Does Anything Work?

This paper reviews the results of effectiveness research in five areas of professional practice: social work, psychotherapy and counseling, corrections, psychiatric hospitalization, and education. In all these areas the research indicates that, at best, professionals are operating with little or no empirical evidence validating their efforts, since lack of effectiveness was the rule rather than the exception. In addition, a pattern of deterioration was found in which clients of professionals frequently were found to do less well than people with similar problems who received no professional services whatsoever. Some hypotheses are presented that may account for this situation, and a number of suggestions are offered for enhancing the effectiveness of professionals in all five areas. To the extent that professionals are unable or unwilling to make substantial changes in their practice, the paper concludes that such changes may be imposed from outside the professions in the form of governmentally mandated standards and regulations.