How should a virtual agent present psychoeducation? Influence of verbal and textual presentation on adherence
Open accessAbstract
BACKGROUND AND OBJECTIVE: With the rise of autonomous e-mental health applications, virtual agents can play a major role in improving trustworthiness, therapy outcome and adherence. In these applications, it is important that patients adhere in the sense that they perform the tasks, but also that they adhere to the specific recommendations on how to do them well. One important construct in improving adherence is psychoeducation, information on the why and how of therapeutic interventions. In an e-mental health context, this can be delivered in two different ways: verbally by a (virtual) embodied conversational agent or just via text on the screen. The aim of this research is to study which presentation mode is preferable for improving adherence. METHODS: This study takes the approach of evaluating a specific part of a therapy, namely psychoeducation. This was done in a non-clinical sample, to first test the general constructs of the human-computer interaction. We performed an experimental study on the effect of presentation mode of psychoeducation on adherence. In this study, we took into account the moderating effects of attitude towards the virtual agent and recollection of the information. Within the paradigm of expressive writing, we asked participants (n= 46) to pick one of their worst memories to describe in a digital diary after receiving verbal or textual psychoeducation. RESULTS AND CONCLUSION: We found that both the attitude towards the virtual agent and how well the psychoeducation was recollected were positively related to adherence in the form of task execution. Moreover, after controlling for the attitude to the agent and recollection, presentation of psychoeducation via text resulted in higher adherence than verbal presentation by the virtual agent did.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Some potentially relevant conversational agents developed for the treatment of mental health problems were excluded from this review because of not reporting a mental health outcome measure.
“Furthermore, some potentially relevant conversational agents developed for the treatment of mental health problems were excluded from this review because of not reporting a mental health outcome measure (eg, ELIZA [2,42-44]).”
From Conversational agents in the treatment of mental health problems: mixed-method systematic review (2019) · cites this paper as [44]
Preliminary research on modality for psychoeducation delivery found that text-based presentation resulted in higher program adherence than verbal presentation.
“preliminary research on modality for psychoeducation delivery specifically found that text-based presentation resulted in higher program adherence than verbal presentation”
From A Therapeutic Relational Agent for Reducing Problematic Substance Use (Woebot): Development and Usability Study (2021) · cites this paper as [26]
Adherence to psychoeducation, operationalized as successful task execution, may be improved by attitude toward a virtual agent, such as their level of trust of the agent, its realism, and its amiableness.
“Adherence to psychoeducation, operationalized as successful task execution, may be improved by attitude toward a virtual agent, such as their level of trust of the agent, its realism, and its amiableness [64].”
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
Adherence to Long-Term Therapies: Evidence for Action
Geest, S. D., & Sabate, E. J. (2003) · European Journal of Cardiovascular Nursing · doi:10.1016/s1474-5151(03)00091-4 · Cited by 6,274 · see citing works
Wang, P. S., Lane, M., Olfson, M., Pincus, H. A., Wells, K. B., & Kessler, R. C. (2005) · Archives of General Psychiatry · doi:10.1001/archpsyc.62.6.629 · Cited by 2,695 · see citing works
Confronting a traumatic event: Toward an understanding of inhibition and disease.
Pennebaker, J. W., & Beall, S. K. (1986) · Journal of Abnormal Psychology · doi:10.1037/0021-843x.95.3.274 · Cited by 1,898 · cited 2× · see citing works
“Expressive writing is a therapeutic tool [50] where healthy participants have to write about the most negative events in their life, which evoked the most stress.”
BackgroundEstablishing and maintaining long-term human-computer relationships
Bickmore, T. W., & Picard, R. W. (2005) · ACM Transactions on Computer-Human Interaction · doi:10.1145/1067860.1067867 · Cited by 1,333 · see citing works
The heuristic model of persuasion.
Chaiken, S. (1987) · Cited by 1,264 · see citing works
Linking primary care performance to outcomes of care.
Safran, D. G., Taira, D. A., Rogers, W. H., Kosinski, M. R., Ware, J. E., & Tarlov, A. R. (1998) · PubMed · Cited by 877 · see citing works
A Systematic Review of the Impact of Adherence on the Effectiveness of e-Therapies
Donkin, L., Christensen, H., Naismith, S. L., Neal, B., Hickie, I. B., & Glozier, N. (2011) · Journal of Medical Internet Research · doi:10.2196/jmir.1772 · Cited by 876 · see citing works
Qiu, L., & Benbasat, I. (2009) · Journal of Management Information Systems · doi:10.2753/mis0742-1222250405 · Cited by 737 · cited 1× · see citing works
“It is also important to consider that the speech of a virtual agent might not be as easy to understand as that of a human because many agents use a text-to-speech system [26].”
BackgroundWhat makes Web sites credible?: a report on a large quantitative study
Fogg, B. J., Marshall, J., Laraki, O., Osipovich, A., Varma, C., Fang, N., Paul, J., Rangnekar, A., Shon, J., Swani, P., et al. (2001) · Proceedings of the SIGCHI Conference on Human Factors in Computing Systems · doi:10.1145/365024.365037 · Cited by 685 · see citing works
Emotional and physical health benefits of expressive writing
Baikie, K. A., & Wilhelm, K. (2005) · Advances in Psychiatric Treatment · doi:10.1192/apt.11.5.338 · Cited by 517 · see citing works
Communication modality as a determinant of message persuasiveness and message comprehensibility.
Chaiken, S., & Eagly, A. H. (1976) · Journal of Personality and Social Psychology · doi:10.1037/0022-3514.34.4.605 · Cited by 465 · cited 1× · see citing works
“to have a greater persuasive effect than audio or video for complicated persuasive messages [67].”
BackgroundFiscella, K. A., Meldrum, S. C., Franks, P. J., Shields, C. G., Duberstein, P. R., McDaniel, S. H., & Epstein, R. M. (2004) · Medical Care · doi:10.1097/00005650-200411000-00003 · Cited by 448 · see citing works
Embodied conversational agents in clinical psychology: a scoping review
Provoost, S., Lau, H. M., Ruwaard, J., & Riper, H. (2017) · Journal of Medical Internet Research · doi:10.2196/jmir.6553 · Cited by 433 · cited 1× · see citing works
“Interventions with such virtual agents have been developed for a range of mentalhealth problems [76] such as insomnia [77], depression [78], social phobia [79] and PTSD [80].”
BackgroundSetting, elaborating, and reflecting on personal goals improves academic performance.
Morisano, D., Hirsh, J. B., Peterson, J. B., Pihl, R. O., & Shore, B. M. (2010) · Journal of Applied Psychology · doi:10.1037/a0018478 · Cited by 403 · see citing works
Therapist effects: facilitative interpersonal skills as a predictor of therapist success.
