Typically, the session begins with the client lying face up, fully clothed on a massage table, or chaise, although it is possible to receive a Reiki treatment while seated if the client has physical difficulties that prevent them from lying on the table or chaise.  A blanket is offered for added warmth and comfort, and a pillow may be placed under the knees.  Often the atmosphere in the room is enhanced with candles and quiet meditative music to help eliminate distractions and promote relaxation.

The practitioner may initially scan the client by passing hands several inches above the length of the body to detect imbalances in the energy field that indicate areas in need of specific treatment.  The client is also asked if they have any specific physical or emotional difficulties they are experiencing and would like attention directed to it. Because Reiki energy has its own intelligence, it will always flow to the area or areas most in need of treatment, in addition to where it is directed by the practitioner.

During the treatment session, the practitioner lays their hands lightly on the client in a series of positions designed to treat the body’s energy centers, spending additional time on any problem areas detected or reported.  None of these hand positions involve touching the breasts nor genitals.  Should the client prefer not to be touched, the practitioner can treat with their hands held just above the body.  

It is common for the client to experience heat coming from the practitioners' hands. This is normal and indicates that Reiki energy is flowing freely to the client.  Other sensations such as tingling, pulsing or vibrations may also be experienced.  When the treatment is completed, which generally takes about an hour, the client usually experiences a feeling of deep relaxation and peace and is given time to come fully alert, since it is often common for a client to fall asleep during treatment.  Water is offered and encouraged and the client and practitioner can discuss the experience and schedule additional treatments, if desired.