Published on in Vol 20, No 6 (2018): June

Preprints (earlier versions) of this paper are available at, first published .
Towards an Artificially Empathic Conversational Agent for Mental Health Applications: System Design and User Perceptions

Towards an Artificially Empathic Conversational Agent for Mental Health Applications: System Design and User Perceptions

Towards an Artificially Empathic Conversational Agent for Mental Health Applications: System Design and User Perceptions


  1. Dekker I, De Jong E, Schippers M, De Bruijn-Smolders M, Alexiou A, Giesbers B. Optimizing Students’ Mental Health and Academic Performance: AI-Enhanced Life Crafting. Frontiers in Psychology 2020;11 View
  2. Tudor Car L, Dhinagaran D, Kyaw B, Kowatsch T, Joty S, Theng Y, Atun R. Conversational Agents in Health Care: Scoping Review and Conceptual Analysis. Journal of Medical Internet Research 2020;22(8):e17158 View
  3. Chan S, Li L, Torous J, Gratzer D, Yellowlees P. Review and Implementation of Self-Help and Automated Tools in Mental Health Care. Psychiatric Clinics of North America 2019;42(4):597 View
  4. Palanica A, Flaschner P, Thommandram A, Li M, Fossat Y. Physicians’ Perceptions of Chatbots in Health Care: Cross-Sectional Web-Based Survey. Journal of Medical Internet Research 2019;21(4):e12887 View
  5. Nadarzynski T, Miles O, Cowie A, Ridge D. Acceptability of artificial intelligence (AI)-led chatbot services in healthcare: A mixed-methods study. DIGITAL HEALTH 2019;5:205520761987180 View
  6. Miller E, Polson D. Apps, Avatars, and Robots: The Future of Mental Healthcare. Issues in Mental Health Nursing 2019;40(3):208 View
  7. Bibault J, Chaix B, Nectoux P, Pienkowski A, Guillemasé A, Brouard B. Healthcare ex Machina: Are conversational agents ready for prime time in oncology?. Clinical and Translational Radiation Oncology 2019;16:55 View
  8. Bernecker S, Williams J, Caporale-Berkowitz N, Wasil A, Constantino M. Nonprofessional Peer Support to Improve Mental Health: Randomized Trial of a Scalable Web-Based Peer Counseling Course. Journal of Medical Internet Research 2020;22(9):e17164 View
  9. D’Alfonso S. AI in mental health. Current Opinion in Psychology 2020;36:112 View
  10. Moore J, Caudill R. The Bot Will See You Now. Psychiatric Clinics of North America 2019;42(4):627 View
  11. Bickmore T, Trinh H, Olafsson S, O'Leary T, Asadi R, Rickles N, Cruz R. Patient and Consumer Safety Risks When Using Conversational Assistants for Medical Information: An Observational Study of Siri, Alexa, and Google Assistant. Journal of Medical Internet Research 2018;20(9):e11510 View
  12. Glover A, Schueller S, Winiarski D, Smith D, Karnik N, Zalta A. Automated Mobile Phone–Based Mental Health Resource for Homeless Youth: Pilot Study Assessing Feasibility and Acceptability. JMIR Mental Health 2019;6(10):e15144 View
  13. Park S, Choi J, Lee S, Oh C, Kim C, La S, Lee J, Suh B. Designing a Chatbot for a Brief Motivational Interview on Stress Management: Qualitative Case Study. Journal of Medical Internet Research 2019;21(4):e12231 View
  14. Pepito J, Ito H, Betriana F, Tanioka T, Locsin R. Intelligent humanoid robots expressing artificial humanlike empathy in nursing situations. Nursing Philosophy 2020;21(4) View
  15. Abd-Alrazaq A, Alajlani M, Ali N, Denecke K, Bewick B, Househ M. Perceptions and Opinions of Patients About Mental Health Chatbots: Scoping Review. Journal of Medical Internet Research 2021;23(1):e17828 View
  16. Ni P, Li Y, Li G, Chang V. Natural language understanding approaches based on joint task of intent detection and slot filling for IoT voice interaction. Neural Computing and Applications 2020;32(20):16149 View
  17. Safi Z, Abd-Alrazaq A, Khalifa M, Househ M. Technical Aspects of Developing Chatbots for Medical Applications: Scoping Review. Journal of Medical Internet Research 2020;22(12):e19127 View
  18. Chung K, Cho H, Park J. A Chatbot for Perinatal Women’s and Partners’ Obstetric and Mental Health Care: Development and Usability Evaluation Study. JMIR Medical Informatics 2021;9(3):e18607 View
