This paper traces the close relationship between psychoanalysis and social work after Freudian theory's dramatic impact on social work practice in the 1920s. It shows how revisions and expansion of psychoanalytic theory beyond its traditional base influenced clinical work during later decades until the 1960s, when society turned its attention to macrosystems intervention and other theoretical frameworks and practice models. The paper considers the impact of this change in emphasis on clinicians, direct practice, and schools of social work. Although it describes the resurgence of direct practice that occurred in the 1970s and 1980s, it discusses the reasons for the greatly diminished role of psychoanalytic theories in social work curricula. It concludes that there is little reason for optimism about psychoanalysis regaining a prominent position within the profession at the present time and comments on some implications of this state of affairs for those committed to advanced clinical training.