Inclusion criteria:  Orthopedic patient presenting for outpatient clinic evaluation to a spine specialist for neck and/or back pain Musculoskeletal spine pain for 3+ months  Exclusion criteria:  Routine post-operative visit with no plans for further surgery Endorses mental health crisis (active suicidal or homicidal ideation, psychosis) Cognitive impairment which would interfere with meaningful engagement with research interview, questionnaires, and/or intervention