JMIR Publications

ABSTRACT

Background:

Background E-mental health care systems incorporating virtual agents can play a major role, as barriers to care still prevent some patients from receiving the help they need. To properly assist the users of these systems, the virtual agent needs to promote motivation, something which can be done by offering motivational messages.

Objective:

This paper presents the design and evaluation of a motivational message system for a virtual agent assisting in post-traumatic stress disorder (PTSD) therapy. A database of motivational statements was built with expert (n=13) input on what types of statements to use in what user situation. Using this database, the system generates personalized motivational messages.

Methods:

To investigate if the motivational message system improves motivation to continue and trust in a good therapy outcome, an online study was performed (n=207). Participants were asked to imagine they were in a certain situation, and received either a personalized motivational message as generated by the system, a general motivational message, or a message without motivation. They were asked how this message changed their motivation and trust, as well as how much they felt being heard by the agent.

Results:

Overall, receiving a motivational message improved motivation to continue, trust in a good therapy outcome and the feeling of being heard by the agent. Moreover, this feeling of being heard was further improved if the motivational message was personalized to the user’s situation. This personalization was also shown to be important in those situations where the symptoms were getting worse. In these situations, personalized messages outperformed general messages both in terms of motivation to continue and trust in a good therapy outcome.

Conclusions:

Based on expert’s input, a personalized motivational message system was developed, which can improve motivation and trust in PTSD therapy. Given the confrontational nature of PTSD therapy, this system has the potential to make an important difference. As both motivation and trust play an important role in many other e-mental health systems as well, personalized motivational message systems such as these can be very valuable.