Language is a powerful tool in shaping perceptions, particularly when it comes to mental health. For many seeking help, the environment and language they encounter in therapeutic settings can make a huge difference in how they feel about their journey. Mental health professionals are uniquely positioned to challenge stigma through careful choice of words and welcoming clinical environments. By doing so, they can foster an atmosphere where clients feel valued, understood, and empowered rather than labeled or pathologized.
Here’s how psychotherapists can reduce stigma by shifting the language used in clinical settings and interactions.
1. Linguistic accuracy and knowing your audience
Words from experts matter, they may be taken as fact. Diagnostic language in clinical settings can come from one of two places: Formal diagnoses or hypotheses. When speaking with clients and coworkers alike, acknowledging which type of diagnostic language you're using by carefully selecting your wording can help combat stigma.
Diagnostic language involves words like “diagnosis”, “disorder”, and “illness” and is phrased in a factual manner. Sometimes diagnostic language goes even further to imply that the label is an integral part of the person. In the case of client’s who’ve internalized their labels in a helpful way, diagnostic language is appropriate. However, for many, diagnostic language carries negative connotations and reinforces the idea that mental health struggles are aberrations rather than part of the broader human experience. Research shows that people with mental health issues often internalize these labels, leading to shame and self-stigmatization, which can deter them from seeking help or fully engaging in therapy (Corrigan et al., 2014). These clients may report finding diagnostic language undermining, unfair, cold, or even harsh. Knowing which way your client feels about it helps clinicians tailor the client experience.
Diagnostic hypotheses use words like “symptoms”, “potential”, “suspected”, and “tendencies” and qualifiers such as “reported”, “like”, “akin to”, or “in line with”. Well-phased non-diagnostic language and sentences acknowledge their hypothetical nature and are grounded in client experience. As a result, they tend to be longer and more descriptive. When speaking with clients, you are actively tending to the therapeutic relationship when you take the time to use more accurate language, even if it is less concise. Generally, for clients who are undiagnosed, using accurate non-diagnostic language reflects their experience with precision instead of with assumption: Assumptions with which clients and therapists alike can become fused to in an unhelpful manner, decreasing the quality of care. Additionally, when speaking with clients who are diagnosed but dislike their diagnosis, non-diagnostic language may destigmatize their experience thereby increasing accessibility of care without necessarily impacting their treatment plan.
Consider the following four scenarios and which type of language you would use with them:
You have a formally diagnosed client who takes reassurance from their diagnosis - in knowing that they’re not alone in this experience and it’s part of the broader human experience.
When, if ever, might you opt for non-diagnostic language?
You have a formally diagnosed client who is deeply uncomfortable with diagnostic language as they feel itl undermines the nuances of their personal experience.
When would each type of language be preferable? Clinical judgment will be paramount here.
Please note, if a client reports that their diagnosis does not seem to fit them, especially after psychoeducation about it, consider the possibility of facilitating another opinion. Misdiagnoses can happen. Explore the possibility when necessary.
You have a self-diagnosed client who does not have a formal diagnosis but uses a lot of diagnostic language themselves.
Be weary of assumptions - both your own and the client’s. Balance this with nurturing the therapeutic relationship.
You have an undiagnosed client who is not open to getting a diagnostic assessment done but you whole-heartedly believe a diagnosis would be beneficial to them and your work together.
Regardless of your training and your legal and ethical restrictions, you can not assume a diagnosis until it is tested.
Notice the pattern here. There is a clinical judgment about diagnostic status and there is a clinical judgment about client preferences and views on mental health. Both are required to make a sound decision. Lastly, as a note, if you do not know your client’s feelings about mental health and their diagnostic status - ask them. Be explicit. Be compassionate. Most of all, be curious and humble.
When in doubt, in a clinical setting, only use diagnostic terms when the client has a diagnosis and it is therapeutically beneficial to use such language. The rest of the time, opting for more descriptive choices can make clients feel seen as individuals rather than as cases or conditions.
