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�Is PEARLS the Right Fit?

Facilitators

Sherri Pratt (she/her), The Women’s Center of Tarrant County
Mark Snowden (he/him), PEARLS Team at the UW Health Promotion Research Center
Lesley Steinman (she/her), PEARLS Team at the UW Health Promotion Research Center

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Zoom Housekeeping

Please turn on your web camera so we can all see each other.

Feel free to turn off your camera if it affects your audio or video quality.

Use chat box, raise hand, or unmute for questions.

Feel free to ask questions throughout today’s event.

Let James know if you need tech support.

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What to Expect Today

Welcome & Introductions
PEARLS Overview
Explore if PEARLS Is the Right Fit
Breakout Rooms & Group Discussion
What’s Next

Let’s learn together.

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What Is PEARLS?

Supports older adults who have depression and are isolated.

No diagnosis needed.

Focuses on skill building and problem-solving.
Meets various community needs as a collaborative effort.

Requested by and developed with community organizations who use it.

Simple and easy to administer.

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Program to Encourage Active, Rewarding Lives

Lesley

We want to make sure everyone has a general understanding of what PEARLS is and does before we discuss how to know whether PEARLS is a good fit for your organization.

Messages to highlight:

No diagnosis needed.
PEARLS is an effective, home-based, skill-building program that helps older adults manage and reduce their feelings of depression and isolation. Some older adults might also describe those feelings as persistent sadness, loneliness, frustration, being overwhelmed, or losing interest in things they love.
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.
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.

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PEARLS Model

Screening with standardized questionnaires (PHQ-2 or PHQ-9).
Creating a line of referrals from inside and/or outside your organization.

Screening & Referrals

Measuring using standardized questionnaire (PHQ-9) for each session.

Measuring Outcomes

We offer training on how to provide PEARLS.

Problem-Solving Treatment and Behavioral Activation

Trained Care Manager

Coordination between older adults, PEARLS coaches, program supervisor, and primary care providers.

Team-Based Care

Offering services in a home or community-based setting, as well as through phone or video conferencing.

Accessible Settings

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Start-Up Expectations With PEARLS

Outreach & Referrals

Time is needed for these key pieces.

Caseloads

Smaller than clinic/center-based models.

Quality, Not Quantity

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Preparing Your PEARLS Team

Identify Staff for Training

Multiple or a single staff member could take training.
Staff members would ideally have the following:

Trust and rapport
Experience with evidence-based programming
Dedicated time for PEARLS

Set Up Clinical Supervision

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Funding for Program Staff

Multiple Funding Streams
Internal & External Funding
Funding Needs Vary

Depends on staffing and caseload.
PEARLS as tool in toolbox vs stand-alone program.

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Balancing Fidelity, Needs, & Adaptions

Maintain Program Fidelity (PEARLS Model)

Keep what makes PEARLS effective.

Adapt PEARLS to Meet Community & Organization Needs

Trusted, existing staff
Appropriate interventions
Accessible format (whether remote or in-person)

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Reach Underserved Communities

Reach Seniors in Underserved Zip Codes

Hospital grant using community benefit money.
AAA and local organizations partner to address social and health needs.

Adapt PEARLS to Meet Community Needs

Ongoing learning with community members and partners.

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PEARLS Is Adaptable

Outreach & Referrals

Schedule time at the front end.
Plan for how to handle referrals (pre-PEARLS phone call).

Balance PEARLS Model & Client Needs

Build rapport while setting boundaries (> 1 hour first sessions).
Provide the questionnaire (PHQ-9) at each visit.
Complete key PEARLS pieces while ensuring a client feels heard.

Sherri

Outreach is hard – their grant requires them to focus on high need/high risk areas that are historically disadvantaged, areas with a lot of distrust, where often people bring stuff too us but don’t ask if that’s the stuff we need. Talked to pastors and churches – only got a few more referrals. Would have thought PEARLS be perfect antidote to pandemic, but didn’t. Didn’t do enough marketing legwork to community pre-pandemic. Need to do this at front end.

When they get a referral, they have to spend a lot of time calling to butter them up. Do several calls, etc. Referral does not mean boom you are in the door. Takes time.

Give clients time to talk – 1 hour. May need more time in first sessions. Building rapport while setting boundaries.

They always do PHQ-9 each visit even if can’t finish worksheet.

