Background Problematic substance use among young people is a major public health problem. Despite availability of services, attrition rates among young people with substance use are high. Past studies have found treatment expectancies to be an important predictor of treatment retention and outcomes. Methods The current pilot study aimed to explore predictors of treatment expectancies among 25 young people between 18 and 21 who attended a youth Drug Health Services in Victoria, Australia. Twenty‐five participants were administered self‐report questionnaires. Multiple regression analyses were conducted to examine the strongest predictors of treatment expectancies. Results Treatment expectancies were most strongly predicted by satisfaction with past services. These expectancies were also associated with first impressions of the current service. Young people's expectancies about drug and alcohol treatment are shaped by past experiences with services and by early impressions of the current service. Conclusions This study highlights the importance of past and early service satisfaction for treatment expectancies. Given the small sample size employed in the current study, larger studies are required to support such findings.