This study compared two theoretically opposed strategies for acute pain management: an acceptance-based and a change-based approach. These two strategies were compared in a within-subjects design using the cold pressor test as an acute pain induction method. Participants completed a baseline pain tolerance assessment followed by one of the two interventions and another pain tolerance test. The alternate strategy was presented in a separate, but otherwise identical, experimental session. On average, both interventions significantly increased pain tolerance relative to baseline, with no significant difference between the two intervention conditions. Baseline psychological acceptance emerged as a significant moderator of intervention efficacy; individuals with a high level of acceptance benefited significantly more from the acceptance intervention, whereas those with a low level of acceptance benefited more from the change-based intervention. Implications for increasing the effectiveness of psychotherapeutic treatments based on individual differences are discussed. (Contains 1 note and 2 figures.)