Conversation analysis (CA) can provide insight into interactional micro-processes of family therapy. Past reviews of CA and family therapy have focused on methodology without descriptions of research findings, reducing the likelihood that the findings of CA research are employed to guide practice. This narrative review provides therapists with a description of CA findings that can inform family therapy practice. Systematic searches of databases, individual journals, and citation analyses were completed in April 2018 resulting in twenty-five articles for review. The findings of this narrative review were summarised around three areas: family members’ talk about each other, therapists’ responses to the family, and the use of reflecting teams. The use of reflecting teams and various conversational devices may help engage multiple participants. Future CA research into family therapy could focus on longer sequences, the overall structural organisation of sessions and the interactions of multiple therapists. Practitioner points: CA can offer practitioners insight into the interactional micro-processes occurring in family therapy that can inform future practice Micro-interactions between therapists and family members can indicate their perspectives on sensitive topics, blame and accountability Blaming talk creates a dilemma for therapists trying to maintain both neutrality and engagement Family therapists use conversational practices to respond to difficult conversations while maintaining engagement and collaboration Reflecting teams may help to acknowledge and engage multiple family members.