Anderson, T., Ogles, Patterson, C. L., Lambert, M. J., & Vermeersch, D. A. (2009) · Journal of Clinical Psychology · doi:10.1002/jclp.20583 · Cited by 400 · cited 1× · see citing works
“Studies show that factors such as the type of language used [36], interpersonal encounter skills [37], and introduction style [38] all influence alliance.”
BackgroundA meta-analysis of self-help treatment approaches
Gould, R. A., & Clum, G. A. (1993) · Clinical Psychology Review · doi:10.1016/0272-7358(93)90039-o · Cited by 337 · cited 1× · see citing works
“The question arises though, if any of these measures fully describe adherence, as there is a difference in passively viewing information and actively applying its contents [14].”
BackgroundEconomic evaluations of Internet interventions for mental health: a systematic review
Donker, T., Blankers, M., Hedman, E., Ljótsson, B., Petrie, K., & Christensen, H. (2015) · Psychological Medicine · doi:10.1017/s0033291715001427 · Cited by 316 · cited 1× · see citing works
“Aside from being available remotely and being privacy sensitive [4], they are also cost-effective in use [5], and efforts are also being made to reduce cost in the development of these interventions [6].”
BackgroundEvaluating eHealth Interventions: The Need for Continuous Systemic Evaluation
Catwell, L., & Sheikh, A. (2009) · PLoS Medicine · doi:10.1371/journal.pmed.1000126 · Cited by 307 · see citing works
Virtual Humans and Persuasion: The Effects of Agency and Behavioral Realism
Guadagno, R. E., Blascovich, J., Bailenson, J. N., & Mccall, C. (2007) · Cited by 307 · see citing works
Dropout From Outpatient Mental Health Care in the United States
Olfson, M., Mojtabai, R., Sampson, N. A., Hwang, I., Druss, B., Wang, P. S., Wells, K. B., Pincus, H. A., & Kessler, R. C. (2009) · Psychiatric Services · doi:10.1176/ps.2009.60.7.898 · Cited by 303 · cited 1× · see citing works
“With rising costs in health-care [1], long travel distances to clinics and access to care in rural areas [2], and stigma on seeking help from a therapist [3] all preventing people from seeking care, these applications can fill an important gap.”
BackgroundPromoting motivation with virtual agents and avatars: role of visual presence and appearance
Baylor, A. L. (2009) · Philosophical Transactions of the Royal Society B Biological Sciences · doi:10.1098/rstb.2009.0148 · Cited by 275 · see citing works
Recommendations for the ethical use and design of artificial intelligent care providers
Luxton, D. D. (2014) · Artificial Intelligence in Medicine · doi:10.1016/j.artmed.2014.06.004 · Cited by 243 · see citing works
Looije, R., Neerincx, M. A., & Cnossen, F. (2010) · International Journal of Human-Computer Studies · doi:10.1016/j.ijhcs.2009.08.007 · Cited by 243 · see citing works
Self-citationYee, N., Bailenson, J. N., & Rickertsen, K. (2007) · CHI Conference on Human Factors in Computing Systems · doi:10.1145/1240624.1240626 · Cited by 243 · cited 1× · see citing works
“Virtual agents can play a central role in AEMH applications, contributing to the effectiveness and acceptability of the system and intervention [7–10].”
BackgroundQiu, L., & Benbasat, I. (2005) · International Journal of Human-Computer Interaction · doi:10.1207/s15327590ijhc1901_6 · Cited by 232 · see citing works
Baker, T. B., Gustafson, D. H., & Shah, D. (2014) · Journal of Medical Internet Research · doi:10.2196/jmir.2925 · Cited by 221 · cited 1× · see citing works
“One recommendation for these evaluations in the development stage is the use of proximal outcome measures such as self-efficacy and adherence [45].”
BackgroundCan computer-generated speech have gender?
Lee, E. J., Nass, C., & Brave, S. (2000) · CHI Conference Extended Abstracts on Human Factors in Computing Systems (CHI EA) · doi:10.1145/633292.633461 · Cited by 178 · cited 1× · see citing works
“Gender was matched with the participant to avoid possible effects of interacting with someone with a mismatched gender [58–61].”
BackgroundTaylor-Rodgers, E., & Batterham, P. J. (2014) · Journal of Affective Disorders · doi:10.1016/j.jad.2014.06.047 · Cited by 165 · cited 1× · see citing works
“Psy-choeducation can be an intervention of its own, informing patients on their disorder and how to deal with it [15–17].”
BackgroundHemenover, S. H. (2003) · Personality and Social Psychology Bulletin · doi:10.1177/0146167203255228 · Cited by 150 · see citing works
Effects of (very) brief writing on health: The two‐minute miracle
Burton, C. M., & King, L. A. (2008) · British Journal of Health Psychology · doi:10.1348/135910707x250910 · Cited by 142 · see citing works
Does expressive writing reduce health care utilization? A meta-analysis of randomized trials.
Harris, A. H. S. (2006) · Journal of Consulting and Clinical Psychology · doi:10.1037/0022-006x.74.2.243 · Cited by 127 · see citing works
Theory at a glance: a guide for health promotion practice (Second edition).
Bk, R., & Glanz, K. (2005) · Cited by 127 · see citing works
The Therapeutic Alliance: An Evidence-Based Guide to Practice
Muran, J. C., & Barber, J. P. (2010) · Cited by 123 · see citing works
Czobor, P., Van Dorn, R. A., Citrome, L., Kahn, R. S., Fleischhacker, W. W., & Volavka, J. (2015) · European Neuropsychopharmacology · doi:10.1016/j.euroneuro.2015.04.003 · Cited by 112 · cited 2× · see citing works
“therapist alliance is related to adherence [32,33].”
BackgroundRelational Agents in Clinical Psychiatry
Bickmore, T., & Gruber, A. (2010) · Harvard Review of Psychiatry · doi:10.3109/10673221003707538 · Cited by 112 · cited 1× · see citing works
“Therapeutic alliance has been shown to be relevant for virtual agents [34,35] as well as human therapists.”
BackgroundAn online lifestyle diary with a persuasive computer assistant providing feedback on self-management
Blanson Henkemans, O. A., van der Boog, P. J. M., Lindenberg, J., van der Mast, C. A. P. G., Neerincx, M. A., & Zwetsloot-Schonk, B. J. H. M. (2009) · Technology and Health Care · doi:10.3233/thc-2009-0545 · Cited by 96 · see citing works
Self-citationHo, R., Mak, K., Chua, A. N., Ho, C. S. H., & Mak, A. (2013) · Expert Review of Pharmacoeconomics & Outcomes Research · doi:10.1586/14737167.2013.815409 · Cited by 93 · cited 1× · see citing works
“Given the societal burden of mental health problems that lead to both direct and indirect cost [74], as well as loss of quality of life [75], good and effective mental health applications are very valuable.”
