This paper describes a multidisciplinary approach to the evaluation and treatment of the patient with chronic spinal pain with particular emphasis on the cooperative roles of the physical disabilities occupational therapist and the psychosocial occupational therapist. The goal of the total program is to help patients progress from a sick role of dependent, painful behavior to a less pain-centered, more productive role–one in which they have begun to assume control over the way they feel and function. The success of the program is measured by the patient’s increased activity level and improved ability to cope with the demands of home and job. A review of patient records after one year of operation showed that only 4 of 54 patients who completed both phases of the program were returning to the orthopedic back clinic as outpatients.