In this paper the psychological treatment of functional somatic symptoms is discussed. The first, and most important, step in the treatment is the engagement of the patient. The therapist needs to acknowledge the reality of the symptoms explicitly. The labeling of psychological and social aspects as consequences of the symptoms rather than possibly aetiological factors facilitates the engagement of the patients. It is necessary to share the formulation of the symptoms with the patients before developing a treatment plan. Attention is paid to some specific treatment methods for unexplained symptoms which have been demonstrated to be effective in some recently conducted randomised controlled trials..