When Is It Appropriate to Use Person-First Language?

In school, you were probably taught that person-first language is the most appropriate way to talk about clients. You put the person before their diagnosis. You see both the diagnosis as well as the whole person.

There’s another way of talking about people that is equally important, and that’s identity-first language. This way of talking about people puts the diagnosis first. 

For example, using person-first language when talking about someone with Autism Spectrum Disorder (ASD) would be to refer to the person as “a person with autism.” Identity-first language would be to say “that person is autistic.”

There’s a time and a place to use both. The most important part of talking to and about your clients is understanding how they’d like to be referenced.

Many people with autism prefer identity-first language, while the caregivers and professionals tend to use person-first language. Identity-first language when it comes to autism is about empowerment. It demonstrates that having ASD it isn’t something to be ashamed of. [1] 

Person-First vs. Identity-First Language

Person-first language is not always the answer. It’s difficult when talking about “disabilities” (a term that I hate). Sometimes a person finds power in identifying with what makes them differently-abled, such as being deaf or blind. A person in a wheelchair may or may not want to be defined by their disability. Other people, such as someone with a mental health diagnosis, may not want to be labeled by that diagnosis.

Labels are important because they help you get resources, medication, and a sense of closure. If you spend the first five years of your adult life having manic episodes but not understanding what that is and then one day a doctor says to you “you have bipolar disorder, that’s why you experience such large mood swings and sometimes feel like you’re going to jump out of your skin and other days you’re so depressed you can’t get out of bed.” If you hear that after several years of not knowing what’s wrong with you, you’ll most likely have a greater sense of peace knowing what it is. That doesn’t mean you’ll like it, it just means you can put a name to it, which is empowering.

Identification and Language

I used to work with children and teenagers with ASD. One day we did an exercise where I made “stations” around the room that had different activities. There were puzzles, worksheets, and an article about ASD to read. I’ll never forget when one of my boys, about 14 years old, said out loud as he was reading the article “Oh, so THAT’s why I am the way I am!” Suddenly the pieces fell into place for him and for the first time in his life he understood why he struggled with certain things. 

Because many people with ASD identify as autistic, it’s important to ask how they prefer to be referenced. Many clinicians may think that person-first language is the only way to go, but there are certain groups of people, such as those with ASD, that prefer identity-first language. It’s similar to people who are deaf or blind. You would never say “a person that is deaf.”

Identity-first language, in this case, identifies the person by their disability, but it also makes them feel empowered. Deaf is not all they are, but it is a big part of them that they identify with. “I am deaf” vs. “I am a person with deafness” is the difference between identity-first and person-first language.

It all comes down to a personal preference, but it is recommended that mental health professionals use person-first language unless otherwise directed. It’s difficult to know, though, what’s the right answer. Is someone an alcoholic or are they a person with an alcohol problem? [2]

The National Institute of Mental Health uses person-first language when writing about things like bipolar disorder [3]. Many people with bipolar disorder prefer person-first language over saying “I’m bipolar.” The difference here is that bipolar disorder is a disease and ASD is a neurodevelopmental disorder. There is room to say that you are autistic, but I would never say that someone is bipolar.

Similarly, one person told me that although they have Attention Deficit and Hyperactivity Disorder (ADHD). They would never say that they are ADD because it isn’t their identity, while other people might find power in using identity-first language to describe themselves this way.

Ingraining in the Training

As a therapist, you were probably trained to use person-first language when speaking about your clients. I know I was. My teachers made sure we always used person-first language in class and in our writing. And it is important to do so. But you must also take into consideration identity-first language and how empowering it is for those who use it.

Not everyone with ASD will call themselves autistic. The world might, though. This is why it’s important to ask someone with any diagnosis how they would like to be referred to. One person with ADHD might HATE being called ADD and another person may make that part of their identity.

Of course, in the case of something like ADHD or Obsessive Compulsive Disorder (OCD), people throw around these terms incorrectly all the time. How often do you hear someone say “I’m so ADD” to refer to their difficulty focusing or “I’m OCD” to refer to being particular about certain things. Some of these people might actually have ADHD or OCD and are using identity-first language, but a lot of the time they’re people misusing the terms.

However, you would never throw those terms around lightly when speaking to your clients or colleagues. And it’s important to make sure that you don’t do that in your writing either. Whether using identity-first or person-first language, make sure it’s appropriate to the person or people you’re writing about.

This is a good time to think about topics to write about. Maybe you’re passionate about empowering people with ASD to use identity-first language and want to write about that. Go for it! Or maybe you care a lot about people with bipolar disorder not being marginalized and labeled by their diagnosis. Write about that! 

I hope you use these ideas as a springboard for your writing. I want you to walk away from reading this having a greater understanding of best practices when talking about (and to) your clients. Hold your colleagues responsible just as much as you hold yourself responsible.

Using Language Correctly

In order to make sure you’re using the correct language when speaking about clients and potential clients, work with a skilled mental health copywriter. In particular, you could work with this copywriter, who both has a diagnosis and was once a therapist. 

I understand the importance of using identity-first and person-first language better than most. I’m confident I can help you write about people in a way that empowers them without marginalizing or pathologizing them. 

If you’re ready to take the leap and work with that type of copywriter, contact me to set up a call to discuss how I can help you use your words for good.





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