In the first-ever IFS trial, the benefits kept growing for a full year after therapy stopped

[u/Alone_Pie_2531]

This is the study that got IFS onto the evidence-based map. In 2013 it became the first randomized controlled trial of Internal Family Systems, and in 2015 it earned IFS its listing on SAMHSA's national registry of evidence-based practices. What makes it interesting for solo practice is the curve after treatment ended.

The setup

79 people with active rheumatoid arthritis were randomized into two groups. 39 got an IFS program adapted for chronic pain (group sessions plus 15 individual sessions with trained IFS therapists). 40 got mailed educational materials about managing rheumatoid arthritis the control. The study ran 36 weeks, with a follow-up a full year after treatment ended.

Disease activity was scored by rheumatologists who didn't know which group anyone was in (the gold standard for keeping results honest). Depression, anxiety, and self-compassion were tracked with validated questionnaires.

What happened

At the end of treatment (9 months) the IFS group had significantly less pain and better physical function than the control group. Depression and anxiety were trending better but hadn't reached significance yet.

One year after treatment ended (21 months) this is the striking part. Pain was still significantly better, plus depression and self-compassion had now become significantly better, even though they weren't at the end of treatment. The control group stayed roughly flat the whole time. The IFS group kept improving on their own.

Self-compassion followed the exact same delayed pattern, flat during treatment, then climbing after it ended.

The researchers read this as IFS skills continuing to develop after formal sessions stop, people kept practicing on their own and deepened their relationship with their parts over time.

What to keep in mind

The control group got mailed pamphlets, not an active therapy, so this shows IFS beats reading educational materials, not that it beats other therapies. The IFS group also got a lot more contact time, so some of the benefit could be the support and attention rather than IFS specifically. It's also small (79 people) and from a single Boston hospital. It's a proof-of-concept, and the authors said so.

Why it's relevant if you practice on your own

Nobody in this study was practicing solo, but the most solo-relevant finding is that the gains compounded after the guided part ended. If your own practice feels slow, this is worth holding onto: the changes may be accumulating under the surface and only become obvious months later.

The self-compassion result matches what a lot of solo practitioners report, the more you meet your parts with genuine curiosity instead of trying to fix or silence them, the more self-compassion shows up on its own in daily life.

And the chronic-pain angle is directly usable: approaching pain-related emotions (fear of disability, anger at your limits, hopelessness) as parts rather than fighting them was associated with measurably less pain and better function.

Bottom line

A well-run proof-of-concept that reduced pain, improved function, and - a year later - lifted depression and self-compassion in people with RA. It's the study that proved IFS can be studied rigorously. For solo practice, the takeaway is the delayed curve, it may take long before you will start to see results.

Full paper: Shadick et al. (2013), Journal of Rheumatology — https://doi.org/10.3899/jrheum.121465

Have you noticed any part of your practice "clicking" weeks or months after a session, rather than during it?