  19. Dosovitsky G, Pineda B, Jacobson N, Chang C, Escoredo M, Bunge E. Artificial Intelligence Chatbot for Depression: Descriptive Study of Usage. JMIR Formative Research 2020;4(11):e17065 View
  20. Mitchell E, Maimone R, Cassells A, Tobin J, Davidson P, Smaldone A, Mamykina L. Automated vs. Human Health Coaching. Proceedings of the ACM on Human-Computer Interaction 2021;5(CSCW1):1 View
  21. Zolyomi A, Snyder J. Social-Emotional-Sensory Design Map for Affective Computing Informed by Neurodivergent Experiences. Proceedings of the ACM on Human-Computer Interaction 2021;5(CSCW1):1 View
  22. Erel H, Trayman D, Levy C, Manor A, Mikulincer M, Zuckerman O. Enhancing Emotional Support: The Effect of a Robotic Object on Human–Human Support Quality. International Journal of Social Robotics 2022;14(1):257 View
  23. Kolenik T, Gams M. Intelligent Cognitive Assistants for Attitude and Behavior Change Support in Mental Health: State-of-the-Art Technical Review. Electronics 2021;10(11):1250 View
  24. Alam L, Mueller S. Examining the effect of explanation on satisfaction and trust in AI diagnostic systems. BMC Medical Informatics and Decision Making 2021;21(1) View
  25. Vilaza G, McCashin D. Is the Automation of Digital Mental Health Ethical? Applying an Ethical Framework to Chatbots for Cognitive Behaviour Therapy. Frontiers in Digital Health 2021;3 View
  26. Ziv I, Baram H, Bar K, Zilberstein V, Itzikowitz S, Harel E, Dershowitz N. Morphological characteristics of spoken language in schizophrenia patients – an exploratory study. Scandinavian Journal of Psychology 2022;63(2):91 View
  27. Lavelle J, Dunne N, Mulcahy H, McHugh L. Chatbot-Delivered Cognitive Defusion versus Cognitive Restructuring for Negative Self-Referential Thoughts: A Pilot Study. The Psychological Record 2022;72(2):247 View
  28. Hu J, Huang Y, Hu X, Xu Y. The Acoustically Emotion-Aware Conversational Agent With Speech Emotion Recognition and Empathetic Responses. IEEE Transactions on Affective Computing 2023;14(1):17 View
  29. Huq S, Maskeliūnas R, Damaševičius R. Dialogue agents for artificial intelligence-based conversational systems for cognitively disabled: a systematic review. Disability and Rehabilitation: Assistive Technology 2024;19(3):1059 View
  30. Islam A, Chaudhry B. A Relational Agent for the COVID-19 Patients: Design, Approach, and Implications (Preprint). JMIR Human Factors 2022 View
  31. Bendig E, Erb B, Schulze-Thuesing L, Baumeister H. The Next Generation: Chatbots in Clinical Psychology and Psychotherapy to Foster Mental Health – A Scoping Review. Verhaltenstherapie 2022;32(Suppl. 1):64 View
  32. Potts C, Ennis E, Bond R, Mulvenna M, McTear M, Boyd K, Broderick T, Malcolm M, Kuosmanen L, Nieminen H, Vartiainen A, Kostenius C, Cahill B, Vakaloudis A, McConvey G, O’Neill S. Chatbots to Support Mental Wellbeing of People Living in Rural Areas: Can User Groups Contribute to Co-design?. Journal of Technology in Behavioral Science 2021;6(4):652 View
  33. Powell L, Nizam M, Nour R, Zidoun Y, Sleibi R, Kaladhara Warrier S, Al Suwaidi H, Zary N. Conversational Agents in Health Education: Protocol for a Scoping Review. JMIR Research Protocols 2022;11(4):e31923 View
  34. Kornfield R, Mohr D, Ranney R, Lattie E, Meyerhoff J, Williams J, Reddy M. Involving Crowdworkers with Lived Experience in Content-Development for Push-Based Digital Mental Health Tools: Lessons Learned from Crowdsourcing Mental Health Messages. Proceedings of the ACM on Human-Computer Interaction 2022;6(CSCW1):1 View
  35. Smith C, Alam I, Tan C, Keegan B, Blanchard A. The Impact of Governance Bots on Sense of Virtual Community. Proceedings of the ACM on Human-Computer Interaction 2022;6(CSCW2):1 View
  36. García-Corretjer M, Ros R, Mallol R, Miralles D. Empathy as an engaging strategy in social robotics: a pilot study. User Modeling and User-Adapted Interaction 2023;33(2):221 View
  37. Lattie E, Stiles-Shields C, Graham A. An overview of and recommendations for more accessible digital mental health services. Nature Reviews Psychology 2022;1(2):87 View
