A digital coach to promote emotion regulation skills

There is growing awareness that effective emotion regulation is critical for health, adjustment and wellbeing. Emerging evidence suggests that interventions that promote flexible emotion regulation may have the potential to reduce the incidence and prevalence of mental health problems in specific at-risk populations. The challenge is how best to engage with at risk populations, who may not be actively seeking assistance, to deliver this early intervention approach. One possible solution is via digital technology and development, which has rapidly accelerated in this space. Such rapid growth has, however, occurred at the expense of developing a deep understanding of key elements of successful program design and specific mechanisms that influence health behavior change. This paper presents a detailed description of the design, development and evaluation of an emotion regulation intervention conversational agent (ERICA) who acts as a digital coach. ERICA uses interactive conversation to encourage self-reflection and to support and empower users to learn a range of cognitive emotion regulation strategies including Refocusing, Reappraisal, Planning and Putting into Perspective. A pilot evaluation of ERICA was conducted with 138 university students and confirmed that ERICA provided a feasible and highly usable method for delivering an emotion regulation intervention. The results also indicated that ERICA was able to develop a therapeutic relationship with participants and increase their intent to use a range of cognitive emotion regulation strategies. These findings suggest that ERICA holds potential to be an effective approach for delivering an early intervention to support mental health and wellbeing. ERICA’s dialogue, embedded with interactivity, therapeutic alliance and empathy cues, provide the basis for the development of other psychoeducation interventions.