I think, like anything else in therapy, it will depend on that therapist and that client. If a therapist doesn't initiate touch and it doesn't come up in conversation I don't see how it can happen. I've mentioned touch and had therapists adjust to what we discussed and I'm sure therapists have "reached out" to me and then adjusted to my reaction/response without conversation, too. I know I've had conversation where a T has said it wasn't her "syle" and that has been fine with me. The relationship and that "happens" as a result of the interactions within therapy are what have been most important to me so I have tried to use whatever happens for healing.