BackgroundA population based analysis of subclinical psychosis and help-seeking behavior
Murphy, J., Shevlin, M., Houston, J., & Adamson, G. (2012) · Schizophrenia Bulletin · doi:10.1093/schbul/sbq092 · Cited by 91 · cited 1× · see citing works
“The validity of this choice is supported by the continuum hypothesis [46], which defines mental states on a continuous scale and has been supported for disorders such as psychosis [47], depression [48] and PTSD [49].”
BackgroundA Roadmap to Computer-Based Psychotherapy in the United States
Cartreine, J. A., Ahern, D. K., & Locke, S. E. (2010) · Harvard Review of Psychiatry · doi:10.3109/10673221003707702 · Cited by 88 · cited 1× · see citing works
“Aside from being available remotely and being privacy sensitive [4], they are also cost-effective in use [5], and efforts are also being made to reduce cost in the development of these interventions [6].”
BackgroundReading and listening to oral‐based versus literate‐based discourse
Rubin, D. L., Hafer, T., & Arata, K. (2000) · Communication Education · doi:10.1080/03634520009379200 · Cited by 80 · cited 1× · see citing works
“showed similar results, also measuring mental effort, which was higher for reading [22].”
ResultDeterminants of adherence to treatment in first-episode psychosis: a comprehensive review
Leclerc, E., Noto, C., Bressan, R. A., & Brietzke, E. (2015) · Revista Brasileira de Psiquiatria · doi:10.1590/1516-4446-2014-1539 · Cited by 78 · cited 2× · see citing works
“therapist alliance is related to adherence [32,33].”
BackgroundEker, F., & Gemicioğlu, Ş. H. (2012) · Journal of Affective Disorders · doi:10.1016/j.jad.2012.01.004 · Cited by 77 · cited 1× · see citing works
“In this case, it often entails information on how the therapy works and why patients will have to perform certain tasks [18,19].”
BackgroundTackling nonadherence in psychiatric disorders: current opinion
Farooq, S., & Naeem, F. (2014) · Neuropsychiatric Disease and Treatment · doi:10.2147/ndt.s40777 · Cited by 75 · cited 1× · see citing works
“In this case, it often entails information on how the therapy works and why patients will have to perform certain tasks [18,19].”
BackgroundLaska, K. M., Smith, T. L., Wislocki, A. P., Minami, T., & Wampold, B. E. (2013) · Journal of Counseling Psychology · doi:10.1037/a0031294 · Cited by 71 · cited 1× · see citing works
“Studies show that factors such as the type of language used [36], interpersonal encounter skills [37], and introduction style [38] all influence alliance.”
BackgroundAn Intelligent Virtual Human System for Providing Healthcare Information and Support
Rizzo, A., Lange, B. S., Buckwalter, J. G., Forbell, E., Kim, J. M., Sagae, K., Josh, W., ROTHBAUM, B. O., JoAnn, D., Reger, G. M., et al. (2011) · Studies in health technology and informatics · doi:10.3233/978-1-60750-706-2-503 · Cited by 68 · cited 6× · see citing works
“Psychoeducation is especially relevant for therapies where patients need to perform difficult tasks such as changing habits or facing fears, as is the case in expressive writing or PTSD treatment.”
BackgroundInfluentialVariations in the spacing of expressive writing sessions
Chung, C. K., & Pennebaker, J. W. (2008) · British Journal of Health Psychology · doi:10.1348/135910707x251171 · Cited by 66 · see citing works
Use of an interactive computer agent to support breastfeeding
Edwards, R. A., Bickmore, T., Jenkins, L., Foley, M., & Manjourides, J. (2013) · Maternal and Child Health Journal · doi:10.1007/s10995-013-1222-0 · Cited by 63 · cited 1× · see citing works
“Virtual agents are being developed for these uses [81,82] and as with mental health care adherence to the agent is an important aspect [34].”
BackgroundInterface agents as social models
Baylor, A. L., Rosenberg‐Kima, R. B., & Plant, E. A. (2006) · CHI Conference Extended Abstracts on Human Factors in Computing Systems (CHI EA) · doi:10.1145/1125451.1125564 · Cited by 62 · see citing works
Walter, N., Ortbach, K., & Niehaves, B. (2014) · International Journal of Human-Computer Studies · doi:10.1016/j.ijhcs.2014.12.001 · Cited by 59 · cited 2× · see citing works
“remembered better than audio [21], for agents a preference of voice over text has been reported [25].”
BackgroundFrattaroli, J., Thomas, M. L., & Lyubomirsky, S. (2011) · Emotion · doi:10.1037/a0022946 · Cited by 58 · see citing works
Application of Low-Cost Methodologies for Mobile Phone App Development
Zhang, M. W., Cheow, E., Ho, C. S. H., Ng, B. Y., Ho, R., & Cheok, C. C. S. (2014) · JMIR mhealth and uhealth · doi:10.2196/mhealth.3549 · Cited by 53 · cited 1× · see citing works
“Aside from being available remotely and being privacy sensitive [4], they are also cost-effective in use [5], and efforts are also being made to reduce cost in the development of these interventions [6].”
BackgroundLee, H., Lee, S., Kim, H.-S., Kwon, S., & Telch, M. J. (2004) · Behaviour Research and Therapy · doi:10.1016/j.brat.2004.06.017 · Cited by 51 · cited 1× · see citing works
“The validity of this choice is supported by the continuum hypothesis [46], which defines mental states on a continuous scale and has been supported for disorders such as psychosis [47], depression [48] and PTSD [49].”
BackgroundCoulthard, K., Patel, D., Brizzolara, C., Morriss, R. K., & Watson, S. (2013) · BMC Psychiatry · doi:10.1186/1471-244x-13-301 · Cited by 46 · cited 1× · see citing works
“Psy-choeducation can be an intervention of its own, informing patients on their disorder and how to deal with it [15–17].”
BackgroundNarcissism and Depression: MMPI-2 Evidence for the Continuum Hypothesis in Clinical Samples
Watson, P. J., Sawrie, S. M., Greene, R. L., & Arredondo, R. (2002) · Journal of Personality Assessment · doi:10.1207/s15327752jpa7901_06 · Cited by 45 · cited 1× · see citing works
“The validity of this choice is supported by the continuum hypothesis [46], which defines mental states on a continuous scale and has been supported for disorders such as psychosis [47], depression [48] and PTSD [49].”
BackgroundAn evaluation of stress symptoms associated with academic sexual harassment
McDermut, J. F., Haaga, D. A. F., & Kirk, L. (2000) · Journal of Traumatic Stress · doi:10.1023/a:1007725022534 · Cited by 43 · cited 6× · see citing works
“Psychoeducation is especially relevant for therapies where patients need to perform difficult tasks such as changing habits or facing fears, as is the case in expressive writing or PTSD treatment.”
