Depression and Self-care in Heart Failure

Inclusion Criteria: * New York Heart Association Class I, II, or III Heart Failure (Clinically diagnosed at least 3 months ago) * Meets the DSM-IV criteria for a current major depressive episode, or for current minor depression with a past history of at least one major depressive episode. * PHQ-9 score of 10 or greater plus 2 or 3 on question 1 or 2 over the last 2 weeks including today Exclusion Criteria: * Less than 30 years old * Current ETOH / drug abuse * Bipolar disorder, schizophrenia, or other psychotic disorder * Communication barrier * Dementia * Currently in competing research protocol * High risk for suicide * Insurmountable logistical barriers to laboratory assessment visits * Major mobility-limiting physical disability * Poor 1 year prognosis not r/t heart failure * Hospitalized for heart failure or acute coronary syndrome in last month * Initiated antidepressant therapy in the past 4 weeks * Current non-study psychotherapy for depression or other psychiatric problem