Christian Counseling - Client or Patient

When someone seeks therapy, the therapist will usually refer to person seeking therapy as their "client". Others refer to the therapy seeker as a "patient". One might think that the choice of words does not matter. However, the language we use to describe ourselves in relationship is important. Think about an adult child calling their mother "mommy". The term mommy brings with it certain images of dependence and has a child-like connotation. When an adult child speaks of their "mom", there is a sense of an adult relationship in the description. However, if the adult child uses the term "mother", their is an image conjured in the mind of distance and formality. So, the words we use to describe our relationships are important.

The term "patient" had been used for many years to describe the relationship of the person seeking therapy to the therapist. However, the word patient brings to mind our experiences with medical doctors. This relationship is more formal. There are many possible ways to view this relationship, but, a typical view is that of seeking advice from an expert or authority figure. Although this view is changing somewhat, many still feel inhibited in terms of disagreeing with their medical doctors.

If the doctor/patient dynamic is carried into a therapy relationship, it could be problematic in many ways. One, the "patient" may expect the therapist to prescribe a solution to their problems. Two, the patient may feel unable to disagree with the therapist. Either way can result in the patient becoming dependent on therapist or even resentful should the therapist's suggestions not prove as fruitful as hoped. In the end, the person in therapy needs to accept personal responsibility for the decisions in their life, even decisions that the therapist may have suggested. It is for these reasons that most therapists prefer the word "client" to describe their relationship with the person in therapy. The word client indicates a more collaborative relationship. As a client, the person may feel more free to disagree with or even reject certain interpretations the therapist might make. Finally, as a client, the person in therapy remains in control and responsible for the course that their life takes. My colleague, Dr. Frank Mancuso, uses a metaphor to describe therapy. He describes therapy as two people in a row boat, except the client is the only one with an oar. The therapist, while sitting in the boat, can offer observations, suggestions, etc. However, ultimately the course of the client's life is up to the client.