BackgroundInfluentialLyons, C., Hopley, P., & HORROCKS, J. (2009) · Journal of Psychiatric and Mental Health Nursing · doi:10.1111/j.1365-2850.2009.01390.x · Cited by 42 · see citing works
Andrade, A. D., Anam, R., Karanam, C., Downey, P. A., & Ruiz, J. G. (2015) · Urology · doi:10.1016/j.urology.2014.11.017 · Cited by 41 · see citing works
Zhang, M. W., & Ho, R. (2016) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2016.00040 · Cited by 39 · see citing works
Improving Adherence in Automated e-Coaching
Beun, R. J., Brinkman, W., Fitrianie, S., Griffioen-Both, F., Horsch, C. H. G., Lancee, J., & Spruit, S. (2016) · Lecture notes in computer science · doi:10.1007/978-3-319-31510-2_24 · Cited by 38 · cited 1× · see citing works
“Interventions with such virtual agents have been developed for a range of mentalhealth problems [76] such as insomnia [77], depression [78], social phobia [79] and PTSD [80].”
BackgroundSelf-citationIterative development and evaluation methods of mHealth behavior change interventions
Jacobs, M. A., & Graham, A. L. (2015) · Current Opinion in Psychology · doi:10.1016/j.copsyc.2015.09.001 · Cited by 36 · see citing works
Bohnert, A. M., Zivin, K., Welsh, D. E., & Kilbourne, A. M. (2011) · Health Communication · doi:10.1080/10410236.2010.549813 · Cited by 30 · see citing works
An Ontology-Based Question System for a Virtual Coach Assisting in Trauma Recollection
Tielman, M. L., van Meggelen, M., Neerincx, M. A., & Brinkman, W. (2015) · Lecture notes in computer science · doi:10.1007/978-3-319-21996-7_2 · Cited by 21 · cited 1× · see citing works
“It had no interactive or personalising features such as in Gilani et al. [72], and did not assist in the actual recollection of the memory such as in Tielman et al. [73].”
BackgroundSelf-citationHome-Based Virtual Reality Exposure Therapy with Virtual Health Agent Support
Hartanto, D., Brinkman, W.-P., Kampmann, I. L., Morina, N., Emmelkamp, P. G. M., & Neerincx, M. A. (2016) · Communications in Computer and Information Science · doi:10.1007/978-3-319-32270-4_9 · Cited by 21 · cited 1× · see citing works
“Interventions with such virtual agents have been developed for a range of mentalhealth problems [76] such as insomnia [77], depression [78], social phobia [79] and PTSD [80].”
BackgroundSelf-citationSpecifying and testing the design rationale of social robots for behavior change in children
Looije, R., Neerincx, M. A., & Hindriks, K. V. (2016) · Cognitive Systems Research · doi:10.1016/j.cogsys.2016.07.002 · Cited by 20 · cited 1× · see citing works
“The gold standard in evaluating e-health interventions is a coherent set of dedicated evaluations in the development stage to test program components, followed by a Randomized Controlled Trial (RCT) when the intervention is stable [41–44].”
BackgroundSelf-citationThe use of modality in the design of verbal aids in computer-based learning environments
Sánchez, E. F., & García-Rodicio, H. (2008) · Interacting with Computers · doi:10.1016/j.intcom.2008.08.001 · Cited by 17 · cited 1× · see citing works
“In the domain of humancomputer interaction, verbal-visual learning aids were found to be more beneficial for retention than verbal aids [23].”
BackgroundThe Effect of Embodiment and Competence on Trust and Cooperation in Human–Agent Interaction
Kulms, P., & Kopp, S. (2016) · Lecture notes in computer science · doi:10.1007/978-3-319-47665-0_7 · Cited by 16 · cited 2× · see citing works
“but this effect needs to grow over time [39].”
BackgroundResultWhat Kind of Stories Should a Virtual Human Swap?
Gilani, S. N., Sheetz, K. E., Lucas, G., & Traum, D. R. (2016) · Lecture notes in computer science · doi:10.1007/978-3-319-47665-0_12 · Cited by 15 · cited 1× · see citing works
“[72], and did not assist in the actual recollection of the memory such as in Tielman et al.”
BackgroundHow psychiatrists should introduce themselves in the first consultation: an experimental study
Priebe, S., Palumbo, C., Ahmed, S., Strappelli, N., Gavrilovic, J. J., & Bremner, S. A. (2013) · The British Journal of Psychiatry · doi:10.1192/bjp.bp.112.123877 · Cited by 11 · cited 1× · see citing works
“Studies show that factors such as the type of language used [36], interpersonal encounter skills [37], and introduction style [38] all influence alliance.”
BackgroundComprehension by reading versus hearing.
Webb, W. B., & Wallon, E. J. (1956) · Journal of Applied Psychology · doi:10.1037/h0047579 · Cited by 10 · cited 2× · see citing works
“remembered better than audio [21], for agents a preference of voice over text has been reported [25].”
BackgroundRelational Agents to Promote eHealth Advice Adherence
Baker, S., Richards, D., & Caldwell, P. H. Y. (2014) · Lecture notes in computer science · doi:10.1007/978-3-319-13560-1_87 · Cited by 9 · cited 2× · see citing works
“Therapeutic alliance has been shown to be relevant for virtual agents [34,35] as well as human therapists.”
BackgroundSupporting longitudinal change in many health behaviors
Ren, J., Schulman, D. J., Jack, B. W., & Bickmore, T. (2014) · CHI Conference Extended Abstracts on Human Factors in Computing Systems (CHI EA) · doi:10.1145/2559206.2581201 · Cited by 7 · cited 1× · see citing works
“Virtual agents are being developed for these uses [81,82] and as with mental health care adherence to the agent is an important aspect [34].”
BackgroundCan computer-generated speech have gender?
Lee, E. J., Nass, C., & Brave, S. (2000) · CHI '01 extended abstracts on Human factors in computer systems - CHI '01 · doi:10.1145/633458.633461 · Cited by 7 · see citing works
Leveraging Adaptive Sessions Based on Therapeutic Empathy Through a Virtual Agent
Bresó, A., Martı́nez-Miranda, J., & Garcia-Gomez, J. M. (2016) · Cited by 5 · see citing works
Cognitive engineering for technology in mental health care and rehabilitation
Brinkman, W., Doherty, G. J., Gorini, A., Gaggioli, A., & Neerincx, M. A. (2010) · European Conference on Cognitive Ergonomics · doi:10.1145/1962300.1962360 · Cited by 4 · see citing works
Self-citationRecommendations for Designing Maximally Effective and Persuasive Health Agents
Fox, J., & Ahn, S. J. (2014) · Lecture notes in computer science · doi:10.1007/978-3-319-09767-1_21 · Cited by 3 · cited 1× · see citing works
“However, work with virtual agents shows that people often prefer verbal delivery above text [24,25].”
