The effectiveness of hospice social work as a holistic practice remains insufficiently examined partially due to methodological limitations in outcome evaluation. This study applies Qualitative Comparative Analysis (QCA), a set-theory approach suited for complex causal and conjunctural relationships, to explore how components of the Generalist Intervention Model relate to practice goal success or failure across 254 cases. Necessity analysis revealed that providing funeral support, providing grief support, and not offering religion-informed preparation were necessary for success, while not providing counseling and family guidance and grief support were necessary for failure. Eight configurations were related to goal achievement, all involving funeral support. Six configurations were associated with goal failure, each involving a cancer diagnosis. Findings highlight critical roles of funeral and grief support, the need for tailored religious and existential interventions and tailored services to cancer patients. The value of QCA in revealing complex pathways to social work effectiveness was underscored.