In cognitive-behavioral group therapy, the therapeutic alliance with the psychotherapists and between the patients in the group, allows patients to develop coping strategies. These include cognitive and behavioral efforts aimed to control, reduce or tolerate specific demands, whether internal or external, experienced as threatening, exhausting or exceeding the patient's resources. This adaptive mechanism lowers the intensity of anxiety, favors control of fear and reinforces the motivation and energy invested in the process of change. We describe the importance of therapeutic alliance in group therapy with patients suffering from chronic pain. These processes will be illustrated with clinical vignettes.