Emotion Talk in Psychotherapy: A Systematic Review of Conversation Analytic Studies

Emotional communication is central to psychotherapy and plays a key role in shaping clients' experiences and therapeutic change. Conversation analysis (CA) offers a process-oriented approach to examining how emotions are displayed, managed, and responded to in moment-by-moment therapeutic interaction. Although a growing line of CA research has focused on emotion talk in psychotherapy, an integrative synthesis of this literature remains limited. This review synthesizes CA studies on emotion talk in psychotherapy, with a focus on identifying key interactional processes through which emotion talk is produced and managed in naturally occurring therapeutic encounters. Following PRISMA guidelines, we searched six major databases and identified 18 studies that met the inclusion criteria. The thematic analysis revealed two overarching themes: (1) the sequential organization of emotion talk, including clients' emotional displays, therapists' emotional management, and clients' responses; and (2) changes in therapeutic interaction, encompassing shifts in clients' emotional experiences and the therapeutic relationship over time. By integrating CA studies on emotion talk in psychotherapy, the review clarifies the interactional resources through which therapists and clients navigate emotional moments. These findings advance understanding of psychotherapy as an interactional achievement and offer practice-relevant insights into how therapists can attend to and work with clients' emotions to support further therapeutic work.