Society for Social Work and Research

Sixteenth Annual Conference Research That Makes A Difference: Advancing Practice and Shaping Public Policy
11-15 January 2012 I Grand Hyatt Washington I Washington, DC

16044 Impact of Client-Provider Relationship On Treatment Outcomes: A Systematic Review of Substance Abuse, Child Welfare and Mental Health Services Research

Saturday, January 14, 2012: 10:00 AM
Roosevelt (Grand Hyatt Washington)
* noted as presenting author
Beth Angell, PhD, Associate Professor, Rutgers University, New Brunswick, NJ
Jeanne C. Marsh, PhD, Professor, University of Chicago, Chicago, IL
Christina Andrews, MSW, Doctoral Candidate, University of Chicago, Chicago, IL
Ashley Curry, LCSW, Doctoral Student, University of Chicago, Chicago, IL
Background and Purpose: Client-provider relationship has long been considered essential to the delivery of social services and its study has been fundamental to analyses of the helping interaction. A growing number of reviews have been conducted in specific service systems -- mental health, child and family welfare, and substance abuse that are contributing to an expanded base of knowledge on the role of client-provider relationship in effective service delivery. It is the purpose of this systematic review to expand understanding of the client-provider relationship in social service delivery by addressing two questions: (1) Is the impact of client-provider relationship on outcome robust across outcomes and service systems? (2) Is the impact of client-provider relationship directly therapeutic or is it mediated through other factors?

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.

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