  38. Liew T, Tan S. Social cues and implications for designing expert and competent artificial agents: A systematic review. Telematics and Informatics 2021;65:101721 View
  39. Kruzan K, Bazarova N, Whitlock J. Investigating Self-injury Support Solicitations and Responses on a Mobile Peer Support Application. Proceedings of the ACM on Human-Computer Interaction 2021;5(CSCW2):1 View
  40. Denecke K, May R. Developing a Technical-Oriented Taxonomy to Define Archetypes of Conversational Agents in Health Care: Literature Review and Cluster Analysis. Journal of Medical Internet Research 2023;25:e41583 View
  41. Pretorius C, McCashin D, Coyle D. Supporting personal preferences and different levels of need in online help-seeking: a comparative study of help-seeking technologies for mental health. Human–Computer Interaction 2022:1 View
  42. May R, Denecke K. Security, privacy, and healthcare-related conversational agents: a scoping review. Informatics for Health and Social Care 2022;47(2):194 View
  43. Bendig E, Erb B, Schulze-Thuesing L, Baumeister H. Die nächste Generation: Chatbots in der klinischen Psychologie und Psychotherapie zur Förderung mentaler Gesundheit – Ein Scoping-Review. Verhaltenstherapie 2019;29(4):266 View
  44. Bhattacharjee A, Williams J, Chou K, Tomlinson J, Meyerhoff J, Mariakakis A, Kornfield R. "I Kind of Bounce off It":Translating Mental Health Principles into Real Life Through Story-Based Text Messages. Proceedings of the ACM on Human-Computer Interaction 2022;6(CSCW2):1 View
  45. Saka A, Oyedele L, Akanbi L, Ganiyu S, Chan D, Bello S. Conversational artificial intelligence in the AEC industry: A review of present status, challenges and opportunities. Advanced Engineering Informatics 2023;55:101869 View
  46. Chan T, Gauthier R, Suarez A, Sia N, Wallace J. Merlynne. Proceedings of the ACM on Human-Computer Interaction 2021;5(CHI PLAY):1 View
  47. Schick A, Feine J, Morana S, Maedche A, Reininghaus U. Validity of Chatbot Use for Mental Health Assessment: Experimental Study. JMIR mHealth and uHealth 2022;10(10):e28082 View
  48. He Y, Yang L, Zhu X, Wu B, Zhang S, Qian C, Tian T. Mental Health Chatbot for Young Adults With Depressive Symptoms During the COVID-19 Pandemic: Single-Blind, Three-Arm Randomized Controlled Trial. Journal of Medical Internet Research 2022;24(11):e40719 View
  49. Monaro M, Barakova E, Navarin N. Editorial Special Issue Interaction With Artificial Intelligence Systems: New Human-Centered Perspectives and Challenges. IEEE Transactions on Human-Machine Systems 2022;52(3):326 View
  50. Medeiros L, Bosse T, Gerritsen C. Can a Chatbot Comfort Humans? Studying the Impact of a Supportive Chatbot on Users’ Self-Perceived Stress. IEEE Transactions on Human-Machine Systems 2022;52(3):343 View
  51. Dosovitsky G, Bunge E. Bonding With Bot: User Feedback on a Chatbot for Social Isolation. Frontiers in Digital Health 2021;3 View
  52. Smriti D, Kao T, Rathod R, Shin J, Peng W, Williams J, Mujib M, Colosimo M, Huh-Yoo J. Motivational Interviewing Conversational Agent for Parents as Proxies for Their Children in Healthy Eating: Development and User Testing. JMIR Human Factors 2022;9(4):e38908 View
  53. Chaudhry B, Islam A. A Mobile Application-Based Relational Agent as a Health Professional for COVID-19 Patients: Design, Approach, and Implications. International Journal of Environmental Research and Public Health 2022;19(21):13794 View
  54. Koulouri T, Macredie R, Olakitan D. Chatbots to Support Young Adults’ Mental Health: An Exploratory Study of Acceptability. ACM Transactions on Interactive Intelligent Systems 2022;12(2):1 View
  55. Mauriello M, Tantivasadakarn N, Mora-Mendoza M, Lincoln E, Hon G, Nowruzi P, Simon D, Hansen L, Goenawan N, Kim J, Gowda N, Jurafsky D, Paredes P. A Suite of Mobile Conversational Agents for Daily Stress Management (Popbots): Mixed Methods Exploratory Study. JMIR Formative Research 2021;5(9):e25294 View
