My T doesn't have a couch, just a comfy recliner-type chair. (I don't know if it reclines or not, but there's no room in the office to recline it anyway.) Most of the time I just sit in the chair "normally" and speak with her face to face. But sometimes when I am feeling especially awful I don't want to make eye contact so I will kind of slump over in the chair or pull my legs up or rest my head on the arm rest and stare at the floor.