Well... I bring a list. I don't think my T really likes this much. He's made comments about being more spontaneous, but he's so expensive, I don't want to risk forgetting something important while wasting time on something that doesn't matter to me. He also sometimes looks like he wants to giggle a bit when he tells me, "OK, what else is on your list? Did we cover everything?"

I make my list during the week. I'm still pretty new with this T, so sometimes it includes things from the past that I think are important data points for him ("oh yeah, you really need to know about this... for context of my life"). If anything upsetting happens during the weeks in between sessions, I try to jot them down and think about them. I try to prioritize things that are bothering me.

It's not a great approach, because I am not great at T yet, but it's one approach. I try to maintain some flexibility - if we start talking about item #1 of 5, and we get off on something interesting and important that wasn't on the list, I am totally ok with that (unless there's something else pressing on the list that is time sensitive! Then I might tell him that we need to save time for that!).