Client or Patient? How Should Therapists Refer to Those Who Seek Their Services

Patient or client? 

Client or patient? 

“The patient-client issue” is the debate over whether to refer to people you see in your practice as “patients” or “clients.”

In its Dictionary of Psychology, the American Psychological Association (APA) defines the patient–client issue as “the dilemma of how to identify the recipient of psychological services or intervention.”

According to the APA Dictionary entry on this topic, psychiatrists and many clinical psychologists tend to follow the traditional language of the medical model and refer to the people seeking their services as “patients,” whereas counseling psychologists, some clinical psychologists, social workers, and counselors tend to avoid the word “patients,” and instead use the word “clients” to refer people seeking their services.

As practitioners, we realize the importance of word choice. The words we choose to use play a significant role in how we see the world, and how others view us and interpret our statements and feelings. 

Therefore, we want to make an informed decision about how to address the people seeking our services.

This is particularly salient in health care. Those we are seeing in our practices may have experienced emotional wounds—many times these wounds were created by negative words and messages spoken to them.

Clients or Patients? Examining the Meanings of the Words

The word “patient” comes from the Latin root word for suffering—“pati.” In its original translation, “patient” means “the one who suffers.” 

Currently, the Merriam-Webster online dictionary defines “patient” as “a person who receives medical care or treatment.” 

With the first known reference in the 14th century, a patient’s traditional role is as an individual who relies on a doctor for assistance.

The word “client,” on the other hand, was adopted by the mental health field as a rejection of the medicinal significance of “patient.”

Currently, Merriam-Webster defines “client” as “a person who engages the professional advice or services of another.” 

In contrast with patients who—by definition of the word—need treatment,  clients seek professional support of therapists and counselors—often as confidential teammates to work on improving bio-psycho-social aspects of their lives. 

Does It Matter if You Choose to Use ‘Patient,’ Rather Than ‘Client?’

As a practitioner, the words you use reflect how you frame the type of help you offer to those seeking your services. 

“The words therapists use to describe the people they treat also speaks volumes about how they see their roles,” said California-based clinical psychologist Paul DePompo, PsyD. “Do they view themselves as the ‘fixers’ (using the word ‘patients’), or do they see themselves as collaborative partners on the team (using the word ‘clients’)?”

Your word choice is also a reflection of the treatment options available to those who seek your services. 

“The term ‘patient’ is from the medical model, which is a deficit or problem-focused modality, implying that there is something wrong with the individual,” said Virginia-based therapist Ebonie Walker, LCSW.

“I use the term ‘client’ because I am a strength-based, solution-focused clinician—meaning that I focus on the client’s positive characteristics and strengths to help them see that it is possible to overcome their obstacles,” she said.

“By using ‘client,’ I emphasize that our therapeutic relationship is a collaboration—[wherein] the client has the innate ability to be resilient and I am the facilitator or guide in that process,” Walker explained. “I hope to empower individuals as a client versus enabling them as a patient.”

To California-based therapist Lee Berg Marchesani, LMFT, the term patient evokes the concept of someone who is sick. “I don’t view my clients as sick,” Marchesani pointed out. “I see my clients as functioning people who are stuck in some aspect of their lives or their relationships.”

All that said, there are therapists and counselors who believe that by treating someone’s mental health, the term “patient” is the better word choice. 

“My choice of using the word ‘patient’ can be summarized like this,” explained Seattle-based therapist, Tom Linde, MSW. “I deliver care in support of your overall wellness, and this relationship makes me a health practitioner, and it makes those I see patients.”

What’s more, in a 2018 resolution the APA acknowledges that the term “patient” is the word predominantly used in contemporary health care across the inter-professional health care system, including by most other health care professionals and scientists and by third-party payers, health care administrators, health care recipients and their families, and federal and state governments,” and recommends that “psychologists and their students, trainees, or supervisees in all educational and training program are encouraged to use the term patient, rather than client.”

Additionally the resolution states that the APA will use “the term patient (rather than client) in all of its publications, policies, rules, and public relations and news releases when describing those individuals…who are receiving health care services provided by those recognized as health service psychologists.”

So, What Do You Call People Who Seek Your Help?

While most therapists and counselors prefer to use “client,” psychiatrists or psychiatric nurse practitioners, who have had years of medical training, may prefer using the term “patients.” 

You’re the only person who will know which suits your authentic brand of therapy and your practice best.

If you’re unsure of what word to use, try surveying the people you treat. 

Ask them how they feel about both words, then, trust their opinions (and your own intuition) and commit to one or the other.

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