2. Reframe “Disorder” with “Challenge” or “Experience”
Words matter because they frame experiences. Traditionally, clinicians use terms like “mental illness” or “mental disorder” to describe certain psychological phenomena. But for some clients, these terms may suggest that something is “wrong” with them at their core. Studies indicate that language that emphasizes recovery and resilience over deficit or pathology can empower clients, creating a more hopeful therapeutic environment (Link & Phelan, 2001). This shift is about highlighting what a person can do to live well, even in the face of challenges, rather than implying an inherent, unavoidable flaw.
(We should also pause here to acknowledge that a reframing terminology for the sake of hope never over-rides the points made in section one. Clarity is kindness, a.k.a. accuracy is the priority, but reframing terms is a valid strategy. Use your clinical judgement!)
For example, instead of informally diagnosing someone with a “personality disorder,” a clinician might refer to “challenges in managing emotions and relationships.” This simple shift in terminology maintains the integrity of the message while offering a more humanizing perspective. It communicates that, while the client may be experiencing difficulties, they are very likely to be manageable, not inherently defining.
3. Emphasize Person-First Language
Words matter because they tell us what's important. Person-first language is a critical step in reducing stigma. This approach emphasizes that clients are people first, not merely their diagnoses. So, rather than referring to someone as “a schizophrenic” or a “depressed client”; saying instead “a person with schizophrenia” or “someone experiencing depression” can make a significant difference in how clients perceive themselves within therapy (Boyle, 2020). This shift signals that a diagnosis, formal or otherwise, is just one aspect of a person’s experience and does not define their identity.
Additionally, studies show that person-first language not only benefits clients’ self-perception but also affects the broader culture in the clinical setting, reminding therapists, staff, and other clients of the shared humanity in the therapeutic process (American Psychological Association, 2021).
We can practice this outside of clinical settings as well, even when describing ourselves. Think of all the roles you play for different people - you may be a therapist/clinician/boss/employee, you may be the funny/helpful/serious/wild friend, you may be a child/sibling/parent/aunt/uncle. You are all of those things individually, sure; but you are not exclusively one of these things. You are more than how you are perceived or how you interact with others. In that same way, our clients [and ourselves] are more than our diagnoses, and we can use the way we choose words to keep our perspective open and flexible by acknowledging the complexity of being human.
The main complaint that I’ve heard about first-person language is the awkwardness of learning it because it doesn’t roll off the tongue in a succinct manner. However, think about a child learning to speak, a teen learning to drive, or yourself learning a new recipe: in comparison with someone who’d been doing that thing for a year or more. Learning is awkward and growth takes time and practice. Embrace it. Nothing worth doing is effortless.
4. Avoid Terms that Minimize or Trivialize Mental Health Experiences
Words matter, they can empower or destroy. Certain terms, such as “crazy,” “insane,” or “unstable,” may not always be used intentionally in clinical settings but can still arise in casual conversation or internalized thoughts among staff. Such words carry a significant history of stigma and can reinforce negative stereotypes, especially for clients who may already feel misunderstood. Even referring to someone as “high-functioning” can be problematic, as it often downplays the challenges they may face on a daily basis (Corrigan et al., 2014). In working with therapeutic clients, we need to know where their struggles are in order to create an effective treatment plan. Labeling someone high or low functioning is detrimental to that end. It also creates a comparison: If they are high-functioning, who isn’t? What does it say about a person who isn’t worthy of being labeled ‘high-functioning’? What does it say about the complaints of a person who is labeled ‘high-functioning’? It also ignores the fact that they may very well be sacrificing something in an unsustainable way to make others more comfortable and to be perceived as ‘high-functioning’.
Therapists can counter these terms by actively choosing words that are more specific and neutral. For instance, instead of saying someone is “struggling to function,” a therapist might say, “currently facing challenges with daily routines.” This language validates the client’s experience without layering on judgment or reducing their humanity to their difficulties. Better yet, specifying in which domains or ways in which they are struggling may contribute to a more profound understanding of the client and bolster client care.
