courses per accreditation requirements (e.g., MPCAC, CACREP). Counseling techniques courses often focus on common factors in psychotherapy, while counseling theories courses often provide an agnostic overview of all classic psychotherapy theories. Research methods courses often focus on basics of research design and program evaluation. However, there is often a lack of integration across these courses, such that many students graduate as license eligible without an understanding of how to evaluate whether a psychotherapeutic approach has empirical support for addressing particular symptomatology. IFS is a marketable approach that likely draws in client interest (given the popularity on social media), and many of its practitioners are likely not aware of its lack of empirical support. We believe this lack of integrative education potentially leaves many early career psychotherapists to be susceptible to misleading trainings on approaches that are not sufficiently evidence-based.

Additionally, accreditation requirements for many graduate programs in psychotherapy do not include trauma-informed training (Cook et al., 2017). Relatedly, in a survey of doctoral psychology training programs, Henning and colleagues (2022) found that one in five programs offered a class in trauma-informed care. This may be because the roots of most of these disciplines are vocational psychology, adjustment concerns, and familial distress (e.g., Munley et al., 2004), and not the treatment of acute and persistent mental health difficulties. During training and afterwards, clinicians increasingly report working with clients with high acuity symptoms needing trauma-informed psychotherapy across various levels of care (e.g., Xiao et al., 2017). We suspect that many people applying IFS are doing so to meet the needs of their clients, particularly given IFS’ reputation of being a go-to treatment for complex PTSD and dissociation. For example, many Eye Movement Desensitization and Reprocessing (EMDR) practitioner trainings suggest IFS integration with EMDR when clients struggle with complex trauma and dissociation (Brown, 2021). As such, the combination of less than adequate training in evaluating psychotherapies for empirical support and the lack of emphasis on trauma-informed treatment training likely sets the stage for psychotherapists to be interested in an approach like IFS.

IFS Online

As mentioned above, the current authors examined the popularity of IFS on Psychology Today, Instagram, and Tik Tok. These findings indicate a substantial amount of IFS-related content on these sites. Nonetheless, there are no current peer-reviewed articles that have examined the content of posts discussing IFS. As such, the general public is receiving unknown messages from content creators (many of whom are likely mental health providers) regarding IFS.  Some of this content, such as TikTok posts on “Internal Family Systems Techniques” may be encouraging audiences to apply IFS without the supervision of a trained therapist. This may be shaping the broader publics’ understanding of healing and psychotherapy and fueling a demand for IFS from psychotherapy clients. Such demand may, in turn, impact training and continuing education selection for psychotherapists. The popularity of IFS and related language (e.g., #innerchild, #partswork) on social media may also shape the publics’ understanding of mental health, trauma, and identity outside of psychotherapy. As such, IFS content on social media likely shapes dialogue within and outside of psychotherapy spaces.

Future Research Directions for Internal Family Systems

There is a need for research to explore why psychotherapists pursue training in IFS, why and how psychotherapists use social media to talk about tenants of IFS, and what presenting concerns psychotherapists are implementing IFS. We hold concerns regarding potential diagnoses, severity levels, and personality structures that may not benefit (or may be at risk for harm) when considering application of IFS, however, further research is needed to better understand such nuances. Understanding etiologies of psychotherapists’ pursuit of IFS training or integration of IFS tenants into their work may help identify training gaps in trauma-informed care. Understanding the prevalence of “therapy talk” on social media and the reach of posts to consumers may elucidate a need for ethical guidelines around therapy talk in the social media landscape (White & Hanley, 2022).

 

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Lisa Brownstone, PhD (she/they) is an Assistant Professor of the Practice in Counseling Psychology at the University of Denver. They spend their time teaching emerging counselors and psychology trainees about psychotherapy. Her areas of clinical and research specialization include disordered eating, weight stigma, gender affirming care, trauma, and group psychotherapy. Dr. Brownstone identifies as a social justice advocate psychologist and is passionate about non-value neutral practice.

