It depends on the therapist as to what they'll recommend, but most therapists will tell you to dress down as much as YOU feel comfortable. I've asked them if they ever feel a person is too dressed? And they've said sometimes it can effect the treatment because they might not be able to as easily reach the areas they're trying to treat. But even if you do start on your back, they will still have a towel there to cover your breasts and another towel for your midsection. All the ones I've been to have been very professional. Enjoy.