  56. Ghozali M, Amalia Islamy I, Hidayaturrohim B. Effectiveness of an educational mobile-app intervention in improving the knowledge of COVID-19 preventive measures. Informatics in Medicine Unlocked 2022;34:101112 View
  57. van Lotringen C, Lusi B, Westerhof G, Ludden G, Kip H, Kelders S, Noordzij M. The Role of Compassionate Technology in Blended and Digital Mental Health Interventions: Systematic Scoping Review. JMIR Mental Health 2023;10:e42403 View
  58. Moilanen J, van Berkel N, Visuri A, Gadiraju U, van der Maden W, Hosio S. Supporting mental health self-care discovery through a chatbot. Frontiers in Digital Health 2023;5 View
  59. He Y, Yang L, Qian C, Li T, Su Z, Zhang Q, Hou X. Conversational Agent Interventions for Mental Health Problems: Systematic Review and Meta-analysis of Randomized Controlled Trials. Journal of Medical Internet Research 2023;25:e43862 View
  60. Bhattacharjee A, Chen P, Mandal A, Zhou L, Aggarwal J, Hsu A, O'Leary K, Mariakakis A, Williams J. Exploring User Perspectives on Brief Reflective Questioning Activities for Stress Management. SSRN Electronic Journal 2022 View
  61. Priya P, Firdaus M, Ekbal A. A multi-task learning framework for politeness and emotion detection in dialogues for mental health counselling and legal aid. Expert Systems with Applications 2023;224:120025 View
  62. Carlbring P, Hadjistavropoulos H, Kleiboer A, Andersson G. A new era in Internet interventions: The advent of Chat-GPT and AI-assisted therapist guidance. Internet Interventions 2023;32:100621 View
  63. Meng J, Rheu M, Zhang Y, Dai Y, Peng W. Mediated Social Support for Distress Reduction: AI Chatbots vs. Human. Proceedings of the ACM on Human-Computer Interaction 2023;7(CSCW1):1 View
  64. Wang A, Qian Z, Briggs L, Cole A, Reis L, Trinh Q. The Use of Chatbots in Oncological Care: A Narrative Review. International Journal of General Medicine 2023;Volume 16:1591 View
  65. Ilicki J. A Framework for Critically Assessing ChatGPT and Other Large Language Artificial Intelligence Model Applications in Health Care. Mayo Clinic Proceedings: Digital Health 2023;1(2):185 View
  66. Lopes E, Jain G, Carlbring P, Pareek S. Talking Mental Health: a Battle of Wits Between Humans and AI. Journal of Technology in Behavioral Science 2023 View
  67. Concannon S, Tomalin M. Measuring perceived empathy in dialogue systems. AI & SOCIETY 2023 View
  68. Chou Y, Lin C, Lee S, Chang Chien Y, Cheng L. Potential Mobile Health Applications for Improving the Mental Health of the Elderly: A Systematic Review. Clinical Interventions in Aging 2023;Volume 18:1523 View
  69. Volochtchuk A, Leite H, Vieira A. Voice assistant technology applied to populations with developmental and physical disabilities. Behaviour & Information Technology 2023:1 View
  70. Tan T, Roslan N, Li J, Zou X, Chen X, Santosa A. Patient Acceptability of Symptom Screening and Patient Education Using a Chatbot for Autoimmune Inflammatory Diseases: Survey Study. JMIR Formative Research 2023;7:e49239 View
  71. Bhattacharjee A, Chen P, Mandal A, Hsu A, O'Leary K, Mariakakis A, Williams J. Exploring User Perspectives on Brief Reflective Questioning Activities for Stress Management: Mixed-Methods Study (Preprint). JMIR Formative Research 2023 View
  72. Sharma R, Mirzakhalov J, Bharti P, Goyal R, Schmidt T, Chellappan S. A Friend in Need Is a Friend Indeed: Investigating the Quality of Training Data from Peers for Auto-generating Empathetic Textual Responses to Non-Sensitive Posts in a Cohort of College Students. ACM Journal on Computing and Sustainable Societies 2023;1(2):1 View
  73. Coghlan S, Leins K, Sheldrick S, Cheong M, Gooding P, D'Alfonso S. To chat or bot to chat: Ethical issues with using chatbots in mental health. DIGITAL HEALTH 2023;9 View
  74. Wrightson-Hester A, Anderson G, Dunstan J, McEvoy P, Sutton C, Myers B, Egan S, Tai S, Johnston-Hollitt M, Chen W, Gedeon T, Mansell W. An Artificial Therapist (Manage Your Life Online) to Support the Mental Health of Youth: Co-Design and Case Series. JMIR Human Factors 2023;10:e46849 View
