Wicksell and colleagues (2005) addressed the important and currently understudied realm of chronic idiopathic musculoskeletal pain treatment in children. They presented a brief overview of empirically supported treatments for children with chronic pain, detailed their case and intervention strategy, and offered conclusions regarding the potential efficacy and effectiveness of Acceptance and Commitment Therapy (ACT) for childhood chronic idiopathic musculoskeletal pain. Our commentary is divided into several sections. We begin by providing an overview and critique for each of the case conceptualization and the intervention strategy presented. This is followed by a brief discussion of whether or not Wicksell et al.'s ACT approach is fundamentally distinct from more traditional cognitive-behavior therapy (CBT) techniques. We also consider potential mechanisms of action and suggest future research directions needed to establish empirically supported treatments for chronic idiopathic pain in children.