When you are writing, you need to follow general principles to ensure that your language is free of bias. Here we provide guidelines for talking about participation in research with inclusivity and respect.
People participate in research in a variety of settings, including laboratories, homes, schools, businesses, clinics, and hospitals. Specific terms are used in certain contexts. When writing about people who participate in research, descriptive terms such as “college students,” “children,” or “respondents” as well as the more general terms “participants” and “subjects” are acceptable. “Subjects” and “sample” are also customary when discussing established statistical terms and experimental designs (e.g., “within-subjects design,” “between-subjects design,” “sample-size-adjusted Bayesian information criterion,” “between-samples estimate of the variance”).
Use the term “patient” to describe an individual diagnosed with a mental health, behavioral health, and/or medical disease, disorder, or problem who is receiving services from a health care provider (e.g., psychologist, physician, nurse, or other provider). This language is consistent with the language used in the health care system and promotes psychologists as being perceived a part of, and consistently integrated into, the culture of interprofessional, integrated health care. However, in academic, business, school, or other settings, the term “client” (or some other term) might be preferred instead of “patient.” Within all contexts, respect the individual and/or cultural preferences expressed by recipients of psychological services and their families when you choose language to describe those individuals, families, or populations. (For further information, see Resolution for the Use of the Term Patient; APA, 2018).
It is also important to recognize the difference between a case, which is an occurrence of a disorder or illness, and a person who is affected by the disorder or illness and is receiving care from a health care professional. For instance, “manic–depressive cases were treated” is problematic; revising the sentence to read “the people with bipolar disorder were treated” differentiates the people from the disorder. Likewise, in the medical context, avoid the terms “patient management” and “patient placement”; in most cases, the treatment, not the patient, is managed; some alternatives are “coordination of care,” “supportive services,” and “assistance.”
Broad clinical terms such as “borderline” and “at risk” should be properly explained when used. Avoid using these terms in a broad sense (e.g., “the diagnosis was borderline,” “at-risk students”) because such usage obscures the specific clinical or psychometric meaning of the terms. For example, “the diagnosis was borderline” in a neuropsychology and psychometric testing context may be clarified to specify a score on a specific test or instrument (e.g., “standard scores between 70 and 80 are considered psychometrically borderline, or between the low average and mildly impaired ranges, indicating a risk for a diagnosis of X”), whereas in a diagnostic context, “the diagnosis was borderline” may be clarified to specify a diagnosis (e.g., borderline personality disorder). When using the term “at risk,” specify who is at risk and the nature of that risk (e.g., “adolescents who use substances are at risk for early school dropout”).
Across contexts, write about the people who participated in your work in a way that acknowledges their contributions and agency. Sentence structure plays a key role in this acknowledgment, as does using professional language. Use the active voice to describe your actions and the actions of participants; the passive voice suggests individuals are acted upon instead of being actors (e.g., “the subjects completed the trial” and “we collected data from the participants” are preferable to “the trial was completed by the subjects” and “the participants were run”). Avoid the term “failed,” as in “eight participants failed to complete the Rorschach test,” because it can imply a personal shortcoming instead of a research result; “did not complete” is a more neutral choice (Knatterud, 1991). These choices will help ensure that you convey respect for the people about whom you are writing.
American Psychological Association. (2018). APA resolution for the use of the term patient in American Psychological Association policies, rules, and public relations activities when referring to the health-related and scientific activities of health service psychologists and scientists in health care services and settings. https://www.apa.org/about/policy/resolution-term-patient.pdf
Knatterud, M. E. (1991). Writing with the patient in mind: Don’t add insult to injury. American Medical Writers Association Journal, 6(1), 10–17.