BackgroundStudy comparing video-based characters and 3D-based characters on mobile devices for chat
Kang, S., Feng, A., Seymour, M., & Shapiro, A. (2016) · Motion in Games · doi:10.1145/2994258.2994274 · Cited by 3 · cited 1× · see citing works
“Research has shown these mediums to be different [70], but the effect of this difference”
BackgroundHow should a virtual agent present psychoeducation? - Appendix part I - Psychoeducation
Tielman, M. L. (2017) · Data Archiving and Networked Services (DANS) · doi:10.4121/uuid:8231a591-6a51-40f5-bd3c-54435a4fc61c · Cited by 1 · see citing works
Self-citationHow should a virtual agent present psychoeducation? - Appendix part III - Dataset
Tielman, M. L. (2017) · Data Archiving and Networked Services (DANS) · doi:10.4121/uuid:828177fa-3a6d-4ecf-83d0-90d84414f7d7 · Cited by 1 · see citing works
Self-citationHow should a virtual agent present psychoeducation? - Appendix part II - Questionnaires
Tielman, M. L. (2017) · Data Archiving and Networked Services (DANS) · doi:10.4121/uuid:30db1be5-5070-4c7f-87af-210e09bda1c4 · Cited by 1 · see citing works
Self-citation
Flagged first, then by citations
1 of the 80 references couldn’t be matched to a known paper.
Research works printed but not linked: 1
- [12]Shumaker SA, Ockene JK, Riekert KA, editors. The handbook of Health Behavior Change: Springer; 2009.
Cited by
Sorted by citations
Chatbots and Conversational Agents in Mental Health: A Review of the Psychiatric Landscape
Vaidyam, A. N., Wisniewski, H., Halamka, J. D., Kashavan, M. S., & Torous, J. B. (2019) · The Canadian Journal of Psychiatry · doi:10.1177/0706743719828977 · Cited by 1,048 · see citing works
Survey of conversational agents in health
Montenegro, J. L. Z., da Costa, C. A., & da Rosa Righi, R. (2019) · Expert Systems with Applications · doi:10.1016/j.eswa.2019.03.054 · Cited by 322 · see citing works
Perceptions and opinions of patients about mental health chatbots: scoping review
Abd-Alrazaq, A. A., Alajlani, M., Ali, N., Denecke, K., Bewick, B. M., & Househ, M. (2021) · Journal of Medical Internet Research · doi:10.2196/17828 · Cited by 301 · see citing works
“However, other studies demonstrated that participants had neutral perceptions and opinions about the added value of embodied virtual agents with speech [52] or without speech [44].”
InfluentialConversational agents in the treatment of mental health problems: mixed-method systematic review
Gaffney, H., Mansell, W., & Tai, S. (2019) · JMIR Mental Health · doi:10.2196/14166 · Cited by 275 · see citing works
“Furthermore, some potentially relevant conversational agents developed for the treatment of mental health problems were excluded from this review because of not reporting a mental health outcome measure (eg, ELIZA [2,42-44]).”
Prochaska, J. J., Vogel, E. A., Chieng, A., Kendra, M., Baiocchi, M., Pajarito, S., & Robinson, A. (2021) · Journal of Medical Internet Research · doi:10.2196/24850 · Cited by 257 · see citing works
Bendig, E., Erb, B., Schulze-Thuesing, L., & Baumeister, H. (2022) · Verhaltenstherapie · doi:10.1159/000501812 · Cited by 214 · see citing works
“An example of a paradigm that is currently receiving much attention in this research context is therapeutic writing [Tielman et al., 2017; Bendig et al., 2018; Ho et al., 2018].”
Design Features of Embodied Conversational Agents in eHealth: a Literature Review
ter Stal, S., Kramer, L. L., Tabak, M., op den Akker, H., & Hermens, H. (2020) · International Journal of Human-Computer Studies · doi:10.1016/j.ijhcs.2020.102409 · Cited by 188 · see citing works
“Just a few articles provide results re-lated to the users’ perception of their own characteristics (Creed et al., 2015; Frost et al., 2012; Tielman et al., 2017; van Vugt et al., 2006; Yin et al., 2010; Zhou et al., 2014) or report on other outcome variables (Bickmore and Ring, 2010; Bickmore and…”
BackgroundInfluentialTechnical metrics used to evaluate health care chatbots: scoping review
Abd-Alrazaq, A., Safi, Z., Alajlani, M., Warren, J., Househ, M., & Denecke, K. (2020) · Journal of Medical Internet Research · doi:10.2196/18301 · Cited by 150 · see citing works
Artificial intelligence and Psychiatry: An overview
Ray, A., Bhardwaj, A., Malik, Y. K., Singh, S., & Gupta, R. (2022) · Asian Journal of Psychiatry · doi:10.1016/j.ajp.2022.103021 · Cited by 144 · see citing works
“The research on psychoeducation delivery have found that text based conversational agents can lead to higher program adherence compared to verbal presentation (Tielman et al., 2017);also, such conversational agents cause significant reduction in substance use and cravings (Pro-chaska et al., 2021).”
BackgroundTechnologies in Home-Based Digital Rehabilitation: Scoping Review
Arntz, A. R., Weber, F., Handgraaf, M., Lällä, K., Korniloff, K., Murtonen, K.-P., Chichaeva, J., Kidritsch, A., Heller, M., Sakellari, Ε., et al. (2023) · JMIR Rehabilitation and Assistive Technologies · doi:10.2196/43615 · Cited by 138 · see citing works
“The use of virtual humans in assisted care has mainly been implemented for healthy participants [181-183], with the aim of improving their health behaviors and reducing risk factors or physical inactivity.”
BackgroundChatbots to Support Young Adults’ Mental Health: An Exploratory Study of Acceptability
Koulouri, T., Macredie, R. D., & Olakitan, D. (2022) · ACM Transactions on Interactive Intelligent Systems · doi:10.1145/3485874 · Cited by 127 · see citing works
Prochaska, J. J., Vogel, E. A., Chieng, A., Baiocchi, M., Maglalang, D. D., Pajarito, S., Weingardt, K. R., Darcy, A., & Robinson, A. (2021) · Drug and Alcohol Dependence · doi:10.1016/j.drugalcdep.2021.108986 · Cited by 113 · see citing works
“Preliminary research indicates text-based presentation results in higher program adherence than verbal presentation (Tielman et al., 2017).”
BackgroundVaidyam, A. N., Linggonegoro, D. W., & Torous, J. B. (2020) · The Canadian Journal of Psychiatry · doi:10.1177/0706743720966429 · Cited by 83 · see citing works
Rehabilitation, the Great Absentee of Virtual Coaching in Medical Care: Scoping Review
Tropea, P., Schlieter, H., Sterpi, I., Judica, E., Gand, K., Caprino, M., Gabilondo, I., Gomez-Esteban, J. C., Busnatu, S., Sinescu, C., et al. (2019) · Journal of Medical Internet Research · doi:10.2196/12805 · Cited by 73 · see citing works
“A virtual agent was also used with good results in favoring adherence to a therapeutic task within a psychoeducational process [45].”
