Psychological interventions such as cognitive-behavioral therapy (CBT) are known to have beneficial effects on reducing pain and disability in children and adolescents with chronic pain. But it is clear that CBT alone is insufficient to achieve clinically meaningful improvement in pain and disability, particularly with complex musculoskeletal pain conditions such as juvenile fibromyalgia (JFM).  Physical exercise is a necessary component of non-pharmacologic care but standard physical therapy or graded exercise approaches may not be best suited to promote exercise tolerance and long-term adherence to regular physical activity. In this presentation, Dr. Kashikar-Zuck will present how a specialized neuromuscular training approach was developed and integrated for adolescents with JFM.  She will describe how the FIT Teens program has undergone Phase 1, Phase 2 and now Phase 3 testing and is being adapted for use in other chronic pediatric pain and rheumatic diseases.  Precise measurements of movement patterns that increase risk for more pain and fear of movement and fMRI studies of pain processing in the adolescent brain are being used to further our refine our treatment approaches. The ultimate aim is to “train the brain” to achieve long lasting pain relief and mitigate the chances of chronic pain persisting into adulthood.