I don't cry very often - I think maybe 4 times in almost 2 years. The times I have cried, my T just sits across from me, being silently supportive. I always fight my tears, and I think if she did anything other than just let me cry, I'd push the tears back and stop crying. I actually really appreciate that she is just there and lets me go with what I'm feeling. Once I calm down, we always talk about it. As far as tissues, she has them on a little coffee table, easily within reach. Her trash can, on the other hand, is clear across the room...she did move that closer to me during one session, so I didn't have to keep getting up to toss tissues.