He gets me from the waiting room, we shake hands and walk to his room in silence. Then I lie down as much as possible on the chair he provides for clients (certainly not meant to lie down on, but whatever). He asks "So, what about you?" or something similar, and I usually skip right to the most important stuff, because I never really feel like smalltalk, and I want to have time for what I need to discuss.

Then I talk for maybe a few minutes, when I'm done he asks questions. Usually around that time I start crying, which continues until about 5-10 minutes before end of session. I usually have my eyes closed for most of the time too. He will start talking more towards the end, explaining concepts, making sure I understand the stuff we discuss, trying to explain behaviors. Whatever is appropriate at the time.

Then at the 5-10 minute mark, I open my eyes, sit up a bit more straight. If he still thinks he has some point to make, he will continue to do so while I nod. Then we discuss eventual scheduling issues/questions, sometimes I give him something to read for next week. Then we wrap up, shake hands to say good bye, and usually I get accompanied by "see you next week, and you can always call if you need to before that" on the way out.