![]() ![]() For example, virtual agents have been proposed to provide social skills training based on the analysis of non-verbal behavior in autism spectrum disorders ( Tanaka et al., 2017). According to a 2019 survey on the use of virtual agents in health contexts ( Montenegro et al., 2019), some studies refer to medical datasets to study non-verbal behavior. Therefore, dialogues with virtual agents can facilitate healthcare dialogues using non-verbal communication like facial expressions and voices, similar to human dialogues. If a virtual agent, like a psychiatrist, can recognize both verbal and non-verbal behaviors, it might approach the level of cognitive restructurings that humans do with each other. References to patients' facial expressions are also made in the CBT literature in clinical practices ( Beck and Beck, 2011). In actual psychotherapy, the therapist understands the patient's condition not only through words but also through such non-verbal communication as facial expressions, speaking rhythms, and gestures ( Koole and Tschacher, 2016). Virtual agents have many advantages because they can provide face-to-face multimodal interactions like CBT with human therapists. Several types of agent dialogues have also been proposed, such as text-based dialogues in the style of messaging apps ( Fitzpatrick et al., 2017 Ly et al., 2017 Fulmer et al., 2018 Inkster et al., 2018 Suganuma et al., 2018) and virtual agents represented by animated computer characters ( Ring et al., 2016 Kimani et al., 2019). Some proposed virtual agents employ CBT methodology with mixed degrees of effectiveness ( Laranjo et al., 2018 Montenegro et al., 2019). This research supports the possibility of improving the effectiveness of mental health care in cognitive restructuring using virtual agents.Ĭognitive restructuring, an established therapeutic technique that reduces the effects of negative thoughts, is a cognitive behavior therapy (CBT) method ( Beck and Beck, 2011). Based on the results of this analysis, we provide a technical guidance framework that fully automates the identification and evaluation of automatic thoughts to achieve a virtual agent that can interact with users by taking into account their verbal and non-verbal behaviors in face-to-face situations. Therapists also use such non-verbal behaviors as facial expressions to detect changes in a user's mood, which is an important indicator for guidance. We focus on these points because cognitive restructuring by a human therapist starts by identifying automatic thoughts and seeking sufficient evidence to find balanced thoughts (evaluation of automatic thoughts). We collected interaction data between virtual agents and users to observe the mood improvements associated with changes in automatic thoughts that occur in user cognition and addressed the following two points: (1) implementation of a virtual agent that helps a user identify and evaluate automatic thoughts (2) identification of the relationship between a user's facial expressions and the extent of the mood improvement subjectively felt by users during the human-agent interaction. Unfortunately, since the quantitative analysis of human-agent interaction is still insufficient, the effect on the user's cognitive state remains unclear. Since virtual agents can be used anytime and anywhere, they are expected to perform cognitive restructuring without being influenced by medical infrastructure or patients' stigma toward mental illness. 1Nara Institute of Science and Technology, Nara, JapanĬognitive restructuring is a well-established mental health technique for amending automatic thoughts, which are distorted and biased beliefs about a situation, into objective and balanced thoughts.Kazuhiro Shidara 1 * Hiroki Tanaka 1 Hiroyoshi Adachi 2 Daisuke Kanayama 2 Yukako Sakagami 2 Takashi Kudo 2 Satoshi Nakamura 1 ![]()
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