Family interactions of 71 adolescents hospitalized following a suicide attempt were compared with those of 29 psychiatric controls, using observational methods and a 2-year prospective, longitudinal design. Parent-adolescent dyadic interactions were coded for emotional validation and invalidation, and problem-solving constructiveness. There were no between-group differences for parents. However, adolescents who had attempted suicide displayed more emotional invalidation than controls. Within the suicide attempt group, maternal constructive problem solving predicted greater declines in youth suicide ideation, and a similar trend was observed for fathers. Adolescents who displayed more unconstructive problem solving with fathers were more likely to reattempt suicide during the follow up.