Chronic pain treatment programs in North America are based predominantly on
a behavioral science model of contingency management, whereby the focus of
treatment is directed toward the psychological aspects of pain. Treatment
objectives are designed to eliminate reinforcing environmental contingencie
s, thus changing pain behavior and reestablishing well behavior. The purpos
e of this article is to displace the contingency management model with deco
nstruction and thus present all alternative conceptualization based on the
experiences of chronic pain sufferers. Social work's value base of self-det
ermination and empowerment upholds these challenges to the predominant trea
tment model. Alternative social work interventions are explored.