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Patients or Clients?

What word should psychologists use to describe the people they help?

What term should psychologists use to describe the people they work with: patients or clients?

And does it matter? I’ve heard the argument that it doesn’t. As one clinician said: “I’ve asked patients if they would prefer to be called clients, but they don’t mind what I call them.”

Yes, it is true that the people seeking help don’t necessarily care whether they are referred to as patients or clients. But this misses the point of the discussion—let me explain why.

The words we use reflect how we think about the help we offer. The term a therapist uses is important—not because of what the patient thinks, but because of what the therapist thinks. Each of the different terms reflects a different ideology on the part of the helper.

The term patient implies the language of medicine and puts the therapist in a doctor-like position in which they, and they alone, have expertise on what is best for the patient. The word portrays someone seeking help as damaged, impaired, and deficient. Psychotherapists who adopt the language of medicine put themselves in a position in which they need to diagnose the disorder affecting the patient in order to provide the right treatment.

The word client, on the other hand, was developed to signify a rejection of this medical way of thinking and replace it with the humanistic language of growth and change. In this language, it is the client who has expertise on what is best for them. Psychological problems are not illnesses to be cured but instead, states of self and social alienation. As such, therapy, in this view, is not about curing illness but about helping people to find solutions and new directions in life for themselves.

In this way, I do think the choice of language matters. But the debate is not so much about the word actually used in conversation, or about what word people seeking help prefer. Instead, it is about how it signifies the way in which the therapist thinks.

To find out more about my work, visit www.profstephenjoseph.com.

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