The aim of this article is to explore how affiliation (Stivers 2008) with the patient is displayed and interactionally achieved in the context of an interpreter-mediated therapeutic dialogue. More specifically, it focuses on the interplay between affiliative listener responses – especially head nods – and gaze in this setting. Interpreter-mediated therapeutic talk is not only a setting that has received very little systematic scrutiny in the literature, but it is also particularly interesting for the study of listener responses. Drawing on the insights from Conversation Analysis, a naturally occurring interpreter-mediated therapeutic session was analysed that had been recorded using mobile eye-tracking technology. This approach allowed for a detailed analysis of the interlocutors’ synchronous gaze behaviour in relation to speech and head nods during the interaction. The results revealed differences in the interpreter’s and the therapist’s affiliative listener responses that were linked to the interactional goals of the encounter and to their social roles. Moreover, the paper found a strong relationship between mutual gaze and head nods as tokens of affiliation. Thus, these findings provide support for the inclusion of gaze in studies of interpreter-mediated dialogue and, more broadly, in the study of affiliation in social interaction.