Each time I see someone, whether it's their first appointment or we've been working together for ten years, I ask them how they are and what their goals are for today's session. People's needs can shift from week to week or month to month, and I can't just assume that what worked last time is appropriate today.
The most frequent adjustment we make is in the scope of our work. Sometimes it's more worthwhile to focus on the aches and pains that demand the most of your attention; sometimes it's a better plan to look at the body as a whole. Clients can often second-guess this decision, worried that they're asking for the wrong kind of massage.
The only "wrong" kind of massage is when the techniques or scope of the session are mismatched to your goals for that day. If you just want to relax, but I give you 90 minutes of challenging and rigorous neck and shoulders work, it's the wrong massage. If you are having headaches and you want to use your massage to treat them, but I spend all our time working on the running injury that we usually treat, then it's the wrong massage.
Even when you have a valid concern that massage therapy would be perfect to treat, it doesn't have to be your goal for the day. There is a misconception that relaxation work has no legitimate lasting benefit, and that a full body massage is a waste of time and money. There's actually a great slideshow on the Huffington Post website that starts to explain the wider range of benefits, few of which are tied to specific, local therapeutic interventions. I think that this is valuable, but that we should not have to demand that every massage has therapeutic effects.
Massage is valuable in and of itself. If you want to problem solve, great. If you just want to chill out, great. Your goals should be set by you. Don't feel guilty if you've come to my office for stress relief or a one-hour vacation on my table: that's worthwhile, and it's neither a waste of your time nor mine. If you want to dig in and focus, we can do that too. And if you change your mind in the middle of your session, well, that happens too. Let me know that your goals have changed, and we'll switch gears. Let me know what the "right" massage is for the day, and I"ll do my best to get your pointed in that direction.