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Client or Patient: What Should Your Therapist Call You?

Image source: AJC therapists, the choice to use the term “patients” or “clients” often reflects years of academic debate about the relationship between mental health clinicians (Psychologists, psychiatrists, social workers, counselors, therapists, etc.)  and those they are seeking to help.

The debate may seem semantic, but the words we use to describe the people, and world, around us can often have a profound effect on the way we perceive and think about it. In medical science, we know that the language used to describe our ailments can sometimes change how we perceive the problem.

The origin of the word patient goes back to Latin, deriving from meaning “to suffer,” and it makes sense in a lot of contexts. Most people don’t take issue with describing back pain as “suffering,” or a doctor whose role is to prescribe you some pain medicine and send you on your way. But when it comes to mental health, your therapist doesn’t just tell you to stop being sad and send you on your way. “Patient” implies a hierarchical relation – wherein a treatment plan travels one way – from doctor to patient. Additionally, the term patient implies that your brain is “sick” or “suffering.” For many people, that’s not an accurate, or helpful, way to look at therapy.

It was for these reasons that people started using the term “client,” instead of patient. Michael Shevell notes the genesis of the term.

“The word ‘client’ to denote a recipient of health care has its origin in the mid-twentieth century humanistic approach to psychological counseling of Carl Rogers (i.e. ‘Client Centered Therapy’). The word was specifically selected to avoid a connotation of being sick or ill. … Users of this term seek to convey a non-medical, humanistic, less acute care model of orientation to health care delivery that is thought to be more empowering to the actual recipient of health care”

But client, too, is not a perfect term. For many, it sounds like a business relationship. In this view, the therapist is a business, who provides services to a client for a fee. But a person’s relationship with their therapist is much more than economics and involve compassion, empathy and caring.

So to answer the dilemma, patient or client – I say neither. I use the terms interchangeably, because neither fits quite right. And often, it depends on the context and the person.

One survey of people dealing with substance abuse found that a majority of them actually preferred the term patient. The choice in terms not only colors the individual’s expectations and perceptions of therapy, but the therapist’s expectations and perceptions as well.

And of course, we can always just refer to “patients” and “clients” as “people.” No term will be able to accurately describe the nature of each individual’s unique relationship with their therapist.


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