Although multidisciplinary pain programs have been demonstrated to be effective, the processes of improvement have yet to be clarified. Cognitive–behavioral models posit that improvement is due, in part, to changes in patient pain beliefs and coping strategies. To test the relationships between treatment outcome and changes in beliefs and coping strategies, 94 chronic pain patients completed measures of physical and psychological functioning, health care utilization, pain beliefs, and use of pain coping strategies at admission and 3 to 6 months after inpatient pain treatment. Improved functioning and decreased health care use were associated with changes in both beliefs and cognitive coping strategies. However, changes in some coping strategies, such as exercise and use of rest, were not associated with improvement.