Parents and adolescents commonly discuss stressful experiences. However, little is known about the features of these conversations that may have implications for health. One hundred five adolescents and their parents engaged in conversations about two challenging events, with parental contributions to the discussions coded for four scaffolding behaviors (reiterations, negations, move alongs, and new interpretations). Systolic blood pressure, diastolic blood pressure, and heart rate were measured in both participants at baseline and throughout the conversation. Parent-reported relationship quality was also assessed. For both parents and adolescents, negative scaffolding behaviors were associated with increased physiological reactivity, whereas positive scaffolding behaviors were associated with decreased reactivity. Furthermore, children in higher quality parent-child relationships showed greater reactivity to reiterations and lower reactivity to new interpretations, but those in lower quality relationships demonstrated the opposite patterns. Specific aspects of parent-child interactions appear to contribute to physiological responses to challenging events, which in turn may have implications for health.