Patients with schizophrenia who are exposed to family environments high in expressed emotion (EE) are at increased risk of relapse. EE is usually measured by an interview with one family member and does not include a direct assessment of family interaction. To understand better the key processes that underlie the relationship between EE and course of illness, we applied a well-validated measure of family interaction, the Structural Family Systems Ratings (SFSR), to 28 Mexican-Americans with schizophrenia and their families. The relationships among EE indices, SFSR components, and relapse were examined. Although measures of EE and family interactions were not related, both EE and one component of the SFSR, family resonance, were associated with a psychotic relapse within 1 year of the assessment. The results suggest that Mexican Americans with schizophrenia benefit from living with families that are able to adapt to the ever-changing circumstances and needs of their ill relatives.