This work will reflect the clinical practice and experience of the current author. The work is structured around this and a further three sections: empirical research into pain related disability and pain self efficacy; professional practice describing my role on the Active Back Programme and a critical review of the literature on Goal Attainment Scaling. I am a chartered health psychologist working in a specialist National Health Service orthopaedic hospital. This work will draw on my experience over the past seven years. My duties include delivering individual and group cognitive behavioural therapy sessions, service evaluation and development. I provide clinical leadership and expertise within chronic pain rehabilitation for two in-patient programmes. This work will draw on both programmes: the empirical research will use data from the Pain Management Programme, and the professional practice will describe how I developed and deliver my contribution on the Active Back programme. Goal Attainment Scaling is used as an outcome and evaluation tool on the Pain Management Programme. Section D is a critical review of the Goal Attainments caling literature.