Martínez-Miranda, J., Martínez, A., Ramos, R., Aguilar, H., Jiménez, L., Arias, H., Rosales, G., & Valencia, E. (2019) · Journal of Medical Systems · doi:10.1007/s10916-019-1387-1 · Cited by 79 · see citing works
Miloff, A., Carlbring, P., Hamilton, W., Andersson, G., Reuterskiöld, L., & Lindner, P. (2020) · Journal of Medical Internet Research · doi:10.2196/16660 · Cited by 60 · see citing works
Bendig, E., Erb, B., Schulze-Thuesing, L., & Baumeister, H. (2019) · Verhaltenstherapie · doi:10.1159/000499492 · Cited by 62 · see citing works
“Ein Beispiel für ein Paradigma, das in diesem Forschungskontext aktuell viel Aufmerksamkeit erfährt, ist das therapeutische Schreiben [Bendig et al., 2018; Ho et al., 2018; Tielman et al., 2017].”
BackgroundSix challenges for human-AI Co-learning
van den Bosch, K., Schoonderwoerd, T., Blankendaal, R., & Neerincx, M. (2019) · Lecture notes in computer science · doi:10.1007/978-3-030-22341-0_45 · Cited by 50 · see citing works
“1, such as chat bots [11], virtual assistants [16,54], and personal teaching agents [25,55].”
BackgroundSelf-citationJegundo, A. L., Dantas, C., Quintas, J., Dutra, J., Almeida, A. L., Caravau, H., Rosa, A. F., Martins, A. I., & Pacheco Rocha, N. (2020) · Technologies · doi:10.3390/technologies8030042 · Cited by 45 · see citing works
Das, A., Selek, S., Warner, A. R., Zuo, X., Hu, Y., Kuttichi Keloth, V., Li, J., Zheng, W. J., & Xu, H. (2022) · Proceedings of the 21st Workshop on Biomedical Language Processing · doi:10.18653/v1/2022.bionlp-1.27 · Cited by 47 · see citing works
“Most of the systems like (Bick-more et al., 2010b,a; Tielman et al., 2017a,b) used three-dimensional setups or interfaces to interact with the users.”
MethodInternet-based Tailored Virtual Human Health Intervention to Promote Colorectal Cancer Screening
Zalake, M. S., Tavassoli, F., Griffin, L. N., Krieger, J. L. R., & Lok, B. C. L. (2019) · ACM International Conference on Intelligent Virtual Agents (IVA) · doi:10.1145/3308532.3329471 · Cited by 40 · see citing works
Pallavicini, F., Orena, E., di Santo, S., Greci, L., Caragnano, C., Ranieri, P., Vuolato, C., Pepe, A., Veronese, G., Stefanini, S., et al. (2022) · Trials · doi:10.1186/s13063-022-06337-2 · Cited by 37 · see citing works
Bhattacharjee, A., Williams, J. J., Meyerhoff, J., Kumar, H., Mariakakis, A. T., & Kornfield, R. (2023) · CHI Conference on Human Factors in Computing Systems · doi:10.1145/3544548.3580774 · Cited by 34 · see citing works
“Lastly, researchers have explored the design of artificially intelligent chatbots that try to promote self-reflection by engaging users in human-like conversations [50, 59, 123].”
BackgroundBhattacharjee, A., Williams, J. J., Chou, K., Tomlinson, J., Meyerhoff, J., Mariakakis, A. T., & Kornfield, R. (2022) · Proceedings of the ACM on Human-Computer Interaction · doi:10.1145/3555123 · Cited by 29 · see citing works
“[119] suggest that chatbots can encourage people to maintain digital diaries, improving awareness about their mental state.”
BackgroundAdaptive Systems for Internet-Delivered Psychological Treatments
Mukhiya, S. K., Wake, J. D., İnal, Y., & Lamo, Y. (2020) · IEEE Access · doi:10.1109/access.2020.3002793 · Cited by 28 · see citing works
“, [28], [30], [31]) have also found that the presence of accountable and trusted moderators, for example, enhances participant motivation and adherence in online therapy environments.”
BackgroundCAEVR: Biosignals-Driven Context-Aware Empathy in Virtual Reality
Gupta, K., Zhang, Y., Gunasekaran, T. S., Krishna, N., Pai, Y. S., & Billinghurst, M. (2024) · IEEE Transactions on Visualization and Computer Graphics · doi:10.1109/tvcg.2024.3372130 · Cited by 27 · see citing works
“This finding aligns with Tielman et al.’s research [85], which explored the influence of verbal and textual presentation on adherence and user engagement, demonstrating the potential benefits of empathic virtual agents in therapeutic settings.”
ResultA Digital Coach to Promote Emotion Regulation Skills
Hopman, K., Richards, D., & Norberg, M. M. (2023) · Multimodal Technologies and Interaction · doi:10.3390/mti7060057 · Cited by 26 · see citing works
“This duplication was used because studies have shown that the text presentation of educational materials has been found to improve learning over speech alone [43].”
MethodKruse, L., Hertel, J., Mostajeran, F., Schmidt, S., & Steinicke, F. (2023) · Proceedings - International Symposium on Mixed and Augmented Reality, ISMAR · doi:10.1109/ismar59233.2023.00082 · Cited by 23 · see citing works
“Multiple papers consider factors that could negatively influence the (mental) health status, including stress [76], social exclusion or rejection [14], and psychological or emotional distress [19,55,65,68,69].”
BackgroundZalake, M. S., Tavassoli, F., Duke, K., George, T. J., Modave, F., Neil, J., Krieger, J. L., & Lok, B. C. (2019) · Journal on Multimodal User Interfaces · doi:10.1007/s12193-020-00357-5 · Cited by 41 · see citing works
“Several studies have compared a VH-based intervention to the existing standard of text-based intervention to understand the influence of information delivery medium on user healthrelated attitudes and have found inconsistent results [13,33, 44,49].”
BackgroundResultInfluentialPsychoeducation on Stress and Anxiety Using Virtual Reality: A Mixed-Methods Study
Pallavicini, F., Orena, E. F., Achille, F., Cassa, M. I., Vuolato, C., Stefanini, S., Caragnano, C., Pepe, A., Veronese, G., Ranieri, P., et al. (2022) · Applied Sciences · doi:10.3390/app12189110 · Cited by 18 · see citing works
“Although VR represents one of the key technologies to change the way education is delivered, to date, few studies have tested the use of VR within psychoeducation programs [30,32,80].”
