Methods: The study used multiple search strategies to identify the articles for the review. Electronic databases were searched articles and federally-funded research reports for the period January 1990 to April 2011: EBSCO, Medline, PubMed, PsychInfo, Social Services Abstracts, Sociological Abstracts, Google Scholar, C2-SPECTR, ERIC, Dissertation Abstracts, and the Child Welfare Information Gateway using the terms listed in Table 1. Rigorous inclusion/exclusion criteria selected experimental or quasi-experimental design and quantitative outcome measures. As a final step, reference sections of sources obtained were searched for additional studies meeting the inclusion/exclusion criteria. This search procedure resulted in a total of 53 studies, 6 in child welfare, 29 in mental health, and 18 in substance abuse.
Results: Results indicated that client-provider relationship was related to intermediate process and final outcomes across the three service domains of mental health, child welfare and substance abuse. The relationship did not seem to be mediated by rater of relationship. The strength of the relation did appear to be affected the immediacy, quality and malleability of the outcome measure and by the maturity of the research in a particular domain. Conclusions and implications: Overall, the studies reviewed indicate the impact of client provider relationship on outcome is robust across the three service domains with impact appearing to be both directly therapeutic as well as mediated to some extent by other factors. Findings point to the importance of including client-provider relationship as an ingredient in the development of effective service delivery models.