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You relax, fully clothed, on a couch or seated while the healer holds his hands on or above you. A treatment can last an hour or longer depending on the treatment required. In the western world many practitioners use the standard hand positions and commonly a full treatment is given covering all the important organs of the body.
There is no pressure on the body making it ideal for treating all ages and conditions, sometimes hands are even held away from the body. The energy flows wherever it is required (spiritually guided) and can normally be felt as a warm sensation or tingling in the body. Receiving Reiki is a very relaxing and soothing experience!