BackgroundDesigning Chatbots for Guiding Online Peer Support Conversations for Adults with ADHD
Nordberg, O. E., Wake, J. D., Nordby, E. S., Flobak, E., Nordgreen, T., Mukhiya, S. K., & Guribye, F. (2020) · Lecture notes in computer science · doi:10.1007/978-3-030-39540-7_8 · Cited by 17 · see citing works
Pallavicini, F., Orena, E. F., Santo, S. G. D., Greci, L., Caragnano, C., Ranieri, P., Vuolato, C., Pepe, A., Veronese, G., Dakanalis, A., et al. (2021) · Frontiers in Virtual Reality · doi:10.3389/frvir.2021.620225 · Cited by 18 · see citing works
“Despite the important role that virtual reality could play in providing information regarding mental suffering conditions, only a few previous studies to date have investigated the possibilities of virtual reality for psychoeducation (Rizzo et al., 2009, 2010; Riva et al., 2012; Tielman et al., 2017; Migoya-Borja et a…”
BackgroundMertens, E. C. A., Siezenga, A. M., van der Schalk, J., & van Gelder, J. (2023) · Prevention Science · doi:10.1007/s11121-023-01609-y · Cited by 12 · see citing works
“Multimedia tools can provide content in different formats, such as video, audio, text, and graphic illustrations (e.g., Tielman et al., 2017).”
BackgroundDEPRA: An Early Depression Detection Analysis Chatbot
Kaywan, P., Ahmed, K. E. U., Miao, Y., Ibaida, A., & Gu, B. (2021) · Lecture notes in computer science · doi:10.1007/978-3-030-90885-0_18 · Cited by 12 · see citing works
Mertens, E. C. A., Siezenga, A. M., Tettero, T., van Gelder, J., Tettero, T., & van Gelder, J. (2022) · BMC Psychology · doi:10.1186/s40359-022-01025-x · Cited by 10 · see citing works
Vermetten, E. H. G. J. M., Tielman, M. L., van Dort, E., Binsch, O., Li, X., Rozendaal, M. C., Veldkamp, B. P., Wynn, G. H., & Jetly, R. (2020) · Journal of Military Veteran and Family Health · doi:10.3138/jmvfh.2019-0033 · Cited by 13 · see citing works
Self-citationPallavicini, F., Orena, E. F., Arnoldi, L., Achille, F., Stefanini, S., Cassa, M. I., Pepe, A., Veronese, G., Bernardelli, L., Sforza, F., et al. (2024) · JMIR Serious Games · doi:10.2196/50326 · Cited by 12 · see citing works
“This result, in line with previous literature [21,61,62], stresses the potential of VR as a valuable and innovative tool for promoting scientific and medical knowledge on stress and anxiety and other mental disorders such as depression [22,23].”
Look who's talking: appearance of embodied conversational agents in eHealth
ter Stal, S. (2021) · doi:10.3990/1.9789036551267 · Cited by 9 · see citing works
Prochaska, J. J., Vogel, E. A., Chieng, A., Baiocchi, M., Pajarito, S., Pirner, M., Darcy, A. M., & Robinson, A. H. (2023) · Contemporary Clinical Trials · doi:10.1016/j.cct.2023.107125 · Cited by 10 · see citing works
Impact of artificial intelligence on healthcare
Francis, J., Varghese, J. V., & Thomas, A. (2023) · International Journal of Advances in Medicine · doi:10.18203/2349-3933.ijam20232839 · Cited by 9 · see citing works
Designing an Adaptive Embodied Conversational Agent for Health Literacy
Egede, J., Trigo, M. J. G., Hazzard, A., Porcheron, M., Bodiaj, E., Fischer, J. E., Greenhalgh, C., & Valstar, M. (2021) · ACM International Conference on Intelligent Virtual Agents (IVA) · doi:10.1145/3472306.3478350 · Cited by 5 · see citing works
“ECAs are increasingly employed in healthcare settings (e.g., [17, 19, 33]) across a number of specialisms, such as healthy eating [9], guiding treatment choices [30], and post-traumatic stress [34].”
BackgroundMendes, D. C. G., Costa, R., Agrela, J. G., Badia, S. B. I., & Cameirão, M. S. (2024) · SeGAH ... IEEE ... International Conference on Serious Games and Applications for Health/IEEE International Conference on Serious Games and Applications for Health · doi:10.1109/segah61285.2024.10639572 · Cited by 6 · see citing works
“It has been suggested that text on screen might be better for adherence when the agents provide psychoeducation [20].”
BackgroundMethodInfluentialHopman, K., Richards, D., & Norberg, M. M. (2025) · Behaviour and Information Technology · doi:10.1080/0144929x.2025.2477757 · Cited by 4 · see citing works
Lim, S., Yang, Q., Meng, J., & Rains, S. A. (2025) · Behaviour and Information Technology · doi:10.1080/0144929x.2025.2567989 · Cited by 3 · see citing works
“…studies documented that textual presentation of education by a virtual agent resulted in users’ higher adherence to the programme than verbal presentation (Tielman et al. 2017); however, an AI’s verbal delivery was rated by users as more preferrable over text (Walter, Ortbach, and Niehaves 2015).”
Hopman, K., Richards, D., & Norberg, M. M. (2024) · Lecture notes in computer science · doi:10.1007/978-3-031-58226-4_13 · Cited by 3 · see citing works
Digital Psychiatry: Opportunities, Challenges, and Future Directions
Sidani, L., Nadar, S. M., Tfaili, J., Rayes, S. E., Sharara, F., Elhage, J. C., & Fakhoury, M. (2024) · Journal of Psychiatric Practice · doi:10.1097/pra.0000000000000819 · Cited by 5 · see citing works
“87 However, mixed fi ndings were reported by Tielman et al, 88 indicating that some individuals would not consider a virtual agent a useful addition in psycho-education and prevention.”
Uma revisão integrativa sobre o uso de chatbot para subsidiar o ensino na área da saúde
Cursino, J. R. V., Filho, A. S. D. C., Calista, A. A., & Nascimento, J. E. D. M. (2020) · Revista de Saúde Digital e Tecnologias Educacionais · doi:10.36517/resdite.v5.n1.2020.a8 · Cited by 3 · see citing works
Rizkina, T., Damaianti, V. S., Muslim, A. B., Sumiyadi, S., & Laeli, W. (2025) · Journal of Poetry Therapy · doi:10.1080/08893675.2025.2557575 · Cited by 3 · see citing works
A Scoping Review of Conversational Agents in Adolescence
Madera, F., Nicodemo, G., Guasco, S., Ciulli, T., & Cardinali, P. (2026) · European Psychologist · doi:10.1027/1016-9040/a000580 · Cited by 2 · see citing works
Prabandari, K., & Indriana, Y. (2020) · Jurnal EMPATI · doi:10.14710/empati.2018.21852 · Cited by 2 · see citing works
Addressing the Challenges of Mental Health Conversations with Large Language Models
Shiwakoti, S., Shah, S. B., Razzak, I., Thapa, S., & Naseem, U. (2025) · International World Wide Web Conference (WWW) · doi:10.1145/3701716.3718374 · Cited by 2 · see citing works
“…research indicates that VMHAs, when well-designed, can not only deliver evidence-based therapeutic exercises—such as Cognitive Behavioral Therapy (CBT) [16] and psychoeducation [17]—but also foster empathetic, user-centered dialogues that play a critical role in mental health support [11].”
