Psychological factors are central to the experience of pain, the delivery of effective analgesia and for the specific treatment of chronic pain and disability. Improvement in pain management can often be brought about by very simple, if subtle, changes in clinical practice. Although simple, these changes can have significant effects in the experience of pain, distress and use of health-care resources. For the chronic pain patient, the presentation is much more complex and the treatment interdisciplinary and programmatic. The evidence for the effectiveness of cognitive behaviour therapy for adults with chronic pain is now well established. This treatment should be available as a core part of any chronic pain service.