The confusion surrounding whether a therapist uses the term “patient” or “client” for the person receiving care is a common point of misunderstanding in the mental health field. The choice of terminology is not arbitrary, but rather reflects the professional’s training, the setting of the practice, and the underlying philosophy of the care being provided. Both terms are widely used, depending heavily on the specific context and the professional’s view of the therapeutic relationship.
Understanding the Term “Patient”
The term “patient” finds its origin in the medical and disease model of care, aligning with the Latin root pati, which means “to suffer” or “to bear.” This usage suggests that the individual is suffering from a pathological condition that requires expert intervention and treatment. In this model, the professional is viewed as the authority figure responsible for providing a diagnosis and a specific treatment plan. The term has a strong association with traditional medical settings, such as hospitals and psychiatric clinics, and implies a more passive role for the individual receiving the service.
Understanding the Term “Client”
The adoption of the term “client” in mental health originated from the humanistic and collaborative models, notably with Carl Rogers’ Client-Centered Therapy. This choice was a deliberate rejection of the hierarchical medical model, framing the therapeutic relationship as a professional partnership. Using “client” emphasizes that the individual seeking help has agency and is an active participant in their own healing and growth process. The focus shifts away from a deficit or illness-based perspective toward wellness and strengths. This language encourages the individual to take responsibility for defining their goals in collaboration with the professional.
The Philosophical Debate: Why Terminology Matters
The choice between “patient” and “client” reflects a philosophical divide over the nature of mental distress and the appropriate relationship dynamic. The use of “patient” often signifies that the professional views distress as an “illness” requiring diagnosis and treatment, which can reinforce a power imbalance. This language may suggest that the individual is passively receiving a cure from an expert, potentially impeding their sense of autonomy. Conversely, the term “client” positions the individual as an active collaborator and an expert in their own life, promoting empowerment and shared responsibility.
This linguistic choice reveals the core ideology of the therapist regarding who “owns” the treatment process. Professionals using “client” embrace a psychological or social model where distress is seen as a “problem in living” or a challenge to be overcome through personal growth. Adopting the “patient” term aligns the professional with the medical model, which necessitates a pathological view of the individual for diagnosis. The debate is less about what the individual prefers and more about how the professional conceptualizes the entire therapeutic endeavor.
Terminology Across Mental Health Professions
The practical application of these terms often correlates directly with the professional’s specific license, training, and scope of practice.
Psychiatrists and Medical Doctors
Psychiatrists are medical doctors (MD or DO) who specialize in mental health. Because their training includes medical school and residency, their practice is firmly rooted in the medical model. These professionals diagnose mental health disorders and manage treatment through medication. This necessitates the use of “patient” due to legal, insurance, and medical documentation requirements, aligning with the language of medicine and the expectation of treating a condition.
Psychologists and Licensed Counselors
Psychologists (Ph.D. or Psy.D.) and licensed counselors (such as Licensed Professional Counselors or Licensed Mental Health Counselors) are non-medical practitioners who focus primarily on talk therapy and behavioral interventions. These professionals often prefer “client” to highlight the collaborative nature of their work and to avoid the stigma associated with the medical illness model. While counseling psychologists and counselors generally favor “client,” some clinical psychologists who perform formal psychological testing may occasionally use “patient.”
Social Workers and Marriage and Family Therapists
Social workers (LCSW) and Marriage and Family Therapists (LMFT) tend to have the strongest preference for the term “client.” Their professional models are based on systems theory, viewing the individual within the context of their environment, relationships, and social structures. This framework focuses less on individual pathology and more on relationship dynamics or environmental factors contributing to distress. Consequently, these practitioners favor “client” or sometimes “consumer” to prioritize a systemic and relationship-focused approach over a medical diagnosis.
The Modern Trend and Hybrid Usage
In real-world practice, the strict philosophical distinctions between “patient” and “client” have become blurred, resulting in hybrid usage. Many mental health professionals use the terms interchangeably depending on the specific context of the interaction. For instance, a counselor might use “patient” when completing insurance paperwork to meet administrative and legal requirements. However, the same professional will consistently use “client” during the actual therapy session to honor the collaborative relationship. Some organizations have adopted alternatives such as “service user” or “consumer” to emphasize the individual’s role as a recipient of services.