Heart failure (HF) affects 5 million people in the US and is the most common cause of hospitalization in elderly adults. One-third of patients who are hospitalized with HF have major depression. Depressed HF patients have double the rates of morbidity and/or mortality and worse health-related quality of life than non-depressed HF patients. The investigators previous pilot research suggests that a brief Cognitive Therapy (CT) intervention may improve short-term cardiac survival among depressed hospitalized HF patients compared to non-depressed HF patients who received usual care. Therefore, the investigators will conduct a larger study to evaluate the effects of the intervention on longer cardiac event-free survival, symptoms of depression, health-related quality of life, and stress levels in patients with HF. The investigators hypothesize that patients in the intervention group will experience longer cardiac event-free survival, lower levels of depressive symptom, better health-related quality of life, and lower salivary cortisol levels at follow-up than patients who receive usual care.

Inclusion Criteria:

• Admitted to the hospital with a primary or secondary diagnosis of congestive heart failure OR admitted to the hospital for cardiac reasons and has a history of chronic heart failure
• American College of Cardiology/ American Heart Association Stage C HF
• 21 years or older

Exclusion Criteria:

• Co-existing terminal illness likely to be fatal within the next 12 months
• End-stage HF (defined as American College of Cardiology Stage D HF)
• Cognitive impairment that precludes the ability to give informed consent
• Active suicidality (defined choosing option 1, 2 or 3 on Item 9 of the PHQ-9)
• History of the death of a spouse or child within the past month
• History of psychotic illness or bipolar illness
• Current alcohol dependence or other substance abuse
• Non-English speaking or possessing any other communication barrier