Cite This Article

Brownstone, L. M., Hunsicker, M. J., & Greene, A. K. (2024, June). Internal family systems: Exploring its problematic popularity. Psychotherapy Bulletin, 59 (3).

References

Brown, G. O. (2021). Internal family systems informed eye movement desensitization and reprocessing: An integrative technique for treatment of complex posttraumatic stress disorder. International Body Psychotherapy Journal, 19, 112-122. https://isc.training/wp-content/uploads/2023/06/oshea-brown-IFS_EMDR.pdf

Cook, J. M., Simiola, V., Ellis, A. E., & Thompson, R. (2017). Training in trauma psychology: A national survey of doctoral graduate programs. Training and Education in Professional Psychology, 11, 108–114. https://doi.org/10.1037/tep0000150

Courtois, C. A., & Ford, J. D. (2016). Treatment of complex trauma: A sequenced, relationship-based approach. The Guilford Press.

Deacon, S. A., & Davis, J. C. (2001). Internal Family Systems theory: A technical integration. Journal of Systemic Therapies, 20, 45–58. https://doi.org/10.1521/jsyt.20.1.45.19410

Doe v. Riverside Partners, CV 117 CDP No. 4:22. (2022).  https://casetext.com/case/doe-v-riverside-partners-llc-1

Haddock, S. A., Weiler, L. M., Trump, L. J., & Henry, K. L. (2016). The efficacy of Internal Family Systems therapy in the treatment of depression among female college students: A pilot study. Journal of Marital and Family Therapy, 43(1), 131–144. https://doi.org/10.1111/jmft.12184

Henning, J. A., Brand, B., & Courtois, C. A. (2022). Graduate training and certification in trauma treatment for clinical practitioners. Training and Education in Professional Psychology, 16(4), 362-375. https://doi.org/10.1037/tep0000326

Hodgdon, H. B., Anderson, F. G., Southwell, E., Hrubec, W., & Schwartz, R. (2022). Internal Family Systems (IFS) therapy for posttraumatic stress disorder (PTSD) among survivors of multiple childhood trauma: A pilot effectiveness study. Journal of Aggression, Maltreatment & Trauma, 31, 22–43. https://doi.org/10.1080/10926771.2021.2013375

IFS Institute. What is Internal Family Systems? | IFS Institute. (2024). Retrieved June 3, 2024, from https://ifs-institute.com/about-us.

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Psychology Today. Find an Internal Family Systems (IFS) Therapist. (2024). Retrieved June 3, 2024, from https://www.psychologytoday.com/us/therapists?category=internal-family-systems-ifs.

Shadick, N. A., Sowell, N. F., Frits, M. L., Hoffman, S. M., Hartz, S. A., Booth, F. D., Sweezy, M., Rogers, P. R., Dubin, R. L., Atkinson, J. C., Friedman, A. L., Augusto, F., Iannaccone, C. K., Fossel, A. H., Quinn, G., Cui, J., Losina, E., & Schwartz, R. C. (2013). A randomized controlled trial of an internal family systems-based psychotherapeutic intervention on outcomes in rheumatoid arthritis: A proof-of-concept study. The Journal of Rheumatology, 40, 1831–1841. https://doi.org/10.3899/jrheum.121465

White, E., & Hanley, T. (2022). Therapist + social media = mental health influencer? Considering the research focusing upon key ethical issues around the use of social media by therapists. Counselling and Psychotherapy Research, 23(1), 1-5. https://doi.org/10.1002/capr.12577

Xiao, H., Carney, D. M., Youn, S. J., Janis, R. A., Castonguay, L. G., Hayes, J. A., & Locke, B. D. (2017). Are we in crisis? National mental health and treatment trends in college counseling centers. Psychological Services, 14, 407–415. https://doi.org/10.1037/ser0000130

 

 

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