5. Use Collaborative Language for Goal-Setting and Progress
Words matter because they set the mood and communicate expectations. A collaborative approach in therapy not only empowers clients but also reduces the chance of inadvertently using language that could be perceived as stigmatizing. For example, instead of saying, “We need to address your issues with self-control,” - which could easily be taken as judgmental, a therapist could reframe this as, “Let’s explore ways to support your goals around self-regulation.” This minor change fosters a sense of partnership and solution-orientation rather than implying that the client has a problem to fix.
Research supports the idea that using collaborative language increases engagement and adherence to treatment, as clients feel a greater sense of ownership over their therapeutic journey (Link & Phelan, 2001). It’s about moving away from language that positions the therapist as the authority “fixing” the client and instead positioning therapy as a shared journey toward growth.
There’s nothing wrong with acknowledging your expertise in the therapeutic room, but balancing that with communicating explicitly and implicitly that the client is an expert on themselves and their own experience is a helpful shift in perspective.
6. Curate a Stigma-Free Clinical Environment
Words matter, even when you think they may not. Beyond direct interactions, the clinical setting itself can either reinforce or challenge stigma. This involves everything from waiting room decor to informational pamphlets and reading material in the clinic. For instance, posters or materials that feature diverse representations of people from various backgrounds and mental health experiences can communicate that mental health challenges are common and normal.
Clinics might also avoid placing diagnostic terms or stigmatizing labels on clinic paperwork outside of case notes or in visible areas. Instead, language that focuses on well-being, resilience, and holistic health can subtly reinforce the message that the clinic is a place of support, not judgment (Boyle, 2020). Additionally, training staff to use non-stigmatizing language when interacting with clients can create a more welcoming atmosphere for everyone who walks through the door.
7. Lead by Example: Continuous Learning and Reflection
Words matter, no matter which position you hold. Finally, reducing stigma in clinical language is an ongoing journey. Mental health clinicians can lead by example, staying up-to-date with best practices in non-stigmatizing language and actively reflecting on their word choices. Reading literature, attending workshops, and participating in peer discussions on stigma reduction can help clinicians stay sensitive to language that may be unintentionally stigmatizing. Corrigan et al. (2014) highlight that mental health professionals themselves may unintentionally reinforce stigma due to implicit biases or ingrained clinical language. Therefore, actively challenging these tendencies, and being open to feedback from clients and peers, can enhance a therapist’s practice and foster a more inclusive and understanding environment for all clients.
Conclusion
In an era where mental health stigma is being actively challenged, therapists and clinicians have a vital role in shaping a client’s experience through their choice of words. Shifting away from stigmatizing language can create a therapeutic environment that feels empowering, supportive, and free from judgment. By reframing diagnostic terms everywhere that it is appropriate, using person-first language, avoiding trivializing terminology, employing collaborative language, and fostering a stigma-free clinical setting, therapists can help clients feel more valued and understood.
Reducing stigma starts with intention and reflection. By embracing thoughtful language, therapists can become allies in their clients’ journeys, nurturing a healing process that honors each person’s dignity and resilience.
If you’re not in the mental health field and would like to learn more about reducing stigma in therapy or are interested in ways to make your workplace a more inclusive and welcoming space, feel free to reach out here or to a mental health professional in your area.
Small language shifts can make a big difference, and everybody deserves to feel valued on their path to wellness.
References
Words matter, so does where they come from.
American Psychological Association. (2021). Guidelines for the practice of telepsychology. American Psychological Association. https://doi.org/10.1037/0000165-000
Boyle, M. (2020). Challenging the stigma of mental illness: Changing minds, changing behavior. Cambridge University Press.
Corrigan, P. W., Druss, B. G., & Perlick, D. A. (2014). The impact of mental illness stigma on seeking and participating in mental health care. Psychological Science in the Public Interest, 15(2), 37-70. https://doi.org/10.1177/1529100614531398
Link, B. G., & Phelan, J. C. (2001). Conceptualizing stigma. Annual Review of Sociology, 27, 363-385. https://doi.org/10.1146/annurev.soc.27.1.363
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