Can an LLM-Powered Socially Assistive Robot Effectively and Safely Deliver Cognitive Behavioral Therapy? A Study With University Students

Cognitive behavioral therapy (CBT) is a widely used therapeutic method for guiding individuals toward restructuring their thinking patterns as a means of addressing anxiety, depression, and other challenges. We developed a large language model (LLM)-powered prompt-engineered socially assistive robot (SAR) that guides participants through interactive CBT at-home exercises. We evaluated the performance of the SAR through a 15-day study with 38 university students randomly assigned to interact daily with the robot or a chatbot (using the same LLM), or complete traditional CBT worksheets throughout the duration of the study. We measured weekly therapeutic outcomes, changes in pre-/post-session anxiety measures, and adherence to completing CBT exercises. We found that self-reported measures of general psychological distress significantly decreased over the study period in the robot and worksheet conditions but not the chatbot condition. Furthermore, the SAR enabled significant single-session improvements for more sessions than the other two conditions combined. Our findings suggest that SAR-guided LLM-powered CBT may be as effective as traditional worksheet methods in supporting therapeutic progress from the beginning to the end of the study and superior in decreasing user anxiety immediately after completing the CBT exercise.

Evaluating and Personalizing User-Perceived Quality of Text-to-Speech Voices for Delivering Mindfulness Meditation with Different Physical Embodiments

Mindfulness-based therapies have been shown to be effective in improving mental health, and technology-based methods have the potential to expand the accessibility of these therapies. To enable real-time personalized content generation for mindfulness practice in these methods, high-quality computer-synthesized text-to-speech (TTS) voices are needed to provide verbal guidance and respond to user performance and preferences. However, the user-perceived quality of state-of-the-art TTS voices has not yet been evaluated for administering mindfulness meditation, which requires emotional expressiveness. In addition, work has not yet been done to study the effect of physical embodiment and personalization on the user-perceived quality of TTS voices for mindfulness. To that end, we designed a two-phase human subject study. In Phase 1, an online Mechanical Turk between-subject study (N=471) evaluated 3 (feminine, masculine, child-like) state-of-the-art TTS voices with 2 (feminine, masculine) human therapists' voices in 3 different physical embodiment settings (no agent, conversational agent, socially assistive robot) with remote participants. Building on findings from Phase 1, in Phase 2, an in-person within-subject study (N=94), we used a novel framework we developed for personalizing TTS voices based on user preferences, and evaluated user-perceived quality compared to best-rated non-personalized voices from Phase 1. We found that the best-rated human voice was perceived better than all TTS voices; the emotional expressiveness and naturalness of TTS voices were poorly rated, while users were satisfied with the clarity of TTS voices. Surprisingly, by allowing users to fine-tune TTS voice features, the user-personalized TTS voices could perform almost as well as human voices, suggesting user personalization could be a simple and very effective tool to improve user-perceived quality of TTS voice.

Service Pet Robot Design: Queer, Feminine and Sexuality Aspects

The integration of robots and AI in society raises concerns about discrimination and biases mostly affecting underrepresented groups, including queer and feminine figures. Socially assistive robots (SAR) are being used in a variety of service and companion roles, following social norms during their interaction with humans and seem to be beneficial in many roles, such as the pet therapy robots. To promote inclusion and representation, robot design should incorporate queer and feminine characteristics. As a response to these concerns, a pet robot called BB was designed using a multidisciplinary and inclusive approach. BB was presented in a queer architecture and aesthetics environment, emphasizing aspects of techno-touch, vulnerability, and sexuality in human-robot interactions. The audience's perception of both the robot and the female researcher was evaluated through questionnaires and focus groups. This study aims to explore how technology and design can better accommodate diverse perspectives and needs in the field of SAR.