Linehan has a discussion about the patient / client terminology in her book. I think she chooses to go with client in the book and patient in the skills training manual (though i could be wrong about that).

She said that there are positive and negative aspects to each choice. I probably can't remember all of them, but I'll have a bit of a go:

- Patient conveys something along the lines of someone who is patiently coping. It conveys the virtue of patience. It also does seem to conjure up images of helplessness and passivity, however. It also seems to convey the notion that the clinician is this paternalistic and rescuing figure.

- Client conveys something along the lines of an active consumer who has full mental faculties and hence is able to take an active and informed role in their care especially with regards to which clinicians they choose to contract to work with and which interventions they consent to. It also does seem to convey the notion that the mental health service is a service akin to others like hairdressing and gardening and housecleaning and the like, however. It also conjures up images of negotiating with insurance companies and the like.