The transition from acute to chronic pain has created an enormous burden on the healthcare system. This has led to a shift away from opioid therapy and to treating patients with a multimodal therapeutic approach. The focus has been to better identify the risk factors that contribute to the development of persistent pain. Psychological factors such as anxiety, depression, pain catastrophizing, and pain self-efficacy have been found to contribute substantially to surgical outcomes. A well-timed multimodal approach including a combination of pharmacological, regional, and nonpharmacological therapies is crucial to optimize postoperative pain management and to prevent transition to chronic pain states. Evidence based psychological therapies, such as cognitive behavioral therapy, mindfulness based cognitive therapy, and acceptance and commitment therapy have utility in managing pain within the perioperative setting and complement traditional medical treatments. Often, pain coping skills cannot be learned, internalized, and enacted within a perioperative timeframe. A comprehensive and coordinated effort in the pre- and postoperative phases could have the greatest positive effect on outcomes and will be discussed during this presentation.