Program to Encourage Active, Rewarding Lives (PEARLS)

PEARLS particpant story - DonnaThe Program to Encourage Active, Rewarding Lives (PEARLS) helps older adults with depression create happier, healthier lives. The program educates older community members about what depression is (and is not) and helps them develop the skills they need for self-sufficiency and more active lives. PEARLS offers a home-based option that is more accessible and comfortable for older adults who do not see other mental health programs as a good fit for them, while also allowing for coordination with their current health care providers.

“All these skills helped me realize I can have a life I enjoy. Before PEARLS, I did not see beyond a day.”
– PEARLS participant

PEARLS is simple and easy to administer by staff at community-based organizations who might not have previous counseling experience or a higher education. There is PEARLS training that prepares staff to provide the program to your community members.

PEARLS is adaptable to various community needs and helps expand access to depression care in underserved communities, including rural ones. The program is responsive to numerous cultural, racial, and ethnic communities, regardless of where they live.

What Makes PEARLS Different

PEARLS was designed in collaboration with the organizations that deliver it, validated in partnership with the communities where it will be used, and adaptable to the people who need it.

It is part of a cultural shift in how depression is managed by and for aging community members. Most programs address depression in older adults using only the clinical mental health toolkit (counseling and/or medication). PEARLS is one of only a handful of programs that focuses on helping older adults develop the skills they need to maintain their health, happiness, and independence.

PEARLS Overview

A bit about what PEARLS is and what is has to offer. 

  • Empower older adults by teaching them skills necessary to take action and make lasting life changes so they can lead more active and rewarding lives. 
  • Offer a client-driven, team-based approach. 
  • Allow collaboration with older adults in their homes or other accessible community settings over six to eight PEARLS sessions. 
  • Improve quality of life, as well as reduce depressive symptoms. 
  • Support a variety of older adults, including those who have chronic illness such as epilepsy. 

Program History

How It Started

The UW Health Promotion Research Center bridges the public and private sectors, uniting nonprofits, businesses, government organizations, and community networks toward a common goal.

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 (UW HPRC) for a way to serve older adults with depression, including those served by the agency’s home- and community-based services (HCBS) program and/or those who might not have a clinical diagnosis of depress. Depression is high among older adult who are homebound; when we analyzed data from 16,032 elders receiving HCBS in Washington state in 2005, two-thirds met criteria for clinical depression. Older adults do not need a depression diagnosis to participate in PEARLS. In fact, we know depression can appear as sadness, frustration, loneliness, or loss of interest in activities someone once loved.

The academic-community partnership between the university and local aging service providers resulted in PEARLS as a way to support older adults and increase access to mental health services.


The UW Health Promotion Research Center provides long-standing and deeply rooted support for PEARLS, including its establishment as an evidence-based program. Our center has supported PEARLS from its early development. We are committed to its success.

PEARLS continues to be shared in close partnership with community-based organizations, as well as local, state, and national agencies working to improve the health and well-being of older adults.