First, my T greets me by shaking my hand. I always need to time to 'warm up' so she usually asks me how my week has been. I tell her something like "uuuuh... okay, I think" () so she follows up with some questions and gets me talking. Sometimes she will also ask me how I felt after the last session. Or she might have a follow-up question...
After a few minutes of our warm-up-talk T asks me, if we are already on the right topic, or if I'd like to focus on something else. It works for me.

(In the very beginning of my therapy she would just look at me, waiting for me to talk. This freaked me out and I'm glad we have found a compromise!)