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Adapting the Number of Questions Based on Detected Psychological Distress for Cognitive Behavioral Therapy With an
Kazuhiro Shidara1, Hiroki Tanaka1, Hiroyoshi Adachi2
1Nara Institute of Science and Technology, Ikoma, Japan.
JMIR Formative Research
|March 14, 2024
Summary
This study developed an adaptive embodied conversational agent (ECA) for cognitive behavioral therapy (CBT). The adaptive ECA, which adjusts Socratic questions based on user distress, significantly reduced psychological distress and improved cognitive changes compared to a non-adaptive ECA.
Area of Science:
- Digital Health and Mental Healthcare Technologies
- Human-Computer Interaction in Therapeutic Settings
- Artificial Intelligence in Psychology
Background:
- High prevalence of mental illness and limited access to mental health services necessitate innovative solutions.
- Embodied conversational agents (ECAs) offer scalable delivery of cognitive behavioral therapy (CBT) without location or time constraints.
- Current ECAs lack the ability to adapt therapeutic techniques, such as Socratic questioning, to user's emotional state.
Purpose of the Study:
- To develop and evaluate a method for ECAs to automatically adapt the number of Socratic questions based on detected psychological distress.
- To test the hypothesis that adaptive questioning reduces psychological distress and enhances cognitive changes compared to random questioning.
- To improve the efficacy of CBT delivered via ECAs by personalizing the therapeutic interaction.
Main Methods:
- Recruited participants aged 18-65 for a study comparing two conditions: an ECA adapting questions based on distress detection versus an ECA with random questioning.
- Participants underwent a single CBT session with an assigned ECA.
- Psychological distress and cognitive changes were assessed using pre- and post-session questionnaires.
Main Results:
- The adaptive ECA condition demonstrated significantly lower psychological distress post-session compared to the random questioning condition.
- A significant difference in cognitive change was observed when the number of questions was adapted to the detected distress level.
- Fewer questions than appropriate for detected distress levels resulted in less cognitive change.
Conclusions:
- Adapting the number of Socratic questions based on detected distress levels enhances the effectiveness of CBT delivered by ECAs.
- Adaptive questioning leads to greater distress reduction and more substantial cognitive changes than random questioning.
- This approach supports the development of more tailored and effective mental healthcare solutions through ECAs.
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