  75. Chow J, Wong V, Sanders L, Li K. Developing an AI-Assisted Educational Chatbot for Radiotherapy Using the IBM Watson Assistant Platform. Healthcare 2023;11(17):2417 View
  76. Spadaro B, Martin-Key N, Funnell E, Benáček J, Bahn S. Opportunities for the Implementation of a Digital Mental Health Assessment Tool in the United Kingdom: Exploratory Survey Study. JMIR Formative Research 2023;7:e43271 View
  77. Malgaroli M, Hull T, Zech J, Althoff T. Natural language processing for mental health interventions: a systematic review and research framework. Translational Psychiatry 2023;13(1) View
  78. Choi S, Zhou J. Inducing consumers’ self-disclosure through the fit between Chatbot’s interaction styles and regulatory focus. Journal of Business Research 2023;166:114127 View
  79. Song F. Incorporating Morris' Design Thoughts for AI and Big Data-Enabled Coverage Optimization in China's Wireless Communication Network. Journal of Information Systems Engineering and Management 2024;9(1):23622 View
  80. Brännström A, Wester J, Nieves J. A formal understanding of computational empathy in interactive agents. Cognitive Systems Research 2024;85:101203 View
  81. Siwek J, Żywica P, Siwek P, Wójcik A, Woch W, Pierzyński K, Dyczkowski K. Implementation of an Artificially Empathetic Robot Swarm. Sensors 2023;24(1):242 View
  82. Curumsing M, Rivera Villicana J, Vouliotis A, Burns K, Babaei M, Petrovich T, Mouzakis K, Vasa R. Talk with Ted: an embodied conversational agent for caregivers. Gerontology & Geriatrics Education 2024:1 View
  83. Rheu M, Dai Y, Meng J, Peng W. When a Chatbot Disappoints You: Expectancy Violation in Human-Chatbot Interaction in a Social Support Context. Communication Research 2024 View
  84. Martins A, Londral A, L. Nunes I, V. Lapão L. Unlocking human-like conversations: Scoping review of automation techniques for personalized healthcare interventions using conversational agents. International Journal of Medical Informatics 2024;185:105385 View
  85. Smith C, Lane W, Miller Hillberg H, Kluver D, Terveen L, Yarosh S. Effective Strategies for Crowd-Powered Cognitive Reappraisal Systems: A Field Deployment of the Flip*Doubt Web Application for Mental Health. Proceedings of the ACM on Human-Computer Interaction 2021;5(CSCW2):1 View
  86. Jin Y, Chen L, Zhao X, Cai W. The way you assess matters: User interaction design of survey chatbots for mental health. International Journal of Human-Computer Studies 2024;189:103290 View
  87. Nordholt S, Garrison P, Aichhorn W, Ochs M, Schiepek G. Pattern transitions in diary data of MDD patients: a mixed-methods multiple case study of psychotherapy dynamics. Frontiers in Psychology 2024;15 View

Books/Policy Documents

  1. Medeiros L, Gerritsen C, Bosse T. Computational Collective Intelligence. View
  2. Callejas Z, Griol D. Dialog Systems. View
  3. Paiva A, Correia F, Oliveira R, Santos F, Arriaga P. The Handbook on Socially Interactive Agents. View
  4. Kaveladze B, Kaveladze G, Yom-Tov E, Schueller S. Pervasive Computing Technologies for Healthcare. View
  5. Ogilvie L, Prescott J, Hanley T, Carson J. Digital Innovations for Mental Health Support. View
  6. Kolenik T. Integrating Artificial Intelligence and IoT for Advanced Health Informatics. View
  7. Kaveladze B, Schueller S. Digital Therapeutics for Mental Health and Addiction. View
  8. Bickmore T, O'Leary T. Digital Therapeutics for Mental Health and Addiction. View
  9. Almutairi S, Khan S, Kuhail M, Taj I. Trends, Applications, and Challenges of Chatbot Technology. View
  10. Mattioli M. Governing Privacy in Knowledge Commons. View
  11. Zhang M, Yue L, Xu M. Advanced Data Mining and Applications. View
  12. Tucker I. After Lockdown, Opening Up. View
  13. Callejas Z, Fernández-Martínez F, Esposito A, Griol D. Applications of Artificial Intelligence and Neural Systems to Data Science. View
  14. Apablaza J, Cano S. Social Computing and Social Media. View
  15. Aicher A, Fuchs M, Minker W, Ultes S. Artificial Intelligence in HCI. View