What to Expect in the First Therapy Session for Kids and Teens


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So you have made the decision to see a therapist for your child. Maybe you were referred by a teacher or your child’s doctor, or perhaps you’ve had some concerns about your child and want to consult with a professional.  First of all, it is normal to feel some anxiety about your first therapy session, especially if you have never done therapy before.  You are meeting with someone who is a perfect stranger to talk about your child or some difficult issues that you are facing as a family.  This can feel scary for some people. Your therapist understands this and hopefully will be able to put you at ease.

Some important information about therapy for your child or teen:

  • Consent of BOTH parents is generally required, even if only one is participating in therapy.
  • If your child is between 14 and 18, the therapist will break confidentiality if they feel that your child is at risk and could be a danger to themselves or to others.
  • The therapist may decide to meet with other family members besides the parent(s) (e.g. siblings, other people living in home) to get a better understanding of the  family dynamics.
  • Different therapists will require a different level of family involvement for children under 14 – this may also depend on the presenting issue. For example, after an initial assessment, we may recommend a systemic (family) approach, versus one that is focused on the child.
  • It is possible, especially younger children, that the therapist may recommend sessions without the child, and instead focus on working with you, the the parents about how you are responding to your child, setting boundaries, in order to provide some guidance about the ways that you can work with your child to support them.

What can you expect for the first therapy session?

Depending on the issue and the age of your child, the therapist may first want to meet with you alone to get some background information about the issues that your child is facing along with some developmental history.  Other times, they may want to meet with you and your child together, or in the case of teens, possibly with your child alone.

Your therapist will greet all of you in the designated waiting area for your appointment.  If you are a bit early, you can have a seat and wait until your therapist comes to greet you.  Often they will be in a meeting with someone else before hand and will come to find you at your appointment time.

Once you go into the office and have a chance to get seated, there will often be paperwork to complete.  The therapist will already have your appointment form containing the basic information, but may want to confirm some additional details.  This can help to break the ice.

The therapist may want to collect some basic information about you for your file and complete an informed consent form, which is a document that explains the framework of therapy- the frequency and duration of your sessions, the rules about confidentiality and information about fees and payment.  The informed consent is basically the contract between you and your therapist which describes the way you will work together.  The age of consent is 14 years old, so in the case of younger children, it is the parents who sign on behalf of the child.  Children who are 14 years of age and older sign their own consent forms.

From here, different therapists will work in different ways.  Some may have a structured questionnaire that they will go through with you to do a full assessment of the child’s history, your concerns and the reasons that you are seeking therapy.  Other therapists prefer to work in a less structured way, opening with some variation of “What’s bringing you here?” and letting the conversation flow from there.

In cases where younger children are involved, your therapist may use different approaches to engage the child or family members, for instance, creating a family mural or family sculpture, or through structured play.  This allows children to  have the opportunity to communicate in a way that is more familiar to them.

Here are some things your therapist may want to know about in the first (or first few) sessions:

  1. This information will help to guide your therapist toward the best ways of working with you:
  2. Your reason for seeking therapy at this time- concerns that you are having about your child or any symptoms that they are displaying.
  3. The relationships between various members in the family.
  4. Your current home situation including relationships with extended family, work or school, and daily life.
  5. Your child’s developmental history.
  6. Past experiences that your child or family has had with therapy: if there was anything about your past experience that was particularly helpful or not.
  7. More fully exploring your goals for therapy to understand better what you are hoping to get out of the experience.

Many therapists will view the first therapy session as an evaluation period.  The goal here is to get to know one another better and to see if you are a good fit.

One of the most important factors in therapy is that you and your child feel comfortable with your therapist and that you feel like you are a good match.  Not every person clicks well with every therapist, and your therapist understands this.

Feel free to bring up questions or concerns if there is something that you don’t feel so comfortable with or think that the therapist’s approach isn’t what you need.  We appreciate your feedback and your therapist wants to make sure that you get the best service possible.  Many times, with your input, the therapist is able to adapt his or her approach so that it may be more helpful for you, your personality style and your unique needs.

If for any reason, your therapist really doesn’t feel like a good fit, this is completely okay. Your therapist should be able to help facilitate a transfer to another professional, or if you prefer to contact our intake team to ask to be reassigned, we would be happy to help you find another professional on our team who would better suit your needs.