T often starts like this for me: (If the wording is strange, that's because I'm translating because English is not my native tongue. My T would never say "that sucks" for example.)
T: How are you?
I: Do you mean "right now", "today" or "how has this last week been?"
T: Let's start at right now.
I: I'm OK. About as good as it can get at the moment, actually.
T: That's wonderful! Has all day been like this?
I: No, this morning I was lying on my bed and I couldn't manage to move, and x and y were particularly bad, so I just hugged my stuffed animal for three hours straight.
T: That sucks. Does that happen often? Has it happened often this past week?
I: yes ...

The "how are you" question has so many avenues of interpretation I usually answer 'wrong' on purpose (for example: T: How are you? I: My leg is doing better) so I can avoid really answering. However by asking the T "you mean right now, today, or this week?" she in turn 'forces' me to talk about the whole picture.