IEEE Technology and Society Magazine - March 2021 - 81

used for mental health and well-being [14], [15],
which advances the societal effort toward equality, and offers easier access to mental health care,
thus reducing the inequality resulting from such
barriers [16].

Overview
In this section, we review the area that covers PT
and behavior change for SAD symptoms relief.
Behavior change is a phenomenon that is considered to be a temporary or lasting effect on an individual regarding their behavior when compared to
how they behaved in the past [13], and it includes
not only behavior, but attitudes and mental states
as well. Behavior change interventions are a large
part of PT, which are already extensively used in the
health and wellness areas, where AI tracks people's
behavior as well as physiological and mental states
to motivate them and affect their mental states and
attitudes along with AI offering people help in natural language [15], [17].
One of the most used persuasive and behavior
change frameworks that such technologies employ
is Cialdini's principles of persuasion (CPP) [18].
Although other frameworks also exist [14], [15], for
the purposes of this work, we considered only CPP.
CPP's main idea is that there is no general persuasive strategy that works for all people, hence orthogonal strategies should be identified and applied to
those that are most susceptible to individual strategies. CPP posits seven strategic bases for influencing people: 1) authority, which targets people that
are more inclined to be motivated by a legitimate
authority; 2) commitment, which targets people
that tend to commit to their previous behavior; 3)
social proof, which targets people that tend to do
what others do; 4) liking, which targets people that
are more likely to be motivated by someone they
like; 5) reciprocity, which targets people that tend
to return a favor; 6) scarcity, which targets people
that consider scarce things more valuable; and 7)
unity, which targets people that are influenced by
appealing to their group identity. Different people
are influenced by different strategies, and interactive technology can be utilized to choose specific
strategies that work for specific people.
To determine the most effective strategy, PT
mostly relies on personality models such as the Big
Five personality traits [19] as well as domain-specific
questionnaires. Personality is measured on different

March 2021

dimensions (e.g., openness, conscientiousness, extroversion, agreeableness, and neuroticism), which try
to describe an individual's tendencies that relate to
their psychological and cognitive functionalities, such
as the mental states and decision-making. In terms of
domain-specific data, SAD questionnaires [20] can
be used to categorize people with SAD symptoms
and select the best strategies. Such questionnaires
give insights into what influences which individuals
the most. What is more, the use of smart devices such
as smart bracelets, gives researchers the possibility
to connect questionnaire data with biophysiological
data, giving them additional insights and possibilities
for behavior change interventions. Databases that
collect and connect data on personality with human
biophysiology already exist [21].
Persuasive frameworks can be housed in various
technological platforms. A recent comprehensive
review of PT for health and wellness [15] found that
the most frequently used platforms are mobile and
handheld devices (28%), followed by games (17%),
web and social networks (14%), other specialized
devices (13%), desktop applications (12%), sensors and wearable devices (9%), and ambient and
public displays (5%). Regarding specific forms PT
takes, intelligent cognitive assistants (ICAs; also
known as chatbots and conversational AI) seem to
be the most advanced and widely used [15]-[17],
[22]-[24]. ICAs exhibit a number of human-like
abilities, as they can, to a degree, understand
context, adapt, learn, communicate, collaborate,
predict, perceive, act, interpret, and reason. Most
importantly, ICAs possess the ability to converse
in natural language and can, therefore, be constructed to offer therapeutic help. The results of various review articles [15]-[17], [22]-[24] show that
ICA is an effective vessel for relieving SAD symptoms. We conducted a short overview of the articles on state-of-the-art persuasive ICAs for mental
health and selected three for inclusion in this work
to demonstrate their use. All three ICAs [25]-[27]
operate similarly, by using scripted conversations
to offer help that depends on the user model, which
holds data on users' emotions and SAD levels. All
ICAs perform better than the government-approved
self-help material in relieving SAD by 15%-20%.
More advanced architectural designs are expected
to produce even better results [28].
Such technology provides a number of advantages if utilized in the mental health care field:

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