The presentation describes the engagement of patients and caregivers after the conduction of two clinical trials to inform the direction of future research activities. The aims were (1) to explore and validate treatment change processes of exposure treatment in youth with chronic pain, (2) to prioritize and develop ideas for improvement, and (3) to identify particularly helpful treatment elements. Qualitative exit interviews with patients (n=52) and caregivers (n=52) were collected at discharge of two clinical trials (ClinicalTrials.gov: NCT01974791, NCT03699007). Six independent co-design meetings were held with patient (n= 10) and caregiver (n=14) consultants to establish consensus within and between groups. Patients and caregivers described that exposure treatment helped them to better process pain-related emotions, feel empowered, and improve their relationship with each other. Consultants developed and agreed upon twelve ideas for improvement (e.g., to make patients, caregivers, and the general public more aware about pain exposure treatment). Consultants prioritized thirteen helpful treatment elements (e.g., the personalization of treatment through the pursuit of individualized goals). The clear and meaningful outcomes of this co-design and qualitative approach strongly support involving patients in pain treatment manual developments and pain study designs.