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M urray and Lopez (1997) predict that by the year 2020 the top two contributors to the burden of disease worldwide will be ischemic heart diseases and depression. More than five million Americans suffer from Congestive Heart Failure (CHF;Miller & Missov, 2001). This disease accounts for greater than 20 billion dollars in annual medical costs (American Heart Association, 2001), perhaps because it requires so much inpatient care. Like many chronic diseases, CHF is debilitating over time and manifests both physically and emotionally. Patients experience increasing shortness of breath, difficulty lying down when sleeping because of fluid retention, and increasing fatigue. It is a deadly illness, as well. Poorly controlled symptoms often lead to depression for patients secondary to concerns about their quality of life, overall functioning, and mortality.Their families and friends often share these concerns.Many studies have shown that elderly patients hospitalized for CHF are likely to have comorbid diagnoses of major depression. In one outpatient study (Gottlieb, Khatta, Friedmann, Einbinder, Katzen, & Baker, 2004) 7% of patients with stable CHF were prescribed antidepressant medications and 48% scored in the depressed range on the Beck Depression Inventory (BDI). Moreover, the depressed patients reported significantly poorer quality of life than nondepressed patients. Lane, Chong, & Lip (2006) raised the concern that patients who are depressed are less likely to take their medications and modify their lifestyle appropriately, which increases the likelihood of recurrent cardiac events and death. HENRY'S STORYHenry lived in the same town his entire life, and loved his home and community. In fact, the cover of the town's commemorative book featured a picture of Henry and his two brothers as young boys sleeping on the banks of a canal on a hot summer day, with their fishing poles by their sides. The picture captures the simplicity and joy of their early life. Henry always took particular pride in the photograph, prominently