What Happens in a First Session with a Child

A step-by-step account of a child's first psychology session, covering who is in the room, what the psychologist asks, what your child does, and what you leave with.

In a first session with a child, the psychologist spends most of the time gathering information about what has been happening, how long for, and what you have already tried. For younger children, parents are usually in the room or seen alone first, and the child's part of the session is play, drawing or conversation rather than anything test-like.

Nobody is expected to do therapy in the first appointment. It is 50 minutes, and its job is to build a shared understanding of what is going on.

Who is in the room

It depends on age, and we will agree it with you beforehand.

• Younger children, roughly under eight: often the parents are seen first, alone, then the child joins for part of the session
• Primary-aged children: usually a mix, with parents present for some of it and the child seen alone for a portion
• Adolescents: generally seen on their own for most of the session, with parents included at the start or end

For teenagers, some separate time is deliberate. Young people often say more when a parent is not there, and knowing that the room is partly theirs is what makes the next session work.

What the psychologist asks you

• What has brought you in now, and what a bad day looks like in concrete detail
• When it started, and whether anything was happening at the time
• How it is affecting school, friendships, sleep, eating and home life
• What you have tried, and what has helped even slightly
• Developmental and medical history, and anything relevant in the family
• What you are hoping will be different in three months

Bring anything written that already exists, such as school reports, teacher emails and letters from a paediatrician or GP. You do not need to prepare a document, but concrete examples are far more useful than general descriptions.

What your child does

For younger children, the session looks like drawing, playing, or talking about school, friends, pets and interests. The psychologist is learning how your child communicates, what they enjoy, how they handle a new adult and an unfamiliar room, and what they understand about why they are there.

For older children and adolescents, it is mostly conversation, and often starts well away from the presenting problem. There are no tests in a first therapy session, and nothing your child can get wrong.

How to prepare your child

Tell them where they are going and roughly why, in plain language and without loading it. Something like this works well. We are going to see someone whose job is helping kids with worries, and she will want to know what you like doing. Avoid framing it as a consequence, a fix, or a secret.

With adolescents, be straightforward about why you booked it. They generally cope better with the truth than with discovering they were brought in under a pretext.

Confidentiality, in practical terms

What your child says is treated as confidential, with the limits explained to them in age-appropriate language, which is that the psychologist will act if there is a risk of serious harm to them or someone else.

For parents, that means you will not receive a transcript of what your child said. You will receive a picture of what is going on, what the plan is, and what to do at home. With adolescents in particular, respecting that boundary is what keeps them talking.

What you leave with

• An initial sense of what is going on, though sometimes the clinician will want another session before committing to a formulation
• A plan for the next few sessions, including who attends
• Something practical to try at home, where there is an obvious candidate
• An honest indication of likely length of work, and whether assessment or another service would be a better fit

If the answer is that your child does not need ongoing therapy, we will say so.

If it does not go well

Some children say nothing for the first session or two. That is normal and not a failure. Some do not click with the clinician, and if that happens, tell us. Changing clinicians early is far better than pushing on with a poor fit, and no one takes it personally.

Where we see children

• Therapy at Ivy Psychology
• Psychology in Kensington
• Psychologist in Randwick

In summary

The first session is information gathering, not treatment. Parents are heavily involved, particularly for younger children, and your child is not being tested. Bring concrete examples and any existing reports, tell your child the truth about why you are going, and expect to leave with a plan rather than a solution.