Method Article

Virtual Agent for Real-Time Motivational Interviewing by Integrating Adaptive Nonverbal Behavior and Language Models

DOI:

10.3791/69254

December 23rd, 2025

In This Article

Summary

Loading...
$$\rightleftharpoonup{xx}$$ $$\longleftharp{xx}$$, $$\longrightharp{xx}$$,

We present an open-source virtual agent platform for conducting real-time motivational interviews, combining state-of-the-art language and diffusion models to adapt to users' behavior and profile. Utilizing the Greta 2.0 platform, it supports various topics, including nutrition and sport-focused interventions, and offers a flexible, validated tool for enhancing digital therapeutic interactions.

Abstract

Loading...
$$\rightleftharpoonup{xx}$$ $$\longleftharp{xx}$$, $$\longrightharp{xx}$$,

The growing demand for therapeutic support increasingly exceeds the capacity of available professionals. A virtual agent capable of performing motivational interviewing (MI) offers a promising solution to assist patients in reaching their goal of behavior change between sessions with human therapists. MI is inherently a cooperative and adaptive form of communication. Therefore, developing an agent capable of adapting its conversational strategies to the context could significantly enhance the effectiveness of therapy. During MI sessions, human therapists adjust both their verbal and nonverbal behaviors based on the human patients' responses, as well as their profiles. Depending on the patient's level of motivation, the therapist will modify their approach accordingly. Thus, personalization and adaptability are essential for developing effective MI virtual agents. In this paper, we present a virtual agent capable of conducting MI sessions by dynamically adapting verbally and nonverbally to users in real time. Leveraging state-of-the-art models, this system enables MI interactions. The virtual agent is embodied using the Greta 2.0 platform. Its nonverbal behavior is generated through a diffusion model called MODIFF, which adapts to the user's facial expressions and their readiness to change. These facial expressions were learned on an MI corpus and validated through a dedicated user study. The dialogue is generated using a state-of-the-art large language model (LLM), enhanced by a dialogue manager specifically designed for MI, with a reinforcement learning approach, and validated through user testing. Furthermore, the dialogue manager is able to adapt to different user profiles. The resulting platform is open-source and facilitates the generation of real-time, multimodal MI dialogues, providing new tools for digitally mediated therapeutic interactions.

Introduction

Loading...
$$\rightleftharpoonup{xx}$$ $$\longleftharp{xx}$$, $$\longrightharp{xx}$$,

Motivational interviewing (MI) is a collaborative therapeutic approach that encourages behavioral change. During MI sessions, MI practitioners help patients articulate and foster their motivation for change1. To this aim, they use dialogue strategies, such as reflections or questions, reinforced by non-verbal behaviors, such as smiles or specific head and body postures.

As the frequency of mental health issues has increased in recent years, a gap has emerged between the demand for mental health services and the available resources2. This has led to longer waiting times for patients before they....

Access restricted. Please log in or start a trial to view this content.

Protocol

Loading...
$$\rightleftharpoonup{xx}$$ $$\longleftharp{xx}$$, $$\longrightharp{xx}$$,

The method received ethical IRB approval from the INSEAD institute (Institut européen d'administration des affaires) with acceptance numbers: INSEAD 2024-78 and INSEAD 2025-23. All participants provided informed consent and were compensated for their experiment time.

1. Recruitment of participants

  1. Call for participants using the institute's mailing lists. No constraints on participants, except familiarity with digital interfaces and fluency in French. Three participants were excluded due to internet resource drops, which significantly increased the global system response latency.

Access restricted. Please log in or start a trial to view this content.

Results

Loading...
$$\rightleftharpoonup{xx}$$ $$\longleftharp{xx}$$, $$\longrightharp{xx}$$,

In the presented protocol, we collected interaction transcripts and user feedback using questionnaires adapted to the behaviors we want to measure. We compared the results of the interaction with or without our models.

Using the protocol to evaluate the impact of the MODIFF-8 adaptive expressions generation
The MODIFF-8 module was designed to enhance the social responsiveness of the virtual agent by enabling it to generate facial expressions that are both contextually appr.......

Access restricted. Please log in or start a trial to view this content.

Discussion

Loading...
$$\rightleftharpoonup{xx}$$ $$\longleftharp{xx}$$, $$\longrightharp{xx}$$,

In this paper, we present a protocol for delivering tailored Motivational Interviewing interventions and for testing individual behavior generation modules within a controlled and reproducible interaction framework. This method is built upon the modular architecture of the Greta 2.0 platform, which offers control over the components involved in agent behavior, allowing researchers to easily toggle specific modules on or off. This flexibility makes Greta 2.0 well-suited for both experimental manipulations and targeted eva.......

Access restricted. Please log in or start a trial to view this content.

Disclosures

Loading...
$$\rightleftharpoonup{xx}$$ $$\longleftharp{xx}$$, $$\longrightharp{xx}$$,

The authors have nothing to disclose.

Acknowledgements

Loading...
$$\rightleftharpoonup{xx}$$ $$\longleftharp{xx}$$, $$\longrightharp{xx}$$,

This work was partially funded by the ANR-DFG-JST Panorama, ANR-JST-CREST TAPAS (19-JSTS-0001-01), Enhancer (ANR-22-EXEN-0004), and PEPR-Ensemble PC3 (ANR-22-EXEN-0004) projects. The evaluation presented in this paper was funded by the Idex Sorbonne Université as part of the State support for the Investments for the Future programs. This work was also supported by a French government grant managed by the Agence Nationale de la Recherche as part of the France 2030 program, reference ANR-22-EXEN-0004 (PEPR eNSEMBLE / MATCHING) and 22-PESN-0009 (PEPR AUTONOM-HEALTH).

....

Access restricted. Please log in or start a trial to view this content.

Materials

List of materials used in this article
NameCompanyCatalog NumberComments
ComputerDellComputer with processor Intel Core i7-14700 and a Nvidia RTX5000
Microphone HeadsetEposA Headset with a Microphone
WebcamLogitechFor facial expression extraction
Webcam2LogitechFor video recording

References

Loading...
$$\rightleftharpoonup{xx}$$ $$\longleftharp{xx}$$, $$\longrightharp{xx}$$,
  1. Miller, W. R., Rollnick, S. Motivational Interviewing: Helping People Change. , Guilford Press. (2012).
  2. Towards a chatbot for digital counselling. Cameron, G., et al. Proc 31st Br Comp Soc Human Comp Interact Conf, , 1-7 (2017).
  3. Denecke, K., Vaaheesan, S., Arulnathan, A.

Access restricted. Please log in or start a trial to view this content.

Reprints and Permissions

Request permission to reuse the text or figures of this JoVE article

Request Permission

Tags

Large Language ModelReal Time InteractionDialogue ManagerFacial Expression AdaptationReinforcement LearningMultimodal InteractionSocial Rapport

Related Articles