There is now ample evidence that psychosocial factors such as selfefficacy, fear of pain and/or movement/re-injury, catastrophizing, and social reinforcement contingencies contribute to the development of persistent pain and disability. In our research group at Uppsala University we have developed an integrated behavioral medicine and physical therapy treatment approach for patients with MSP that builds on basic motor and behavior learning principles and cognitivebehavioral principles. The approach comprises identification of problems and goals, monitoring of problems, functional behavioral analyses, basic and applied skills acquisition, generalization of skills, and relapse prevention. Evaluation of the approach involves clinical studies at both the individual level and group level and there are promising results at both short-term and long-term follow-up. Recent studies have focused on 1) targeting and tailoring of treatment based on screening of psychosocial factors and individual functional analyses, and 2) screening for psychosocial risk factors in telephone counseling. An emerging research area concerns implementation of the integrated approach in general clinical practice within PHC. Pilot work in our research group indicates that physical therapists may have greater difficulties in adopting this integrated approach than anticipated, lack of theoretical knowledge being one possible explanation. Further implementation efforts involve research as well as systematic integration of the approach in physical therapy curricula, the latter being done at two Swedish universities. Hypervigilance to pain and attentional bias are considered as key processes in understanding chronic pain, distress and suffering (Crombez et al., 2005; Pincus & Morley, 2001; Vlaeyen et al., 1995) .