John's Blog

The Blog of John Gibson, PhD

Patient vs Client

Client or Patient?

This is one of the oldest debates among therapists. Do we call the people we serve clients or patients? And does it matter?

The word “patient” has medical connotations. But strictly speaking, therapy isn’t a medical procedure, no matter what the insurance companies say (it’s a relationship). By contrast, the word “client” emphasizes the business aspects of the arrangement. To be sure, a therapy relationship is a business relationship because it’s something you pay for. But it is so much more than that. There are few other professional relationships that are so personal. Perhaps neither label is satisfactory.

Regardless of the label we use, the person in therapy has to admit he or she has a problem if the therapy is to work. And she must also agree, by virtue of seeking help, to be open to the therapist’s judgement, influence, recommendations, and care. Whether we call you a client or a patient, you are still assuming a role –- one who needs help, guidance, insight, change, support, or encouragement. Accepting this role is really the first step of the therapy process.

Which is why I am reluctant to let adults call on behalf of other adults in making appointments.

“I’m calling for my husband,” a caller might say. To which I reply, “Is there a reason why he is not able to use the phone himself?”

“Well, no.”

“If he wants therapy, please have him call me.”

This may sound harsh to some. But what’s really at stake here is whether the intended client or patient is ready to assume the role of being in therapy. If he is, he must declare the role for himself by owning his problem and owning his need for help. It is not enough to merely agree, at his wife’s coaxing, to come to the office for a consultation. He must decide if this is what he wants for himself.

Think of it this way. If you go to a medical doctor, he or she can do things
to you –- an injection, a surgery, a check of vitals. You can consent to let these things happen. But a therapist does things with you. Without your full participation in the process, nothing much happens.

You are a “patient” in the sense that you are under the care of a therapist, but you are a “client” in the sense that you have purchased the services of a guide who knows the psychological terrain. But perhaps the real question isn’t which label we pick, it’s whether you are ready to do something about your problem.