The chronic pain experience is the product of a complex interaction of many factors including biological, social, psychological, environmental, and familial. The presence of chronic pain can impact the family system with significant, negative consequences; the family may also be responsible, in part, for maintaining and perpetuating pain problems. The need to examine the family dimension of the chronic pain experience and offer family/couple therapy, should it be indicated, is vital to comprehensive pain management. Operant behavioral, cognitive-behavioral, and structural family therapy approaches are advocated for such families, along with a clear need for controlled evaluations of these approaches.