With two recent clients they felt PEARLS was too regimented – they had a newer counselor who went by the formula boom boom and they wanted more conversation. Transitioned to more experienced counselor who could do PEARLS (PHQ-9, Worksheet) in more conversational style – balance the program pieces while making someone feel heard.

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Adapt PEARLS for a Better Fit

Engage older adults during and after PEARLS.

Provide gifts and activities.
Create support groups with activities.

Staffing PEARLS

Balance PEARLS structure and rapport building.
Keep case management and PEARLS separate.
Tailor clinical supervision to their caseload and expertise.

Sherri

Bear gifts and they love it – gas cards, donations, adult coloring books, keep engagement and pleasant activity

Added PEARLS Connect – post PEARLS support group with activities + support for PST

Not just Counselor’s experience that allows this but she has always been this way, points to ideal counselor fit being able to follow structure while balancing rapport building.

100% agree CM and counselor is separate (CM does PEARLS Connect as well, outreach, f/u calls, so allows them to do this)

Sherri is clinical supr – 2x/month with Tarrant and Parker AAA. Share costs across programs with group. Recently reduced Donnie’s to 1x/month bc costs and caseload. She does not have medical provider review Rx – she worked in clinical settings and at psych hospital for years so has this experience, and either she calls their PCP with permission or client calls. Doesn’t make reccs but shared here’s what we are seeing since not a medical providers

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A System of Care & PEARLS

PEARLS Provides Opportunities

Another place for older adults to go.
Connection to long-term counseling and social services.
PEARLS successes lead to credibility and funding.
Value to providers

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Breakout Room

What else do you need to decide whether PEARLS is/is not a good fit?

How can we support you?

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Poll #1

What underserved older populations do you reach? (check all that apply)

Black
American Indian / Alaska Native
Latinx
Asian
Hawaiian / Pacific Islander
Rural
Speak language other than English
Low-income

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Poll #2

Established trust and rapport with clients to engage in depression care
Current staff who can be trained as PEARLS coaches
Connection to clinical supports for supervision
Motivated/flexible leadership to champion PEARLS
Possible funding mechanisms
Experience with evidence-based programs

What pieces do you have in place to adopt PEARLS (check all that apply)

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Expanding Access to Depression Care

15-minute survey about your organization to help us better understand:

Organizations providing services for mental health care and/or older adults
Who is being served by these organizations
Resources and funding available to these organizations

Entered into a drawing for $500 toward a conference or training.

A collaborative, proactive project.

Mark

In addition to the every day PEARLS partnerships and work, we started a project to ensure all older adults can get the support they need, regardless of their race, ethnicity, language, income, or location. Previously, we have collaborated with organizations as they come to us to better understand who they are, why they are interested, and what they need to support their efforts. With this new project we are taking a more proactive approach to connect with organizations like yours. We realized that waiting for people to come to us was actually another barrier. A more proactive approach is more equitable.

To make this more project possible, we are asking you or one of your coworkers to help by completing a brief 15-minute survey about your organization. The 15-minute survey will let us know if you are providing services for mental health care and/or older adults, who you serve, and your funding resources. This is a key first step in the project.

Organizations that complete a 15-minute survey will be entered into a drawing for $500 toward a conference or training of their choice.

We will send you all a link to this survey in our email after this webinar with additional links to the recording and presentation from this event.

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Thank you!

Getting Higher-Ups Buy In to Adopt PEARLS

Thursday, March 24

Noon – 1:00 p.m.

Invitations to come.

Hope to see you at our next event.

Lesley

We’ll go over key information to share with higher-ups about PEARLS, such as staffing models, delivery options, client outcomes, success stories, and program evidence and recognition. Another PEARLS partner will also provide examples of how organizations like yours have received buy in from their higher-ups. We will email reminders with more info.

Before we wrap up the recorded webinar, I want to thank Sherri and everyone who attended today. It was great hear from you all.

We will stay on for an additional half hour – until 1:30 – so please stay on if you have additional questions to bring to the group.

For those of you who have to go, we would like to say thank you.

STOP RECORDING

Lesley

Thank you on behalf of the UW Health Promotion Research Center where we collaborate with community partners like yourself to improve the health and well-being of middle-age and older adults. It was an honor to learn together today.

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Great to see you today!