 In the United States, pain accounts for nearly 20 of all primary health care visits. In the majority of cases, the pain is musculoskeletal and primarily affects the lower back, hips, and knees. Studies have shown that at least one-third of patients with pain also suffer from depression. It has not been determined whether treatments for depression are effective in patients with comorbid pain and depression. The Stepped Care for Affective Disorders and Musculoskeletal Pain SCAMP study will determine the most effective treatment for patients with pain and depression. 