Conversational analysis (CA) has long promised to fill the gaps in psychotherapy theory by conceptualizing and describing the moment-by-moment exchange between therapist and client. Conversation Analysis and Psychotherapy makes a large payment in fulfilment of this ambitious promise. The authors build on continuities with normal conversation to examine therapy's distinctive features.

Though devoutly grounded in observation and sometimes professing to be atheoretical, CA has accumulated a wealth of interlinked theoretical concepts, well illustrated in Chapter 1 in the editors' introductory overview. Each chapter proposes further theoretical categories and distinctions that elaborate the abstractions of therapy theories and the coding categories of psychotherapy process researchers (e.g. Stiles, 1992). The authors place conversational actions in sequences and detail ways that they serve therapists' and clients' purposes. CA's comfort with the complexity and responsiveness of therapeutic conversation often makes psychotherapy theories seem blunt and vague by contrast.

But CA complements rather than competes with psychotherapeutic approaches, such as psychoanalysis, solution-focused therapy, child therapy, or the Minnesota 12-step model. As Streeck (Chapter 10) points out, CA does not attempt an explanation of psychological change or prescriptions for interventions. Instead, CA elaborates therapists' abstractions. Many therapists would agree that each word and inflection is there for a reason; CA actually studies the reasons in relation to the therapeutic approach.