The question of whether mental health professionals use the term “client” or “patient” is a common point of confusion. The choice of terminology reflects a provider’s professional training, therapeutic philosophy, and the dynamic they wish to establish. Understanding this distinction goes beyond semantics, as the language used shapes expectations about power and responsibility. The specific word a therapist chooses offers insight into how they view the person seeking support.
Client Versus Patient The Core Distinction
The difference between “client” and “patient” lies in the philosophical model of care the term represents. Using the word patient aligns with the traditional medical model, which views psychological distress through the lens of illness and diagnosis. In this framework, the individual is seen as suffering from a condition requiring expert treatment, often placing them in a passive role. Conversely, the term client suggests a collaborative, consumer-oriented partnership between two equals. This term is favored by non-medical therapists because it emphasizes the individual’s autonomy and active participation in the therapeutic process.
Terminology Across Different Mental Health Professions
The professional’s training and license are strong determinants of the language they adopt. Psychiatrists, who are medical doctors (MDs or DOs), almost exclusively use the term “patient.” Their medical background dictates the use of a medical model, involving diagnosing mental illnesses and managing treatment that often includes prescribing medication. Psychiatric nurses and other medical professionals similarly default to “patient” to align with their training and the institutional language of healthcare.
In contrast, professionals with non-medical training, such as Licensed Professional Counselors (LPCs), Licensed Marriage and Family Therapists (LMFTs), and Licensed Clinical Social Workers (LCSWs), typically prefer the word client. Their training emphasizes psychotherapy, behavioral science, and the social context of distress, rather than biological pathology. Social workers often use “client” or “service user” to reflect a collaborative approach centered on self-determination and the individual’s environment.
Psychologists (PhDs or PsyDs) often find themselves at a crossroads, though many favor the term “client.” While clinical psychologists may work closely with the medical model, their training focuses on psychological assessment and therapy rather than medical intervention. Counseling psychologists commonly use “client” to highlight the non-medical nature of their work, focusing on personal growth and behavioral change. The professional’s specific therapeutic orientation often outweighs their doctoral title in this choice.
Context Matters Settings Where Terms Differ
The physical location where a professional practices can sometimes override their preference for terminology. In hospitals, inpatient psychiatric units, and integrated medical clinics, the term patient is the institutional standard. This is due to administrative requirements, where billing, medical records, and legal documentation are structured around the language of healthcare. Even a non-medical therapist working in a hospital setting may be required to use “patient” to conform to facility protocols.
Conversely, the term client is the common default in private practice settings and community counseling centers. These environments operate outside the strictures of the medical complex, allowing practitioners to fully embrace a collaborative model of care. In school counseling or corporate employee assistance programs, “client” or “counselee” are standard because the services are framed as professional support rather than medical treatment. The setting dictates the institutional perception of the service, which influences the mandated language.
The Rise of Client Centered Language
The preference for “client” is deeply rooted in the historical development of humanistic psychology in the mid-20th century. Carl Rogers, a prominent figure, deliberately introduced and popularized the term client with his Person-Centered Therapy. Rogers rejected the notion that the individual seeking help was inherently sick, which he felt the word “patient” implied. His approach challenged theories that positioned the therapist as the expert authority, reframing the relationship as a partnership. By using “client,” Rogers emphasized the individual’s capacity for self-actualization and promoted their agency and autonomy.
When Is the Term Patient Appropriate
Despite the shift toward client-centered language, the term patient remains the correct descriptor in several specific contexts. When care involves medical intervention, such as the management of psychotropic medication, the individual is appropriately referred to as a patient. This is because the provider, typically a psychiatrist or psychiatric nurse, is functioning in a medical capacity. The use of the word reflects a clinical relationship involving medical diagnosis and treatment.
Institutional documentation, insurance claims, and legal requirements often mandate the use of “patient.” Many government programs and medical insurance providers require the term for billing and record-keeping, especially when a formal diagnosis is submitted for reimbursement. The term is also standard in clinical research studies focusing on the efficacy of treatments for specific illnesses. In these situations, the language ensures compliance with medical and regulatory systems.