Rings, S., Kruse, L., Rudschies, C., Rolvien, L., Schauenburg, G., Gallinat, J., Schneider, I., & Steinicke, F. (2025) · Mensch und Computer (MuC) · doi:10.1145/3743049.3743063 · Cited by 1 · see citing works
Kuswik, H., Poletaykina, A., Rittmann, A., Kruse, L., & Steinicke, F. (2025) · ACM Symposium on Spatial User Interaction (SUI) · doi:10.1145/3694907.3765934 · Cited by 1 · see citing works
“Since not every method of instruction, including VAs, is equally suitable for all users [50], it is important to consider the specific advantages and disadvantages of each method.”
Prochaska, J. J., Wang, M., Chieng, A., Moore, J. B., Vogel, E. A., Baiocchi, M., Pajarito, S., Pirner, M., Bullard, L., Darcy, A. M., et al. (2026) · Journal of Substance Use and Addiction Treatment · doi:10.1016/j.josat.2026.209993 · Cited by 1 · see citing works
How should a virtual agent present psychoeducation? - Appendix part I - Psychoeducation
Tielman, M. L. (2017) · Data Archiving and Networked Services (DANS) · doi:10.4121/uuid:8231a591-6a51-40f5-bd3c-54435a4fc61c · Cited by 1 · see citing works
Self-citationHow should a virtual agent present psychoeducation? - Appendix part III - Dataset
Tielman, M. L. (2017) · Data Archiving and Networked Services (DANS) · doi:10.4121/uuid:828177fa-3a6d-4ecf-83d0-90d84414f7d7 · Cited by 1 · see citing works
Self-citationHow should a virtual agent present psychoeducation? - Appendix part II - Questionnaires
Tielman, M. L. (2017) · Data Archiving and Networked Services (DANS) · doi:10.4121/uuid:30db1be5-5070-4c7f-87af-210e09bda1c4 · Cited by 1 · see citing works
Self-citationExploring User Perspectives on Brief Reflective Questioning Activities for Stress ManagementPreprint
Bhattacharjee, A., Chen, P., Mandal, A., Zhou, L., Aggarwal, J., Hsu, A., O'Leary, K., Mariakakis, A. T., & Williams, J. J. (2022) · SSRN Electronic Journal · doi:10.2139/ssrn.4057942 · Cited by 1 · see citing works
Impact of Psychoeducational Campaign “DEEP” in Portuguese University Students
Durán, L., & Almeida, A. M. P. (2020) · Iberian Conference on Information Systems and Technologies (CISTI) · doi:10.23919/cisti49556.2020.9140878
“Estas disponibilizam recursos educativos para integrar estratégias de orientação cognitiva que permitem aos intervenientes enfrentar situações e conhecer informação relevante relacionada com transtornos mentais [13,14].”
BackgroundHow should a virtual agent present psychoeducation? - Appendix
Tielman, M. L. (2017) · Data Archiving and Networked Services (DANS) · doi:10.4121/uuid:cb822fdb-f3e9-4d22-a605-952041c3059e
Self-citationA Structured Literature Review on Conversational Agents that Empower Health Interventions
Pietrantoni, N. (2023) · International Conference on Information Systems and Software Technologies (ICI2ST) · doi:10.1109/ici2st62251.2023.00024
“Human identity [22], [37], [63], [69]–[71], [73], [75], [77]–[80], [83]–[86], [88]–[90], [93], [94], [96], [98], [100], [103], [105], [109], [110] Verbal communication [19], [22], [37], [56], [63], [67], [68], [74], [78], [81], [83], [85]–[87], [92], [95], [97]–[102], [104], [106]”
InfluentialYu, Y., & Levitan, S. I. (2025) · ACM International Conference on Intelligent Virtual Agents (IVA) · doi:10.1145/3717511.3747069
Mendes, D. C. G., Costa, R., Fonseca, A., & Cameirão, M. S. (2025) · SeGAH ... IEEE ... International Conference on Serious Games and Applications for Health/IEEE International Conference on Serious Games and Applications for Health · doi:10.1109/segah65397.2025.11168290
“A study found text to be preferred depending on the instruction or information given, but having both was ideal [30].”
- Authors
- Tielman, M. L., Neerincx, M. A., van Meggelen, M., Franken, I., & Brinkman, W.-P.
- Affiliations
- Delft University of Technology (NL)
- Netherlands Organisation for Applied Scientific Research (NL)
- Erasmus University Rotterdam, Rotterdam, The Netherlands
- Erasmus University Rotterdam (NL)
- Corresponding author
- Tielman, Myrthe L.
- Venue
- Technology and Health Care
- Publisher
- SAGE Publications
- Published
- 2018-02-06
- Volume
- 25
- Issue
- 6
- Pages
- 1081-1096
- ISSN
- 0928-7329 (ISSN-L)
- 1878-7401
- PMC
- PMC5814660
- OpenAlex
- W2743183116
- Cited by
- 63
- References
- 80
- Citations by year
- 2026: 2 · 2025: 8 · 2024: 5 · 2023: 8 · 2022: 8 · 2021: 7 · 2020: 12 · 2019: 9 · 2017: 4
- FWCI
- 7.82
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Technology and Health Care (publishedVersion, cc-by-nc)
- Europe PMC (PubMed Central) (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- EUR Research Repository (Erasmus University Rotterdam) (publishedVersion, other-oa)
- EUR Research Repository (Erasmus University Rotterdam) (submittedVersion, other-oa)
- RePub (Erasmus University Rotterdam) (submittedVersion, other-oa)
- TNO Repository (submittedVersion)
- Repository hosted by TU Delft Library (TU Delft) (submittedVersion)
- Research Repository (Delft University of Technology) (submittedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion, cc-by-nc)
- Topics
- Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
- Social Sciences › Psychology › Social Psychology › Social Robot Interaction and HRI
- Physical Sciences › Computer Science › Human-Computer Interaction › Virtual Reality Applications and Impacts
- Keywords
- virtual agents, psychoeducation, medication adherence, e-mental health, embodied conversational agents, expressive writing, digital diaries
- MeSH terms
- Adult, Female, Humans, Male, Mental Health Services, Netherlands, Patient Compliance, Patient Education as Topic, Stress Disorders, Post-Traumatic, Telemedicine, Young Adult
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
