The coping responses of 23 hospitalized adolescent suicide attempters were compared to those of 19 hospitalized non-attempters matched on diagnosis and demographics. Relative to the comparison group, suicide attempters made fewer effortful-approach and more automatic-approach coping responses, and were judged by trained raters to have coped less effectively. Coders' ratings of greater coping effectiveness among suicide attempters were associated with a greater decline in suicidal symptoms assessed at 6-month follow-up intervals across a 2-year period. The findings are discussed in light of a model of coping that incorporates both individual differences and situational characteristics.