PEARLS Program

PEARLS Program for Older Adults

PEARLS Program for older adult depression





Welcome to PEARLS! This website can help you consider if PEARLS is a good fit for your organization—with information about training and implementation, research evidence and participant stories, frequently asked questions, and how to learn more about the PEARLS program.

The Program to Encourage Active, Rewarding Lives (PEARLS) is a national evidence-based program for late-life depression. PEARLS brings high quality mental health care into community-based settings that reach vulnerable older adults.

During six to eight sessions that take place in the client’s home and focus on brief behavioral techniques, PEARLS counselors empower individuals to take action and make lasting changes so they can lead more active and rewarding lives.

The PEARLS Program:

  • PEARLS participant quoteFocuses on teaching each client the skills necessary to move to action and make lasting life changes
  • Is delivered in the client’s home or other accessible community setting
  • Is designed to be delivered in the community through social service or other trusted community-based organizations
  • Takes a team-based approach, involving the PEARLS counselor, clinical supervisor, and health provider
  • Aims to improve quality of life, as well as reduce depressive symptoms
  • Is well-suited for individuals with chronic illness, including people with epilepsy


The Program to Encourage Active, Rewarding Lives (PEARLS) began in the late 1990s when the director of Aging and Disability Services, the area agency on aging for Seattle and King County, approached the University of Washington Health Promotion Research Center (HPRC). She was looking for a way to serve older adults with depression, including those served by the agency’s home- and community-based services (HCBS) program. Depression in this population is high; when we analyzed data from 16,032 elders receiving HCBS in Washington state in 2005, two-thirds met criteria for clinical depression.

This academic-community partnership between the university and local aging service providers resulted in PEARLS, a brief, home-based program to teach people tools to effectively tackle the overwhelming issues in their lives, and to, in turn, improve their depressive symptoms. PEARLS was developed by a team led by Dr. Ed Wagner, primary developer of the Chronic Care Model, which summarizes core elements for improving care in health systems at the community, organization, practice, and patient levels.

Today, PEARLS continues to be disseminated by HPRC in close partnership with local, state, and national organizations working to improve the health and well-being of older adults.

Read about a new study on PEARLS and social isolation, funded by the AARP and conducted by HPRC.

About the Developers

The PEARLS Program was developed by researchers at the University of Washington (UW), and various UW organizations remain actively involved with PEARLS.

UW Health Promotion Research Center
One of the original Prevention Research Centers of the Centers for Disease Control and Prevention.

Other UW Partners
HPRC has worked with several other UW organizations to develop and now disseminate PEARLS. We worked closely with investigators and staff from the Department of Psychiatry and Behavioral Sciences in the UW School of Medicine to design and evaluate the PEARLS model and to create practical, skills-based trainings. CoMotion at the University of Washington managed PEARLS offsite trainings and developed the PEARLS online training, and the Northwest Center for Public Health Practice now manages the online and master training modules. We also partner with the AIMS Center for Advancing Integrated Mental Health Solutions to provide PEARLS coaching through the Care Partners initiative for late-life depression.

Centers for Disease Control and Prevention (CDC)
The Centers for Disease Control provided the funding for the PEARLS research projects. Additionally, the CDC continues to support efforts to disseminate the PEARLS Program.


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