This review of the current status of theoretically based behavioral research for chronic illness management makes the following points: (a) Behavioral interventions have demonstrated effectiveness for improving health outcomes using biomedical indicators, (b) current interventions are too costly and time consuming to be used in clinical and community settings, (c) translation of the conceptual models generated from studies of the problem-solving processes underlying self-management and the relationship of these processes to the self system and cultural and institutional contexts suggest new avenues for developing effective and efficient cognitive-behavioral interventions, and (d) it is proposed that integration of the conceptual developments in self-management with new approaches to the design of clinical trials can generate tailored, behavioral interventions that will improve quality of care.