I like to listen carefully to the needs of my students and prepare my lessons with that in mind. I am happy provide a range of lessons for example:

A speaking lesson can be a role play focussing on specific vocabulary and pronunciation with some grammar work if required
A writing class, perhaps specifically for an exam will look at the structure of the writing and how to get the highest marks
Some students like to practise listening which would be based on a topic the student is interested in
And of course reading is always a useful way to reinforce vocabulary, to practise speaking and to look at specific grammar

And if all that sounds a bit heavy, there are lots of games we can play!