Research: An IFS Treatment That Can Benefit Those With PTSD

Co-authored with Diane Joss, Alexandra Comeau, River Chevannes, Hanna Soumerai Rea, Clare Bumpus, Fiona Kate Rice, Mary Catherine Ward, Laure Tobiasz Veltz, Dilara Ally, David Lovas, and Zev Schuman-Olivier

The United States has a large number of underserved populations with a high prevalence of PTSD. Although community mental health centers play a vital role in providing services for PTSD, they struggle with staff shortages and long wait times. One promising option for addressing the need for accessible, cost-effective PTSD treatment is group-based interventions, which can particularly benefits patients who are marginalized or socially isolated and clinics that are financially strapped.

Accordingly, the Center for Mindfulness and Compassion (CMC) at the Cambridge Health Alliance, a Harvard Medical School affiliate, developed the “Program for Alleviating and Resolving Trauma and Stress” (PARTS), an online telehealth-based 16-week group-based treatment program for PTSD that is derived from Internal Family Systems (IFS) therapy.

IFS is an increasingly popular contemplative mental health intervention that integrates elements from various psychotherapeutic approaches and has been shown to enhance de-centering (a form of mindful meta-awareness), self-compassion, and emotion regulation – all shown to be important in treatment of PTSD. At the same time, there is limited rigorous research exploring the clinical efficacy of IFS.

In this study of 60 patients with PTSD, participants were randomly assigned to either the PARTS intervention or an active control arm called Nature-Based Stress Reduction for Trauma Survivors (NBSR-T). Important differences emerged. Patients in the PARTS treatment arm reported higher levels of group satisfaction than the control arm, and most PARTS participants rated the group experience as excellent, at proportions that were statistically significantly above the control arm. As well, patients in the PARTS arm attended on average 12.8 of the total of 16 group sessions, which was significantly more than the average of 10 sessions attended by the NBSR-T treatment arm.

The two treatment arms, however, were similar in an important way. Both led to statistically significant large reductions in PTSD symptoms. This outcome is consistent with emerging findings from large-scale meta-analyses showing no significant differences when multiple popular psychotherapy interventions like cognitive processing therapy, cognitive behavioral therapy, prolonged exposure, or eye-movement desensitization and reprocessing (EMDR) were compared with active control conditions.

It's worth noting that the IFS RCT PARTS study has several limitations, including 1) limited funding and resources; 2) a small sample size; 3) the use of a primary outcome measure (CAPS-5) that does not capture symptoms of complex trauma or attachment trauma, or positive psychology measures such as resilience, post-traumatic growth, or whole person well-being.

Nonetheless, it demonstrated the feasibility and acceptability of PARTS as an accessible and affordable group-based online treatment program for PTSD treatment in community mental health settings.