The understanding of therapeutic change is explored in two ways. The first is by providing a model of change that emphasizes moment-to-moment, “local-level” interactions in the analytic dyad. The second is to offer detailed clinical information—taken from the videotape of a child analyst's first session with a three-year-old girl—that illustrates how this change model can be useful to clinicians. The clinical material is presented in the form of verbal trascripts and descriptions of nonverbal communicative exchanges between child and analyst. Both the model of change and the technique of videotape microanalysis build upon work by infant researchers and thus show how advances in related fields can supplement traditional psychoanalytic methods.