Children’s in-session involvement in child and family therapies correlates with both positive and negative treatment outcomes. Thus, it is important to gain a better understanding of the clinical practices that facilitate children’s involvement in therapy sessions so that practitioners can employ them with greater precision. To address this need, we conducted a study to answer the following question: What clinical practices facilitate children’s in-session involvement in child and family therapies? The data consisted of 16 extant audiovisual recordings of child and family therapy sessions and 24 stimulated-recall interviews with the participants in the recordings. Following constructivist grounded theory and incorporating storyline as an additional analytical technique, we have constructed a framework consisting of four involvement-enhancing practices: managing time, staying relevant, adjusting intensity, and facilitating inclusion. Furthermore, by detailing some of the complex processes that practitioners navigate when they facilitate children’s involvement, our study adds a multilayered and dynamic dimension to the list of already established involvement facilitators. It may be used to moderate an overstandardized work culture that continues to characterize services that address children’s needs. The results may be applied to other institutional encounters, providing resonance beyond the analyzed therapy sessions.