One of the most accepted approaches to the psychological issues involving chronic pain is that of Cognitive Behavioral Therapy (CBT). This is a psychological treatment that involves active questioning of the current mindset that patients have about their pain and the effect is has upon their lives.

Approaches for CBT can range from specific structured time limited sessions to integration into an overall treatment plan. The ten to twelve structured treatments are often quite useful in helping patients to regain control over their lives and to confront the self-defeating attitudes that have interfered with recovery. The patient is often given homework assignments between sessions and is asked to question everything from self-defeating emotions to actual destructive thought processes. Patients are asked to replace self destructive thinking and behavior with more positive ways of coping with chronic pain. Often their is assigned reading to help with establishing guidelines for improvement.

When CBT techniques are being integrated into an overall treatment plan, patients are asked to assess their view of being disabled, in order to develop the highest level of psychological and physical function. Important here is acceptance of physical limitations, while becoming as functional as possible. Patient's must accept disability, while not giving up the things that give meaning and bring pleasure of life. CBT approaches can be utilized to help patients understand that being disabled does not necessarily mean that they cannot work, be physically active and maintain relationships. It helps them to understand the cycles that lead to depression and anxiety and how to short circuit these processes. These approaches are used in concert with appropriate use of medications, routine physical exercise, supportive psychotherapy, vocational rehabilitation, invasive medical treatments, ergonomic changes and social interventions.