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.CPT was originally developed with the written trauma account as one component of treatment, but sometimes it is delivered without this and more emphasis is placed on cognitive techniques.Kazuhiro Shidara 1 * Hiroki Tanaka 1 Hiroyoshi Adachi 2 Daisuke Kanayama 2 Yukako Sakagami 2 Takashi Kudo 2 Satoshi Nakamura 1 Regardless of modality, patients will have out-of-session practice assignments. Therapists may particularly focus on safety, trust, power, control, esteem and intimacy as these are all areas that can be affected by traumatic experiences.ĬPT can be delivered both individually and in structured group sessions. At this point, the therapist is helping the patient develop the ability to use these adaptive strategies outside of treatment to improve overall functioning and quality of life. The therapist uses Socratic questioning and other strategies to help the patient question his or her unhelpful thoughts about the trauma (e.g., self-blaming thoughts) in order to modify any maladaptive thinking.įinally, once the patient has developed skills to identify and address unhelpful thinking, she or he uses those skills to continue evaluating and modifying beliefs related to traumatic events. The patient writes a detailed account of the worst traumatic experience, which the patient reads in the next session to try and break the pattern of avoiding thoughts and feelings associated with the trauma. Next, the patient begins more formal processing of the trauma(s). The patient writes an impact statement that details current understanding of why the traumatic event occurred and the impact it has had on beliefs about self, others, and the world. The patient becomes more aware of the relationship between thoughts and emotions and begins to identify “automatic thoughts” that may be maintaining the PTSD symptoms. Treatment begins with psychoeducation regarding PTSD, thoughts, and emotions.
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