Client or Patient? A Clinician’s Guide to Ethical Language in Mental Health Practice

Updated on: July 26, 2025

Language matters. For therapists, psychotherapists, social workers, and other mental health professionals, the choice between referring to someone as a client, patient, or even by name reflects deeper values, theory, and ethical commitments. While the distinction may seem semantic at first glance, words shape expectations, power dynamics, and the therapeutic alliance.

Why the Terminology Debate Exists

• Medical vs. Humanistic Traditions
  Historically, psychiatrists and medically trained psychologists tend to use the term patient. In contrast, counselors, social workers, and those trained in humanistic or client-centered traditions often prefer client.
• Implications for Power and Agency
  Patient, derived from the Latin patiens (to suffer), can imply passivity and a hierarchical relationship. Client suggests a service-oriented and collaborative relationship—more egalitarian and empowering.
• Identity and Empowerment Movements
  Mental health activists and consumer rights advocates have promoted shifting from patient to terms like consumer, survivor, or client—to reduce stigma and highlight personal agency.

What Each Term Communicates

Pros and Cons of Each Term

Patient

• Pros
  • Conveys medical legitimacy and aligns with healthcare systems.
  • Recognized in insurance and clinical documentation.
• Cons
  • May imply passivity and pathology.
  • Can reinforce hierarchical dynamics.

Client

• Pros
  • Encourages partnership and client autonomy.
  • Feels neutral, non-stigmatizing, and aligned with humanistic models.
• Cons
  • Some settings perceive it as informal.
  • May be misunderstood by insurance providers or physicians.

Name (e.g., “Sam,” “this individual”)

• Pros
  • Promotes person-first language and individualization.
  • Reduces reliance on labels.
• Cons
  • Inconsistent use may affect professionalism.
  • Not ideal for formal documents or inter-agency records.

How Clinicians Decide What to Use

Factors to Consider

• Theoretical Orientation: Humanistic or systems-based therapists tend to prefer client. Medical-model practitioners tend to use patient.
• Setting: Hospitals, psychiatric units, and integrated care teams often require use of patient.
• Client Preferences: Some people prefer to be referred to as a client, others feel more comfortable with patient.
• Regulatory Requirements: While licensing boards may not mandate one term, certain institutional forms or EMRs may default to patient.

Clinical Reflections

Many clinicians base their choice on training and philosophy. For example:

• “To me, ‘client’ feels less stigmatizing and emphasizes autonomy.”
• “I use ‘patient’ in medical documentation, but ‘client’ in my private practice.”

These choices often reflect deeper values around the therapeutic relationship, power, and language.

Ethical and Documentation Considerations

• Consistency is Key: Whether you choose client, patient, or name-based documentation, consistency throughout the session notes, treatment plans, and communications is critical.
• Clarity in Collaboration: Teams may include professionals from different disciplines. Agreeing on terminology improves clarity and minimizes confusion.
• Documentation Tone: Regardless of the word used, professionalism is reflected in objective, concise, and ethical documentation—not just vocabulary.
• Client Dignity: Language should reflect respect. Person-first phrasing like “the client experiencing anxiety” avoids defining individuals by diagnosis.

Chart: Summary Comparison

Practical Tips for Clinicians

1. Define Your Style Early

Set a documentation style in your practice manual or EMR. Whether you use client or patient, consistency reflects professionalism.

2. Ask for Preference

In intake, include a quick question: “Do you prefer to be referred to as a client, patient, or simply by name in your records?” It can enhance rapport.

3. Match Setting Expectations

If you work in a multidisciplinary environment, match the broader system while preserving your voice where possible.

4. Educate Staff and Interns

Ensure your team understands the importance of consistent terminology, especially for collaborative documentation and audits.

Sample Use Scenarios

Scenario 1: Solo Therapist in Private Practice

A licensed counselor uses client throughout her session notes, treatment goals, and portal communications. She includes a preferences section in intake paperwork and adapts when necessary.

Scenario 2: Clinical Psychologist in Hospital

The psychologist uses patient in progress notes and team meetings, as it’s aligned with the broader institution and billing requirements. For therapy discussions, they occasionally reference the individual’s name when reviewing goals.

Scenario 3: Group Practice with Multimodal Providers

The EMR defaults to patient, but therapists include personal preferences in session narratives or treatment summaries. A practice-wide note style guide helps ensure clarity and consistency.

How Word Choice Shapes Perception

Language is never neutral. Here’s what different terms may signal to the person receiving care:

While one is not inherently better than the other, the therapist’s intention and the setting should guide the choice—and ideally, so should the person receiving care.

Client vs. Patient in Insurance and Legal Contexts

• Insurance Forms: Often default to patient. This is acceptable even if you use client internally.
• Medical Necessity Notes: Using patient may align better with insurance reviewers.
• Court Reports / Legal Documents: Maintain consistency and formality; patient may be more appropriate.
• HIPAA / FERPA: No legal requirement to use either term, but patient is often seen in compliance templates.

What Emerging Professionals Should Know

• Your chosen term should reflect your orientation, practice values, and documentation structure.
• Avoid switching terms mid-document unless it serves a specific, justified purpose.
• Remember: professionalism = tone + ethics + consistency—not just word choice.

How Organizations Can Standardize Language

To avoid confusion, many agencies adopt a style guide with terms to use in different contexts:

Establishing terminology standards boosts clarity, improves documentation flow, and supports a shared ethical language.

Conclusion: Choose with Intention, Communicate with Respect

What you call the people you serve—client, patient, or by name—communicates your clinical philosophy and your view of the therapeutic relationship. While there is no single right answer, the best choice is one that is intentional, respectful, consistent, and aligned with both your values and your client’s needs.

Key Takeaways:

• Client emphasizes collaboration, autonomy, and respect.
• Patient aligns with medical models and institutional norms.
• Names personalize therapy and may reduce the sense of clinical detachment.
• Consistency is more important than the actual word used.
• Always center the person—not the label.

What you call them matters—client or patient?
Choose language that reflects your values and enhances therapeutic care with DocScrib — DocScrib.