A cognitive behavioural treatment program for chronic lower back pain was designed, implemented and evaluated. The outpatient treatment program included education sessions, goal setting, graded activity training, physical exercise, relaxation training, cognitive techniques, social skills training, and medication reduction. Three participants volunteered to participate in the eightweek treatment program. Of the three participants, only one completed the program successfully. The results were used to critically discuss and evaluate the literature. The successful participant showed significant improvement in activity levels, decrease in subjective levels of pain, as well as decreased levels of anxiety and depression. It was shown that correcting cognitive distortions (e.g. selective abstraction, catastrophising, misattribution) and challenging early maladaptive schemas of abandonment, emotional deprivation and emotional inhibition (Young, 1990) assisted in enhancing coping mechanisms and the belief that the pain episodes would be short-lived and could be controlled. There was considerable improvement for the second participant, although he chose to withdraw from the program prior to its completion. The components of the psycho-education, relaxation and stress management and exercise program were beneficial for him. The third participant failed to accept the treatment formulation, and did not engage collaboratively in the treatment program. The case is presented as a point for examining therapeutic ailures.