There is an expanding corpus of conversation analysis (CA) research in the field of psychotherapy that advances the concept of talk-in-interaction and its relevance in constructing and applying analytical categories beneficial to mental health practice. Such discussion concerns both methodological and technical improvement of psychotherapy, and the qualification of the so-called “psy” sciences (psychiatry, psychology, and psychoanalysis) as major areas for mental health care. The study of the interactional sequences of client and therapist responses is also crucial for gaining a deeper comprehension and refinement of public and private services, to inquiry institutionalized clinical protocols (e.g., DSM-5 and ICD-11), and for developing and enhancing healthcare policies. In this chapter, our aim is to discuss how agents take practical account for their actions in psychotherapeutic working scenarios, emphasizing how this understanding constitutes a key element in comprehending the underlying praxis. By using the conversation analytic approach specific to psychotherapeutic contexts, we take a closer look at participants’ social roles and linguistic practices to address the procedural and pragmatic organization of institutional interaction, as well as the ensuing evaluation of clinical interventions.