The social services in Sweden are clearly influenced by international development towards organizational specialization. However, little is known about how organizational structures influence the client work of social services. The current paper presents a narrative research review aimed to summarize and discuss the research on organizational structures in the social services, and the impact of these structures on client work. Building on the tension between specialization and integration, the paper identifies both the advantages and the disadvantages of the different approaches to organizing social services along a continuum from high levels of specialization, via coordination and collaboration solutions, to high levels of integration. The findings suggest that, to function adequately, social service organizations need to combine and balance aspects of both specialization and integration.