What to Expect at Your Child’s First Therapy Appointment

Taking the step of calling a therapist can feel scary if you do not know what to expect. Even if you are confident about your choice to begin therapy, it is normal to feel some anxiety about your first appointment. It may differ slightly from therapist to therapist but, generally, the early stages of treatment will follow a similar path.  

Remember, you are in charge

There are lots of options for therapists so determine what is important to you and your child. Do you want to be sure they see someone of a certain gender? Race? Ethnicity? Do you need someone nearby? Are you looking for a certain type of treatment? You can use the filter tools on our site to help narrow it down.

Tip: Being specific about who would make your child most comfortable will improve your experience in treatment. It may also mean that you have to wait a little longer to find a match with availability so keep that in mind if your needs are urgent.  

Providing information is key

Your first appointment will be a clinical assessment in which you and your child will meet with the
therapist and discuss your child’s birth and early development, educational challenges, family history, trauma history, medical concerns, emotional concerns and behavioral concerns. Depending on why you are seeking therapy, there may be some additional screening tools that the clinician gives. Some of the questions may be about things that are hard to think about, but remember that the more information you are able to provide, the more effective the treatment will be.

This appointment often takes up to two hours and can be pretty tedious but it is important to provide the therapist with as much information as you can. This helps them to determine the best type of treatment and to create a plan for you and your family. If your child is young, you may want to bring some of their favorite toys or fidgets, along with a snack, to the appointment to help entertain them while you talk.  

A diagnosis is not a definition

Your child’s therapist may need to give your child an official diagnosis in order for insurance to cover your treatment. They should thoroughly explain this to you including what the diagnosis is, why they have chosen it, and what treatments are most effective.

A diagnosis is simply a term that helps therapists to narrow down their treatment focus to a specific set of symptoms. It does not mean that something is wrong with your child and does not mean that your child will have this diagnosis forever. Instead, it signals that they are experiencing some current challenges and need support, and sometimes a diagnosis is the thing that opens the door to treatment.

A diagnosis can also be empowering – it gives children an explanation for some of the behaviors that have been bothering them. Often children know they are struggling and want to do something about it. A diagnosis can help them to understand that something is going on with them that is bigger than just their behavior.  

Make a plan

In one of your early sessions, your therapist will collaborate with you and your child to develop some treatment goals. These are usually two to three areas that are most problematic to you and your child that you all want to work on. You will revisit these goals every few months to see if they need to be adjusted or, if the goals are met, you may want to add another one. Progress on these goals is what helps the therapist to know when your child might be ready to graduate from therapy.

Tip: Your therapist should never create these goals for you. Therapy is for you and your child to find the healing and support you need so, what you choose to work on in sessions is up to you.

Are we there yet?

People always want to know how long they will need to be in therapy. Unfortunately, this is impossible to know early in treatment. Evidence-based models typically take around six months assuming the client attends weekly and fully participates.

Sometimes though, if a child has experienced trauma, has complex developmental needs, or has a diagnosis that is more long-term, they may need therapy for a longer period of time or off-and-on over a longer period of time.

Your therapist will be able to guide you on what is best, but listen to your instincts. If your child begins to complain about sessions or resists going, it might be time for a therapy break. Sometimes children need to pause treatment for a period of time so that they can integrate everything they have learned. Consult with your therapist so that you can determine the best plan together.  

Tip: If at any point you feel like things are not going well, you can make a change. Sometimes it takes a few tries to find a therapist that makes everyone feel comfortable. It’s ok to speak up and keep looking until you find someone that you and your child really click with.  

Stick With It

Remember, it takes more than a few sessions to see a change. It will not be immediate. Therapists are not there to “fix” anyone but, rather, guide you and your child on the path of healing. They create opportunities for people to learn about themselves, to reflect and think about who they want to become, and to provide information about mental health.

It is important to follow the recommendations of your therapist as best you can. If they assign
homework or something for your child to work on during the week, try to support them by checking in with your child to be sure it is complete. If they ask you to attend weekly, make every effort to do so.

Therapy can be hard work so, if your child is tired, quiet or out of sorts after their sessions, it’s ok to give them some space; they are trying to process what they have just learned.