This study involves the development of an integrated psychotherapy that addresses both chronic pain and opioid dependence(POD).

To conduct a pre-pilot study with 20 POD patients to a) evaluate the acceptability and potential efficacy of specific sessions (i.e., reduced illicit opioid use as assessed by urine toxicology and self-report findings, and decreased pain as evidenced by attenuated pain intensity and pain interference on self-report measures from baseline throughout treatment) for inclusion in integrated Cognitive Behavioral Therapy (CBT) for POD and the sequence of sessions, b) assess patients' satisfaction with integrated CBT as evidenced by qualitative feedback from individual exit interviews, and c) develop and modify initial therapist training and process rating measures. Products will include a) a manual for integrated CBT for POD to be used in opioid treatment programs and primary care settings with POD patients, b) therapist training materials, and c) process rating instruments.

Inclusion Criteria:

• at least 18 years of age
• currently in Methadone Maintenance Treatment (MMT) at the APT Foundation in New Haven, CT
• opioid dependence
• experience moderate to severe chronic pain

Exclusion Criteria:

• current suicide or homicide risk
• are unable to complete the informed consent or surveys because of psychiatric impairment
• have cognitive impairment
• are unable to read or understand English