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In this paper I offer a theoretical basis for activity analysis in professional discourse settings, followed by an illustration of data from the genetic counselling encounter. By taking activity as the basic unit of (inter)action, I briefly draw on “activity theory” as proposed by Leontyev, supplemented by Wittgenstein’s notion of “language games” and Levinson’s notion of “activity types”. I argue that activity analysis in the professional discourse settings has to go beyond mere coding of instances of language use towards an interpretive understanding of the activity-specific ecology, including the role-relational dimensions of copresent and absent participants. Such an interpretive task can be achieved through thematic and interactional mapping of a given encounter, by taking into consideration the structural and relational properties situated language use.