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Program to Encourage Active, Rewarding Lives for Seniors (PEARLS) 

From: Best practice guidelines for mental health promotion programs: Older adults 55+ (© 2010, 2011 CAMH)

Goals and objectives

  • to empower participants and help them develop the skills to define and solve their problems
  • to enable participants to become more socially and physically active, and experience more pleasant activities
  • to decrease participants’ symptoms of depression and improve their health-related quality-of-life and emotional well-being.


PEARLS for Older Adults is primarily a community-based, participant-driven intervention that uses problem solving, social and physical activation, and increased pleasant events to reduce minor depression (Guideline 2) in physically impaired and socially isolated adults aged sixty and older (Guideline 1).

The PEARLS intervention is delivered by professionals over the course of six to eight sessions in a six-month period. The intervention consists of problem solving treatment, behavioral activation, and pleasant activities scheduling (Guideline 7).

Initially developed to be part of a research study, the efficacy of PEARLS was validated. Those who participated in the PEARLS Program were three times as likely to experience a reduction in their depressive symptoms as those who were not treated with the PEARLS Program. The program also had a positive influence on the participants’ health-related quality of life and emotional well-being, as well as a demonstrated trend of decreased hospitalizations. Subsequently, PEARLS was established as a program that can be broadly implemented in the real world (Guideline 11).

The success of PEARLS is founded on a collaborative effort among several key roles within an organization carried out by professionals and para-professionals from varied fields: social work, mental health, or a related field.  The strength of the intervention also reflects its links to existing community infrastructures.

The three basic components of the PEARLS Program include:

Problem-Solving Treatment–a seven-step, participant-driven approach in which the individual is supported by a counsellor to identify and solve problems that the participant wants to address (Guideline 5

Social and Physical Activation–counsellors work with participants to increase their engagement in social, physical and recreational activities, in both their homes and in their community (Guideline 3

Pleasant Activity Scheduling–participants are encouraged to select an activity they would enjoy doing on their own or in the company of others (a pleasant activity they can do as “homework”); over 200 diverse activities are offered in the PEARLS Toolkit as possible options for participants to consider (Guideline 5).

Several agencies provide the PEARLS Program, and a PEARLS Implementation Toolkit is available online at

Additional information

Start date  2000 
Guideline 1: Audience, specific populations 
  • physically impaired and socially isolated adults aged sixty and older
Guideline 2: Protective and risk factors, and determinants of health 

Protective factors

  • mental health
  • physical activity

Risk factors

  • homebound
  • depression
  • chronic physical illness

Determinants of health

  • personal health practices and coping skills
  • social support networks 
Guideline 3: Intervene in multiple settings private home
  • private home
  • community settings 
Guideline 5: Provide a focus on empowerment and resilience
  • problem-solving skills
  • physical activity
  • enhance active participation
  • build social networks
Guideline 7: Adopt multiple interventions
  • home visits
  • community engagement
  • community social events
Guideline 11: Evaluation  yes 
Learn more 

Ciechanowski, P., Wagner, E., Schmaling, K., Schwartz, S., Williams, B., Diehr, P., Kulzer, J., Gray, S., Collier, C. & Logerfo, J. (2004). Community-Integrated Home-Based Depression Treatment in Older Adults. A Randomized Controlled Trial. Journal of the American Medical Association, 291(13), 1569-77.

PEARLS Program website

Contact:  PEARLS Program email:


In Best practice guidelines for mental health promotion programs: Older Adults 55+

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