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What Can I Expect in My Child's First Therapy Session?

Our young child therapist Kelly Jean Tucker, LCMHC created this blog series to help walk you through the process of supporting your child in therapy. If you haven't had a chance to read her previous posts about deciding whether your child could benefit from therapy (linked here) and how to find a great fit therapist (linked here), check them out before diving into this latest installment.

While each therapist does things a little differently, there are a few things that you can generally expect during a first appointment with your child’s therapist:

1. Time to Speak with The Therapist Separately. Many child therapists complete the first initial intake appointment just with the parents or caregivers so that you can talk openly about concerns and issues that may not be developmentally appropriate to discuss in front of your child. This is an excellent opportunity to talk not just about your child's individual needs but also about difficult family dynamics, family history of mental health or substance use issues, traumatic events, background information about your child's early development, or any other issues that you may not want your child to hear details about at this time. Having one-on-one time with the therapist also allows you to ask questions about their approach, conversation style, professional training, and any other things that you would like to know in order to help you confirm that they will be a good fit for your child and your family.

Note: It is possible that your insurance (or the therapist’s employer) may require that your child is there for the first intake appointment, but ideally they will allow time to speak with you without your child being in the room or they will schedule a follow-up appointment or phone call with you.

2. Setting Goals. Goals will be the guide posts for therapy and make discussing progress in therapy more tangible. Consider these questions when thinking of goals for your child: “If I woke up tomorrow and my child got what they needed from therapy, what would they have learned? What would be different?” Some common goals for younger children in therapy might include things like increasing their emotional literacy, learning how to express emotions in a helpful manner, processing through traumatic experiences, falling asleep more easily at night, decreasing their separation anxiety, etc. Your child's goals will be personalized to their unique needs and goals can change over time as your child develops new skills and faces new challenges.

3. Discussing your Child’s Strengths. Knowing your child’s interests, hobbies, and sources of resiliency will help your child’s therapist build a positive connection quickly and will be incorporated throughout therapy. Do they love Legos? Are they really into Paw Patrol right now or going through a "watching The Little Mermaid twice a day" phase? Do they play soccer or are they in a drama group at school? What family members and friends and neighbors are they close with? How do they seem to learn best? All of these are things that we can incorporate into their sessions.

4. Other helpful tips.

* Fill out Paperwork Before Appointment: I, along with many other therapists, use an electronic health record system that maintains your child's confidentiality to the highest level possible and makes paperwork a breeze. Filling out paperwork ahead of time makes the first appointment more efficient and effective as the therapist will be coming in with an understanding of your concerns. There is a lot of important information about the therapist’s policies and their experience to carefully review, too. Feel free to ask questions about anything you read in their paperwork that you'd like to clarify.

* Know that the first appointment is just The beginning of an ongoing conversation. It can feel overwhelming to think you have to tell your child's (or family’s) whole story in just one appointment. Remember that the goal in the first session is for the therapist to begin to understand your child’s needs, know how they can help, and answer any questions and concerns you may have. With children, there is a high amount of parent involvement in therapy and you will have plenty of opportunities to discuss your concerns and review their progress with the child’s therapist.

I hope this post has been helpful in explaining what to expect during your first intake session with your child's new therapist! Next up, we will talk in more detail about what exactly therapy with your child will look like (linked here). Until then, take care!

Kelly Jean Tucker is a Licensed Clinical Mental Health Counselor in Asheville, NC providing parenting support and therapy to children ages 3-11 struggling with anxiety, behavioral concerns, or recovering from trauma in Asheville, NC. addition to parenting You can read more about Kelly Jean here.


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