Individuals with chronic pain differ markedly in their physical and psychological adjustment to the pain condition. Many factors influence this adjustment process, and the nature and severity of the physical injury or illness and the degree of pain experienced cannot account fully for the impact of chronic pain. A variety of other psycho-social factors are involved, including the individual's attitudes and beliefs about his or her condition, coping skills, operant reinforcement factors, avoidance learning, and psychophysiological variables. Intervention programs that are designed to facilitate positive adjustment to chronic pain need to consider these biological, psychological, and social factors within an integrated framework. Cognitive therapy has a significant role to play in this process, in order to tackle maladaptive cognitive factors that interfere with adjustment. Evidence concerning attitudes and beliefs relevant to the pain condition and their relationship with the use of coping skills and response to pain, is reviewed.