• This report portrays the distinctive clinical features of four groups of families with psychiatrically hospitalized adolescents. The classification of families into the four groups was made by objective measures of their performance in a standard problemsolving task. Clinicians, blind to this classification, synthesized and described their clinical impressions of these families. There were clear differences among the four groups in family dynamics and in the adolescents' ward behavior. Furthermore, families who experienced themselves as an integrated group became more effectively engaged in a family-oriented inpatient treatment program. Families with noticeable alienation between members did not become effectively engaged in the familyoriented program and may be better candidates for other approaches to inpatient care.