Client vs Patient: What Therapists Should Call Them

Why Does Terminology Matter in Therapy?

Whether to refer to individuals receiving mental health services as “clients” or “patients” carries implications for therapeutic approach, professionalism, and therapeutic alliance. Terminology shapes power dynamics, client autonomy, and service context, influencing both clinical outcomes and client perceptions.

Research shows that person-centered terminology improves therapeutic alliance by 20% and increases treatment engagement. The choice between “client” and “patient” should align with ethical guidelines, regulatory requirements, and practice philosophy while promoting respect and empowerment.

S10.AI’s documentation and client portal language can be customized to support practices’ chosen terminology and maintain consistent professional branding across all touchpoints.

What Are the Historical Origins of “Client” and “Patient” in Therapy?

Medical Model (“Patient”) Origins:

• Traditionally used in medical settings to denote individuals receiving healthcare
• Implies a medical diagnostic and treatment relationship
• Focuses on illness, pathology, and clinician-directed treatment
• Hierarchical dynamic with clinician as authority and patient as recipient

Humanistic Model (“Client”) Origins:

• Adopted in counseling and therapy fields emphasizing equality and collaboration
• Reflects person-centered, client-led approach valuing autonomy
• De-emphasizes pathology, supports self-directed growth
• Egalitarian dynamic with therapist as facilitator and client as active participant

What Are Key Differences Between “Client” and “Patient”?

When Should You Use “Patient” vs. “Client”?

Use “Patient” When:

• Licensed medical or psychiatric services are provided
• Medical model and diagnosis-focused treatment apply
• Referring to billing contexts requiring medical documentation
• Interdisciplinary collaboration with medical professionals
• Practice setting is hospital or integrated healthcare system

Use “Client” When:

• Person-centered or counseling-focused services delivered
• Emphasis on empowerment and self-directed change
• Private practice, community mental health, coaching contexts
• Therapeutic modality aligns with humanistic or systemic approaches
• Professional standards recommend non-medical terminology

How Do Ethical Guidelines Influence Terminology Choice?

Professional organizations provide guidance on terminology based on scope of practice and practice setting.

Ethical Guidelines Summary:

• American Psychological Association (APA):
  • Refers to individuals as clients in counseling and psychotherapy contexts
  • Use of “patient” appropriate when collaborating in medical settings
• National Association of Social Workers (NASW):
  • Uses “client” to emphasize strengths-based, person-in-environment approach
  • Supports terminology aligning with profession’s values
• American Psychiatric Association:
  • Uses “patient” to reflect medical model and psychiatric treatment context
  • Diagnostic and treatment planning framed in medical terminology
• American Counseling Association (ACA):
  • Prefers “client” to honor autonomy and reduce power differentials
  • Ethical standards emphasize collaborative decision-making

What Are Clients’ and Patients’ Perspectives on Terminology?

Studies exploring recipient preferences reveal that terminology affects perceived respect, autonomy, and treatment engagement.

Client/Patient Surveys:

• 70% of counseling recipients prefer “client” for non-medical therapy
• 60% of psychiatric treatment recipients prefer “patient” for medical clarity
• Preferences vary by treatment type, cultural background, and severity of condition
• Terminology consistency across communications improves trust and clarity

Cultural and Individual Considerations:

• Some cultures perceive “patient” as stigmatizing, others find it comforting
• Severity of mental health condition may influence preference for medical terminology
• Collaborative decision-making includes discussing terminology preferences

How Should Therapists Decide on Terminology?

A thoughtful decision-making process ensures terminology aligns with practice philosophy, ethical standards, and client preferences.

Terminology Decision Framework:

TERMINOLOGY SELECTION CHECKLIST:

Practice Philosophy and Model:

• Humanistic/counseling model → Use "Client"
• Medical/psychiatric model → Use "Patient"
• Integrated care → Use context-specific terminology

Practice Setting and Regulations:

• Private counseling practice → Client
• Hospital/medical center → Patient
• Insurance documentation → Patient
• Licensing board expectations → Follow professional guidelines

Client Preferences:

• Discuss terminology during informed consent
• Note individual preference in clinical record
• Use chosen term consistently across documentation
• Revisit preferences if service context changes

Ethical and Cultural Considerations:

• Respect cultural perspectives on terminology
• Avoid stigmatizing language
• Maintain consistent terminology for clarity
• Document rationale for terminology choice

Technology Implementation:

• Customize portal language to chosen terms
• Update templates and forms accordingly
• Train staff on consistent terminology use
• Audit communications for alignment

How Does Terminology Affect Clinical Documentation and Communication?

Consistent use of “client” or “patient” enhances clarity, professionalism, and therapeutic alliance across all communication channels.

Documentation Impacts:

• Intake forms, progress notes, treatment plans, and discharge summaries use consistent terminology
• Billing and insurance claims reflect appropriate terminology for coding and compliance
• Client portal messaging, appointment reminders, and educational materials align with chosen terminology
• Interdisciplinary communication with medical professionals uses context-specific language

Client Communication Benefits:

• Clear role definition improves expectations and engagement
• Reduces confusion when switching between medical and counseling contexts
• Strengthens therapeutic alliance by respecting client identity
• Enhances informed consent through terminology discussion

Technology Tools for Consistent Terminology Implementation

Modern practice management systems can enforce consistent terminology across all client-facing and internal communications.

Practice Management Features:

• Global terminology settings within EHR and client portals
• Template libraries updated to reflect chosen terminology
• Automated reminders and communications using standardized terms
• Staff training modules on terminology usage and guideline compliance
• Audit logs monitoring terminology consistency across records

S10.AI provides customizable terminology settings, ensuring “client” or “patient” usage remains consistent across clinical documentation, client portals, billing, and communication workflows.

Complete Terminology Decision Matrix

CLIENT vs PATIENT DECISION MATRIX:

IMPLEMENTATION STEPS:

• Determine primary practice context
• Review ethical and professional guidelines
• Survey clients on terminology preferences
• Configure terminology settings in systems
• Train staff and update templates
• Monitor terminology usage for compliance

Best Practices for Terminology Excellence in Therapy

Terminology choice is a small but impactful aspect of therapeutic practice that influences professional image, therapeutic alliance, and clinical outcomes. Mental health professionals who carefully select and consistently use “client” or “patient” report improved treatment engagement, clearer communication, and stronger professional credibility.

Key success factors include reflective practice, ongoing client feedback, ethical guidelines adherence, cultural sensitivity, and technology integration for consistency. S10.AI supports practices by providing customizable terminology management features and ensuring cohesion across all practice communications and documentation.