What It Means To Be The 'Designated Patient' In Family Therapy

In many families, there’s a shared but unspoken understanding about who they collectively consider “the problem”.

It might be the teenager acting out, the parent with depression or the sibling struggling with addiction. In clinical terms, that person is often called the “designated patient” or “identified patient” – the individual whose behaviour, emotions, or symptoms are seen as the root of the family’s distress.

But as family therapists emphasise, this role rarely forms in a vacuum. The designated patient is usually expressing — often unconsciously — something the family system as a whole can’t address directly. Their symptoms become the family’s signal flare.

“In typical family therapy sessions, the term ‘designated patient’ or ‘identified patient’ is used to describe the member of