Social work depends on relationship building to achieve its goals. This requires knowledge derived from research, as well as the intuitive understanding and interpretive abilities that are refined through experience with clients. The evidence-based practice movement and its forebears have for decades attempted to determine which theory or method of practice is most effective when applied to specific problems or diagnoses. However, extensive meta-analyses have determined that other variables–-in particular, the quality of alliance formed between worker and client–-matter most in predicting outcomes. This article summarizes the research and concludes that the evidence supports an improvisatory conception of practice, and that improved outcomes will result when there is increased attention to those variables that enhance the working alliance.
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