Over the past few years there has been growing evidence that the clinical encounter plays a critical role pain treatment outcomes, for better or worse. Our ability to effectively assess and manage chronic pain in children and youth often rests on effective communication between clinicians, children and their families. While there has been substantial work documenting the nature of the encounter, researchers are now starting to examine developing solutions for clinicians and patients to deal with clinical uncertainty and harness the encounter’s therapeutic benefits. This symposium will cover three elements that should assist in making the clinical encounter therapeutic. These include the role (and words) of the clinician, the clinician’s ability to recognize and manage uncertainty, and an exploration of pain explanations and the ways youth themselves explain their pain.